C28 School-Age Child

The parents of an 8-year-old boy report their son is being bullied and teased by a group of boys in the neighborhood. Which response by the nurse is best? a) "Your son is at high risk for bullying other children as a result of this situation." b) "Perhaps teaching your son self-defense courses will help him to have a greater sense of control and safety." c) "Fortunately the scars of being picked on will fade as your son grows up." d) "Bullying can have lifelong effects on the self-esteem of a child."

"Bullying can have lifelong effects on the self-esteem of a child."

The nurse is teaching a group of caregivers of school-age children on various topics. Which statement made by the caregivers indicates a need for further teaching?

"Food is so expensive, we always make our children eat everything on their plates."

The mother of a 12-year-old boy is talking with the school nurse about her son's clumsiness. She reports that he seems to fall a lot, his writing is horrible, and as much as he practices he can't play his guitar very well. How should the nurse respond to the mother? a) "Have you spoken with your pediatrician about your observations?" b) "Boys tend to refine their fine motor skills by this age." c) "Boys tend to take a bit longer than girls to mature." d) "I will make a note of your observations and talk to his teachers."

"Have you spoken with your pediatrician about your observations?"

The nurse is discussing the topic of obesity with a group of mothers of school-age children. Which statement made by the caregivers indicates the best understanding of factors that contribute to obesity? "Neither my husband nor I have ever had any concerns with weight." "We eat fast foods only on weekends because we are too busy to cook." "I keep lots of snacks on hand because my child eats all day long." "I always cook foods that are low in fat."

"I always cook foods that are low in fat."

The nurse is discussing nutrition choices with a group of parents of 10- to 12-year-old children. The nurse determines that the discussion was successful based on which statements by a parent? Select all that apply.

"My 12-year-old son, who plays soccer, needs to consume around 2,000 calories a day to maintain good health." "The highest percentage of my child's diet should come from carbohydrates."

During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be?

"Play helps children to develop cognitively, socially, physically, and emotionally." It is important to recognize that the child is busy with other activities but that this does not replace the need to engage in play. Children need time to play because it helps them to develop cognitively, socially, physically, and emotionally. Play at this age embodies the needs for rules and structures. Engaging in group activities allows children to be part of a social group. Page 155

The mother of two children ages 6 and 12 reports that her 6-year-old child seems to have "cold after cold" while her older child never seems to be ill. She questions if there is something wrong with her younger child. What is the best response by the nurse?

"The immune system of your younger child is less mature and may result in having more infections."

The nurse is conducting teaching with families of school-age children. Which statement made by the nurse is most appropriate related to topics that would be covered with this group of individuals?

"The school-age child needs 10 to 12 hours of sleep per night."

The parents of a 9-year-old child voice concern that their daughter seems to be gaining weight rapidly. The nurse reviews the medical record and notes the child has increased his weight by 6 or 7 pounds (2.7 to 3.2 kg) per year for the past 2 years. What response by the nurse is indicated?

"Weight gains of about 7 pounds per year are normal for children in this age range."

As the school nurse conducting screening for vision in a 6-year-old child, you would refer the child to a specialist if the visual acuity in both eyes is: 1. 20/20 2. 20/25 3. 20/30 4. 20/50

20/50

The father of a 12-year-old girl reports his daughter does not have high self-esteem. He asks for suggestions to increase her feels of self-worth. What activities would be appropriate for the nurse to suggest? Select all that apply.

Encourage the child to join a club at school. Recommend she begin to participate in after-school activities. Recommend the child investigate opportunities for volunteering at local charities.

When considering the psychosocial development of a school-aged child, which is the primary developmental task?

Establishing a social network Erikson describes the task of the school-age years as industry versus inferiority. During this period, the child is developing his or her sense of self-worth by becoming involved in multiple activities at home, at school, and in the community, which develops his or her cognitive and social skills.

An 8-year-old boy is doing well with adding and subtraction. His father asks for suggestions regarding projects that would help increase his understanding of conservation of mass. What project would the nurse suggest?

Form vases from blocks of clay.

The parents of an 11-year-old girl tell the school nurse that their child has a very "slow to warm up" temperament, and that they are concerned with her starting a new school. Which activities should the nurse tell the child's teacher to initially avoid based on this information? Select all that apply.

Having the child introduce herself by standing at the front of the class and telling something interesting about herself Assigning the child a role-play scenario to perform with another student in front of the class Encouraging the child to join the drama club, which is practicing for an upcoming play

A mother brings her 8-year-old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that the mother is concerned that there is something wrong. The girl has no other symptoms, however. The nurse knows that this is most likely the cause of the enlarged tonsils:

Normal growth of lymphatic tissue for this age

A mother brings her 8-year-old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that the mother is concerned that there is something wrong. The girl has no other symptoms, however. The nurse knows that which of the following is most likely the cause of the enlarged tonsils? a) A pituitary disorder b) Tonsillitis c) Normal growth of lymphatic tissue for this age d) An allergic reaction

Normal growth of lymphatic tissue for this age

The nurse is observing a playgroup of children of all ages. The school-age child in the group would most likely be doing which activity?

Painting pictures in the art corner of the room.

Which activities will promote weight loss in an obese school-age child? (Choose all that apply.) 1. Unlimited computer and TV time 2. Role modeling by family 3. Becoming active in sports 4. Eating unstructured meals 5. Involving child in meal planning and grocery shopping 6. Drinking three glasses of water per day

Role modeling by family Becoming active in sports Involving child in meal planning and grocery shopping

The school nurse is working with a group of 6- to 8-year-old children. Which responsibility would the school nurse most likely have for this age child?

Testing the children's vision and hearing

Which behavior involving a 11-year-old child warrants further education to the family? Select all that apply.

The child is allowed to sit in the front seat of the car. The child wears a lap belt when riding in the car. The child uses a backpack to carry books when riding their back to and from school. When riding in the car children under the age of 12 should ride in the back seat and not the front seat. Safety belts consisting of a lap and shoulder harness should be employed. Front bike baskets should be used to carry heavy objects. Using a backpack can cause balance issues leading to a fall and should be avoided. page 163

The nurse is observing a group of 8-year-olds who are being taught the concept of conservation of weight. Which of the following activities would best help these children understand this concept? a) Weighing and measuring each other and comparing the number of pounds to the number of inches for each person. b) Weighing a pound of oranges and a pound of bricks and counting how many of each make a pound. c) Measuring the weight of a handful of popcorn and then the weight of a handful of pennies. d) Using a balance scale to weigh a variety of objects and counting how many pennies must be used to balance the scales.

Weighing a pound of oranges and a pound of bricks and counting how many of each make a pound.

A mother tells you her 6-year-old has been biting his fingernails since he began first grade. After analyzing the cause of this as increased stress, the advice you would give his mother regarding this problem would be to a) allow some time every day for the child to talk about new experiences. b) distract the child by teaching him a new skill, such as whistling. c) encourage the child to drink more milk for stronger nails. d) allow the child to choose a reward for not biting his nails.

allow some time every day for the child to talk about new experiences. Beginning school can be a time of extreme stress for children. Allowing them time to discuss these experiences helps them to put experiences in perspective and begin to deal with them.

The developmental task of the school-aged period, according to Erikson, is gaining a sense of a) industry versus inferiority. b) autonomy versus shame. c) identity versus failure. d) independence versus dependence.

industry versus inferiority

A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to:

make her child attend school every day. School phobia may result from both a parent not wanting a child to attend school and a child not wanting to leave a parent. Helping them work together while keeping the child in school to resolve the issue is helpful. page 172

The Boy Scouts is an organization that continues to be a favorite with school-aged boys because a) hiking is a favorite school-aged activity. b) fathers participate in Boy Scouts. c) merit badges require completing small tasks for rewards. d) no girls are included in the organization.

merit badges require completing small tasks for rewards

During a well child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group the nurse understands that: a) discussing death and dying may hint at a psychological disorder. b) at this age, children are not afraid of death. c) preoccupation with death and dying is common in the school-aged child. d) consistent thoughts of death and dying at this age leads to the later development of depression.

preoccupation with death and dying is common in the school-aged child. School-aged children are often preoccupied with thoughts of death and dying. There is no indication these thoughts will lead to mental health issues or the development of depression. School-aged children fear death but are fascinated by death and dying.

On physical examination, you discover that a 6-year-old's palatine tonsils are somewhat enlarged in the back of his throat. Your best action would be to a) give the child something for pain. b) record this as a normal early school-aged finding. c) take the child's temperature; this must be tonsillitis. d) suggest a resident examine him for breathing difficulty.

record this as a normal early school-aged finding.

The nurse is talking with the parents of an 8-year-old boy who has been cheating at school. Which comment should be the nurse's primary message? a) "Make sure that your behavior around your son is exemplary." b) "Punishment should be severe and long lasting." c) "Resolve this by providing an opportunity for him to cheat and then dealing with it." d) "You may be putting too much pressure on him to succeed."

"Make sure that your behavior around your son is exemplary."

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which of the following statements made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child? a) "My son doesn't even know when he's tired." b) "She stays up late when she takes a nap after school." c) "My child sleeps between 11 and 12 hours a night." d) "My teenage child doesn't sleep as much as my 9-year-old does."

"My child sleeps between 11 and 12 hours a night."

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which statement made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child?

"My child sleeps between 11 and 12 hours a night." The school-age child needs 10 to 12 hours of sleep each night. Staying up late after taking an after-school nap, not knowing when the child is tired, and sleeping more than a teenager when compared with a school-age child refer to sleep behaviors and needs of children of younger and older ages. page 168

The parents of a 10-year-old tell the clinic nurse that they are concerned because they noticed that their child has gained about 10 pounds over the past 2 years. What is the best response by the nurse? "Your child doesn't seem to be overweight, so it isn't a concern." "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain." "Normal growth and development for this age results in an average weight gain of 7 pounds per year." "We see most children of this age in our clinic gaining similar amounts."

"Normal growth and development for this age results in an average weight gain of 7 pounds per year." Children of school-age grow an average of 2.5 inches (6 to 7 centimeters) per year and gain an average of 7 pounds per year; therefore, the 10 pounds over 2 years is normal and it is important for the parents to know this, regardless if they are not overweight. Simply comparing them to other children seen in the clinic doesn't mean it is a normal expectation. While activity is important, the nurse must first address the parent's concern. Page 154

The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond? a) "Remind your daughter of the importance of proper oral hygiene." b) "Remind her in simple terms what will happen in the dentist's office." c) "Wait to tell her about the visit until just before the appointment." d) "Tell your daughter that it is just like going to see the pediatrician."

"Remind her in simple terms what will happen in the dentist's office."

The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond? "Remind her in simple terms what will happen in the dentist's office." "Remind your daughter of the importance of proper oral hygiene." "Tell your daughter that it is just like going to see the pediatrician." "Wait to tell her about the visit until just before the appointment."

"Remind her in simple terms what will happen in the dentist's office." Due to the girl's temperament, it is best if the parent's talk to the dentist before the first visit to find out exactly what the dentist will be doing and then describe to the child in simple terms what will occur. Reminding the child about the importance of proper oral hygiene is unhelpful. Telling the child that the dental checkup is just like going to see the pediatrician is untrue. It is inappropriate to advise the parents to not prepare the girl in advance. page 159

The nurse is conducting teaching with families of school-age children. Which of the following statements made by the nurse is most appropriate related to topics that would be covered with this group of individuals? a) "The school-age child should have a routine physical exam every six months." b) "The school-age child should brush their teeth at bedtime." c) "The school-age child needs 10 to 12 hours of sleep per night." d) "The school-age child should be screened for scoliosis once a year."

"The school-age child needs 10 to 12 hours of sleep per night."

The parents of a 9-year-old boy report they have been homeschooling their son and now plan to enroll him in the local public school. They voice concerns about the influence of the other children on their son's values. Which information should the nurse provide the parents?

"The values of the family will likely prevail for your son."

The parents of a 9-year-old boy report they have been homeschooling their son and now plan to enroll him in the local public school. They voice concerns about the influence of the other children on their son's values. Which information should the nurse provide the parents? a) "Values are largely inborn and will be impacted only in a limited way by environmental influences." b) "At your son's age, values are most influenced by peers." c) "The values of the family will likely prevail for your son." d) "The teacher will begin to have the largest influence on a child's values at this age."

"The values of the family will likely prevail for your son."

During an annual visit of a 6-year-old boy, the nurse observes dental caries on two of the child's primary teeth. Which response by the parents suggests more education is needed regarding the importance of primary teeth?

"These are only his baby teeth so we are not worried."

The nurse is caring for a 10-year-old who has been admitted for surgery. What action would be the most important for the nurse to do when caring for this child?

Answer questions the child asks regarding pain. School-age children need privacy more than younger children do and may not want to have physical contact with adults; this wish should be respected. These attitudes should be recognized and handled in a way that ensures as much privacy as possible. Children's questions, including those about pain, should be answered truthfully. An opportunity to verbalize anxieties will help a child deal with them. Family caregivers may feel guilty about the child's need for hospitalization and, as a result, may overindulge the child. The child may regress in response to this, but this regression should not be encouraged. Page 161

While treating a minor playground injury for an 8-year-old girl, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action? a) Question those responsible for the bullying. b) Assess the situation with the help of the school staff and parents. c) Determine if there have been other playground bullying incidents. d) Immediately call the bullied child's parents.

Assess the situation with the help of the school staff and parents.

Eight-year-old Ted's foster mother is discussing her concerns about Ted's recent dental checkup in which three cavities were found in his permanent teeth. Ted's mother is concerned because Ted eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. What would the nurse suggest to this mother is the most appropriate in regard to Ted's dental health? The nurse would suggest that the mother a) Have Ted's teeth professionally cleaned every three months b) Ensure that Ted brushes his teeth after each meal and snacks c) Accept Ted is genetically predisposed to having more cavities than most children d) Encourage Ted to abstain from eating sugary snacks at school

Ensure that Ted brushes his teeth after each meal and snacks

The mother of two sons, ages 6 and 9, states they want to play on the same baseball team. As the school nurse, what advice would you give their mother? 1. Having the boys on the same team will make it more convenient for the mother. 2. Levels of coordination and concentration differ, so the boys need to be on different teams. 3. Put the boys on the same team because they are both school-age children. 4. It is best to avoid putting the boys on the same team to prevent sibling rivalry.

Levels of coordination and concentration differ, so the boys need to be on different teams.

The nurse is assessing the moral developmental level of children being seen in the clinic according to the Kohlberg's conventional stage of moral development. Which children does the nurse determine have met this stage of development? Select all that apply.

The 8-year-old child who frequently asks the teacher if he is doing his math correctly The 10-year-old child who visits his elderly neighbor three times per week The 9-year-old child who tells his friends that they shouldn't throw rocks because they will "get in trouble" The 7-year-old child who yells at his mother, "I don't understand why I can't go to the park!" The 10-year-old who states, "I sure wouldn't want to be my friend taking that bad report card home."

The father of an 11-year-old boy is worried that the child spends too much time watching TV. What information should the nurse share with this father? Select all that apply.

The American Academy of Pediatrics recommends 2 hours or less of TV daily. Establish guidelines on when a child can watch TV. Watch programs together and discuss subject matter with the child.

A 7-year-old has taken money from his brother's dresser on two occasions. When counseling his mother about this, you would advise her that a) she should talk to the child's teacher about putting less pressure on him. b) she may need to remind him of property rights. c) stealing is unusual for a 7-year-old. d) she should buy his brother a bank that cannot be opened.

she may need to remind him of property rights.

A 7-year-old has taken money from his brother's dresser on two occasions. When counseling his mother about this, you would advise her that:

she may need to remind him of property rights. As children begin to be aware of the importance of money, they may fail to realize that property rights regarding money need to be respected. Page 172

A mother calls the advance practice pediatric nurse practitioner about her 7-year-old daughter's dental hygiene. The daughter has had three cavities. She does not know what to do and asks the nurse for guidance. How should the nurse respond?

"Are you able to supervise her brushing?"

The nurse is educating the parents of a 10-year-old girl in ways to help their child avoid tobacco. Which suggestion should be part of the nurse's advice? a) "Always go outside when you have a cigarette." b) "Keep your cigarettes where she can't get to them." c) "Tell her only losers smoke and chew tobacco." d) "As parents, you need to be good role models."

"As parents, you need to be good role models."

The mother of a 7-year-old girl is asking the nurse's advice about getting her daughter a 2-wheel bike. Which response by the nurse is most important? a) "Be sure to get the proper size bike." b) "Learning to ride the bike will improve her coordination." c) "Teach her where she'll land on the grass if she falls." d) "She won't need a helmet if she has training wheels."

"Be sure to get the proper size bike."

The parents of a 10-year-old girl voice concern to the nurse because their daughter seems to "have a higher amount of body fat" than they expect based on the healthy eating habits and high activity level of the family. What is the best response by the nurse?

"Before adolescence the body fat composition of school-age children increases earlier and in greater amounts in girls than in boys." Boys have more lean body mass per inch of height than girls during the late school-age years, in preparation for adolescence. page 166

The nurse is working with a group of caregivers of 6-year-olds. One of the mothers states her son has been lying and making up stories; she asks for some advice about how to address the issue. Which of the following would be an appropriate response by the nurse? a) "Is there any possibility he is telling the truth and you just don't know it is the truth?" b) "Your child could be in serious trouble in school if he continues to tell lies." c) "Children this age sometimes can't distinguish between fantasy and reality." d) "The child should have privileges taken away for several days each time he tells a lie."

"Children this age sometimes can't distinguish between fantasy and reality."

The nurse is working with a group of caregivers of 6-year-olds. One of the mothers states her son has been lying and making up stories; she asks for some advice about how to address the issue. What would be an appropriate response by the nurse?

"Children this age sometimes can't distinguish between fantasy and reality." Children in the age group 6 to 7 years often engage in magical thinking. They may still believe in the tooth fairy, Santa Claus, monsters under the bed, and other imaginary characters. These children's keen imaginations may also conjure up fears, especially at night, about remote, fanciful, or imaginary events. If a child of this age has trouble distinguishing fantasy from reality, it may incline them to lie to escape punishment or to boost self-confidence. The other choices do not consider this child's stage of development or give the mother the most appropriate information for the situation. Page 171

The nurse is teaching a group of caregivers of school-age children on various topics. Which of the following statements made by the caregivers indicates a need for further teaching? a) "Sometimes we have to be firm, but our children wash their hands before eating." b) "Food is so expensive, we always make our children eat everything on their plate." c) "Even if the weather is cool and cloudy, our children play outside every day." d) "I make sure they have good teeth by giving them calcium and phosphorus."

"Food is so expensive, we always make our children eat everything on their plate."

The school nurse asks a group of school-age children about pedestrian safety. Which comments by the children should the nurse address with either the child or parents of the child? Select all that apply. "I always remind my sister to look right, then left, then right again before we cross the street." "I think it is funny to hide behind my dad's car before he leaves for work and scare him." "My mom always says she looks around really well to be sure I'm not playing behind our car before she leaves." My friends and I like to walk on the side of the road because our sidewalk is very uneven." "I am 6 years old and I walk my younger brother to the park that is 5 blocks from our house."

"I am 6 years old and I walk my younger brother to the park that is 5 blocks from our house." My friends and I like to walk on the side of the road because our sidewalk is very uneven." "I think it is funny to hide behind my dad's car before he leaves for work and scare him."

The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents? a) "Is there a family history of hypertension, heart disease, or diabetes?" b) "How important is exercise?" c) "Is breakfast eaten regularly?" d) "What beverages are preferred?"

"Is there a family history of hypertension, heart disease, or diabetes?"

The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents?

"Is there a family history of hypertension, heart disease, or diabetes?" Parents would be more knowledgeable than the child regarding health problems within the family. The other questions are appropriate for the child to answer and may motivate him to think about meal patterns, diet, and exercise habits. The parents will benefit from listening to these questions also since their habits influence the child page 166

The school-age child develops the ability to recognize that if a block of clay is in a round ball and then is flattened, the shape changes but not the amount of clay. This child has developed an understanding of:

conservation.

A nurse is caring for a hospitalized 10 year old. What would be an appropriate activity for this child to meet the developmental tasks of this age group? a) Participating in a craft project b) Playing with a jack-in-the-box c) Writing letters to friends d) Playing with blocks

Participating in a craft project

A mother tells the nurse she is having difficulty getting her 6-year-old to do chores. Based on the child's developmental level, what activity would be best for the nurse to recommend to the mother? putting books on shelf folding clothes raking leaves vacuuming

putting books on shelf

The school nurse is speaking with a group of teachers about bullying. Which statement by a teacher would indicate a need for further education by the nurse?

"Boys bully more often but girls are more likely to be bullied."

A mother calls the advance practice pediatric nurse practitioner about her 7-year-old daughter's dental hygiene. The daughter has had three cavities. She does not know what to do and asks the nurse for guidance. How should the nurse respond? a) "What type of toothbrush does she use?" b) "Did you teach her how to brush her teeth?" c) "Are you able to supervise her brushing?" d) "Is there fluoride toothpaste available for her use?"

"Are you able to supervise her brushing?"

The mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse? "Is there any possibility he is telling the truth and you just don't know it is the truth?" "The child should have privileges taken away for several days each time he tells a lie." "Your child could be in serious trouble in school if he continues to tell lies." "Children this age sometimes can't distinguish between fantasy and reality."

"Children this age sometimes can't distinguish between fantasy and reality."

The parents of a 10-year-old child tell the nurse that they don't understand how their child falls into the obesity category. They state that they are consistent with good nutrition and their child is very active in sports and clubs. What would be appropriate questions for the nurse to ask? Select all that apply. "A lot of children of this age commonly have thyroid issues. Does this run in your family?" "Could you keep a food diary over a 2 to 3 days time for us to review?" "Does your child consume soda and other fluids high in sugars?" "Can you give me an idea of a typical day for you and your child?" "Given your busy schedules does your family eat a lot of meals late in the evening?"

"Could you keep a food diary over a 2 to 3 days time for us to review?" "Does your child consume soda and other fluids high in sugars?" "Can you give me an idea of a typical day for you and your child?" "Given your busy schedules does your family eat a lot of meals late in the evening?"

A 12-year-old child tells the school nurse, "I do not understand why my parents will not allow me to go to concerts without chaperones like some of my friends' parents. I feel like a baby compared to my friends." How will the nurse respond? "Have you given any thought to why they do not let you go without a chaperone?" "Your parents are right. Twelve years of age is too young to be attending concerts without a chaperone." "I am sure your parents are worried about your safety when attending concerts at a young age." "You are so young that you have plenty of time to go to concerts alone. Your parents care about you."

"Have you given any thought to why they do not let you go without a chaperone?" Keeping dialogue open with the child and encouraging exploration of feelings is beneficial and therapeutic communication. This will allow the child to identify reasons without being told why the parents have this rule. The nurse would explore reasons and rationales with the client. Peer pressure can be difficult for children to manage. Helping them identify reasons for the parents' actions can help. Telling the child how to feel or that the parents only care does not allow conversation.

The parents of a 7-year-old tell the nurse that they are concerned that their child has attention deficit activity disorder (ADHD) because he can't seem to stay focused when playing in a baseball game. What questions/comments by the nurse are appropriate? Select all that apply.

"How is his attention span during school?" "Do you notice him getting distracted in other activities, like bicycling?"

During a routine wellness examination, the nurse is trying to determine how well a 5-year-old boy communicates and comprehends instructions. Which of the following is the best specific trigger question to determine the preschooler's linguistic and cognitive progress? a) "How well does your son communicate or follow instructions?" b) "Would you say your son has a vocabulary of about 900 words?" c) "Does your son speak in complete sentences all the time?" d) "Is your son's speech clear enough that anyone can understand it?"

"How well does your son communicate or follow instructions?"

The school nurse is the guest speaker in a classroom of fourth-grade children, and they are discussing eating habits and the number of servings from each of the food groups that is appropriate for the school-age child. Which of the following statements made by the children best indicates an appropriate intake of one of the food groups for this age child? a) "My gramma cooks for us and she lets me eat two chicken breasts for supper." b) "My dad doesn't like bread so I get my grain in the morning when I eat a bowl of cereal." c) "I love fruit so every day I eat the half of orange my mom puts in my lunch." d) "I drink three big glasses of milk each day."

"I drink three big glasses of milk each day."

The nurse is discussing nutrition with the mother of a 6-year-old boy. Which response by the boy's mother indicates a need for further discussion?

"I make him eat some of everything I put on his plate."

A 10-year-old child tells the school nurse that she is embarrassed that she is afraid of the dark. Which is the best response by the nurse? "That is so horrible that you are afraid of the dark. Can you sleep at night at all?" "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?" "It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?" "I was afraid of the dark at your age. You will grow out of that fear soon."

"It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?"

During a well-child visit, an 11-year-old girl complains to the nurse that she looks different from her friends who are wearing bras. What is an appropriate response? a) "It is normal for there to be differences in the time and rate girls your age develop." b) "You are doing well in school. Be happy with this success." c) "Remember the methods you have been taught to manage peer pressure." d) "It is common for girls your age to worry about being different."

"It is normal for there to be differences in the time and rate girls your age develop."

The nurse is talking with the parents of an 8-year-old boy who has been cheating at school. Which comment should be the nurse's primary message?

"Make sure that your behavior around your son is exemplary."

The nurse is caring for an 8-year-old girl. She is reviewing her nutritional requirements and describing interventions that promote healthy eating habits. Which of the following responses by the girl's mother indicates a need for further discussion? a) "My daughter must stay at the table until she has cleaned her plate." b) "My daughter likes to have a glass of milk with her meal." c) "My daughter eats one item at a time." d) "My daughter likes many different kinds of fruits and vegetables."

"My daughter must stay at the table until she has cleaned her plate."

The nurse is caring for a 6-year-old boy. During the course of a routine wellness examination, the mother proudly reports that the child eats whatever the mother puts on his plate. The nurse wants to emphasize the importance of allowing the child to make some of his own choices regarding the types of foods he eats. How should the nurse communicate this to the mother?

"Now is the time to let him choose some of his meals."

The nurse is caring for a 6-year-old child. During the course of a routine wellness examination, the parent proudly reports that the child eats whatever the parent puts on the plate. The nurse wants to emphasize the importance of allowing the child to make some choices regarding the types of foods eaten. How should the nurse communicate this to the parent? "You must let your child make some choices for oneself." "I want you to give your child choices about the food eaten." "Now is the time to let your child choose some of the meals." "You need to make sure your child has input regarding the food eaten."

"Now is the time to let your child choose some of the meals."

The nurse is assessing the nutritional needs of an 8-year-old girl who weighs 65 pounds. Which of the following amounts would provide the proper daily caloric intake for this child? a) 2,065 calories per day b) 2,385 calories per day c) 1,895 calories per day d) 2,245 calories per day

2,065 calories per day (29.5 kg x 70 calories per day per kg = 2,065 calories per day).

A mother brings her 8-year-old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that the mother is concerned that her breathing will be obstructed. The girl has no pain, fever or other symptoms. Following this data collection, which instruction is best? "An allergic reaction is often the cause. What type of allergies does she have?" "A pituitary disorder may be the cause. Blood work may be indicated." "With the increase in tissue size, tonsillitis is suspected." "This may be normal growth of lymphatic tissue for this age."

"This may be normal growth of lymphatic tissue for this age."

A 7-year-old child has taken money from a sibling's dresser on two occasions. When counseling the parent about this behavior, what would the nurse advise? "You may need to remind your child about property rights." "Stealing is unusual for a 7-year-old child." "You should buy your other child a bank that cannot be opened." You should talk to the child's teacher about putting less pressure on your child."

"You may need to remind your child about property rights."

A parent brings a 6 year old to the clinic and informs the nurse that the child is tired all the time even though the child sleeps 7 to 8 hours each night. What is the best response by the nurse? a) "Your child should be getting 8 to 9 hours of sleep per night." b) "We should ask the physician to run some tests; with that much sleep, the child should not be tired." c) "Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school." d) "Your child should be getting at least 9 hours of sleep per night."

"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."

The parents of a 7-year-old girl report concerns about her seemingly low self-esteem. The parents question how self-esteem is developed in a young girl. Which response by the nurse is best? a) "Several interrelated factors are to blame for low self-esteem." b) "The peers of a child at this age are the greatest influence on self-esteem." c) "Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age." d) "A child's self-esteem is greatly inborn and environmental influences guide it."

"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."

A hospitalized 7 year old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? a) A sense of doubt b) A sense of mistrust c) A sense of shame d) A feeling of inferiority

A feeling of inferiority

The school nurse notices that one of the children in the classroom next to the nurse's room frequently goes to the bathroom. The nurse knows that the bladder capacity for this 11-year-old child should be how much?

13

The nurse is assessing the nutritional needs of an 8-year-old girl who weighs 65 pounds (29.5 kg). Which amount of calories would provide the proper daily caloric intake for this child?

2,065 calories per day

The nurse is observing a playgroup of children of all ages. The school-age child in the group would most likely be doing which of the following activities? a) Playing with the plastic vaccum cleaner, pushing it around the room. b) Pretending to be mommies and daddies in the playhouse. c) Watching a movie with other children their age. d) Painting pictures in the art corner of the room.

Painting pictures in the art corner of the room.

A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? A sense of doubt A sense of mistrust A sense of shame A feeling of inferiority

A feeling of inferiority Children who are unsuccessful in completing activities during the school-age phase, whether from physical, social, or cognitive disadvantages, develop a feeling of inferiority. Page 155

The nurse is discussing sleep and the amounts of sleep necessary for an 11-year-old child with the child's caregivers. For the child who gets up at 6:30 a.m., which bedtime would the nurse recommend the caregivers require the child to go to bed? a) 7:30 p.m. b) 10:00 p.m. c) 9:30 p.m. d) 8:00 p.m.

9:30 p.m.

A nurse is caring for a hospitalized 7-year-old whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group? A card game such as solitaire A board game such as monopoly A paint-by-numbers activity creating a picture An activity focusing on learning fractions

A paint-by-numbers activity Between the ages of 6 and 8 years, children begin to enjoy participating in real-life activities, such as helping with gardening, housework, and other chores. They love making things, such as drawings, paintings, and craft projects.

The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory? The principle of conservation Lack of the ability to think abstractly The conventional stage of development A sense of competence, mastery, and worth

A sense of competence, mastery, and worth

The nurse is conducting a support group for parents of 9 & 10 year old. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide?

A sense of security as children gain independence 9 year old take their peer groups seriously. They are more interested in how other children dress than what their parents want them to wear. This is the club age where groups are formed and others are excluded from the club. This age group is imitating their peers as they develop their own identify and separate from their parents. Groups are fluid as they change regularly due to many reasons; each member lives on the same street, each member plays on the same ball team, or one member has fewer material things than the others. Security is gained through these clubs because it helps the school-age child develop independence away from the family. Most of the time in the school-age-child peer groups relationships are the same -sex friends. Children do not become self-sufficient through these clubs. They remain dependent on their families for their physical needs.

The nurse is caring for a 10-year-old who has been admitted for surgery. Which of the following would be the most important for the nurse to do when caring for this child? The nurse should a) Avoid prolonged discussions about the patient's anxiety b) Answer questions the child asks regarding pain c) Offer to help the child wash her private parts when bathing d) Encourage family caregivers to frequently sing songs the child enjoys

Answer questions the child asks regarding pain

An 11-year-old boy is significantly above the 100% percentile for height. The boy tells the school nurse that his parents expect so much out of him when he is playing basketball for the school team that he is thinking of quitting. What action should the nurse take?

Arrange a conference with the parents, son, and nurse to discuss the child's concerns.

A nursing student is presenting information to the class about abuse of children. The nursing instructor should intervene when the student presents which information? Select all that apply.

Child abuse and sexual abuse are not the same thing The concepts of "good touch" versus "bad touch" should be taught around the age of 10 years The nurse should speak with the family first if child abuse is suspected Child abuse includes physical, emotional, and sexual abuse. Parents should teach children the concept of "good touch" versus "bad touch" prior to school-age years. If school-age child's behavior yields suspicion of physical or sexual abuse, the nurse should report to the appropriate authorities in his or her state. page 166

A nurse is assigned to care for a 7 year old with cystic fibrosis. The child wants to show the nurse his collection of baseball cards. The nurse understands that the collection of objects is common in this age group and is known as what type of thinking? a) Egocentric thinking b) Classification c) Decentration d) Preoperational thinking

Classification

A nurse is assigned to care for a 7-year-old with cystic fibrosis. The child wants to show the nurse his collection of baseball cards. The nurse understands that the collection of objects is common in this age group and is known as what type of thinking?

Classification

The parents of a school-aged child with school phobia have taken her to three different psychiatrists trying to resolve this problem. Based on this, which nursing diagnosis would be most appropriate?

Compromised parental coping related to inability to enforce school attendance

The parents of a school-aged child with school phobia have taken her to three different psychiatrists trying to resolve this problem. Based on this, which nursing diagnosis would be most appropriate? a) Noncompliance with expected school behavior related to school phobia b) Ineffective tissue perfusion, cerebral, related to anxiety over attending school c) Compromised parental coping related to inability to enforce school attendance d) Disturbed thought processes related to difficulty in school adjustment

Compromised parental coping related to inability to enforce school attendance

The nurse is about to see a 9-year-old girl for a well child check-up. Knowing that the child is in Piaget's period of concrete operational thought, which characteristic should the child display? a) Make generalized assumptions about groups of things b) View the world in terms of her own experience c) Know lying is bad because she gets sent to her room for it d) Consider an action and its consequences

Consider an action and its consequences

The nurse is about to see a 9-year-old girl for a well-child checkup. Knowing that the child is in Piaget's period of concrete operational thought, which characteristic should the child display?

Consider an action and its consequences. The child will be able to consider an action and its consequences in Piaget's period of concrete operational thought. However, she is now able to empathize with others. She is more adept at classifying and dividing things into sets. Defining lying as bad because she gets punished for it is a Kohlberg characteristic.

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by: 1. Learning from repeating tasks 2. Developing a sense of worth and competence 3. Using fantasy and magical thinking to cope with problems 4. Developing a sense of trust

Developing a sense of worth and competence

A 9-year-old child is feeling conflict from seeing other children in her class engaging in behaviors she senses are not appropriate. When making decisions about what actions are most appropriate, a child of this age will rely most heavily on which party of influence?

Parents

An anxious 12-year-old girl receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, "Is it hard to give someone an injection?" This girl's question is evidence that she has developed which cognitive skill? a) Decentering b) Class inclusion c) Conservation d) Accommodation

Decentering

A nurse is carrying on a conversation with a 7-year-old girl during an office visit. Which of the following is an example of the level of language development the nurse should expect in this child? a) Inability to speak in full sentences b) Difficulty understanding the concept of "half past" in reference to time c) Fascination with bathroom language d) Ability to carry on an adult conversation

Difficulty understanding the concept of "half past" in reference to time

The nurse is teaching parents of an 11-year old girl how to deal with the issues relating to peer pressure to use tobacco and alcohol. Which suggestion provides the best course of action for the parents? a) Hide alcohol out of the child's reach b) Forbid the child to have friends that smoke or drink c) Avoid smoking in the house or in front of the child d) Discuss tobacco and alcohol use with the child

Discuss tobacco and alcohol use with the child

While observing a group of 9-year-old children at school, the nurse is concerned that one of the children is not cognitively developing according the Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned? Arrives to class late from recess and apologizes to the teacher Does not understand the phrase "slow as molasses" when used by the teacher Enjoys math instruction and decides to join the math club Believed that not turning in homework on time was acceptable, but has since decided it is not acceptable

Does not understand the phrase "slow as molasses" when used by the teacher

An 8-year-old boy's foster mother is discussing her concerns about three recent cavities found in his permanent teeth. The mother reports that her child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. What would the nurse suggest to this mother is the most appropriate in regard to the child's dental health?

Ensure that the child brushes his teeth after each meal and snacks. Proper dental hygiene includes a routine inspection and conscientious brushing after meals. A well-balanced diet with plenty of calcium and phosphorus and minimal sugar is important to healthy teeth. Foods containing sugar should be eaten only at mealtimes and should be followed immediately by proper brushing. The school-age child should visit the dentist at least twice a year for a cleaning and application of fluoride. page 168

Children can become physically addicted to glue. a) False b) True

False Explanation: Children do not become physically addicted to glue but do become psychologically dependent on it.

The student nurse is preparing a presentation on obesity in children. What information should the student nurse include regarding factors linked to causing obesity? Select all that apply.

Family role modeling Reduced physical education programs Unsafe neighborhoods Lack or reduced amount of recess periods during the school day

Eight-year-old Matt is doing well with adding and subtraction. His father asks for suggestions regarding projects that would help increase Matt's understanding of conservation of mass. Of the following projects, which would most help Matt understand conservation of mass? a) Build a doghouse. b) Build a sandcastle with a water-filled moat. c) Stack blocks in a tower. d) Form vases from blocks of clay.

Form vases from blocks of clay.

The nurse is educating the parents of a 6-year-old boy how to manage the child's introduction into elementary school. The child has an easy temperament. Which should the nurse suggest? a) Scheduling several visits to the school before classes start b) Comforting the child when he is frustrated c) Being firm with episodes of moodiness and irritability d) Helping the child deal with minor stresses

Helping the child deal with minor stresses

The school nurse is assessing the nutritional status of an overweight 12-year-old girl. Which question is appropriate for the nurse to ask?

How often does everyone in your family eat together?

The school nurse is assessing the nutritional status of an overweight 12-year-old girl. Which question is appropriate for the nurse to ask? a) Does your family have rules about foods and how they are prepared? b) Have you gained weight recently? c) How often does everyone in your family eat together? d) What does your family do for exercise?

How often does everyone in your family eat together?

An 8-year-old boy, who says he wants to be a doctor when he grows up, pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then, he asks, "did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age, which is what? a) Conservation b) Perfectionism c) Accommodation d) Industry

Industry

A nurse overhears a 7 year old calling her hospital roommate a vulgar name. What is the best action by the nurse? a) Inform the child that she will not be able to stay in the hospital if she is going to use that type of language. b) Inform the child that if she does not behave, she will get a shot. c) Inform the child that talking to the roommate using that language is not acceptable behavior. d) Inform the child that the nurse is going to call the parents and tell them what was said.

Inform the child that talking to the roommate using that language is not acceptable behavior.

A father brings his 6-year-old son in to the doctor's office. He says his son just began first grade a week ago and, after attending the first day of classes, has refused to go to school each day since, complaining of stomach cramps and nausea. He says he has spoken to the boy's teacher, who says she did not notice anything unusual with her interaction with the boy, other than perhaps a bit of homesickness. After the nurse examines the boy and finds nothing wrong, the father asks how he should handle the problem. Which of the following should the nurse recommend? a) Have the child attend a different school b) Hold the child back a year and let him try again next year c) Insist that the child return to school d) Homeschool the child

Insist that the child return to school

A 9-year-old boy has arrived for a health maintenance visit. Which milestone of physical growth should the nurse expect to observe? a) Brain growth is complete and the shape of the head is longer. b) Lymphatic tissue growth is complete providing greater resistance to infections. c) All deciduous teeth are replaced by 32 permanent teeth. d) Frontal sinuses are developed while tonsils have decreased in size.

Lymphatic tissue growth is complete providing greater resistance to infections.

A mother states that her 6-year-old has starting biting nails and regressing to baby talk since beginning school. What instructions are best for the nurse to give the mother regarding this behavior? Remind the child to stop each time the behavior is witnessed. Make time each day to spend with the child individually. Apply a nail biting product to the nails to deter biting. Get a description of the classroom behavior from the teacher.

Make time each day to spend with the child individually. Explanation: Many first graders are capable of mature action at school but appear less mature when they return home. They may bite their fingernails, suck their thumb, or talk baby talk.

What activities would a nurse recommend to the families of school-aged children to promote attainment of Erikson's developmental stage of industry vs. inferiority? Select all that apply. Commiserating with the child when he or she does not get selected for the school choir Participating on the school soccer team Allowing the child to assist her teacher in straightening up the classroom Voicing parental doubts when the child begins a new activity, such as playing a musical instrument to avoid embarrassment Praising the child for their academic efforts

Participating on the school soccer team Praising the child for their academic efforts Allowing the child to assist her teacher in straightening up the classroom

A nurse is speaking with a 7-year-old boy in the hospital. The boy asks the nurse, "Where is the westroom? I need to use the westroom." The nurse recognizes that this developmental problem is which of the following? a) Caries b) Broken fluency c) Poor articulation d) Malocclusion

Poor articulation

A 10-year-old spends 2 hours by herself every afternoon before her parents arrive home. Which of the following would be the most appropriate safety measure to suggest that the parents teach the child? a) Wearing the house key prominently around her neck b) Lighting candles in case there is a power failure c) Preparing a no-cook snack for herself d) Telling people at school she is by herself for added safety

Preparing a no-cook snack for herself

A 10-year-old boy is above normal weight for a child his age and height. He tells the nurse he doesn't eat much candy but he loves to eat fruit, pasta, potatoes, and bread. What would the nurse recommend to the boy's caregivers as to ways to help him maintain a healthy weight? Change to a very low-fat and no-carbohydrate diet. Encourage the child to not worry about weight until he is older. Encourage activities that will increase his physical activity. Encourage portion control at each meal

Provide activities for the child that will increase his physical activity.

The nurse is observing a group of 8-year-olds who are being taught the concept of conservation of numbers. Which activity would best help these children understand this concept?

Rearranging a group of coins first into a circle, then a triangle and then a square

The nurse is reviewing the medical record for a 13-year-old child who is being seen for concerns about school attendance. The physician has noted the child has "school phobia". What behaviors may be noted in a child experiencing this phenomena? Select all that apply.

Reports of fear when attending school Demonstrates negative behaviors before school Chronically late for school

The nurse is preparing a care plan for a 7-year-old child on the pediatric unit newly diagnosed with asthma. One of the child's parents is employed as a family practice physician and the other as a lawyer. The child has two older siblings and two younger siblings. Which nursing diagnoses would apply to this situation? Select all that apply.

Risk for caregiver role strain Risk for infection Knowledge deficit regarding disease process Knowledge deficit regarding use of inhaler medication for asthma

The nurse is talking with a school-aged child about her interests. In which interest do most school-aged children place the most focus? School Pets Family Church

School

The school nurse is reviewing the chart of a 12-year-old student who has had excessive absences due respiratory infections. What is the best action by the nurse? Ask the child if he really has had respiratory infections during these absences Discuss with the child's teacher to determine if the number of absences has effected academic performance Continue to monitor the child's absences Speak with the parents about the unusual increased number of respiratory infections

Speak with the parents about the unusual increased number of respiratory infections

The mother of an 11-year-old child tells the nurse that her child seems to be "hungry all of the time" and seems to "never get full". The nurse suspects a physiological developmental problem. What is the rationale for the nurse suspecting a physiological developmental issue? Select all that apply.

Stomach capacity increases, which should permit retention of food for longer periods of time The caloric needs of the school-age child are lower than in the earlier years of life

The school nurse is working with a group of 6- to 8-year-old children. Which of the following responsibilities would the school nurse most likely have for this age child? The nurse would be a) Teaching a class on sex education b) Testing the children's vision and hearing c) Giving tetanus-diphtheria booster shots d) Monitoring the children for signs of scoliosis

Testing the children's vision and hearing

The nurse has taken a health history and performed a physical exam for a 12-year-old boy. Which finding is the most likely? a) The child described a somewhat reduced appetite. b) The child has different diet preferences than his parents. c) The child's body fat has decreased since last year. d) The child has a leaner body mass than a girl at this age.

The child has a leaner body mass than a girl at this age.

The nurse is assessing the psychosocial development of a 10-year-old child. What observations would lead the nurse to determine that the child is not achieving the developmental task of Erikson's industry versus inferiority? Select all that apply.

The child tries out for various teams at school but does not make any of them The child is an average soccer player and the parents enforce 1 to 2 hours of practice per day

Which of the following best describes Erikson's psychosocial development task for the school-age child? a) The child wants to successfully complete activities. b) The child is developing his or her own personal identity. c) The child understands and responds to discipline. d) The child is learning to do things on its own.

The child wants to successfully complete activities.

Which statement best describes Erikson's psychosocial development task for the school-age child?

The child wants to successfully complete activities.

The school nurse is monitoring children as they arrive at school riding their bicycles. Which children should the nurse speak with about their riding habits? Select all that apply.

The child who is wearing flip flops when riding the bicycle to school The child who is wearing a book bag hanging off one shoulder The child who wears a stocking cap under the helmet during cold weather

The parents of a 12-year-old girl report their daughter is missing an increasing amount of school. They further share that the child says she feels ill and begs to stay home. What action by the parents will be most therapeutic?

The parents need to attempt to determine why the child is avoiding school.

Which of the following are reasons that stealing occurs in school-age children? (Choose all that apply.) 1. To escape punishment 2. High self-esteem 3. Low expectations of family/peers 4. Lack of sense of propriety 5. Strong desire to own something

To escape punishment Lack of sense of propriety Strong desire to own something

Conformity is vital to school-age children. a) False b) True

True

A 12-year-old girl has recently begun menstruating and is well into puberty. She is visiting the doctor today for a routine physical examination. Which of the following findings should cause concern in the nurse? a) Irregular periods b) Supernumerary nipple c) Breasts of slightly different sizes d) Vulvar irritation

Vulvar irritation

A group of 10-year-old girls have formed a "girls only" club. It is only open to girls who still like to play with dolls. How should this behavior be interpreted? appropriate social development encouragement for bullying and sexism immaturity for this age group poor peer relationships

appropriate social development

The parents of an 11-year-old tell the nurse they are concerned their child may have experimented with some type of inhalant. The nurse should teach the parents to observe for which symptom of inhalation? Select all that apply. irregular respirations irritability giddiness drowsiness irregular heart rate

irregular respirations giddiness irregular heart rate Explanation: Inhalation of fumes causes the child to experience a feeling of exhilaration or giddiness. Because these products contain freon, they can cause severe respiratory and cardiac irregularities. In high concentrations glue fumes can cause extensive liver damage or pulmonary edema, which can be fatal. Irritability, inattentiveness, and drowsiness are associated with recreational drug use, not inhalation.

The nurse is caring for a hospitalized 5-year old child. The child's mother has reported her child is becoming very "clingy." Which advice should the nurse provide? Select all that apply. a) "Regression is normal during hospitalization." b) "These behaviors are the result of a loss of self-control and are likely temporary." c) "The child may miss school and interaction with peers." d) "Allowing the child to have some input in the care may be helpful in managing these behaviors." e) "Be careful not to coddle the child or it will result in regressive behaviors."

• "Regression is normal during hospitalization." • "Allowing the child to have some input in the care may be helpful in managing these behaviors." • "The child may miss school and interaction with peers."

The nurse is providing information to the parents of a 6-year-old boy who has been caught lying at home and at school. Which would the nurse share with the parents? Select all that apply. a) Indicate that the child is probably lying to impress his friends. b) Explain that children this age typically lie to avoid punishment. c) Recommend the use of immediate and firm punishment. d) Suggest reading a story with the child about the consequences of lying.

• Explain that children this age typically lie to avoid punishment. • Suggest reading a story with the child about the consequences of lying.

A nurse is discussing a 9-year-old girl's obesity with her parents. Which of the following recommendations should she make to the parents? (Select all that apply.) a) Participation in formal exercise classes b) Participation in a formal weight-control organization c) Preparation of a special meal just for the child d) Intake of about 1,200 calories a day e) Limiting time spent in physical inactivity f) Adherence to a high-protein diet

• Intake of about 1,200 calories a day • Limiting time spent in physical inactivity • Participation in a formal weight-control organization • Participation in formal exercise classes

The father of an 11-year-old boy is worried that the child spends too much time watching TV. What information should the nurse share with this father? Select all that apply. a) Limit TV time by using it as a reward. b) Use video games that are more active to offset sedentary TV viewing. c) Establish guidelines on when a child can watch TV. d) Watch programs together and discuss subject matter with the child. e) The American Academy of Pediatrics recommends 2 hours or less of TV daily.

• The American Academy of Pediatrics recommends 2 hours or less of TV daily. • Establish guidelines on when a child can watch TV. • Watch programs together and discuss subject matter with the child.