Chapter 28: Growth and Development of the School-Age Child
A parent calls the health care provider about the 7-year-old child's dental hygiene. The child has had three cavities. The parent does not know what to do and asks the nurse for guidance. How should the nurse respond? "Are you able to supervise your child's brushing?" "Is there fluoride toothpaste available for use?" "Did you teach your child how to brush the teeth?" "What type of toothbrush does your child use?"
"Are you able to supervise your child's brushing?" Dental caries is the leading chronic disease in the United States. Children need help with toothbrushing until they are between 7 and 10 years of age. The parent should monitor the toothbrushing to make sure it is thorough, observe for any abnormal tooth alignment, and schedule cleanings every 6 months. Children tend to concentrate on the front teeth, because they can see them easily and "forget" the teeth in the back. Parental oversight is needed to be sure those teeth are brushed carefully.
The nurse is talking with the parents of an 8-year-old child who has been cheating at school. Which comment by the nurse would be appropriate as a first step? "If cheating is noted at this age, referral to a family counselor is highly recommended." "Perhaps the academic environment is too easy for your child, causing the cheating." "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior."
"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." Because they are role models for their children, parents must first realize the importance of their own behaviors. If the academic environment is too difficult, not too easy, the child may be cheating to keep up with the increased rigor. Punishment should be geared toward discussion and helping the child understand the seriousness of cheating, and not be a subtle approach. After a discussion with the child, a review of the child's academic situation (is the work too hard? Is tutoring needed?) and positive role-modeling is assured, then referral to a counselor would be indicated but not as the first step in the resolution.
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? "She won't need a helmet if she has training wheels." "Learning to ride the bike will improve her coordination." "Be sure to get the proper size bike." "Teach her where she'll land on the grass if she falls."
"Be sure to get the proper size bike." It is very important to get a bike of the proper size for the child. Getting a bike that the child can "grow into" is dangerous. Training wheels and grass to fall on are not acceptable substitutes for the proper protective gear. The child should already demonstrate good coordination in other playing skills before attempting to ride a bike.
The nurse is presenting information about school-aged children at a community event. Which statement from the group should the nurse prioritize to address with further teaching and more information? "I make sure they have good teeth by giving them calcium and phosphorus." "Even if the weather is cool and cloudy, our children play outside every day." "Food is so expensive, we always make our children eat everything on their plates." "Sometimes we have to be firm, but our children wash their hands before eating."
"Food is so expensive, we always make our children eat everything on their plates." Obesity can be an issue in the school-aged child, especially if they are urged to clean their plates even if they have more food than they want or need on the plate. The parents should be encouraged to use smaller plates for the children so they will still appear to have a full plate but smaller portions. Firm guidance and direction is important with the school-aged child. Calcium and phosphorus are important to healthy teeth. Exercise each day is important, especially outdoor exercise.
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? "How important is exercise?" "Is there a family history of hypertension, heart disease, or diabetes?" "Is breakfast eaten regularly?" "What beverages are preferred?"
"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 since their habits influence the child.
The nurse is educating a group of parents about childhood nutrition, specifically caloric needs. Which statement, when made by a parent, indicates teaching was successful? "I will assure that at least 75% of calories for my 10-year-old child's diet come from simple carbohydrate sources." "My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health." "We will make sure that our 11-year-old child consumes at least 900 calories, primarily through protein sources." "It is convenient that my 8-year-old and 12-year-old children both need to consume the same amount of calories."
"My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health." Boys and girls 4 to 8 years old who are moderately active will need about 1,400 to 1,600 calories per day. Boys 9 to 13 years old who are moderately active need about 1,800 to 2,000 calories a day and girls 9 to 13 years old who are moderately active need about 1,600 to 2,000 calories a day. Approximately 45% to 65% of calories should come from carbohydrates.
After teaching the parents of a 9-year-old child about safety, which statement indicates the need for additional teaching? "Our child should ride the bike on the same side of the road and in the same direction as traffic." "We signed our child up for swim lesions at the local community center." "We need to buy our child a helmet so the child can ride a scooter." "Our child can ride in the front seat of the car once reaching 10 years of age."
"Our child can ride in the front seat of the car once reaching 10 years of age." Children younger than 12 years of age must sit in the back seat of the car. Laws in most states require helmets for riding bicycles and scooters. When riding a bike, the child should ride on the side of the road traveling with the traffic. Children should know how to swim. If swimming skills are limited, the child must wear a life preserver at all times.
The nurse is reinforcing education to the parents of a 10-year-old child who are seeking to improve the nutritional status of their son. Which statement(s) by the parents indicate an understanding of the education? Select all that apply. "Age is one of the determinants of the caloric needs for my son." "Since my son is moderately active he will need about 2,200 calories per day." "The largest components of my son's diet should be carbohydrates." "The caloric needs of my child are based upon his level of activity." "Gender does not influence my child's caloric needs at this age."
"The caloric needs of my child are based upon his level of activity." "Age is one of the determinants of the caloric needs for my son." "The largest components of my son's diet should be carbohydrates." The determination of caloric needs is based on a child's gender, age, and level of activity. When planning the diet, approximately 65% of caloric intake should be carbohydrates. In a moderately active boy of this age, the caloric intake should range from 1,800 to 2,000 per day.
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 child's self-esteem is greatly inborn and environmental influences guide it." "The peers of a child at this age are the greatest influence on self-esteem." "Several interrelated factors are to blame for low self-esteem." "Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."
"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age." Self-esteem is developed early in childhood. The feedback a child receives from those perceived in authority such as parents and educators impacts the child's sense of self-worth. As the child ages, the influence of peers and their treatment of the child begin to have an increasing influence on self-esteem.
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 feeling of inferiority A sense of shame A sense of doubt A sense of mistrust
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.
What teaching points would a nurse provide for families of school-aged children to help prevent substance abuse? Select all that apply. Encourage decision-making and discuss family values. Set firm rules regarding alcohol and other drug usage and discuss consequences associated with breaking the rules. Explain that what you do has nothing to do with what your expectations are for them since you are an adult. Threaten the child if they get caught using alcohol or other drugs including tobacco. Give the child "what if" examples to situations they may face.
Give the child "what if" examples to situations they may face. Set firm rules regarding alcohol and other drug usage and discuss consequences associated with breaking the rules. Encourage decision-making and discuss family values. Children mimic what adults do so it is important to set good examples for behavior regarding substance abuse. Offering children opportunities to think through "what if" situations allows the child to have already thought about difficult situations they may find themselves in. Although threats are not productive, setting strict rules regarding substance abuse is very important. Also, encourage decision-making by the child based upon previous good decisions.
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. What is that step? Conservation Perfectionism Industry Accommodation
Industry During the early school years, children attempt to master their new developmental step: learning a sense of industry or accomplishment. Accommodation is the ability to adapt thought processes to fit what is perceived, such as understanding there can be more than one reason for other people's actions. Conservation is the ability to appreciate that a change in shape does not necessarily mean a change in size. Perfectionism is the desire to do something perfectly. The boy's desire to apply the band-aid "the right way" is a hallmark of the development of industry. The other answers are not as pertinent.
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? Get a description of the classroom behavior from the teacher. Make time each day to spend with the child individually. Remind the child to stop each time the behavior is witnessed. Apply a nail biting product to the nails to deter biting.
Make time each day to spend with the child individually. 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. Scolding, nagging, threatening, or punishing does not stop the problem and can actually make them worse. Methods such as bad-flavored nail polish or restraining the child's hands make the problems worse. These behaviors stop when the underlying stress is discovered and alleviated. Parents should be urged to spend time with the child after school or in the evening so the child continues to feel secure in the family and does not feel pushed out by being sent to school.
A nurse is caring for a hospitalized 10-year-old child. What would be an appropriate activity for this child to meet the developmental tasks of this age group? Participating in a craft project Playing with a jack-in-the-box Playing with blocks Writing letters to friends
Participating in a craft project During this stage, the child is interested in how things are made and run. The child learns to manipulate concrete objects. The child likes engaging in meaningful projects and seeing them through to completion. Playing jack-in-the-box and blocks are for much younger children. If anything, the child would be texting back and forth with friends, not writing a letter.
The nurse has taken a health history and performed a physical exam for a 12-year-old boy. Which finding is the most likely? The child's body fat has decreased since last year. The child has a leaner body mass than a girl at this age. The child described a somewhat reduced appetite. The child has different diet preferences than his parents.
The child has a leaner body mass than a girl at this age. The nurse would have found that the child still has a leaner body mass than girls at this age. Both boys and girls increase body fat at this age. Food preferences will be highly influenced by those of her parents. Although caloric intake may diminish, appetite will increase.
The nurse is conducting a support group for parents of 9- and 10-year-olds. 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? time to remain dependent on their parents a sense of security as children gain independence time to establish relationships with the opposite sex an opportunity for children to become self sufficient
a sense of security as children gain independence Nine-year-olds take their peer group seriously. They are more interested in how other children dress than what their parents want them to wear. This is the age where groups are formed and others are excluded from the club. This age group is imitating their peers as they develop their own identity 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, etc. 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 group relationships are with same-sex friends. Children do not become self-sufficient through these clubs. They remain dependent on their families for their physical needs.
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? poor peer relationships encouragement for bullying and sexism appropriate social development immaturity for this age group
appropriate social development Ten-year-olds take the values of their peer group seriously. They are interested in being with peers of like mind and activities. Clubs are formed with specific exclusions of peers. Such clubs typically have a secret password and secret meeting place. Membership is generally all girls or all boys. These groups are not based on the immaturity of the children nor do they encourage sexism and bullying.
A nurse is discussing ways parents can foster the development of self-confidence in their school-aged child. Which action if stated by the parents would lead the nurse to continue the discussion? comparing the child to an older sibling regarding academic achievements being accepting of mistakes the child makes focusing on what the child is saying in a conversation having clear expectations of behavior whenever the family is out in public
comparing the child to an older sibling regarding academic achievements A school-age child needs consistency, clearly defined expectations, and positive attention in order to develop self-confidence. By being accepting of mistakes the child makes, focusing on the child whenever they are talking, and making sure the child understands behavioral expectations, the parents are fostering self-confidence in the child.
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. What understanding has this child developed? classification reversibility conservation decentration
conservation Piaget described concrete operational thought occurring in the child ages 7 to 10 years. During this time the child develops various skills to see objects and the world. The skill of conservation is the ability to recognize that a change in shape does not necessarily mean a change in amount or mass. Using reversibility, the child can understand that processes can be reversed or canceled out by other things. Decentration is developed when the child can pay attention to multiple attributes of an object or situation instead of only one. In classification, the child is able to put objects together by shared qualities or characteristics.
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 to Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned? believed that not turning in homework on time was acceptable, but has since decided it is not acceptable arrives to class late from recess and apologizes to the teacher enjoys math instruction and decides to join the math club does not understand the phrase "slow as molasses" when used by the teacher
does not understand the phrase "slow as molasses" when used by the teacher Piaget's stage of cognitive development for the 7- to 11-year-old is the period of concrete-operational thoughts. In developing concrete operations, the child is able to assimilate and coordinate information about his or her world from different dimensions. Abstract thinking, such as understanding the meaning of the phrase "slow as molasses," is expected at this stage of cognitive development.
A mother suspects that her 11-year-old son is experimenting with deliriants with his friends. Which symptoms would the nurse advise the mother to look for that would validate her concerns? hyperactivity unexpected bouts of diarrhea giddiness and coughing having bad breath when returning from school
giddiness and coughing Inhalation of substances can cause numerous symptoms, including giddiness and coughing. The child will not experience diarrhea, hyperactivity, or develop bad breath from experimenting with inhalants.
The developmental task of the school-aged period, according to Erikson, is gaining a sense of: autonomy versus shame. identity versus failure. independence versus dependence. industry versus inferiority.
industry versus inferiority. The school-age years, according to Erickson, are the stage of industry versus inferiority. The developmental stage helps increase the child's sense of self worth. Industry is associated with the child's increased interest in knowledge and the development of social skills. Autonomy versus shame is the developmental tasks of 1 to 3 year old children. Erickson's stages do not include the developmental tasks of independence versus dependence nor identity versus failure.
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 family pets church
school The school-age child typically values school attendance and school activities. During school-age, the focus expands from family to teachers, peers, and other outside influences.
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? "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?" "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."
"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.
During a well-child visit, an 11-year-old girl states to the nurse that she looks different from her friends who are wearing bras. What is an appropriate response? "Remember the methods you have been taught to manage peer pressure." "It is normal for there to be differences in the time and rate girls your age develop." "It is common for girls your age to worry about being different." "You are doing well in school. Be happy with this success."
"It is normal for there to be differences in the time and rate girls your age develop." Letting the girl know that differences are normal and that development occurs at different times and rates among girls her age is reassuring. Focusing on strengths is positive but talks around the child's concern. Telling her she has a common worry minimizes her complaint and provides no information. Concern about breast development does not equate to peer pressure.
A nurse is caring for a hospitalized 7-year-old child 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? An activity focusing on learning fractions A paint-by-numbers activity creating a picture A board game such as monopoly A card game such as solitaire
A paint-by-numbers activity creating a picture 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 child would need additional instruction to learn fractions, which may not be considered fun. A card game such as solitaire and a board game of monopoly may be too hard for the 7-year-old. In addition, the game of monopoly would require additional players.
A nurse is assigned to care for a 7-year-old child. The child wants to show the nurse a 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? Decentration Egocentric thinking Classification Preoperational thinking
Classification An important change in thinking during the school-age period is classification. This is the ability to divide things in different sets and identify their relationships to each other. Children in this age group love to collect sports cards, insects, rocks, stamps, coins, etc. These collections may be only a short-term interest, but they are of utmost importance to the child when he or she is collecting them. Decentration occurs in the concrete operational stage from ages 7 to 12 years. It is the ability to consider multiple aspects of a situation. The preoperational stage occurs between ages 2 and 7 years. During this time thinking is at a symbolic level. One part of the preoperational stage is egocentrism. In this stage, the child has the inability to see things from another's point of view.
The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child? Be screened for scoliosis once a year Should brush their teeth at bedtime Needs 10 to 12 hours of sleep per night Have a routine physical exam every 6 months
Needs 10 to 12 hours of sleep per night The school-aged child needs 10 to 12 hours of sleep per night. They need to brush their teeth after every meal and at bedtime. A routine physical exam once a year is all that is necessary. Children are screened around the age of 10 or 11 for scoliosis.
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 teenage child does not sleep as much as my 9-year-old does." "My child sleeps between 11 and 12 hours a night." "My child does not even know when he is tired." "My child stays up late when she takes a nap after school."
"My child sleeps between 11 and 12 hours a night." Sleep for the school-age child varies with the age of the child. A child between the ages 6 to 8 years needs 12 hours of sleep each night. The child between the ages of 8 to 10 years needs 10 to 12 hours of sleep each night. The 10 to 12 year old needs 9 to 10 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.
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? "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." "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain." "Your child doesn't seem to be overweight, so it isn't a concern."
"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.
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? "Now is the time to let your child choose some of the meals." "I want you to give your child choices about the food eaten." "You need to make sure your child has input regarding the food eaten." "You must let your child make some choices for oneself." SUBMIT ANSWER
"Now is the time to let your child choose some of the meals." Diet preferences are established in the preschool years and continue to develop as the child ages. The diet is influenced by family, peers, and media. Because of these influences and the child striving for independence, it is important to involve the child in helping select the food choices and guiding the child to healthy food choices. With parents, as well as children, it is more effective and less a matter of personal opinion to say "now is the time" rather than "you need," "I want you to," or "you must" do something. The nurse can emphasize the importance of the child participating in meal selection while encouraging the child's independence in a gentle manner.
The parents of a 9-year-old child voice concern that the child seems to be gaining weight rapidly. The nurse reviews the medical record and notes the child has increased weight by 6 or 7 lb (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 lb (3.2 kg) per year are normal for children in this age range." "On the contrary, your child's annual weight gain is somewhat low for this age." "Your child does seem to be rapidly gaining weight." "Children in this age range on average gain about 5 lb (2.3 kg) per year."
"Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." Children who are between the ages of 6 and 12 years usually gain about 7 lb (3.2 kg) per year. The child in the scenario is gaining weight at a normal rate.
The nurse is performing a physical assessment of a 10-year-old child. The nurse notes that 1 year ago the child weighed 80 lb (36.3 kg). Which weight, if noted during this assessment, would alert the nurse to further assess the child for appropriate growth and development? 88 lb (40 kg) 82 lb (37.2 kg) 87 lb (39.5 kg) 86 lb (39 kg)
82 lb (37.2 kg) From 6 to 12 years of age, an increase of 7 lb (3 to 3.5 kg) per year in weight is expected, so would be a target weight of 87 lb (39.5 kg). A child weighing near 87 lb, such as 86 lb (39 kg) or 88 lb (40 kg), would be considered appropriate. If the child weighed only 82 lb (37.2 kg), this would alert the nurse to further assess the child for lagging growth.
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? "Your son is at high risk for bullying other children as a result of this situation." "Fortunately the scars of being picked on will fade as your son grows up." "Bullying can have lifelong effects on the self-esteem of a child." "Perhaps teaching your son self-defense courses will help him to have a greater sense of control and safety."
"Bullying can have lifelong effects on the self-esteem of a child." The child can be permanently scarred by negative experiences such a bullying. Activities such as self-defense and sports can promote a sense of accomplishment but don't relate directly to the problem of bullying. There is no indication the child in the scenario will become a bully.
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? "A pituitary disorder may be the cause. Blood work may be indicated." "An allergic reaction is often the cause. What type of allergies does she have?" "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." The immunoglobulins IgG and IgA each reach adult levels during the school-age period; lymphatic tissue continues to grow in size until about age 9. The resulting abundance of tonsillar and adenoid tissue in schoolchildren is often mistaken for disease as the tonsils seem to fill the entire back of the throat. The fact that there are no other symptoms indicates that this child's enlarged tonsils are simply a result of the normal growth of lymphatic tissue for this age.
In teaching school-aged children and their parents, what facts would be valuable for the nurse to emphasize? Select all that apply. Dental checkups are recommended twice a year. For nutritional recommendations, a good resource for parents is choosemyplate.gov. Children need to learn about human reproduction at home. School-age children require 8 to 10 hours of sleep each night. Education about the unhealthy aspects of tobacco and alcohol should begin in elementary school.
Dental checkups are recommended twice a year. Education about the unhealthy aspects of tobacco and alcohol should begin in elementary school. For nutritional recommendations, a good resource for parents is choosemyplate.gov. Dental checkups should occur every 6 months for this age group. By starting education about the hazards of tobacco and alcohol, this lays a good foundation for the future years. One of the best resources for families to use for meal planning is choosemyplate.gov, which is easily accessed on the internet. Someone who is comfortable with the subject should teach human reproduction, and some parents simply do not feel equipped to present the information. Sleep for a school-age child should be 10 to 12 hours each night, not 8 to 10 hours.
The nurse is creating a care plan for a school-aged child with a nursing diagnosis of Ineffective health maintenance related to lack of exercise and poor food choices. Which nursing interventions should the nurse include? Select all that apply. Interview the parents about their eating and exercising habits. Educate the parents and child on the need to increase the amount of daily exercise. Plot out the child's height, weight, and BMI to detect weight loss or gain. Have the parents keep a diary of the child's food and exercise for a week. Educate the parents and the child on the need to decrease TV/computer/device time.
Educate the parents and the child on the need to decrease TV/computer/device time. Educate the parents and child on the need to increase the amount of daily exercise. Interview the parents about their eating and exercising habits. Plot out the child's height, weight, and BMI to detect weight loss or gain. Have the child, not the parents, keep a food and exercise diary for a week to determine current patterns of eating and exercising. Educating the child and parents on the need to increase daily exercise and decrease the amount of TV/computer/device time; interviewing the parents on their eating and exercising habits; and plotting out the child's height, weight, and BMI are all appropriate interventions for this nursing diagnosis.
The parent of a 12-year-old child reports the child does not have high self-esteem. The parent asks for suggestions to increase feelings of self-worth. What activity(ies) would be appropriate for the nurse to suggest? Select all that apply. Encourage the child to develop new skills. Provide the child with a weekly allowance. Recommend the child investigate opportunities for volunteering at local charities. Allow the child to begin staying home alone after school when possible. Recommend the child begin to participate in after-school activities.
Encourage the child to develop new skills. Recommend the child begin to participate in after-school activities. Recommend the child investigate opportunities for volunteering at local charities. The school-age child's satisfaction from achieving success in developing new skills leads him or her to an increased sense of self-worth, which is a person's feeling about one's own value. 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. The school-aged child is very interested in learning how things are made and work. Providing the child an allowance and allowing the child to stay home alone after school will not help increase self confidence, which is how much a person believes in oneself and what one can do.
The nurse is providing anticipatory guidance for parents of a school-age child on teaching the dangers of drugs and alcohol. What advice might be helpful for these parents? School-age children are not ready to absorb information that deals with drugs and alcohol. Parents must prevent their child from being exposed to messages that are in conflict with their values. Discussions with children should focus on past events and future consequences. School-age children can think critically to interpret messages seen in advertising, media, and sports.
School-age children can think critically to interpret messages seen in advertising, media, and sports. School-age children can be taught how to think critically to interpret messages seen in advertising, media, sports, and entertainment personalities. School-age children are ready to absorb information that deals with drugs and alcohol and may be exposed to messages that are in conflict with their parents' values regarding smoking and alcohol. This may occur at school and cannot be prevented. Discussions with children need to be based on facts and focused on the present.
The nurse is teaching a growth and development class to parents of school-age children. What does the nurse teach the parents about the cognitive abilities of their children? They can make judgements based on scientific facts. They make judgments on what they reason. They have developed the ability to reason abstractly. They are able to classify objects.
They are able to classify objects. The period from 5 to 11 years is a transitional stage where children undergo a shift from preoperational thought to concrete operational thought. During this stage, children decenter (have the ability to project one's self into other people's situations), accommodate (develop an understanding there can be more than one reason for people's actions), conserve (the ability to appreciate a change in shape does not necessarily mean a change in size), and develop class inclusion (the ability to understand objects can belong to more than one classification). Class inclusion is necessary for learning mathematics and reading. Children do not develop abstract thinking until adolescence. Cognitive development includes the child's ability to reason through any problem he or she can actually visualize.
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? "Children this age sometimes can't distinguish between fantasy and reality." "Your child could be in serious trouble in school if he continues to tell lies." "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."
"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 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.
The nurse is teaching a group of school-aged children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching? "Menarche is usually the first sign of puberty in school-aged girls." "There are not many physical differences between school-aged boys and girls." "Boys normally grow an average of 5 in (12.5 cm) each year." "Girls typically experience a rapid growth spurt before boys."
"Girls typically experience a rapid growth spurt before boys." Girls typically experience a rapid growth spurt before boys, and are usually taller by about 2 in (5 cm) or more than preadolescent boys. During the school-age years, the child will grow approximately 1 to 2.5 in (2.5 to 6.25 cm) per year. As puberty approaches, there will be significant differences in development between boys and girls. The first sign of puberty for girls is breast changes, not menarche.
During a routine wellness examination, the nurse is trying to determine how well a 5-year-old boy communicates and comprehends instructions. What is the best specific trigger question to determine the preschooler's linguistic and cognitive progress? "Does your son speak in complete sentences all the time?" "Would you say your son has a vocabulary of about 900 words?" "Is your son's speech clear enough that anyone can understand it?" "How well does your son communicate or follow instructions?"
"How well does your son communicate or follow instructions?" Asking how well the boy communicates and follows instructions is the best trigger question because it is open-ended. Asking if the child uses complete sentences or speaks clearly will elicit a yes or no answer about only those specific areas of development. The parents would have no way of judging the size of their child's vocabulary.
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. "My mom always says she looks around really well to be sure I'm not playing behind our car before she leaves." "I always remind my sister to look right, then left, then right again before we cross the street." 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." "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." Older children and adults should provide supervision of younger children, but 6 years old is not considered an older child, especially for 5 blocks of supervision of a younger sibling. Children should always walk on sidewalks because cars may not see children walking in the streets or be distracted while driving. Children should stay away from vehicles when a vehicle is about to be driven and definitely not behind a vehicle.
