Chapter 28: Growth and Development of the School-Age Child
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 shame A sense of doubt A sense of mistrust A feeling of inferiority
A feeling of inferiority
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? A paint-by-numbers activity creating a picture A board game such as monopoly A card game such as solitaire An activity focusing on learning fractions
A paint-by-numbers activity creating a picture
A parent tells the nurse that the 6-year-old child has been biting his fingernails since beginning first grade. After analysis, the cause is determined to be increased stress. What advice would the nurse give the parent regarding this behavior?
Allow some time every day for the child to talk about new experiences
The nurse is caring for a 11-year-old girl who has been identified as weighing 10% more than recommended for her age and height. When developing the plan of care, which intervention is of the highest initial priority? Discuss keeping a food journal with the child and parents. Assess readiness to learn in the child and parents. Review the BMI for other children in the family for familial tendencies. Assess the child's activity level for the past week.
Assess readiness to learn in the child and parents.
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. View the world in terms of her own experience. Know lying is bad because she gets sent to her room for it. Make generalized assumptions about groups of things.
Consider an action and its consequences.
The nurse is caring for a hospitalized 10-year-old client. Which nursing action is mostappropriate? Correct each of the child's mistakes to ensure learning. Discourage the child from assisting with dressing change. Structure a competitive environment between clients. Consistently reinforce the child's self-worth.
Consistently reinforce the child's self-worth.
The school nurse is meeting with a 10-year-boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestion should the nurse prioritize to help him maintain a healthy weight? Encourage portion control at each meal Encourage the child to not worry about weight until he is older. Change to a very low-fat and no-carbohydrate diet. Encourage activities that will increase his physical activity. SUBMIT ANSWER
Encourage activities that will increase his physical activity.
The nurse is caring for a 7-year-old child who will be in the hospital for several weeks. Which action by the nurse will facilitate the child's psychosocial development? Allow the child's peers to visit often. Quickly come to the room while the child presses the call bell. Encourage the child to complete school work and provide guidance. Ask the child what color gown he or she prefers to wear daily.
Encourage the child to complete school work and provide guidance.
An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health? Have the child's teeth professionally cleaned every 3 months. Ensure that the child brushes his teeth after each meal and snacks. Accept that the child is genetically predisposed to having more cavities than most children. Encourage the child to abstain from eating sugary snacks at school.
Ensure that the child brushes his teeth after each meal and snacks.
What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child? Hamburger and a cherry Coke Fish, spinach salad and a glass of milk Chicken sandwich with pretzels and apple juice Bagels and cream cheese with sherbet
Fish, spinach salad and a glass of milk
An 8-year-old child is being seen for a well-child visit. His weight at his visit last year was 50 lb (22.7 kg) and his height was 47 in (119 cm). If he is developing normally, which finding will the nurse expect to note this year? Height 49 in (124.5 cm) The child's weight is seven times his birth weight. The child has all of his adult teeth present. Weight 62 lb (28.1 kg)
Height 49 in (124.5 cm)
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? Does your family have rules about foods and how they are prepared? What does your family do for exercise? Have you gained weight recently?
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. What is that step? Perfectionism Accommodation Industry Conservation
Industry
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.
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? Writing letters to friends Participating in a craft project Playing with blocks Playing with a jack-in-the-box
Participating in a craft project
The nurse is talking with a school-aged child about her interests. In which interest do most school-aged children place the most focus? Pets Family School Church
School
What resource should school-aged children be taught to use whenever they have questions about sex education, if their parents will not discuss the subject? Older siblings School nurse Their friends Material found on the internet
School nurse
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 has a leaner body mass than a girl at this age. The child has different diet preferences than his parents. The child described a somewhat reduced appetite. The child's body fat has decreased since last year.
The child has a leaner body mass than a girl at this age.
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 establish relationships with the opposite sex a sense of security as children gain independence time to remain dependent on their parents an opportunity for children to become self sufficient
a sense of security as children gain independence
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? immaturity for this age group encouragement for bullying and sexism appropriate social development poor peer relationships
appropriate social development
The elementary school teachers are in a class on bullying taught by the school nurse. The nurse encourages the teachers to look for common traits of bullies. What are these traits? Select all that apply. large physical size economically deprived permissive parents becomes angry at small issues poor school grades
large physical size becomes angry at small issues permissive parents
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? vacuuming putting books on shelf folding clothes raking leaves
putting books on shelf
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? "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?" "Is there fluoride toothpaste available for use?"
"Are you able to supervise your child's brushing?"
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? "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." "If cheating is noted at this age, referral to a family counselor is highly recommended." "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." "Perhaps the academic environment is too easy for your child, causing the cheating."
"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior."
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? "The child should have privileges taken away for several days each time he tells a lie." "Is there any possibility he is telling the truth and you just don't know it is the truth?" "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 nurse is teaching a group of school-age children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching? "There are not many physical differences among school age boys." "I will have improved gross motor skills." "I will appear heavier due to an increase in fat production." "I will grow an average of 2.5 in (6.5 cm) per year."
"I will grow an average of 2.5 in (6.5 cm) per year."
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? "What beverages are preferred?" "How important is exercise?" "Is breakfast eaten regularly?" "Is there a family history of hypertension, heart disease, or diabetes?"
"Is there a family history of hypertension, heart disease, or diabetes?"
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 stays up late when she takes a nap after school." "My child does not even know when he is tired." "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 sleeps between 11 and 12 hours a night."
A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed? "I will teach my daughter her full name and phone number." "I will teach my child that policemen are our friends and to they are there to help us." "We will be sure that our child wears a life jacket the next time we go to the lake boating." "My son should only wear his helmet when he goes on long rides around the neighborhood."
"My son should only wear his helmet when he goes on long rides around the neighborhood."
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? "Wow, that is a lot of stuff for a girl her age." "Play helps children to develop cognitively, socially, physically, and emotionally." "It is understandable not playing any more with all these other activities." "All of these other activities teach you as much as traditional play."
"Play helps children to develop cognitively, socially, physically, and emotionally."
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? "I see now we need to use a fluoride toothpaste for our child." "I guess we better look for a pediatric dentist for our son." "These are only his baby teeth so we are not worried." "I guess we will need to supervise our son while he brushes."
"These are only his baby teeth so we are not worried."
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." "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." "The peers of a child at this age are the greatest influence on self-esteem."
"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."
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? "Learning to ride the bike will improve her coordination." "Teach her where she'll land on the grass if she falls." "Be sure to get the proper size bike." "She won't need a helmet if she has training wheels."
"Be sure to get the proper size bike."
The parents of an 11-year-old are discussing having their child come home after school alone rather than continue attending after-school care. They ask the nurse about the implications of making this decision. What should be included in the information provided by the nurse? Select all that apply. "Children who are considered "latch key kids" are at an increased risk for engaging in risky behaviors." "Laws do not support children under the age of 15 years being left home alone." "Maturity and not age should be considered when deciding when a child is ready to stay home alone." "It is recommended that children interact daily with others of a similar age." "Children who do not come home to an adult do not perform as well in school."
"Children who are considered "latch key kids" are at an increased risk for engaging in risky behaviors." "Children who do not come home to an adult do not perform as well in school." "Maturity and not age should be considered when deciding when a child is ready to stay home alone."
The nurse is presenting information about school-aged children at a community event. Which statement should the nurse prioritize for further teaching and providing more information? "Sometimes we have to be firm, but our children wash their hands before eating." "Even if the weather is cool and cloudy, our children play outside every day." "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 plates."
"Food is so expensive, we always make our children eat everything on their plates."
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." "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?"
"Have you given any thought to why they do not let you go without a chaperone?"
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?" "How well does your son communicate or follow instructions?" "Is your son's speech clear enough that anyone can understand it?"
"How well does your son communicate or follow instructions?"
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." "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."
"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."
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? "I was afraid of the dark at your age. You will grow out of that fear soon." "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?" "That is so horrible that you are afraid of the dark. Can you sleep at night at all?" "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?"
"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?"
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? "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." "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."
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 your daughter of the importance of proper oral hygiene." "Remind her in simple terms what will happen in the dentist's office." "Wait to tell her about the visit until just before the appointment." "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 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? "On the contrary, your child's annual weight gain is somewhat low for this age." "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." "Your child does seem to be rapidly gaining weight."
"Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range."
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? Lack of the ability to think abstractly The conventional stage of development A sense of competence, mastery, and worth The principle of conservation
A sense of competence, mastery, and worth
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? 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
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. Recommend the child begin to participate in after-school activities. Allow the child to begin staying home alone after school when possible.
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 mother of a 10-year-old daughter is concerned that her child is becoming overweight. Her weight plots in the 95th percentile in the growth chart. Which action would the nurse recommend to the mother to address her concerns? Limit daily fat intake to 40% of the total calories for the day. Place the child on a diet, eliminating all sweets and snacks. Offer to go walking every day after school with her for 30 minutes. Remind the child daily that she needs to watch what she eats.
Offer to go walking every day after school with her for 30 minutes.
After watching a news broadcast of a school shooting, a child begins experiencing nightmares and bed wetting. How can the nurse instruct the parents to help their child feel safe? Select all that apply. Only allow one viewing of a news broadcast. Have the child sleep in the same room as the parents. Allow children to watch news broadcast only in parent's presence. Continue to provide assurance of safety. Schedule an appointment with the counselor.
Only allow one viewing of a news broadcast. Continue to provide assurance of safety. Allow children to watch news broadcast only in parent's presence.
On physical examination, the nurse discovers that a 6-year-old child's palatine tonsils are somewhat enlarged in the back of the throat. What would be the nurse's best action? Suggest the health care provider examine the child for breathing difficulty. Give the child something for pain. Take the child's temperature; this must be tonsillitis. Record this as a normal finding in an early school-age child.
Record this as a normal finding in an early school-age child.
The school nurse is teaching a class on sports injuries. What information is most important for the nurse to teach? Play the same sport regularly to become proficient. Little league tackle football is not safe for a school age child. Vary the sports to prevent use injuries. Fractures are minimal due to bone growth and calcification.
Vary the sports to prevent use injuries.
The family who are vegetarian voice concern that their child is not growing well. The nurse should suggest which food to increase the calcium intake for adequate bone growth? sweet potato quinoa kale oatmeal
kale
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: preoccupation with death and dying is common in the school-aged child. consistent thoughts of death and dying at this age lead to the later development of depression. discussing death and dying may hint at a psychological disorder. at this age, children are not afraid of death.
preoccupation with death and dying is common in the school-aged child.
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? "Your child does seem to be rapidly gaining weight." "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." "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."
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? "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." "We should ask the health care provider to run some tests; with that much sleep, the child should not be tired." "Your child should be getting 8 to 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."
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? Determine if there have been other playground bullying incidents. Question those responsible for the bullying. Immediately call the bullied child's parents. Assess the situation with the help of the school staff and parents.
Assess the situation with the help of the school staff and parents.
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. Apply a nail biting product to the nails to deter biting. Remind the child to stop each time the behavior is witnessed. Make time each day to spend with the child individually.
Make time each day to spend with the child individually.
