Peds Chapter 24

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Which activity is easier for a school-aged child because of changes in proportions from the preschool stage of development? 1) Climbing 2) Handwriting 3) Problem-solving 4) Cooperative play

1 1 Activities such as bike riding, skateboarding, in-line skating, skiing, and climbing become more comfortable and much easier during the school-aged stage of development. 2 Handwriting is an activity that is still developing during this stage of development. 3 Problem-solving is an activity that is still developing during this stage of development. 4 Although cooperative play is an expectation during this stage of development, this is not due to changes in proportions that occur during the school-aged years.

Which physical change noted by the nurse during a growth and developmental assessment for a 7-year-old patient necessitates further action? 1) Pubescent changes 2) Weight gain of 4 lb (2 kg) per year 3) Eruption of central incisors 4) Height increase of 1 to 2 feet (30 to 60 cm) during the entire period

1 1 Pubescent changes are not anticipated until the age of 8 years. 2 This weight gain is within normal limits for the school-aged patient. 3 Eruption of central incisors is anticipated during the school-aged years. 4 This is an expected finding for the school-aged patient during this stage of development.

Which growth and developmental change indicates increased maturity during the school-aged stage of development? 1) An increase in leg length in relation to height 2) A decreased head circumference in relation to standing height 3) The face growing faster in relation to the remainder of the cranium 4) Little increase in the size of the skull and the brain, which grow very slowly

1 1 The school-aged child experiences an increase in leg length in relation to height. 2 The school-aged child does not experience a decrease in head circumference in relation to standing height. 3 The school-aged child's face does not grow faster in relation to the remainder of the cranium. 4 The skull and the brain have significant growth during the school-aged stage of development.

According to Erikson, which should the nurse anticipate when assessing a school-aged child? (Select all that apply.) 1) Being engaged in tasks 2) Questioning sexual identity 3) Having highly imaginative thoughts 4) Wanting to participate in organized activities 5) Struggling with self-control and independence

1,4 1. This is correct. According to Erikson, the school-aged child should be engaged in tasks. 2. This is incorrect. According to Erikson, the school-aged child should not question sexual identity. 3. This is incorrect. According to Erikson, the school-aged child should not have highly imaginative thoughts. 4. This is correct. According to Erikson, the school-aged child should want to participate in organized activities. 5. This is incorrect. According to Erikson, the school-aged child should not struggle with self-control and independence.

Which deciduous teeth should the nurse anticipate the school-aged child will lose first? 1) Lateral incisors 2) Central incisors 3) Third molars 4) Second molars

2 1 The nurse should not anticipate that the school-aged child will lose the lateral incisors first. 2 The nurse should anticipate that the school-aged child will lose the central incisors first. 3 The nurse should not anticipate that the school-aged child will lose the third molars at all because these are adult teeth. 4 The nurse should not anticipate that the school-aged child will lose the second molars at all because these are adult teeth.

Which teaching point regarding safety should the nurse include in instructions for the parents of a school-aged patient? 1) "Consider getting a pet for your child." 2) "Plan play dates for your child to attend on afternoons you are not home." 3) "Teach your children not to let others know that they are home alone after school." 4) "Encourage your child to use a helmet when riding a bike. Other equipment is not necessary."

3 1 Although a pet may help a school-aged child learn responsibility, this is not a teaching point to enhance safety. 2 Play dates should be planned when a parent is present because the school-aged child requires adult supervision. 3 Children who are latchkey kids should not let others know that they are home alone after school. 4 A helmet, along with knee and elbow pads, should be encouraged for a school-aged child who rides a bike.

How many hours of sleep should the nurse recommend for an 11-year-old patient? 1) 6 to 8 2) 8 to 10 3) 10 to 12 4) 14 to 16

3 1 Six to 8 hours of sleep is not appropriate for a school-aged patient. 2 Eight to 10 hours of sleep is not appropriate for a school-aged patient. 3 Ten to 12 hours of sleep is appropriate for a school-aged patient. 4 Fourteen to 16 hours of sleep is not appropriate for a school-aged patient.

At which stage of development should the nurse anticipate that pediatric patients will begin to show differences in play activities that are related to gender? 1) Preschool 2) Adolescence 3) Late school age 4) Early school age

3 1 The preschool-aged patient does not begin to show differences in play activities related to gender. 2 The adolescent patient has already shown differences (i.e., is not beginning to show differences) in play activities related to gender. 3 During the late school-aged years, the child begins to show differences in play activities related to gender. 4 The early school-aged child does not begin to show differences in play activities related to gender.

Which stage of development is characterized by a slower, steadier pattern of growth and development? 1) Toddler 2) Preschool 3) School-age 4) Adolescence

3 1 The toddler stage of development is not characterized by a slower, steadier pattern of growth and development. 2 The preschool stage of development is not characterized by a slower, steadier pattern of growth and development. 3 The school-aged stage of development is characterized by a slower, steadier pattern of growth and development. 4 The adolescent stage of development is not characterized by a slower, steadier pattern of growth and development.

The nurse is teaching the parents of a 6-year-old child what to expect in terms of normal growth and development. Which parental statement indicates the need for further education? 1) "My child's vision has reached maturity." 2) "I should expect my child to be constantly active." 3) "Finger feeding is abnormal and indicates the need for intervention." 4) "A coloring book is a developmentally appropriate activity for my child."

3 1 Vision has reached maturity by 6 years of age. 2 A 6-year-old, school-aged child is expected to be constantly active. 3 A 6-year-old child is closer to preschool than adolescence; therefore, some preschool behaviors are still expected. This statement indicates the need for further education. 4 A coloring book is developmentally appropriate for a 6-year-old child.

Which should the nurse encourage for a school-aged patient to enhance a sense of accomplishment? 1) Wearing makeup 2) Going on a date 3) Participating in sports activities 4) Gaining weight during the school year

3 1 Wearing makeup is more appropriate for the adolescent than for the school-aged patient. 2 Going on a date is more appropriate for the adolescent than for the school-aged patient. 3 Participation in sports activities enhances a sense of accomplishment for the school-aged patient. 4 Weight gain is anticipated for the school-aged patient each year; however, this does not enhance a sense of accomplishment.

Which behavior noted by the school-aged patient indicates the development of conservation? 1) Learning to spell 2) Becoming interested in collections 3) Developing a sense of cause and effect 4) Being able to classify objects according to mass

4 1 Although learning to spell is an expected behavior during this stage of development, this is not an example of conservation. 2 Although becoming interested in collections is an expected behavior during this stage of development, this is not an example of conservation. 3 Although developing a sense of cause and effect is an expected behavior during this stage of development, this is not an example of conservation. 4 Classification of objects according to mass is an example of conservation.

The nurse is providing care to a school-aged patient who is overweight. Which nursing action is appropriate to enhance the child's intake of a healthy diet? 1) Offering food as a reward for good grades 2) Encouraging the consumption of high-fat foods 3) Educating on the importance of soda consumption 4) Making fruits and vegetables available for daily snacks

4 1 Food should not be offered as a reward for good grades because this can encourage overeating. 2 Low-fat, not high-fat, foods should be encouraged. 3 Soda should be consumed in moderation or not at all because this is a source of sugar. 4 Fruits and vegetables should be encouraged as snacks for the school-aged patient.

Which type of relationship is most important to the school-aged child? 1) Same-sex peer relationship 2) Opposite-sex peer relationship 3) Same-sex parental relationship 4) Opposite-sex parental relationship

1 1 Same-sex peer relationships are most important for the school-aged child. 2 Same-sex, not opposite-sex, peer relationships are most important for the school-aged child. 3 Although the same-sex parental relationship is still important, the peer relationship is most important to the school-aged child. 4 Although the opposite-sex parental relationship is still important, the peer relationship is most important to the school-aged child.

Which information related to school-aged play should the nurse include in a teaching session for the parents of children in this stage of development? (Select all that apply.) 1) Team play 2) Card games 3) Parallel play 4) Board games 5) Club membership

1,2,4,5 1. This is correct. Team play is an appropriate topic to include in a teaching session regarding school-aged play. 2. This is correct. Card games are an appropriate topic to include in a teaching session regarding school-aged play. 3. This is incorrect. Parallel play is more appropriate for the toddler and young preschool-aged child, not the school-aged child. 4. This is correct. Board games are an appropriate topic to include in a teaching session regarding school-aged play. 5. This is correct. Club membership is an appropriate topic to include in a teaching session regarding school-aged play.

Which questions related to socialization should the nurse include when assisting with the assessment of a school-aged child who is new to the pediatric practice? (Select all that apply.) 1) "What grade are you currently attending?" 2) "At what age did your child cut the first tooth?" 3) "Do you have a best friend at your new school?" 4) "What was your child's approximate length at 1 year of age?" 5) "What was your child's approximate weight at 6 months and at 1, 2, and 5 years of age?"

1,3 1. This is correct. When assessing the school-aged patient's socialization, the nurse should ask which grade he or she is currently attending. 2. This is incorrect. Asking when a school-aged child cut the first tooth is not appropriate when assessing socialization. 3. This is correct. When assessing the school-aged patient's socialization, the nurse should ask if he or she has a best friend. 4. This is incorrect. Asking about the child's approximate length at 1 year of age is not appropriate when assessing socialization. 5. This is incorrect. Asking about the child's approximate weight throughout the stages of development is not appropriate when assessing socialization.

According to Piaget, which data does the nurse expect for a school-aged child during the nursing assessment process? (Select all that apply.) 1) Classifying objects 2) Understanding reversibility 3) Having theoretical thoughts 4) Describing a process without actually doing it 5) Believing personal actions are constantly being scrutinized

1,2,4 1. This is correct. According to Piaget, classifying objects is expected for the school-aged child. 2. This is correct. According to Piaget, understanding reversibility is expected for the school-aged child. 3. This is incorrect. Having theoretical thoughts is not anticipated for the school-aged child. 4. This is correct. According to Piaget, describing a process without actually doing it is expected for the school-aged child. 5. This is incorrect. Believing that personal actions are constantly being scrutinized is not anticipated for the school-aged child.

Which psychosocial concern should the nurse monitor for when providing care to a school-aged child who is diagnosed with pediculosis? 1) Itching of the scalp 2) Feeling dirty 3) Applying medication appropriately 4) Educating the family on prevention

2 1 Itching of the scalp is a physiological, not a psychosocial, concern associated with pediculosis. 2 A school-aged child who is diagnosed with pediculosis may have several psychosocial concerns including feeling very bad, dirty, and sad. These are often due to teasing by other children with whom the patient is in contact. 3 Application of the medication is a physiological, not a psychosocial, concern associated with pediculosis. 4 Education related to prevention is a physiological, not a psychosocial, concern associated with pediculosis.

The mother of a school-aged patient says, "My daughter appears much thinner than she did a few years ago. Should I be worried?" Which response by the nurse is most appropriate? 1) "Does your child vomit after meals?" 2) "How many meals does your child eat each day?" 3) "It is important that we monitor your concern closely with frequent visits." 4) "Body fat diminishes and distribution changes during this stage of development."

4 1 There is no indication that the patient is experiencing bulimia nervosa, which would necessitate this question. 2 Although the nurse should determine how many meals the patient eats per day, this is not the most appropriate response by the nurse given the situation. 3 A school-aged patient who appears thinner than a few years prior is not an abnormal finding necessitating close monitoring. 4 Body fat diminishes and distribution changes during the school-aged stage of development; therefore, this is the most appropriate response by the nurse.

The nurse is conducting a growth and development assessment and must calculate the body mass index (BMI) of a pediatric client. The child's weight is 33 lb and 4 oz. The child's height is 37 and 5/8 in. tall. What is the child's BMI? 1) 14.5 2) 15.5 3) 16.5 4) 17.5

3 1 14.5 is not the BMI obtained when using the equation for this patient's height and weight. 2 15.5 is not the BMI obtained when using the equation for this patient's height and weight. 3 This child's BMI is 16.5 using the following equation: [(33.25 lb ÷ 37.625 in.) ÷ 37.625 in.] 703 = 16.5. 4 17.5 is not the BMI obtained when using the equation for this patient's height and weight.


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