PrepU: Chapter 18 - Care of the School-Age Child

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?"

The nurse is conducting a health history for a 9-year-old child with stomach pains. What is a recommended guideline when approaching the child for information?

Allow the child to control the pace and order of the health history.

A mother calls the 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 providing anticipatory guidance to a parent of an 8-year-old girl whose weight is 65 lb (29.5 kg) and height is 50.5 in (128.3 cm). Which statement by the parent demonstrates the need for further teaching?

"Based on my child's weight and height, I should be concerned my child is overweight."

After teaching the parents of a 9-year-old child about safety, which statement indicates the need for additional teaching?

"Our child can ride in the front seat of the car once reaching 10 years of age."

When planning activities for school-age children, the nurse organizes games that include competition. At which age are these kinds of games preferred by children?

10 years old

The school nurse is teaching parents about the effects of bullying on school children. What accurately describes this developmental concern?

Both boys and girls are bullied; boys usually bully boys and use force more often.

Brad is 8 years old and comes to the doctor with a cough. The diagnosis of pertussis is suspected because of what symptom?

Brad has a high-pitched inspiratory cough.

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?

Classification

The nurse wishes to use a distraction technique when administering an injection to an anxious child. Which technique would be best for the nurse to implement?

Have the child blow bubbles.

The nurse providing anticipatory guidance to a group of parents with children in primary school understands the need for further education when which statement is made by one of the parents?

I should encourage my child to participate in 60 minutes of exercise at least 3 times per week.

The nurse is discussing healthy eating habits with a school-age child and her parents. Which recommendation would the nurse make for the family?

Light snacks should be offered so the child doesn't overeat at meals.

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?

Needs 10 to 12 hours of sleep per night

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

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?

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

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.

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?

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

The nurse has determined that an 8-year-old girl is at risk for being overweight. Which intervention would be a priority prior to developing the care plan?

Interviewing the parents about their eating habits

The mother of a 9-year-old female voices concern to the nurse about her daughter developing breasts "at such a young age." How should the nurse respond?

"I understand your concern, but girls typically enter puberty around the age of 9 or 10."

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?

"I will grow an average of 2.5 in (6.5 cm) per year."

The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma?

"I'm going to have this hospital worker take a picture of your lungs."

A child awaiting a blood draw procedure states, "I am so nervous and really do not want to have this done." Which response by the nurse is best?

"Imagine that you are swimming in a cool, shady pool where nothing can harm you."

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?

"My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health."

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 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."

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."

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."

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

An overly tired school-aged child enters the school clinic. The nurse asks the child to state the times he/she usually goes to bed at night and wakes up in the morning. The child answers 11:00 PM and 6:00 AM. Which is the best response made by the nurse?

"That is not enough sleep. You should get at least 9 to 12 hours of sleep each night."

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 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."

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 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."

The nurse is performing a health history on a 6-year-old child who is having trouble adjusting to a new school. Which question will elicit valuable information?

"What are your new classmates like?"

The nurse is conducting a routine well-child evaluation for a family with five children. The parent seems frazzled, and the two oldest children are engrossed in their hand-held video games. The other three children—all preschoolers—are gathered around a portable DVD player watching a movie while they wait for their appointment. The nurse suspects that the children spend a great deal of time in front of electronic screens and that the nurse's values greatly differ from this family's. How should the nurse approach the issue of television exposure during this evaluation?

"Would you like a pamphlet telling how TV watching affects children's health?"

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?

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

The parents of a 7-year-old tell the nurse that they are concerned that their child has attention deficit hyperactivity 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.

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

A 12-year-old girl is experiencing prepubescence, and tells the school nurse that she feels "very out of place" in her school. What would be acceptable responses by the nurse? Select all that apply.

- "It must be difficult for you. Why don't you sit down and we can talk about it." - "Tell me how this makes you feel. Talking about your feelings may help you feel better about school."

The parents of a first grader ask the nurse for guidance in helping to promote success for their child in school and with his homework. Which suggestion would the nurse provide to help the parents meet that goal? Select all that apply.

- "Provide assistance but avoid doing the homework for your child." - "Try setting up a specific time for homework to be done." - "Be sure that the area for homework is quiet and without distractions."

What teaching points would a nurse provide for families of school-aged children to help prevent substance abuse? Select all that apply.

- Set firm rules regarding alcohol and other drug usage and discuss consequences associated with breaking the rules. - Encourage decision-making and discuss family values. - Give the child "what if" examples to situations they may face.

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.

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

After assessing a 10-year-old girl, the nurse documents the appearance of breast buds, identifying this as what body change?

thelarche

The mother and her 8-year-old daughter come to the clinic for a well-child visit. The mother asks the nurse, "About how much sleep should my daughter be getting?" The nurse responds by saying:

10-12 hours.

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

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?

A sense of competence, mastery, and worth

The nurse is collecting data on a 9-year-old child being admitted to the pediatric unit. What is the most appropriate way to gather information from the child's caregiver?

Ask the caregiver questions and document the answers.

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 activities that will increase his physical activity.

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?

Ensure that the child brushes his teeth after each meal and snacks.

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?

Industry

While straightening the top drawer of a 10-year-old client the nurse finds 48 packets of sugar. What should the nurse do at this time?

Place the sugar packets in the drawer as they were found.

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 can think critically to interpret messages seen in advertising, media, and sports.

The nurse is caring for an 8-year-old girl who is hospitalized. To promote acievement of the child's developmental task, which activity would the nurse encourage?

Sewing a pillow that can be completed in one afternoon.

The nurse is conducting family teaching with the caregivers of school-age children on various topics. Which of the following statements is most accurate?

The child should have fluoride applied to his or her teeth at least twice a year.

The nurse caring for a hospitalized 8-year-old child recognizes that the child has developed an understanding of reversibility. Which of the following relates to the development of this understanding?

The child understands that their illness is probably only temporary.

The nurse is instructing a parent on administering ear drops to a 6-year-old. Which parental action demonstrates an understanding of teaching?

The parent has the child sit down and pulls the pinna upward and back

The nurse is assessing a 6-year-old child. The nurse instructs the child, "Let me see all of your pretty white teeth." Which cranial nerve is the nurse assessing?

VII

A 7-year-old seen in the clinic for a routine well-child visit is noted on assessment to have gained 5 lb (2.26 kg) and grown 5 in (12.70 cm) over the past year. The nurse determines this child is within which parameters?

Weight is within expected range and height is above expected range.

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?

a sense of security as children gain independence

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?

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

The Boy Scouts is an organization that continues to be a favorite with school-aged boys because:

merit badges require completing small tasks for rewards.

The nurse is caring for a 6-year-old child with burns on both hands. When assessing this child's pain, which technique would be most appropriate for the nurse to use?

obtaining a self-report

The nurse is monitoring a playgroup of children on the pediatric unit. The nurse predicts the school-age child will most likely be participating in which activity?

painting pictures in the art corner of the room

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

The nurse is assessing a 9-year-old girl during her well-child checkup and notes the child weighs 86 lb (39 kg). After noting she weighed 9.5 lb (4.30 kg) at birth and her growth has been within normal patterns, the nurse determines this girl is within which category?

slightly overweight