ch. 28

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."(p.1021-2023,1134)

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?

"Be sure to get the proper size bike." (p.1019-1020)

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?

"Bullying can have lifelong effects on the self-esteem of a child." (p.1026-1027)

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." (p.985)

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?

"Girls typically experience a rapid growth spurt before boys." (p.1009)

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?

"How well does your son communicate or follow instructions?" (p.1012)

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." (p.1008)

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?" (p.1022)

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?

"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?" (p.1013)

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." (p.1023)

A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed?

"My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." (p.1020)

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." (p.1008)

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." (p.1022)

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." (p.1011-1012)

The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond?

"Remind her in simple terms what will happen in the dentist's office." (p.1013)

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." (p.1023)

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." (p.1023)

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?

"This may be normal growth of lymphatic tissue for this age." (p.1009)

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 11 to 12 hours of sleep per night with some quiet time after school." (p.1023)

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?

- "I am 6 years old and I walk my younger brother to the park that is 5 blocks from our house." - "I think it is funny to hide behind my dad's car before he leaves for work and scare him." - My friends and I like to walk on the side of the road because our sidewalk is very uneven." (p.1018-1019)

What activities would a nurse recommend to the families of school-aged children to promote attainment of Erikson's developmental stage of industry vs. inferiority?

- Allowing the child to assist her teacher in straightening up the classroom - Participating on the school soccer team - Praising the child for their academic efforts (p.1009)

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?

- Recommend the child investigate opportunities for volunteering at local charities. - Recommend the child begin to participate in after-school activities. - Encourage the child to develop new skills. (p.1011)

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 (p.1010)

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 bestbe suited for a child in this age group?

A paint-by-numbers activity creating a picture (p.1026)

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 (p.1009)

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?

Assess the situation with the help of the school staff and parents. (p.1016)

An 8-year-old male 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 49.5 in (124 cm) (p.1008)

What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child?

Fish, spinach salad and a glass of milk (p.1022)

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 (p.1025)

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?

Make time each day to spend with the child individually. (p.1023)

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 (p.1023)

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 (p.1025)

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. (p.1009)

An 11-year-old child is preparing to see the dentist to have his teeth cleaned. Which finding would considered most appropriate for this age?

The child has 28 permanent teeth. (p.1009)

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. (p.1021)

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?

conservation (p.1010)

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 (p.1014)

A group of 10-year-old girls have formed a "girls only" club. It is only open to girls who still like to play with dolls. How should this behavior be interpreted?

appropriate social development (p.1017)

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 (p.1010)

The nurse is preparing a care plan for a school-age child to address her hospitalization. Which factor should the nurse incorporate into this plan?

increased attention span and interest in an activity for a long length of time (p.1018)

The developmental task of the school-aged period, according to Erikson, is gaining a sense of

industry versus inferiority. (p.1009)

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 (p.1008)