Chapter 22 VIDE (ADHD)

The school nurse has asked a group of 8-year-old children to write a sentence about what they have learned from the class regarding bicycle safety. Which statement indicates the need for further teaching in the children? "Always keep as close to the curb as possible." "Always ride with traffic and towards parked cars." "Stay in a single file when riding bikes with friends." "Walk bikes across busy streets only at crosswalks."

"Always ride with traffic and towards parked cars."

A, C, D Feedback: Children with autism display little eye contact with and make few facial expressions toward others; they use limited gestures to communicate. They have limited capacity to relate to peers or parents. They lack spontaneous enjoyment, express no moods or emotional affect, and cannot engage in play or make-believe with toys. There is little intelligible speech. These children engage in stereotyped motor behaviors such as hand flapping, body twisting, or head banging.

1. The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply. A) The child displays little eye contact with others. B) The child thrives on changes in routine. C) The child makes few facial expressions toward others. D) The child does not like repetition. E) The child answers questions verbally.

B Feedback: Parents feel empowered and relieved to have specific strategies that can help them and their child be more successful. Including parents in planning and providing care for the child with ADHD is important. The nurse must listen to the parents' feelings. The education of a child with ADHD is important, but the child is only in school for part of their day. The parents must deal with the child and the other aspects of the child's life at all times.

19. Which one of the following statements about educating parents of a child with ADHD is true? A) It is unimportant to educate the family members about ADHD as they already know the problem too well. B) Parents feel empowered and relieved to have specific strategies that can help them and their child be more successful. C) It is important for the nurse to spend the majority of his or her time with parents of children with ADHD in talking to the parents. D) If the child receives special school services under the Individuals with Disabilities Education Act, there is no need for further services.

B Feedback: Working with parents is a crucial aspect of dealing with children with these disorders. Parents often have the most influence on how these children learn to cope with their disorders. The nurse can teach parents age-appropriate activities and expectations for clients.

24. The nurse understands that when working with a child with a mental health problem, the family must be included in the care. Which is one of the best ways the nurse can advocate for the child? A) Support transferring the child to a healthy living environment. B) Teach the parents age-appropriate expectations of the child. C) Reinforce the parents' expectations of the child's behavior. D) Interpret the child's thoughts and feelings to the parent.

A Feedback: By the time the child starts school, symptoms of ADHD begin to interfere significantly with behavior and performance. He or she cannot listen to directions or complete tasks. The child interrupts and blurts out answers before questions are completed. Academic performance suffers because the child makes hurried, careless mistakes in schoolwork, often loses or forgets homework assignments, and fails to follow directions. Socially, peers may ostracize or even ridicule the child for his or her behavior. The child often loses necessary things.

3. A parent is concerned that his child might suffer from attention deficit hyperactivity disorder (ADHD). Which of the following behaviors reported by the parent would be consistent with this diagnosis? A) The child interrupts others. B) The child has been hoarding objects. C) The child has lots of friends. D) The child is excelling academically in school.

B, D, E Feedback: ADHD is characterized by inattentiveness, overactivity, and impulsiveness. Encopresis is the repeated passage of feces into inappropriate places such as clothing or the floor by a child who is at least 4 years of age either chronologically or developmentally. Enuresis is the repeated voiding of urine during the day or at night into clothing or bed by a child at least 5 years of age either chronologically or developmentally. Encopresis and enuresis are elimination disorders that are unrelated to ADHD.

4. Which of the following symptoms are characteristic of ADHD? Select all that apply. A) Enuresis B) Inattentiveness C) Encopresis D) Overactivity E) Impulsiveness

A, B, D, E Feedback: Approximately 70% to 75% of adults with ADHD have at least one coexisting psychiatric diagnosis, with social phobia, bipolar disorder, major depression, and alcohol dependence being the most common.

5. Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply. A) Social phobia B) Bipolar disorder C) Obsessive-compulsive disorder D) Major depression E) Alcohol dependence

D Feedback: Echolalia is repeating the last heard sound, word, or phrase. Stereotypic movement disorders include waving, rocking, twirling objects, biting fingernails, handing the head, biting or hitting oneself, or picking at the skin or body orifices. Selective mutism is characterized by persistent failure to speak in social situations where speaking is expected.

6. A nurse asks an assigned client, "How are you doing today?" The client responds with "doing today, doing today, doing today." Which speech pattern disturbance is this an example of? A) Reactive attachment disorder B) Stereotypic movement disorder C) Selective mutism D) Echolalia

B Feedback: Palilalia is the repeating of one's own words or sounds. Coprolalia is the use of socially unacceptable words, which are frequently obscene. Echolalia is the repeating of the last heard sound, word, or phrase.

7. Which of the following terms describes the repeating of one's own words or sounds? A) Coprolalia B) Palilalia C) Echolalia D) None of the above

During an assessment, the nurse finds that a child is depressed, frightened, and has low grades in school. By which age-group do children usually worry about school grades? 5 and 6 years of age 6 and 7 years of age 7 and 8 years of age 8 and 9 years of age

8 and 9 years of age

A Feedback: Phonologic disorder involves problems with articulation. Mixed receptive-expressive language disorder includes problems of expressive language disorder along with difficulty understanding and determining the meaning of words and sentences. Expressive language disorder involves an impaired ability to communicate through verbal and sign language. Stuttering is a disturbance of the normal fluency and time patterning of speech.

8. Which of the following disorders involves problems with forming sounds associated with speech? A) Phonologic disorder B) Mixed receptive-expressive language disorder C) Expressive language disorder D) Stuttering

The nurse is teaching the importance of dental health to a group of parents in the community. Which points does the nurse emphasize in order to prevent dental caries in children? Do not let the child have too much sleep Decrease excessive fat intake in the diet Demonstrate how to correctly brush their teeth Teach children how to correctly floss their teeth Reduce the intake of fermentable carbohydrates

Demonstrate how to correctly brush their teeth Teach children how to correctly floss their teeth Reduce the intake of fermentable carbohydrates

The nurse is assessing a child who is taking tricyclic antidepressants. The nurse advises the child to decrease the intake of refined carbohydrates in the diet. What side effect of the drug is the nurse trying to prevent? Dental caries Increased appetite Impaired glucose levels Weight gain and obesity

Dental caries

Parents of a 12-year-old child inform the nurse that their child prefers spending more time with friends rather than with family members. What should the nurse inform the child's parents? "During this age, children do not like social gatherings." "During this age, children avoid interacting with others." "During this age, children enjoy the company of their peers." "During this age, children are more focused on their studies."

During this age, children enjoy the company of their peers."

The school nurse is discussing dental health with some children in first grade. What should the nurse include in the discussion? Teach how to floss teeth properly Recommend a toothbrush with hard nylon bristles Emphasize the importance of brushing before bedtime Recommend nonfluoridated toothpaste approved by the American Dental Association

Emphasize the importance of brushing before bedtime

During an assessment of a late school-age child, the nurse advises the parents to seek immediate orthodontic treatment for the child. What condition does the nurse find in the child? Bleeding gums Some teeth discoloration Improperly arranged teeth Development of several cavities

Improperly arranged teeth

At the beginning of the school year, the school nurse identifies several new children at the school. The nurse knows that which factors place the children at high risk for adjustment problems? The child is from a middle class family. The child appears physically immature. The child exhibits signs of emotional immaturity. The child has not attended a preschool program. The parents of a child demonstrate warm, loving behaviors.

The child appears physically immature. The child exhibits signs of emotional immaturity. The child has not attended a preschool program.

The nurse teaches progressive relaxation of muscle groups to a 12-year-old child. Which sign of stress is the nurse likely to find in the child? Calmness Enthusiasm Bradycardia Facial redness

facial redness

A parent expresses to the nurse that the parents delayed sending their child to school because the child did not want to leave home. What information should the nurse give to the parent to improve the child's adaptability to school? "Provide special care and a lot of attention to the child at home after school." "Let the child be at home until the child feels comfortable attending the school." "Enroll the child as well as the child's best friend in the school at the same time." "I know it is hard to see your child mature, but you need to let your child go to school."

"I know it is hard to see your child mature, but you need to let your child go to school."

Parents reports to the nurse that their 12-year-old child resists going to bed at night. Which advice does the nurse give to the parents to help the child go to bed on time? "Promote daytime naps on a daily basis." "Promote reading a book before bedtime." "Urge video game playing before bedtime." "Allow the child to go to bed at a later time."

"Promote reading a book before bedtime."

B Feedback: Giving stimulants during daytime hours usually effectively combats insomnia. Eating a good breakfast with the morning dose and substantial nutritious snacks late in the day and at bedtime helps the child to maintain an adequate dietary intake. Daytime napping for a child with ADHD is unrealistic and not developmentally necessary.

10. A child with ADHD complains to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice? A) Give the child his medicine at night. B) Have the child eat a good breakfast and snacks late in the day and at bedtime. C) Limit the number of calories the child eats each day. D) Let the child take daytime naps.

A Feedback: Before beginning any task, adults must gain the child's full attention. The adult should tell the child what needs to be done and break the task into smaller steps if necessary. This approach prevents overwhelming the child and provides the opportunity for feedback about each set of problems he or she completes.

11. The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child? A) Break tasks into small steps. B) Let the child complete tasks at his own pace. C) Offer rewards when all tasks are completed. D) Set a time limit to complete all tasks.

The nurse is assessing a healthy 8-year-old child. The nurse notices that the child's height is 130 cm (51 inches). What was the child's approximate height in centimeters at 7 years of age? Record your answer using a whole number.

125 cm

The nurse plans to use tasks based on the concept of conservation to assess the cognitive development of a 5-year-old child. What is the appropriate method used by the nurse? Asking the child to differentiate the weight of two similar things Asking the child to determine the area occupied by two objects Asking the child to compare two differently sized glasses of water Asking the child to find the volume occupied by three or more objects

Asking the child to compare two differently sized glasses of water

The nurse is teaching a community health-promotion class to parents and school-age children related to bicycle safety. Issues to cover in the sessions include what? Bicycles should be walked through busy intersections. Bicycle helmets need to be worn only if the child is planning to ride in traffic. Reflectors should be installed only on bicycles that are to be ridden at night. Bicycles should be ridden against the traffic so that the rider can see the car

Bicycles should be walked through busy intersections.

The school nurse is asked to speak with the parents of a 10-year-old boy who has been bullying other children. On what should the nurse's response be based? - Bullying at this age is considered normal. - Children who bully others usually join gangs. - Children who bully others usually have low self-esteem. - Bullies often have difficulties developing and maintaining relationships.

Bullies often have difficulties developing and maintaining relationships.

The parents tell the nurse that their child experiences dizziness during the school day. The child does not have this symptom during weekends. The nurse assesses the child and asks the parents to observe the child for symptoms over the holidays. What does the nurse suspect the child to have? Sleep disorder Learning disability Impulsive disorder Fear about school

Fear about school

A parent phones the nurse and says that her child just knocked out a permanent tooth. What should the nurse's instructions to the parent include? Rinsing the tooth in hot water Taking the child and tooth to a dentist within 48 hours Holding the tooth by the crown and not by the root area Taking the child to the hospital emergency room if mouth is bleeding

Holding the tooth by the crown and not by the root area

A, C, D, E Feedback: During assessment, the nurse gathers information through direct observation and from the child's parents, day care providers (if any), and teachers. Assessing the child in a group of peers is likely to yield useful information because the child's behavior may be subdued or different in a focused one-to-one interaction with the nurse. Reviewing the client's record will not yield much assessment data.

12. Which of the following would be important circumstances to gather assessment data for a child with ADHD? Select all that apply. A) Direct observation of the child B) Reviewing the client's record C) Interviewing the client's parents D) Interviewing the client's teachers E) Assessing the client in a group of peers

B Feedback: Safety of the child and others is always a priority. The other nursing interventions are appropriate for a child with ADHD, but the priority is safety.

13. Which one of the following nursing interventions should take priority for a child with ADHD? A) Structured daily routine B) Ensuring the child's safety and that of others C) Simplifying instructions and directions D) Improved role performance

B Feedback: If the child is engaged in a potentially dangerous activity, the first step is to stop the behavior. Attempting to talk to or reason with a child engaged in a dangerous activity is unlikely to succeed because his or her ability to pay attention and to listen is limited.

14. An 8-year-old with attention deficit hyperactivity disorder is jumping off the bed onto a chair. Which should be the nurse's first step? A) "I need to talk to you." B) "Stop that right now." C) "You are going to hurt yourself." D) "Why are you jumping off the bed?"

B Feedback: Parents find themselves chronically exhausted mentally and physically. Parents need support and reassurance, and making a statement about the difficulties of handling the child at home validates the mother's feelings. It is not appropriate to say, "Your son is a cute child, but he needs to calm down." It may make the parents defensive to say, "You need to take a firmer approach with your son." "Your son sure is active" is not a therapeutic response.

15. The mother of a 6-year-old boy with attention deficit hyperactivity disorder asks to speak to the nurse about her son's disruptive behavior. The nurse would be most therapeutic by saying which of the following? A) "Your son is a cute child, but he needs to calm down." B) "It must be difficult to handle your son at home." C) "You need to take a firmer approach with your son." D) "Your son sure is active."

A Feedback: Ritalin has a short half-life, so doses are needed about every 4 hours during the day to maintain symptom control. Giving stimulants during daytime hours usually effectively combats insomnia.

16. A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 AM, which behavior might the school nurse expect to see at noon? A) Increased impulsivity or hyperactive behavior B) Lack of appetite for lunch C) Sleepiness or drowsiness D) Social isolation from peers

D Feedback: Autistic traits persist into adulthood, and most people with autism remain dependent to some degree on others. Manifestations vary from little speech and poor daily living skills throughout life to adequate social skills that allow relatively independent functioning. Social skills rarely improve enough to permit marriage and child rearing.

17. The parents of an autistic child ask the nurse, "Will my child ever be normal?" Which would be the most appropriate response by the nurse? A) "You seem worried about your child's future." B) "Autistic children can fully recover with the right treatment and education." C) "Your child should outgrow autistic traits by adolescence." D) "Your child will probably always have some autistic traits."

A, C, E Feedback: Educating parents and helping them with parenting strategies are crucial components of effective treatment of ADHD. Effective approaches include providing consistent rewards and consequences for behavior, offering consistent praise, using time-out, and giving verbal reprimands. Additional strategies are issuing daily report cards for behavior and using point systems for positive and negative behavior.

18. The parents of a child with ADHD express to the nurse, "We get so frustrated when our son never minds us." Which parenting strategies should the nurse discuss with the parents? Select all that apply. A) Use time-out for behavior control. B) Provide occasional rewards and consequences for behavior. C) Give verbal reprimands for negative behavior. D) Resist giving praise until fully compliant with requests. E) Use a point system for positive and negative behavior.

C Feedback: The National Institute of Child Health and Human Development, Centers for Disease control (CDC) and the Academy of Pediatrics have all conducted research studies for several years and have concluded that there is no relationship between vaccines and autism and that the MMR vaccine is safe.

2. A mother expresses concern to the nurse that the child's regularly scheduled vaccines may not be safe. The mother states that she has heard reports that they cause autism. The most appropriate response by the nurse is, A) "It is recommended that you wait until the child is older to vaccinate." B) "There are safer alternative immunizations available now." C) "There has been no research to establish a relationship between vaccines and autism." D) "The risks do not outweigh the benefits of immunization against childhood diseases."

B, C, D Feedback: Although medication can help reduce hyperactivity and inattention and allow the child to focus during school, it is by no means a cure-all. The child needs strategies and practice to improve social skills and academic performance. Because these children are often not diagnosed until the second or third grade, they may have missed much basic learning for reading and math. Parents should know that it takes time for them to catch up with other children of the same age. Most of these children have low self-esteem because they have been labeled as having behavior problems and have been corrected continually by parents and teachers for not listening, not paying attention, and misbehaving. Parents must understand how to help rebuild their child's self-esteem. Parents should give positive comments as much as possible to encourage the child and acknowledge his or her strengths. One technique to help parents to achieve a good balance is to ask them to count the number of times they praise or criticize their child each day for several days. ADHD is not the fault of the parents or the child, and that techniques and school programs are available to help. Children with ADHD do qualify for special school services under the Individuals with Disabilities Education Act.

20. A nurse is providing education to a group of parents who have children with ADHD. Which of the following statements would be accurate and should be included in the education? Select all that apply. A) Medication alone will adequately treat children with ADHD. B) It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem. C) Because raising a child with ADHD can be frustrating and exhausting, it often helps parents to attend support groups that can provide information and encouragement from other parents with the same problems. D) ADHD is not the fault of the parents or the child, and that techniques and school programs are available to help. E) Children with ADHD do not qualify for special school services under the Individuals with Disabilities Education Act.

A Feedback: The child with ADHD cannot accomplish complex tasks, such as homework, in a noisy or chaotic setting where there are a lot of distractions. The other choices do not indicate the need for further teaching.

21. When teaching the parents of a child with attention deficit hyperactivity disorder (ADHD), which statement by the parents would indicate the need for further teaching? A) "We'll have him do his homework at the kitchen table with his brothers and sisters." B) "We'll make sure he completes one task before going on to another." C) "We'll set up rules with specific times for eating, sleeping, and playing." D) "We'll use simple, clear directions and instructions."

D Feedback: Stimulant medications used to treat ADHD can suppress appetite, and the child may lose or fail to gain weight properly. The client is too young to manage his medications independently. Ritalin should be given in divided doses. Ritalin reduces hyperactivity, impulsivity, and mood lability and helps the child to pay attention more appropriately.

22. Which statement would indicate that medication teaching for the parents of a 6-year-old child with attention deficit hyperactivity disorder (ADHD) has been effective? A) "We'll teach him the proper way to take the medication, so he can manage it independently." B) "We'll be sure he takes Ritalin at the same time every day, just before bedtime." C) "We're so glad that Ritalin will eliminate the problems of ADHD." D) "We'll be sure to record his weight on a weekly basis."

A Feedback: The behaviors described by the mother are typical in terms of growth and development for a 15-year-old. The other choices are not found to give valid information to the mother regarding increased adolescent independence.

23. The mother of a 15-year-old boy tells the nurse that her son is becoming more assertive in conflict situations and wants to get a job. She asks if it is healthy for a 15-year-old to be so independent. Which is valid information for the nurse to offer the mother? A) His behaviors reflect normal growth and development. B) He is overly independent. C) It sounds like he is trying to avoid her. D) She should observe for signs of substance abuse.

The nurse is assessing a child during a checkup and notes the child has all permanent teeth and is a healthy weight for his age. What would be the approximate weight of the child? 16 to 26.3 kg (35.5 to 58 pounds) 17.7 to 30 kg (39 to 66.5 pounds) 19.5 to 39.5 kg (43 to 87 pounds) 24.5 to 58 kg (54 to 128 pounds)

24.5 to 58 kg (54 to 128 pounds)

A Feedback: It is much more difficult to diagnose psychiatric disorders in children and adolescents. Many of the same psychiatric disorders that affect adults also occur in children and adolescents, but because psychiatric disorders in children are difficult to diagnose, they do not manifest themselves very quickly.

25. For which reason is it crucial for nurses to advocate for children and adolescents regarding psychiatric disorders? A) It is much more difficult to diagnose psychiatric disorders in children and adolescents. B) It is not necessary because psychiatric disorders do not occur in children and adolescents. C) Children and adolescents experience some of the same mental health problems as adults. D) Psychiatric disorders in children manifest themselves very quickly.

A, B, C Feedback: Psychiatric disorders are not diagnosed as easily in children as they are in adults. Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening. Because they are constantly changing and developing, children have limited sense of a stable, normal self to allow them to discriminate unusual or unwanted symptoms from normal feelings and sensations. Additionally, behaviors that are normal in a child of one age may indicate problems in a child of another age. Sometimes the manifestations of psychiatric disorders in adults are less of a problem than they were for the child at a younger age, but this does not make it more difficult to diagnose psychiatric disorders in children than in adults. Children and adolescents experience some of the same mental health problems as adults and are diagnosed using the same criteria as for adults, but this does not make it more difficult for children to be diagnosed.

26. For which reasons is it more difficult to diagnose psychiatric disorders in children than in adults? Select all that apply. A) Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening. B) Because they are constantly changing and developing, children are unable to discriminate unusual or unwanted symptoms from normal feelings and sensations. C) Behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level. D) Sometimes, children "outgrow" psychiatric disorders. E) Children and adolescents experience some of the same mental health problems as adults and are diagnosed using the same criteria as for adults.

C Feedback: The nurse's beliefs and values about raising children affect how he or she deals with children and parents. The nurse must not be overly critical about how parents handle their children's problems until the situation is fully understood: Caring for a child as a nurse is very different from being responsible around the clock. The parents likely have other obstacles to carrying out effective discipline. Teaching again is not likely to effect change. Given their own skills and problems, parents often give their best efforts. Given the opportunity, resources, support, and education, many parents can improve their parenting. It is premature to refer to family therapy or remove the child from the home. Emotional barriers to effective parenting should be explored first.

27. The nurse has been working with the family of a small child with a psychiatric disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best action for the nurse at this time? A) Review effective disciplinary practices with the parents again. B) Refer the parents to a family therapist. C) Try to remember that the parents are trying to the best of their ability to carry out the suggestions. D) Explore alternative living arrangements for the child.

C Feedback: Working with children and adolescents can be both rewarding and difficult. Many disorders of childhood such as severe developmental disorders severely limit the child's abilities. It may be difficult for the nurse to remain positive with the child and parents when the prognosis for improvement is poor. Even in overwhelming and depressing situations, the nurse has an opportunity to positively influence children and adolescents, who are still in crucial phases of development. The nurse often can help these clients to develop coping mechanisms they will use through adulthood. It is important to remember to focus on the client's and parents' strengths and assets, not just their problems.

28. When the prognosis of improvement in a child with psychiatric disorders is poor, what can the nurse do to positively influence children and adolescents and their parents? A) Continue to remind the child and parents that the prognosis for improvement is very poor. B) Encourage the parents to believe that the child will recover spontaneously. C) Assist the child and the parents to develop coping mechanisms. D) Focus on their problems instead of their strengths and assets.

D Feedback: Pharmacologic treatment with antipsychotics, such as haloperidol (Haldol) or risperidone (Risperdal), may be effective for specific target symptoms such as temper tantrums, aggressiveness, self-injury, hyperactivity, and stereotyped behaviors.

9. A parent of a child with autism spectrum disorder asks the nurse if there is anything that can be done to control the child's tantrums. Which option should the nurse inform the parents that may be appropriate? A) Give the child rewards for resisting tantrums. B) Reason with the child why tantrums are not effective. C) Place the child in a time-out when tantrums occur. D) Explore the use of antipsychotic medications to control tantrums.

The nurse plans to use tasks based on the concept of conservation to assess the cognitive development of a 5-year-old child. What is the appropriate method used by the nurse? Asking the child to differentiate the weight of two similar things Asking the child to determine the area occupied by two objects Asking the child to compare two differently sized glasses of water Asking the child to find the volume occupied by three or more objects

Asking the child to compare two differently sized glasses of water

The community nurse is educating a group of parents about sleep and rest requirements of school-age children. What information does the nurse provide? Children 5 years of age need approximately 11 hours of sleep a night. Children 6 years of age should be encouraged to read before bed time. Children 7 years of age should be encouraged to read before bed time. Children 12 years of age need approximately 6 hours of sleep per night. School-aged children need to have 1- to 2- hour long good naps per day.

Children 5 years of age need approximately 11 hours of sleep a night. Children 6 years of age should be encouraged to read before bed time. Children 7 years of age should be encouraged to read before bed time.

The nurse should teach volunteers in the after-school program that which characteristic is most descriptive of the social development of school-age children? Identification with peers is minimal. Children frequently have "best friends." Peer approval is not yet an influence toward conformity. Boys and girls play equally well with children of either gender.

Children frequently have "best friends."

What information should the nurse include when giving parents guidelines about helping their children in school? Punish children who fail to perform adequately Help children as much as possible with their homework Accept responsibility for children's successes and failures Communicate with teachers if there appears to be a problem

Communicate with teachers if there appears to be a problem

What do nursing interventions to promote health during middle childhood include? Stressing the need for increased calorie intake to meet increased demands Instructing parents to defer questions about sex until the child reaches adolescence Advising parents that the child will need decreasing amounts of rest toward the end of this period Educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt

Educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt

The school teacher speaks with the school nurse about a child who has improper conduct and tends to be aggressive with younger children. The school nurse observes that the child also influences the behavior of others in the group. What is the most appropriate nursing approach for the child's behavior? Suggest the child undergo behavioral therapy Use corporal punishment to discipline the child Advise the child to participate in safety training Encourage the child to join an antibullying program

Encourage the child to join an antibullying program

The school nurse knows that which attribute is characteristic of the psychosocial development of school-age children? Peer approval is not yet a motivating power. A developing sense of initiative is very important. Motivation comes from extrinsic rather than intrinsic sources. Feelings of inferiority or lack of worth can be derived from children themselves or from the environment.

Feelings of inferiority or lack of worth can be derived from children themselves or from the environment.

A 6-year-old child with attention deficit hyperactivity disorder (ADHD) is brought to the hospital with reports of weight loss and loss of appetite. The child has been on the psychostimulant methylphenidate (Ritalin) for the past few months. The child has shown improvement in school since taking the medication. What is the most appropriate instruction given to the parents? "Give the medication with a meal." "Stop the medication immediately." "Give a nutritious snack in morning." "Reduce the dose of the medication."

Give the medication with a meal."

The nurse is assessing the concept of conservation in a group of children 7 years of age. The nurse pours 200 mL water in a small glass, 200 mL water in a big glass, and 100 mL water in a tea cup. The capacities of the small glass (s), big glass (B), and tea cup (t) are 250 mL, 500 mL, and 100 mL respectively. A 7-year-old child is asked to choose the glass with more water. Which glass or glasses would the child choose if the child understands the concept of conservation? Glass B Glass s Glass B and s Glass t and s

Glass B and s

A parent tells the nurse, "I am worried about my 13-year-old son. He hasn't started puberty, and my daughter did when she was 11 years of age." The nurse should explain to this parent that this is what? Unusual and requires further evaluation of the son Unusual because the onset of pubescence is usually the same in siblings Normal because the onset of pubescence is usually earlier in girls than it is in boys Abnormal because the onset of pubescence is usually earlier in boys than it is in girls

Normal because the onset of pubescence is usually earlier in girls than it is in boys

The nurse is teaching a student nurse about the growth and development in school-age children. The nurse states that there are few prominent changes that can be found in the school-age child as compared to a preschooler. Which statement should the nurse include in the teaching? Permanent teeth appear too large for the face. Excess fat deposition provides a bulky appearance. Head circumference decreases in relation to height. Leg length increases in relation to the child's height. Calorie needs are smaller due to low physical activity.

Permanent teeth appear too large for the face. Head circumference decreases in relation to height. Leg length increases in relation to the child's height.

The nurse is assessing a child for attention deficit hyperactivity disorder (ADHD). The nurse rates the child's characteristics as eight symptoms of hyperactivity-impulsivity and three symptoms of inattention. What type of ADHD does the child have? The predominantly inattentive type Predominantly hyperactive-impulsive Signs of a cognitive learning disability Symptoms of a combined type of ADHD

Predominantly hyperactive-impulsive

The school nurse is assessing a child who is taking psychostimulants. The child is instructed to approach the nurse for the medication soon after lunch. What is the most appropriate reason for giving this instruction to the child? It can cause slow human growth. Psychostimulants reduce the appetite. This type of medication helps prevent sleepiness. Food intake reduces psychostimulant drug efficacy.

Psychostimulants reduce the appetite.

A parent of a 7-year-old girl reports that the girl spends most of her time alone at home. The girl does not like to play with boys and needs help with eating at the dining table. The girl copies the shape of a diamond correctly when asked to do so by the nurse. What is the most appropriate step taken next by the nurse? - Refer the girl to a pediatrician - Refer the girl to a psychiatrist - Reexamine her after observation - Reassure the parent that she is fine

Reassure the parent that she is fine

A teacher asks a school nurse what sports should be included in the curriculum for school-aged children. What is the nurse's response? Girls should only compete with girls when they are preadolescents. Sports activities should include both practice sessions and unstructured play. The actual sporting event should aim to stress the point of winning the game. Common sports for school-aged children include baseball, soccer, and swimming. All participants should be recognized in special ceremonies, not just the winners.

Sports activities should include both practice sessions and unstructured play. . Common sports for school-aged children include baseball, soccer, and swimming. All participants should be recognized in special ceremonies, not just the winners.

The parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. The nurse's suggestions regarding participation in sports at this age should include what? Organized sports such as soccer are not appropriate at this age. Competition is detrimental to the establishment of a positive self-image. Sports participation is encouraged if the sport is appropriate to the child's abilities. Girls should compete only against girls because at this age boys are larger and have more muscle mass.

Sports participation is encouraged if the sport is appropriate to the child's abilities.

During an assessment, the nurse notices that a school-age child is under stress. What signs of stress in the child warrant further investigation? Sucking their thumb Red and flushed face Trouble concentrating Slightly increased heart rate Jittery and flustered behavior

Sucking their thumb Trouble concentrating

The nurse is assessing a child who can count backward from 20 to 1. Based on the child's age, what concepts of conservation is the child able to determine? The child can determine the permanence of an object's mass and volume. The child can select the one face from a chart that is different from the rest. The child can determine that the length is the same if objects placed differently. The child can count marbles placed in different rows and decide whether they are equal.

The child can determine the permanence of an object's mass and volume.

The nurse is working with the parents of an 8-year-old child and discovers that the child has bedtime problems. The nurse instructs the parents to encourage a quiet activity before bedtime. Why does the nurse recommend this intervention? The child often wets the bed. The child snores during sleep. The child does not go to sleep. The child talks in his or her sleep.

The child does not go to sleep.

The nurse is assessing the oral cavity of a child. The nurse instructs the child to floss the teeth regularly and use a fluoride toothpaste for brushing. Why did the nurse give this instruction to the child? The child had a reimplanted tooth. The child had a dental injury from sports. The child had bleeding gums with plaque. The child had an eruption of a permanent tooth.

The child had bleeding gums with plaque.

Parents report to the school nurse that their child is hesitant to play with other kids in school. During the assessment, the nurse instructs the parents to avoid giving high-calorie foods to their child. What condition is the nurse helping the parents control? The child has gained too much weight. The child watches too much television. The child spends a lot of time sleeping. The child received low grades in school.

The child has gained too much weight.

A 10-year-old boy reports vomiting, diarrhea, and stomach pain for the past couple of days. The child does not go to school because of these symptoms. However, the child is usually healthy on weekends and whenever allowed to stay at home. On examination the nurse finds that the child's temperature is mildly elevated. What does the nurse inform the parents? The child needs to be put on antibiotic treatment for a high temperature. The child should be allowed to stay at home for as long as the child wants. The child most likely has gastroenteritis and needs admission into a hospital. The child has school phobia, which is the likely reason for the child's presentation.

The child has school phobia, which is the likely reason for the child's presentation.

The nurse advises a working single parent to enroll his or her child in an after-school program. What could be the reason behind the nurse's advice? The child may be lonely and fearful. The child fails to have snacks available. The child has a developmental disorder. The child prefers to spend time outdoors.

The child may be lonely and fearful.

The nurse observes that a child is fidgety, restless, and easily distracted. What does the nurse interpret from these symptoms? The child has many of the signs and symptoms of dysgraphia. The child demonstrates characteristics of conversion reaction. The child exhibits signs of posttraumatic stress disorder (PTSD). The child may have attention deficit hyperactivity disorder (ADHD).

The child may have attention deficit hyperactivity disorder (ADHD).

A 9-year-old child is put on tricyclic antidepressants for attention deficit hyperactivity disorder (ADHD). How does the nurse advise the parents of this child? The child should be advised to limit physical exercise. The child should have a dental checkup done regularly. The child should be encouraged to have plenty of oral fluids. The child should have limited intake of refined carbohydrates. The child should be referred to a cardiologist at the earliest date possible.

The child should have a dental checkup done regularly. The child should be encouraged to have plenty of oral fluids. The child should have limited intake of refined carbohydrates.

Following an assessment, the nurse concludes that the child has a learning disability. Which activities of the child support the conclusion? The child runs useful errands. The child shows trouble listening. The child takes part in group play. The child has difficulty in speaking. The child demonstrates stubborn behavior.

The child shows trouble listening. The child has difficulty in speaking.

The nurse is assessing the oral cavity of a child who is approximately 7 to 8 years of age. The nurse notices that the lateral incisor in the mandible and central incisor in the maxilla have already been lost. Which teeth would erupt when the child is about 11 to 12 years old? The first molar in both the maxilla and in the mandible The third molar in both the maxilla and in the mandible The second bicuspid in both the maxilla and the mandible The second bicuspid in the mandible and the cuspid in the maxilla

The second bicuspid in the mandible and the cuspid in the maxilla

The nurse is giving information about latchkey children to a group of nursing students. What information does the nurse include in the session? A majority of these children develop paranoid schizophrenia when they grow older. These are children who have chronic illnesses and are left alone to care for themselves. These are children who are left to care for themselves unsupervised before or after school. These children may use hiding or playing television at a loud volume to cope with their own fears. These children are more likely to feel lonely and isolated than those who have someone to care for them.

These are children who are left to care for themselves unsupervised before or after school. These children may use hiding or playing television at a loud volume to cope with their own fears. These children are more likely to feel lonely and isolated than those who have someone to care for them.

Parents of a 10-year-old child are concerned that their child recently has been showing signs of low self-esteem. What should the nurse consider when discussing this issue with the parents? Changing self-esteem is difficult after about 5 years old. Self-esteem is the objective judgment of one's worthiness. Transitory periods of lowered self-esteem are expected developmentally. High self-esteem develops when parents show adequate love for the child.

Transitory periods of lowered self-esteem are expected developmentally.

The school nurse is called to attend to a 7-year-old child whose tooth is avulsed while playing. The nurse finds the avulsed tooth on the ground. What is the most appropriate step taken by the nurse? Transport the child immediately to a dentist for further care Hold the tooth by its root and rinse it in running water to wash off dirt Dispose of the tooth and apply a dressing on the wound to prevent infection Insert the tooth back into the socket with the concave surface facing front towards the lip side

Transport the child immediately to a dentist for further care

The nurse is assessing a child who has frequent headaches. The nurse teaches breathing exercises to the child to help relieve the headaches. What condition in the child is the nurse trying to treat? Stress Asthma Influenza Meningitis

stress