Peds Ch 6
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? 1 vacuuming 2 putting books on shelf 3 raking leaves 4 folding clothes
2 School age children need rewards for their accomplishments. Small chores which can be completed quickly give this type of reward. Children can survey their finished work and see they have done a good job. Picking up toys or putting books on the shelf offers a reward because children can clearly see the result of their work. NOT 1 Vacuuming is a chore children do not necessarily like because once finished the rug looks the same before they started. There is no reward for the process. 3 Raking leaves serves as only a temporary reward because even though the child can see the result of the leaves in a pile the leaves still need to be bagged or disposed. 4 Folding clothes also offers small reward because for many 6-year-olds larger pieces of clothing can be too cumbersome to fold correctly and they are not rewarded as the clothes still need to be put away.
A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to: 1 keep her child home until this fear passes. 2 make her child attend school every day. 3 allow her child to decide daily if she wants to go to school or not. 4 ask the teacher to decide if the child should come to school or not each day
2 School phobia may result from both a parent not wanting a child to attend school and a child not wanting to leave a parent. Th nurse's role is to help them work together while keeping the child in school to resolve the issue
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? 1 "Your child doesn't seem to be overweight, so it isn't a concern." 2 "We see most children of this age in our clinic gaining similar amounts." 3 "Normal growth and development for this age results in an average weight gain of 7 pounds per year." 4 "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain."
3 Children of school-age grow an average of 2.5 inches (6 to 7 centimeters) per year and gain an average of 7 pounds per year; therefore, the 10 pounds over 2 years is normal and it is important for the parents to know this, regardless if they are not overweight. NOT 2 Simply comparing them to other children seen in the clinic doesn't mean it is a normal expectation. 1.4. While activity is important, the nurse must first address the parent's concern.
The parents of a 10-year-old child report they are having problems with their child. The child's parent reports the child is not a talented athlete but the spouse continues to encourage the child to play and try to excel. The spouse reports sports will help the child build character. What response by the nurse is most appropriate? 1 "It is important not to let your child quit without trying." 2 "Although your child is not a talented athlete, continue to encourage the child to try." 3 "Perhaps another pursuit would be better suited for your child." 4 "Encouraging involvement in sports can build valuable skills for a child."
3 Children should be encouraged to try new things but, when they are faced with things they are not good at, the pressures can ultimately be counterproductive if they feel they are disappointing their parents or others of importance to them.
A parent calls the health care provider about the 7-year-old child's dental hygiene. The child has had three cavities. The parent does not know what to do and asks the nurse for guidance. How should the nurse respond? 1 "Did you teach your child how to brush the teeth?" 2 "What type of toothbrush does your child use?" 3 "Are you able to supervise your child's brushing?" 4 "Is there fluoride toothpaste available for use?"
3 Dental caries is the leading chronic disease in the United States. Children need help with toothbrushing until they are between 7 and 10 years of age. The parent should monitor the toothbrushing to make sure it is thorough, observe for any abnormal tooth alignment, and schedule cleanings every 6 months. Children tend to concentrate on the front teeth, because they can see them easily and "forget" the teeth in the back. Parental oversight is needed to be sure those teeth are brushed carefully.
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? 1 Industry 2 Perfectionism 3 Accommodation 4 Conservation
1 During the early school years, children attempt to master their new developmental step: learning a sense of industry or accomplishment. The boy's desire to apply the band-aid "the right way" is a hallmark of the development of industry. The other answers are not as pertinent. NOT 3 Accommodation is the ability to adapt thought processes to fit what is perceived, such as understanding there can be more than one reason for other people's actions. 4 Conservation is the ability to appreciate that a change in shape does not necessarily mean a change in size. 2 Perfectionism is the desire to do something perfectly.
The parent of an 11-year-old child is worried that the child spends too much time watching TV. What information should the nurse share with this parent? (Select all that apply.) 1 Watch programs together and discuss subject matter with the child. 2 The American Academy of Pediatrics recommends 2 hours or less of TV daily. 3 Establish guidelines on when a child can watch TV. 4 Limit TV time by using it as a reward. 5 Use video games that are more active to offset sedentary TV viewing.
1 The parents should watch TV with the child and use the opportunity to discuss the subject matter with the child. 2 The American Academy of Pediatrics recommendation is correct. 3 The parents should establish guidelines on when the child can watch TV, such as after chores are completed. NOT 4 Using TV as a reward elevates its importance and may not decrease viewing time. 5 Certain TV programs and video games have merit, yet both represent screen time with little activity difference between the two.
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? 1 Needs 10 to 12 hours of sleep per night 2 Should brush their teeth at bedtime 3 Have a routine physical exam every 6 months 4 Be screened for scoliosis once a year
1 The school-aged child needs 10 to 12 hours of sleep per night. NOT 2 They need to brush their teeth after every meal and at bedtime. 3 A routine physical exam once a year is all that is necessary. 4 Children are screened around the age of 10 or 11 for scoliosis.
An 11-year-old child is continually late for the bus, resulting in asking if it's okay to stay home that day from school. The parents ask the school nurse for advice on what they should do. What is the best response by the nurse? 1 "Could both of you and your child come in for a conference so we can discuss this situation?" 2 "I am sure he has school phobia. We will need to speak with the school counselor." 3 "Is there anything happening at home that is making him want to stay there instead of school?" 4 "It is best if you make him get on the bus whether he is ready or not in order to let him know you are in control."
1 While the child is demonstrating a sign of school phobia, it is not possible to determine this without talking with the child and the parents. Forcing him to get on the bus does not address the situation
1. A 6- to 8-year-old child needs ... 2. The 8- to 10-year-old child needs ... The 10- to 12-year-old child needs ...
1. 12 hours of sleep per night. 2. 10 to 12 hours of sleep per night. 3. between 9 and 10 hours of sleep per night.
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? 1 "There are not many physical differences among school age boys." 2 "I will appear heavier due to an increase in fat production." 3 "I will grow an average of 2.5 in (6.5 cm) per year." 4 "I will have improved gross motor skills."
3 During the school-age years, the child will grow an average of 2.5 in (6.5 cm). NOT 1 As puberty approaches, there will be significant differences in development between boys and girls. 2 As development occurs, weight does increase, but it is not directly related to fat production. This is an area where much education needs to occur with young girls because "dieting" can be detrimental to the child's health and increased size is tied to the child's body image and self-esteem. 4 By 10 years of age, brain growth is complete, and fine motor coordination is refined.
The nurse is discussing nutrition choices with a group of parents of 10- to 12-year-old children. The nurse determines that the discussion was successful based on which statements by a parent? (Select all that apply.) 1 "It's convenient that my 8-year-old and 12-year-old children need to consume the same amount of calories, because they're both active." 2 "We will make sure that our child consumes at least 900 mg of calcium through various sources." 3 "The highest percentage of my child's diet should come from carbohydrates." 4 "My 12-year-old child, who plays soccer, needs to consume around 2,000 calories a day to maintain good health." 5 "Meats, poultry, and fish are good sources of calcium for my child."
3 For this age group 45% to 65% of calories should come from carbohydrates. 4 Boys 9 to 13 years old who are moderately active need about 1,800 to 2,200 calories a day. NOT 2 Children 9- to 13-years-old need 1,300 mg of calcium for maintenance of growth and good nutrition. 1 Boys and girls 4 to 8 years old who are moderately active will need about 1,400 to 1,600 calories a day, and girls 9 to 13 years old who are moderately active need about 1,600 to 2,000 calories a day. 5 Milk, yogurt, and cheese provide protein, vitamins, and minerals and are excellent sources of calcium.
The nurse is caring for a 9-year-old child who is being seen for a well-child care visit. During the visit, the child's parent reports the child is one of the shorter children in class. The parent asks how much more the child will grow in the next few years. Which response by the nurse is most appropriate? 1 "Your child will likely remain one of the shorter children in class." 2 "It is hard to tell at this point." 3 "Your child should grow approximately 10 in (25 cm) over the next 4 years." 4 "Children in this age range can expect to grow about 1 in (2.5 cm) per year until they are about 15 years old."
3 From 6 to 12 years of age, children grow an average of 2.5 in (6 to 7 cm) per year, increasing their height by at least 1 ft (30.5 cm). NOT 1.2. Declaring the child will likely remain short or that the amount of growth is unknown does not answer the question posed by the child's parent. 4 The child's growth will be more than 1 in (2.5 cm) per year if the child maintains normal growth patterns for the age group.
The nursing students working with a group of 8-year-olds have determined they will illustrate the concept of conservation of weight. Which activity would best help these children grasp this concept? 1 weighing and measuring each child and comparing the number of pounds to the number of inches for each person 2 using a balance scale to weigh a variety of objects and counting how many pennies must be used to balance the scales 3 weighing a pound of oranges and a pound of bricks and counting how many of each make a pound 4 measuring the weight of a handful of popcorn and then the weight of a handful of pennies
3 In learning about conservation of weight, the child recognizes that a pound is a pound, regardless of whether oranges or bricks are weighed. NOT 1.2.4. Comparing pounds and inches, noting the number of pennies needed to balance the weight of objects, and measuring the weight of handfuls of popcorn and pennies does not illustrate conservation of weight.
During a well-child visit, an 11-year-old child reports to the nurse looking different from friends who are wearing bras. What is an appropriate response? 1 "Remember the methods you have been taught to manage peer pressure." 2 "It is common for children your age to worry about being different." 3 "It is normal for there to be differences in the time and rate children your age develop." 4 "You are doing well in school. Be happy with this success."
3 Letting the child know that differences are normal and that development occurs at different times and rates among children the child's age is reassuring. NOT 4 Focusing on strengths is positive but talks around the child's concern. 2 Telling the child that the worry is common minimizes the child's report and provides no information. 1 Concern about breast development does not equate to peer pressure
The nurse is presenting information about school-aged children at a community event. Which statement from the group should the nurse prioritize to address with further teaching and more information? 1 "Sometimes we have to be firm, but our children wash their hands before eating." 2 "I make sure they have good teeth by giving them calcium and phosphorus." 3 "Food is so expensive, we always make our children eat everything on their plates." 4 "Even if the weather is cool and cloudy, our children play outside every day."
3 Obesity can be an issue in the school-aged child, especially if they are urged to clean their plates even if they have more food than they want or need on the plate. The parents should be encouraged to use smaller plates for the children so they will still appear to have a full plate but smaller portions. 1 Firm guidance and direction is important with the school-aged child. 2 Calcium and phosphorus are important to healthy teeth. 4 Exercise each day is important, especially outdoor exercise.
The nurse is providing information to the parents of a 6-year-old child who has been caught lying at home and at school. Which would the nurse share with the parents? (Select all that apply.) 1 Suggest reading a story with the child about the consequences of lying. 2 Recommend the use of immediate and firm punishment. 3 Explain that children this age typically lie to avoid punishment. 4 Notify the healthcare provider to check for underlying problems. 5 Indicate that the child is probably lying to impress friends.
3 Parents need to know that lying is common at this age and that it is usually done to avoid punishment. 1 Reading the story would address the unacceptable behavior and reinforce the value of reading. NOT 2 Immediate and firm punishment precludes a calm, measured approach to the issue and may damage self-worth. 5 An older child between 8 and 12 years is more likely to lie to impress friends. 4 If lying persists in older school-age children, parents should discuss the matter with the healthcare provider because the lying may be evidence of underlying problems
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? 1 poor peer relationships 2 encouragement for bullying and sexism 3 appropriate social development 4 immaturity for this age group
3 Ten-year-olds take the values of their peer group seriously. They are interested in being with peers of like mind and activities. Clubs are formed with specific exclusions of peers. Such clubs typically have a secret password and secret meeting place. Membership is generally all girls or all boys. NOT 4.2. These groups are not based on the immaturity of the children nor do they encourage sexism and bullying.
The mother of a 10-year-old daughter is concerned that her child is becoming overweight. Her weight plots in the 95th percentile in the growth chart. Which action would the nurse recommend to the mother to address her concerns? 1 Place the child on a diet, eliminating all sweets and snacks. 2 Remind the child daily that she needs to watch what she eats. 3 Offer to go walking every day after school with her for 30 minutes. 4 Limit daily fat intake to 40% of the total calories for the day.
3 The parent can best assist the child in weight reduction by encouraging physical activity and by offering to participate in the exercise with the daughter. It allows private family time for the two of them. NOT 1.2. Nagging each day about food intake or placing the child on a strict diet does not help the child lose weight and may encourage rebellion. 4 Fat intake is not to exceed 35% of the total calories each day.
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? 1 "I was afraid of the dark at your age. You will grow out of that fear soon." 2 "That is so horrible that you are afraid of the dark. Can you sleep at night at all?" 3 "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?" 4 "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?"
3 The school-age child needs reassurance that his or her fears are normal for this developmental age. Parents, teachers, and other caretakers should discuss the fears and answer questions posed by the child. However, the adult should not embellish the fear in any way. In addition, telling the child that she will "grow out of it" is not reassuring to the child.
The nurse is talking with a school-aged child about interests. In which interest do most school-aged children place the most focus? 1 Pets 2 Family 3 School 4 Church
3 The school-age child typically values school attendance and school activities. During school-age, the focus expands from family to teachers, peers, and other outside influences
A nurse is assisting with a seat belt clinic at a local community center. Which parents should the nurse speak with after inspecting their seat belt use? (Select all that apply.) 1 The parents of a 12-year-old who still uses child-proof locks in the back seats 2 The parents of a 8-year-old who check to see if the lap belt portion of the seat belt is lying low on the hips 3 The parents of a 10-year-old whose child is sitting in the front seat with the seat belt properly fastened 4 The parents of a 6-year-old who has the shoulder belt behind the back due to the strap lying across the face 5 The parents who ask their 9-year-old child to fasten the seat belt before starting the car
3. Children under 12 years of age should sit in the back seat of the vehicle. 4. Shoulder belts should not be behind the child; the shoulder belt should lie on the shoulder, not the neck or face. If the child is too short for the belt to lie on the shoulder, a booster seat or belt clip should be used.
The nurse is caring for a 7-year-old child who will be in the hospital for several weeks. Which action by the nurse will facilitate the child's psychosocial development? 1 Allow the child's peers to visit often. 2 Ask the child what color gown he or she prefers to wear daily. 3 Quickly come to the room while the child presses the call bell. 4 Encourage the child to complete school work and provide guidance.
4 At this age, Erikson states the child's stage of psychosocial development is industry versus inferiority. To meet this stage, children need to develop a sense of pride and accomplishment for their schoolwork, sports, activities, or social life, or they will feel inferior. The nurse can encourage the child to complete his or her schoolwork and assist the child as needed to help facilitate this stage. NOT 1 An adolescent needs peer interaction. 2 Selecting what to wear facilitates autonomy, a stage for children 2 to 3 years of age. 3 Quickly responding to the call bell facilitates trust, a stage for neonates through their first year.
When considering the psychosocial development of a school-aged child, which is the primary developmental task? 1 Establishing trust in friends outside the home family unit 2 Reflecting on recent activities of accomplishment 3 Planning for future events 4 Establishing a social network
4 Erikson (1963) describes the task of the school-age years as industry versus inferiority. During this period, the child is developing his or her sense of self-worth by becoming involved in multiple activities at home, at school, and in the community, which develops his or her cognitive and social skills.
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? 1 Discuss with the child's teacher to determine if the number of absences has effected academic performance 2 Ask the child if he really has had respiratory infections during these absences 3 Continue to monitor the child's absences 4 Speak with the parents about the unusual increased number of respiratory infections
4 In the school-age child the respiratory system continues to mature with the development of the lungs and alveoli, resulting in fewer respiratory infections. Because the child is absent excessively for respiratory infections the nurse should speak with the parents to aid in determining if there is an underlying cause, or suggest the child visits the pediatrician to discuss the issue
After watching a news broadcast of a school shooting, a child begins experiencing nightmares and bed wetting. How can the nurse instruct the parents to help their child feel safe? Select all that apply. 1 Only allow one viewing of a news broadcast. 2 Continue to provide assurance of safety. 3 Have the child sleep in the same room as the parents. 4 Allow children to watch news broadcast only in parent's presence. 5 Schedule an appointment with the counselor.
1.2. Children basically view the world as safe, so it is a shock when violence occurs. Common recommendations for parents to help their children feel safe include: assure the child that they are safe, observe for signs of stress, and prevent the child from viewing footage of traumatic events over and over. 4 Parents should watch news programs with children so it can be explained that the situation portrayed is not near them and that their child is safe. NOT 3 The child may need to sleep in the room or in bed with the parents, but that is an individual family decision. 5 Counseling would be necessary only if the child's fears and stress levels continue to increase after continual reassurance.
A 12-year-old child tells the school nurse about not understanding why the parents don't allow the child to go to concerts without chaperones like some of the friends' parents. "I feel like a baby compared to my friends." How should the nurse respond? 1 "Your parents are right. Twelve years old is too young to be attending concerts without a chaperone." 2 "You are so young that you have plenty of time to go to concerts alone. Your parents just care about you." 3 "I'm sure your parents are just very worried that you could get into trouble attending concerts at a young age." 4 "Have you given any thought to why they don't let you go without a chaperone? Let's talk about some of the reasons they feel this way."
4 Keeping dialogue open with the child and encouraging exploration of feelings is beneficial. This therapeutic communication will allow the child to identify reasons without being told why the parents have this rule. Peer pressure can be difficult for children to manage. Helping them identify reasons for the parents' actions can help. Telling the child how to feel or that the parents only care doesn't allow conversation.
The nurse is teaching parents of an 11-year-old child how to deal with the issue of peer pressure regarding the use of tobacco and alcohol. Which suggestion by the nurse provides the best course of action for the parents? 1 Avoid smoking in the house or in front of the child. 2 Keep any alcohol products in the home in a locked cabinet. 3 Encourage the child to avoid having friends who smoke or drink. 4 Discuss tobacco and alcohol use and effects with the child.
4 Parents are major influences on school-age children and should discuss the dangers of tobacco and alcohol use with the child. NOT 1.2. Not smoking in the house and hiding alcohol send mixed messages to the child. 3 Open and honest discussion is the best approach rather than discouraging the child from making friends with kids that use tobacco or alcohol.
While observing a group of 9-year-old children at school the nurse is concerned that one of the children is not cognitively developing according the Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned? 1 Believed that not turning in homework on time was acceptable, but has since decided it is not acceptable 2 Enjoys math instruction and decides to join the math club 3 Arrives to class late from recess and apologizes to the teacher 4 The child does not understand the phrase "slow as molasses" when used by the teacher
4 Piaget's stage of cognitive development for the 7- to 11-year-old is the period of concrete-operational thoughts. In developing concrete operations, the child is able to assimilate and coordinate information about his or her world from different dimensions. Abstract thinking, such as understanding the meaning of the phrase "slow as molasses" is expected at this stage of cognitive development.
During a well-child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group, the nurse understands that: 1 at this age, children are not afraid of death. 2 discussing death and dying may hint at a psychological disorder. 3 consistent thoughts of death and dying at this age lead to the later development of depression. 4 preoccupation with death and dying is common in the school-aged child.
4 School-aged children are often preoccupied with thoughts of death and dying. NOT 2.3. There is no indication these thoughts will lead to mental health issues or the development of depression. 1 School-aged children fear death but are fascinated by death and dying.
The nurse is educating the parents of a 10-year-old girl in ways to help their child avoid tobacco. Which suggestion should be part of the nurse's advice? 1 "Keep your cigarettes where she can't get to them." 2 "Always go outside when you have a cigarette." 3 "Tell her only losers smoke and chew tobacco." 4 "As parents, you need to be good role models."
4 The nurse would recommend that the parents be good role models and quit smoking. NOT 1.2.3. Locking up or hiding your cigarettes and going outside to smoke is not as effective as having a tobacco-free environment in the home
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. Children who are unsuccessful in completing activities during the school-age phase, whether from physical, social, or cognitive disadvantages, develop a feeling of inferiority.
In reference to physical growth, the differences between girls and boys are more apparent at the end of the preschool years and may become extreme and a source of emotional problems. T/F
False Rationale: The differences between girls and boys are more apparent at the end of the middle-school years and may become extreme and a source of emotional problems
A child between 6 to 8 years of age has enough coordination and balance to ride a bicycle. T/F
True Rationale: During the school-age years, coordination, balance, and rhythm improve, facilitating the opportunity to ride a two-wheel bike, jump rope, dance, and participate in a variety of other sports. School-age children between the ages of 6 and 8 enjoy gross motor activities such as bicycling, skating, and swimming
There is approximately 2 years difference in the onset of prepubescence between boys and girls. T/F
True Rationale: During preadolescence, prepubescence occurs. Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics, a period of rapid growth for girls, and a period of continued growth for boys. There is approximately 2 years difference in the onset of prepubescence between boys and girls
The first sign of puberty for girls is ...
breast changes, not menarche.
Many school-age children suffer from_____________, a condition in which the teeth are crowded, crooked, or misaligned.
malocclusion Rationale: Dental care with emphasis on prevention of caries is important in this age group. School-age children need to brush their teeth two to three times per day for 2 to 3 minutes each time with fluorinated toothpaste
When traveling by car, school age children should sit in the _____ seat
rear
The parents of a 12 year-old child voice concern to the nurse that their child wants to dress like peers and not the way they prefer. Which responses by the nurse are appropriate? (Select all that apply.) 1 "Peer acceptance is an important part of development for children, especially at this age. Maybe talking about it with your child lead to an agreement." 2 "Children at this age often want to connect with their peers. You should probably allow your child to dress like friends." 3 "If the way your child's friends are dressing is not against school dress code, is it worth it to argue about his clothes?" 4 "Have you spoken with your child about the concerns and about your concerns? Open dialogue often helps in resolving these issues." 5 "Peer pressure is hard enough for children of this age without pressure from their parents. You need to seek family counseling immediately."
1 It is important for late school-age children to feel accepted by peers. Lifelong effects can occur if they feel different and are teased. 4 Dialogue is always a good way to resolve conflict so suggesting the parents talk and listen to their child is acceptable guidance by the nurse. NOT 2 Telling the parent what they should do is not in the nurse's scope of practice. 5 The situation does not warrant immediate counseling. If further problems occur counseling is always a good option
The school nurse asks a group of school-age children about pedestrian safety. Which comments by the children should the nurse address with either the child or parents of the child? Select all that apply. 1 "I am 6 years old and I walk my younger brother to the park that is 5 blocks from our house." 2 "I always remind my sister to look right, then left, then right again before we cross the street." 3 My friends and I like to walk on the side of the road because our sidewalk is very uneven." 4 "My mom always says she looks around really well to be sure I'm not playing behind our car before she leaves." 5 "I think it is funny to hide behind my dad's car before he leaves for work and scare him."
1 Older children and adults should provide supervision of younger children, but 6 years old is not considered an older child, especially for 5 blocks of supervision of a younger sibling. 3 Children should always walk on sidewalks because cars may not see children walking in the streets or be distracted while driving. 5 Children should stay away from vehicles when a vehicle is about to be driven and definitely not behind a vehicle.
During an annual visit of a 6-year-old child, 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? 1 "These are only baby teeth so we are not worried." 2 "I see now we need to use a fluoride toothpaste for our child." 3 "I guess we will need to supervise our child while brushing." 4 "I guess we better look for a pediatric dentist for our child."
1 Parents need to understand the value of the primary teeth and not see them only as temporary and soon-to-be replaced. NOT 3.4. Referral to a pediatric dentist and parental supervision of tooth brushing both lead to dental health and may be better appreciated once parents understand the importance of the primary teeth. 2 Fluoride supplementation is not necessary if fluoride is part of the local water supply.
The nurse is preparing a care plan for a 7-year-old child on the pediatric unit newly diagnosed with asthma. One of the child's parents is employed as a family practice physician and the other as a lawyer. The child has two older siblings and two younger siblings. Which nursing diagnoses would apply to this situation? (Select all that apply.) 1 Risk for caregiver role strain 2 Risk for infection 3 Impaired mobility 4 Knowledge deficit regarding use of inhaler medication for asthma 5 Knowledge deficit regarding disease process
1 Regardless of their careers, the parents are at risk for caregiver role strain given the new diagnosis, having jobs, and having four other children. 2 Any chronic illness and hospitalization puts the child at risk for infection. 4.5. The disease is new so the child needs to learn about the disease and inhaler use according to developmental status. NOT 3 There is no indication that mobility is impaired.
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? 1 "My child sleeps between 11 and 12 hours a night." 2 "My child stays up late when she takes a nap after school." 3 "My child does not even know when he is tired." 4 "My teenage child does not sleep as much as my 9-year-old does."
1 Sleep for the school-age child varies with the age of the child. A child between the ages 6 to 8 years needs 12 hours of sleep each night. The child between the ages of 8 to 10 years needs 10 to 12 hours of sleep each night. The 10 to 12 year old needs 9 to 10 hours of sleep each night. NOT 2.3.4. Staying up late after taking an after-school nap, not knowing when the child is tired, and sleeping more than a teenager when compared with a school-age child refer to sleep behaviors and needs of children of younger and older ages
When considering the moral development of a 7-year-old child, which actions are most consistent with the anticipated state of development? 1 The child focuses on being a good girl or boy. 2 The child considers the impact of actions on others in his environment. 3 The child only gives consideration to how the actions will impact himself. 4 The child gears his actions to avoid doing the wrong thing and getting "into trouble".
1 The 7- to 10-year-old usually follows rules out of a sense of being a "good" person. He or she wants to be a good person to parents, friends, and teachers and to himself or herself. The adult is viewed as being right. This is stage 3: interpersonal conformity (good child, bad child), according to Kohlberg. NOT 3.4. Younger children focus on their actions on avoiding punishment and base actions on what is best for them. 2 Older children will give consideration to how their personal actions will impact others.
Parents of an 11-year-old child are bewildered that their child was caught stealing. Which reason for this behavior would the nurse suggest? 1 The child had a strong desire to own the item. 2 The child was attempting to escape punishment. 3 The child has not attained the ability to understand ownership and property rights. 4 This is one way for the child to increase self-esteem.
1 The nurse would point out that the desire to own the item may have overcome the sense of right and wrong. NOT 2 Lying, not stealing, is used to escape punishment. 4 Stealing is not a way to build self-esteem, although it may help the child gain a certain status among peers. 3 The lack of understanding of ownership and property rights are typical of children between 6 and 8 years
The nurse is assessing the moral developmental level of children being seen in the clinic according to the Kohlberg's conventional stage of moral development. Which children does the nurse determine have met this stage of development? (Select all that apply.) 1 The 10-year-old child who visits his elderly neighbor three times per week 2 The 10-year-old who states, "I sure wouldn't want to be my friend taking that bad report card home." 3 The 9-year-old child who tells his friends that they shouldn't throw rocks because they will "get in trouble" 4 The 8-year-old child who frequently asks the teacher if he is doing his math correctly 5 The 7-year-old child who yells at his parent, "I don't understand why I can't go to the park!"
1.2.3.4.5. In the conventional stage of moral development according to Kohlberg, the 7- to 10-year-old usually follows rules out of a sense of being a "good" person. He or she wants to be a good person to parents, friends, and teachers and to himself or herself. The adult is viewed as being right. The child believes an act is wrong only if it brings punishment, not because of the outcome of an act. The child in this phase also doesn't understand the reason behind rules, but can put self in another person's position.
The number of hours of sleep required for growth and development decreases with age. Children between the ages of 6 and 8 years require approximately ____ hours of sleep per night.__________________________
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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? 1 "Does your son speak in complete sentences all the time?" 2 "How well does your son communicate or follow instructions?" 3 "Is your son's speech clear enough that anyone can understand it?" 4 "Would you say your son has a vocabulary of about 900 words?"
2 Asking how well the boy communicates and follows instructions is the best trigger question because it is open-ended. NOT 1.3. Asking if the child uses complete sentences or speaks clearly will elicit a yes or no answer about only those specific areas of development. 4 The parents would have no way of judging the size of their child's vocabulary.
While treating a minor playground injury for an 8-year-old child, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action? 1 Determine if there have been other playground bullying incidents. 2 Assess the situation with the help of the school staff and parents. 3 Immediately call the bullied child's parents. 4 Question those responsible for the bullying.
2 Assessing the situation and following the school's bullying protocol will be an important first step. NOT 3 Immediately calling the bullied child's parents may be premature. 1.4. Questioning those responsible for the bullying and determining if there have been other playground incidents of bullying may be part of the overall assessment, but would not be the first action taken.
The nurse is talking with the parents of an 8-year-old child who has been cheating at school. Which comment by the nurse would be appropriate as a first step? 1 "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." 2 "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." 3 "Perhaps the academic environment is too easy for your child, causing the cheating." 4 "If cheating is noted at this age, referral to a family counselor is highly recommended."
2 Because they are role models for their children, parents must first realize the importance of their own behaviors. NOT 3 If the academic environment is too difficult, not too easy, the child may be cheating to keep up with the increased rigor. 1 Punishment should be geared toward discussion and helping the child understand the seriousness of cheating, and not be a subtle approach. 4 After a discussion with the child, a review of the child's academic situation (is the work too hard? Is tutoring needed?) and positive role-modeling is assured, then referral to a counselor would be indicated but not as the first step in the resolution.
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? 1 "Wow, that is a lot of stuff for a girl her age." 2 "Play helps children to develop cognitively, socially, physically, and emotionally." 3 "It is understandable not playing any more with all these other activities." 4 "All of these other activities teach you as much as traditional play."
2 It is important to recognize that the child is busy with other activities but that this does not replace the need to engage in play. Children need time to play because it helps them to develop cognitively, socially, physically, and emotionally. Play at this age embodies the needs for rules and structures. Engaging in group activities allows children to be part of a social group.
The school nurse is performing a vision screening for a 7-year-old child. Which finding should trigger a referral? 1 Peripheral vision similar to that of the school nurse 2 Slight misalignment of the eyes 3 Visual acuity of 20/20 in both eyes 4 Ability to color discriminate
2 Misalignment of the eyes (strabismus) interferes with vision and eye development. Amblyopia (vision loss) can result. Lack of alignment of the eyes needs referral and treatment. NOT 1.3.4. The rest represent normal visual findings in a 7-year-old.
The nurse is taking a health history for a 12-year-old child who is seriously overweight. Which general question would the nurse direct to the child's parents? 1 "How important is exercise?" 2 "Is there a family history of hypertension, heart disease, or diabetes?" 3 "Is breakfast eaten regularly?" 4 "What beverages are preferred?"
2 Parents would be more knowledgeable than the child regarding health problems within the family. NOT 1.3.4. The other questions are appropriate for the child to answer and may motivate him to think about meal patterns, diet, and exercise habits. The parents will benefit from listening to these questions also since their habits influence the child.
There is approximately 2 years difference in the onset of prepubescence between boys and girls. T/F
T
