Peds Chapter 19

What is the best suggestion by the nurse for an appropriate toy for a hospitalized 6-year-old boy? a. Handheld video game b. MP3 player c. Adventure book d. Jigsaw puzzle

ANS: A The 6-year-old child can perform numerous feats that require muscle coordination. At this age, the handheld video game will offer competition without overexertion.

A 9-year-old boy is often cranky and irritable, and his school performance has declined. What is the most probable factor causing this behavior? a. He sleeps only 6 to 7 hours a night. b. He eats eggs every day. c. He has a new dog. d. He plays about 1 to 3 hours each evening.

ANS: A The 9-year-old child requires about 10 hours of sleep per night.

The nurse advises the parents of a 6-year-old child to try and ensure at least ______ hours of sleep daily for the child.

ANS: 11 The 6-year-old school-age child needs at least 11 hours of sleep.

The nurse is aware that by the age of _____, the first permanent teeth erupt.

ANS: 6 At the age of 6, the first permanent teeth erupt: the 6-year molars.

The school nurse is preserving a tooth that was knocked out on the school playground. What will the nurse be especially careful to do? a. Wrap the tooth loosely in a clean cloth. b. Rinse the tooth with alcohol. c. Handle the tooth only by the crown. d. Place the tooth in a warm environment.

ANS: C When a permanent tooth is avulsed, the tooth should be picked up by the crown to prevent any further damage to the root and placed in milk until the child can be examined by a dentist.

A parent confides in the school nurse that her 8-year-old twins argue and bicker constantly. What is the best response by the nurse? a. Express alarm at the constant aggression. b. Voice concern and investigate referral for counseling. c. Inquire about what punitive action the parents have taken to stop it. d. Offer reassurance that such behavior is normal for 8-year-olds.

ANS: D Argumentative and competitive behavior is normal in 8-year-olds.

The school nurse is planning sex education classes for school-age children. What should the nurse be sure to do? a. Use simple terms. b. Avoid slang or "street" words and concepts. c. Keep topics on biological aspects of sexual development. d. Limit questions to keep content clear.

ANS: A Using simple terms is essential but slang and street terms need to be clarified. Apply age-specific information across broad aspects of biological, social, and current attitudes.

The nurse is assessing a school-age child. What will the nurse expect in regard to physical development of this child? a. Growth of 3 to 6 inches per year b. Gain of 5 to 7 pounds per year c. Increase of head circumference by 1 inch per year d. A visual acuity of 20/20 by 9 years of age

ANS: B During the school-age period, the average weight gain per year is generally 5.5 to 7 pounds.

The nurse is advising parents of a 10-year-old boy about the most developmentally supportive experiences for their son. What is the best experience for this child according to Erikson's theory? a. Constant variety of activities b. Successful performance in Little League c. Feeling healthy and strong d. Having a girlfriend

ANS: B The child who is successful in activities will feel positively about himself or herself.

What should the nurse keep in mind when planning to teach a class on nutrition to fourth-grade students? a. School-age children can concentrate on only one aspect of a situation. b. School-age children can think abstractly. c. School-age children are egocentric in their thinking. d. School-age children think logically and concretely.

ANS: D Piaget refers to the thought process of this period as concrete operations, which involves logical thinking and an understanding of cause and effect.

What type of relationships are the preferred social interactions for the school-age child? a. Heterosexual interest groups b. Association with one "best friend" c. Rigidly organized groups with complex rules d. Same-sex peer groups

ANS: D The preferred social interaction of the school-age child is in same-sex peer groups or cliques.

A school-age child becomes frustrated with a school assignment and says, "I can't do this!" What is the most developmentally supportive response from the parent? a. Ask, "What is it that is so difficult?" b. Allow the child to quit the effort. c. Call in older siblings to help. d. Finish the project for them.

ANS: A Helping the child focus on the problem that is keeping him from mastery can limit frustration. Quitting or having someone else finish is detrimental to the development of industry.

A mother reports that she has a new job and her 12-year-old child is home alone for a time after school. Which statement made by the parent alerts the nurse to a potentially unsafe situation for this child? a. "I told him that he could invite a few friends after school." b. "I put a list of emergency numbers next to the telephone." c. "Last week we made a first aid kit together." d. "There is a neighbor available in case of an emergency."

ANS: A Latchkey children are subject to a higher rate of accidents. Permitting school-age children and their friends to be home alone in an unsupervised environment is an unsafe situation.

When asked about her activities, a 10-year-old girl responded, "I like school. I play the flute in the school band, and I take tennis lessons." What does the nurse know these activities will help this child develop? a. Initiative b. Industry c. Identity d. Intimacy

ANS: B The school-age period is referred to by Erikson as the stage of industry. Successful participation in activities facilitates the child's sense of industry.

The pediatric nurse is presenting school-age children with information on safety issues to follow when going home alone. What guidelines should they be educated to follow? (Select all that apply.) a. Ask for identification before letting someone in the house. b. Never accept rides with strangers. c. Keep doors locked. d. Do not enter house if door is ajar. e. Walk to and from school with friends.

ANS: B, C, D, E Strangers should never be allowed in the house. Children should be instructed never to accept rides with strangers, to keep doors locked, not to enter the house if the door is ajar, and to walk to and from school with friends.

A 10-year-old child with disabilities is begging her parents for a dog. When at the pediatric clinic, the parents inquire about possible benefits pet ownership may provide to their child. What benefits of pet ownership should the nurse indicate? (Select all that apply.) a. Decrease the need for physical therapy b. Lower blood pressure c. Improve communication d. Foster trust e. Ease path to socialization

ANS: B, C, D, E Studies have documented the positive influence of pet ownership on improving the medical and psychological outcome after illness or surgery. Disabled children especially benefit from interacting with pets. The interaction with animals can lower blood pressure and heart rate, reduce loneliness and feelings of isolation, improve communication, foster trust, and motivate participation in physical therapy. Pets allow the ill child who feels separated from other people to feel companionship and acceptance. Shy children often find pet ownership eases the path to socialization with others who initiate contact because of the pet.

Parents ask the pediatric nurse how school life might influence their growing child. What area of development will the nurse indicate that school affects the least? a. Moral development b. Social development c. Physical development d. Cognitive development

ANS: C Physical development is the least affected by school life. Moral development occurs as they have experience with, and understand, rules and fairness in the school setting. Schools have a profound influence on the socialization of children, who bring to school what they have learned and experienced in the home. Success in school requires an integration of cognitive, receptive, and expressive (language) skills.

What is best for the nurse to suggest to the parents of an overweight 9-year-old child to help prevent obesity? a. Use whole milk as a between-meal snack because it is more filling than skim milk. b. Feed the child before family meal times to monitor intake more closely. c. Encourage the child to engage in physical activity for at least an hour a day. d. Remove all sweets and junk food from the house.

ANS: C Regular physical activity reduces weight.

What statement by an 11-year-old child leads the nurse to determine he has moved from the mind-set of egocentrism? a. "I am a member of the best Cub Scout group in the world." b. "I must do my homework before I can play." c. "My dad can do anything!" d. "I'm sorry. I bet that hurt your feelings."

ANS: D The ability to see another's point of view indicates moving away from egocentrism into a more altruistic mind-set.

A mother is concerned because her 9-year-old boy has developed the habit of twitching his eyes and flipping his hair while communicating with anyone. What is the best nursing response to this parent? a. "This may indicate that he needs eyeglasses." b. "Children sometimes do these things for attention." c. "This behavior suggests low self-esteem." d. "Tics appear when a child is under stress."

ANS: D The child cannot help such actions and should not be scolded for them because they are mainly a result of tension.

The nurse discusses preparation for school with the parents of a 6-year-old girl who will soon be starting first grade. What statement by the girl's father leads the nurse to determine that the parents understood the information? a. "We should put a stop to her thumb-sucking." b. "We'll have a talk about what school is like." c. "We will let her walk to the bus stop by herself." d. "We'll have her meet some children who will be in her class."

ANS: D To prepare a child for school, parents can arrange for the child to meet other children who will be entering school with her.

The parents of an 8-year-old child tell the nurse the child wakes the household crying out during his frequent nightmares. What is the nurse's most helpful response to explain nightmares? a. They are a normal extension of the child's fear of mutilation. b. They are an abnormal response to repressed feelings. c. They are a common result of latent sexuality. d. They are a side effect of overactivity and stimulation.

ANS: A The nightmares experienced by an 8-year-old child are an extension of their characteristic fear of mutilation.

What basic "feeling" words should the nurse use in attempting to help a 7-year-old girl express her feelings about being in a new school? (Select all that apply.) a. Mad b. Glad c. Sad d. Scared e. Jealous

ANS: A, B, C, D The words "mad," "glad," "sad," and "scared" are basic feeling words that can prompt a young child to better express his or her feelings.

The school nurse is preparing an educational program for new teachers regarding school-age children. What information is accurate for the nurse to include? (Select all that apply.) a. Participation in group activity increases b. Egocentricity prevails c. Thinking is logical d. Preference is toward family interaction e. Understand cause and effect

ANS: A, C, E Piaget refers to the thought processes of the school-age period as concrete operations. Concrete operations involve logical thinking and an understanding of cause and effect. The egocentric view of the preschool child is replaced by the ability to understand the point of view of another person. Between 6 and 12 years of age, children prefer friends of their own sex and usually prefer the company of their friends to that of their brothers and sisters.

Which stage of cognitive development is a 9-year-old child in according to Piaget? a. Formal operations b. Preoperational c. Concrete operations d. Sensorimotor

ANS: C School-age children are in the concrete operations stage of cognitive development.

A parent asked the nurse, "At what age are children capable of assuming more responsibility for personal belongings?" What is the nurse's best response based on knowledge of growth and development? a. 6 years b. 7 years c. 9 years d. 12 years

ANS: C The 9-year-old child is dependable and assumes more responsibility for personal belongings.

A seventh-grade girl tells the school nurse that her art teacher, a woman, is her hero. What is the most appropriate interpretation of the girl's comment? a. The student may be exploring her career options. b. The comment is cause for concern about sexual abuse. c. The child may have difficulty interacting with her peers. d. Hero worship is a normal phenomenon.

ANS: D School-age children tend to admire their teachers and adult companions. For the 11- to 12-year-old, hero worship is a normal phenomenon.

A parent states, "My 7-year-old really wants a dog. His 10-year-old brother has allergies to animal dander. I don't know what to do." What type of pet should the nurse suggest as the best choice? a. A small breed of dog because the large dogs produce more allergens. b. An older unneutered dog that produces fewer allergens than a younger one. c. A cat because it requires less care and is less allergenic. d. A poodle, which does not shed, making it a good choice for people with allergies

ANS: D The poodle does not have a shed cycle and so it may be the least offensive pet for the allergic child.