PEDS Chapter 6: Growth and Development of the School-age Child
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. A sense of mistrust b. A sense of doubt c. A feeling of inferiority d. A sense of shame
c. 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.
The parents of a 9-year-old boy report they have been homeschooling their son and now plan to enroll him in the local public school. They voice concerns about the influence of the other children on their son's values. Which information should the nurse provide the parents? a. "At your son's age, values are most influenced by peers." b. "The values of the family will likely prevail for your son." c. "Values are largely inborn and will be impacted only in a limited way by environmental influences." d. "The teacher will begin to have the largest influence on a child's values at this age."
b. "The values of the family will likely prevail for your son." The values of a child are determined largely by the influences of their parents. As the child ages the impact of peers does begin to enter the picture. Children may also begin to test the values with their actions. In most cases the values of the family will prevail.
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. Which factor does this best represent? a. poor peer relationships b. encouragement for bullying and sexism c. appropriate social development d. immaturity for this age group
c. appropriate social development During the school-age years, peer groups tend to be same-sex. This helps children learn to work together and to see viewpoints different then their own. Being part of a peer group helps with positive socialization of the school-aged child. The other choices are not represented by this scenario.
The developmental task of the school-aged period, according to Erikson, is gaining a sense of: a. autonomy versus shame. b. independence versus dependence. c. industry versus inferiority. d. identity versus failure.
c. industry versus inferiority. The school-age years, according to Erickson, are the stage of industry versus inferiority. The developmental stage helps increase the child's sense of self worth. Industry is associated with the child's increased interest in knowledge and the development of social skills. Autonomy versus shame is the developmental tasks of 1 to 3 year old children. Erickson's stages do not include the developmental tasks of independence versus dependence nor identity versus failure.
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? a. "There are not many physical differences among school age boys." b. "I will appear heavier due to an increase in fat production." c. "I will grow an average of 2.5 in (6.5 cm) per year." d. "I will have improved gross motor skills."
c. "I will grow an average of 2.5 in (6.5 cm) per year." During the school-age years, the child will grow an average of 2.5 in (6.5 cm). As puberty approaches, there will be significant differences in development between boys and girls. 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. By 10 years of age, brain growth is complete, and fine motor coordination is refined.
The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents? a. "Is there a family history of hypertension, heart disease, or diabetes?" b. "Is breakfast eaten regularly?" c. "What beverages are preferred?" d. "How important is exercise?"
a. "Is there a family history of hypertension, heart disease, or diabetes?" Parents would be more knowledgeable than the child regarding health problems within the family. 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 since their habits influence the child.
What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child? a. Fish, spinach salad and a glass of milk b. Hamburger and a cherry Coke c. Chicken sandwich with pretzels and apple juice d. Bagels and cream cheese with sherbet
a. Fish, spinach salad and a glass of milk A well-balanced diet rich in calcium and phosphorus fosters healthy teeth. Minimal sugar, a diet of whole grain breads, and fish and cheeses are all good sources of calcium and/or phosphorus. Sugary soda drinks and juices, pretzels and bagels, beef and sherbet do not provide substantial amounts of calcium or phosphorus.
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? a. Needs 10 to 12 hours of sleep per night b. Should brush their teeth at bedtime c. Have a routine physical exam every 6 months d. Be screened for scoliosis once a year
a. Needs 10 to 12 hours of sleep per night The school-aged child needs 10 to 12 hours of sleep per night. They need to brush their teeth after every meal and at bedtime. A routine physical exam once a year is all that is necessary. Children are screened around the age of 10 or 11 for scoliosis.
The nurse is teaching a group of school-aged children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching? a. "There are not many physical differences between school-aged boys and girls." b. "Menarche is usually the first sign of puberty in school-aged girls." c. "Boys normally grow an average of 5 in (12.5 cm) each year." d. "Girls typically experience a rapid growth spurt before boys."
d. "Girls typically experience a rapid growth spurt before boys." Girls typically experience a rapid growth spurt before boys, and are usually taller by about 2 in (5 cm) or more than preadolescent boys. During the school-age years, the child will grow approximately 1 to 2.5 in (2.5 to 6.25 cm) per year. As puberty approaches, there will be significant differences in development between boys and girls. The first sign of puberty for girls is breast changes, not menarche.
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? a. Avoid smoking in the house or in front of the child. b. Keep any alcohol products in the home in a locked cabinet. c. Encourage the child to avoid having friends who smoke or drink. d. Discuss tobacco and alcohol use and effects with the child.
d. Discuss tobacco and alcohol use and effects with the child. Parents are major influences on school-age children and should discuss the dangers of tobacco and alcohol use with the child. Not smoking in the house and hiding alcohol send mixed messages to the child. Open and honest discussion is the best approach rather than discouraging the child from making friends with kids that use tobacco or alcohol.
The parent of a 12-year-old child reports the child does not have high self-esteem. The parent asks for suggestions to increase feelings of self-worth. What activity(ies) would be appropriate for the nurse to suggest? Select all that apply. a. Encourage the child to develop new skills. b. Recommend the child begin to participate in after-school activities. c. Provide the child with a weekly allowance. d. Allow the child to begin staying home alone after school when possible. e. Recommend the child investigate opportunities for volunteering at local charities.
a, b, e The school-age child's satisfaction from achieving success in developing new skills leads him or her to an increased sense of self-worth, which is a person's feeling about one's own value. 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-aged child is very interested in learning how things are made and work. Providing the child an allowance and allowing the child to stay home alone after school will not help increase self confidence, which is how much a person believes in oneself and what one can do.
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? a. "My child sleeps between 11 and 12 hours a night." b. "My child stays up late when she takes a nap after school." c. "My child does not even know when he is tired." d. "My teenage child does not sleep as much as my 9-year-old does."
a. "My child sleeps between 11 and 12 hours a night." 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. 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.
The nurse is caring for a hospitalized 10-year-old client. Which nursing action is most appropriate? a. Consistently reinforce the child's self-worth. b. Discourage the child from assisting with dressing change. c. Correct each of the child's mistakes to ensure learning. d. Structure a competitive environment between clients.
a. Consistently reinforce the child's self-worth. Helping school-aged clients experience satisfaction in projects, social activities, family life, and school helps them gain a sense of industry. Reinforcing self-worth provides this satisfaction. The child should not be discouraged from participating in his or her care. The child's mistakes may need corrected to learn; however, the child has to be allowed to make mistakes in a safe environment to promote learning. Pointing out these mistakes needs to be done with care. Competition between clients will not facilitate growth and development or psychosocial development.
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? a. Industry b. Perfectionism c. Accommodation d. Conservation
a. Industry During the early school years, children attempt to master their new developmental step: learning a sense of industry or accomplishment. 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. Conservation is the ability to appreciate that a change in shape does not necessarily mean a change in size. Perfectionism is the desire to do something perfectly. 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.
A father brings his 6-year-old son in to the doctor's office. He says his son just began first grade a week ago and, after attending the first day of classes, has refused to go to school each day since, complaining of stomach cramps and nausea. He says he has spoken to the boy's teacher, who says she did not notice anything unusual with her interaction with the boy, other than perhaps a bit of homesickness. After the nurse examines the boy and finds nothing wrong, the father asks how he should handle the problem. What action should the nurse recommend? a. Insist that the child return to school. b. Hold the child back a year and let him try again next year. c. Have the child attend a different school. d. Homeschool the child.
a. Insist that the child return to school. Because the problem of school refusal is usually only partly the child's, the entire family generally requires counseling to resolve the issue. As a rule, once it has been established the child is free of any illness and the resistance stems from separation anxiety or phobia, the child should be made to attend school. Reinforcement by parents to go to school this way helps to prevent problems such as school failure, peer ridicule, or a pattern of avoiding difficulties. Because the child has only attended one day of class, it is far too soon to recommend that the child be held back a year, moved to another school, or homeschooled. In any case, these may not be options for the family.
A nurse is caring for a hospitalized 10-year-old child. What would be an appropriate activity for this child to meet the developmental tasks of this age group? a. Participating in a craft project b. Playing with a jack-in-the-box c. Playing with blocks d. Writing letters to friends
a. Participating in a craft project During this stage, the child is interested in how things are made and run. The child learns to manipulate concrete objects. The child likes engaging in meaningful projects and seeing them through to completion. Playing jack-in-the-box and blocks are for much younger children. If anything, the child would be texting back and forth with friends, not writing a letter.
When considering the moral development of a 7-year-old child, which actions are most consistent with the anticipated state of development? a. The child focuses on being a good girl or boy. b. The child considers the impact of actions on others in his environment. c. The child only gives consideration to how the actions will impact himself. d. The child gears his actions to avoid doing the wrong thing and getting "into trouble".
a. The child focuses on being a good girl or boy. 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. Younger children focus on their actions on avoiding punishment and base actions on what is best for them. Older children will give consideration to how their personal actions will impact others.
While observing a group of 9-year-old children at school, the nurse is concerned that one of the children is not cognitively developing according to Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned? a. does not understand the phrase "slow as molasses" when used by the teacher b. arrives to class late from recess and apologizes to the teacher c. believed that not turning in homework on time was acceptable, but has since decided it is not acceptable d. enjoys math instruction and decides to join the math club
a. does not understand the phrase "slow as molasses" when used by the teacher 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.
The nurse is creating a care plan for a school-aged child with a nursing diagnosis of Ineffective health maintenance related to lack of exercise and poor food choices. Which nursing interventions should the nurse include? Select all that apply. a. Have the parents keep a diary of the child's food and exercise for a week. b. Educate the parents and the child on the need to decrease TV/computer/device time. c. Educate the parents and child on the need to increase the amount of daily exercise. d. Interview the parents about their eating and exercising habits. e. Plot out the child's height, weight, and BMI to detect weight loss or gain.
b, c, d, e Have the child, not the parents, keep a food and exercise diary for a week to determine current patterns of eating and exercising. Educating the child and parents on the need to increase daily exercise and decrease the amount of TV/computer/device time; interviewing the parents on their eating and exercising habits; and plotting out the child's height, weight, and BMI are all appropriate interventions for this nursing diagnosis.
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? a. "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." b. "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." c. "Perhaps the academic environment is too easy for your child, causing the cheating." d. "If cheating is noted at this age, referral to a family counselor is highly recommended."
b. "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." Because they are role models for their children, parents must first realize the importance of their own behaviors. If the academic environment is too difficult, not too easy, the child may be cheating to keep up with the increased rigor. Punishment should be geared toward discussion and helping the child understand the seriousness of cheating, and not be a subtle approach. 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.
The mother of a 7-year-old girl is asking the nurse's advice about getting her daughter a 2-wheel bike. Which response by the nurse is most important? a. "Teach her where she'll land on the grass if she falls." b. "Be sure to get the proper size bike." c. "She won't need a helmet if she has training wheels." d. "Learning to ride the bike will improve her coordination."
b. "Be sure to get the proper size bike." It is very important to get a bike of the proper size for the child. Getting a bike that the child can "grow into" is dangerous. Training wheels and grass to fall on are not acceptable substitutes for the proper protective gear. The child should already demonstrate good coordination in other playing skills before attempting to ride a bike.
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? a. "Does your son speak in complete sentences all the time?" b. "How well does your son communicate or follow instructions?" c. "Is your son's speech clear enough that anyone can understand it?" d. "Would you say your son has a vocabulary of about 900 words?"
b. "How well does your son communicate or follow instructions?" Asking how well the boy communicates and follows instructions is the best trigger question because it is open-ended. Asking if the child uses complete sentences or speaks clearly will elicit a yes or no answer about only those specific areas of development. The parents would have no way of judging the size of their child's vocabulary.
A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed? a. "I will teach my daughter her full name and phone number." b. "My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." c. "We will be sure that our daughter wears a life jacket the next time we go boating at the lake." d. "I will teach my son not to arrange a meeting with someone he met on the Internet."
b. "My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." Children should be taught ways to stay safe and prevent accidents. All children should wear bicycle helmets; however, unless the bicycle has a sidecar, the bike riding is safe for only one rider. The parents are correct that their children should learn their names and addresses, should not set up a meeting with a person they met on the Internet without parental supervision, and should wear a life jacket when boating.
An 8-year-old male child is being seen for a well-child visit. His weight at his visit last year was 50 lb (22.7 kg) and his height was 47 in (119 cm). If he is developing normally, which finding will the nurse expect to note this year? a. Weight 62 lb (28.1 kg) b. Height 49.5 in (124 cm) c. The child's weight is seven times his birth weight. d. The child has all of his adult teeth present.
b. Height 49.5 in (124 cm) Normal physical growth for school-age children is a gain in height of 2.5 inches (6.25 cm) each year. Thus, a height of 49.5 in (124 cm) would be expected growth. The growth in weight is not within normal parameters as this is a 12 lb (5.4 kg) weight gain. A 7-year-old child, not 8-year-old child, should weigh seven times his birth weight. Adult teeth do not normally come in until age 10 to 12.
The nurse is educating the parents of a 6-year-old boy how to manage the child's introduction into elementary school. The child has an easy temperament. Which action should the nurse suggest? a. Comforting the child when he is frustrated. b. Helping the child deal with minor stresses. c. Scheduling several visits to the school before classes start. d. Being firm with episodes of moodiness and irritability.
b. Helping the child deal with minor stresses. The child with an easy temperament will adapt to school with only minor stresses. The slow-to-warm child will experience frustration. The difficult child will be moody and irritable and may benefit from a preschool visit.
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? a. Ask the child if he really has had respiratory infections during these absences. b. Speak with the parents about the unusual increased number of respiratory infections. c. Continue to monitor the child's absences. d. Discuss with the child's teacher to determine if the number of absences has affected academic performance.
b. Speak with the parents about the unusual increased number of respiratory infections. 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 visit the pediatrician to discuss the issue.
The family who are vegetarian voice concern that their child is not growing well. The nurse should suggest which food to increase the calcium intake for adequate bone growth? a. oatmeal b. kale c. quinoa d. sweet potato
b. kale The consumption of adequate protein and calcium is important for muscle, bone, and dental development. Foods highest in calcium are green leafy vegetables, enriched breads, and cereals. Soybeans, legumes, grains, and immature seeds are high in protein. Oatmeal and quinoa are both high in protein. Sweet potatoes are high in fiber, vitamin A, and potassium.
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? a. vacuuming b. putting books on shelf c. raking leaves d. folding clothes
b. putting books on shelf 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. 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. 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. 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 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? a. "Did you teach your child how to brush the teeth?" b. "What type of toothbrush does your child use?" c. "Are you able to supervise your child's brushing?" d. "Is there fluoride toothpaste available for use?"
c. "Are you able to supervise your child's brushing?" 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.
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? a. "Sometimes we have to be firm, but our children wash their hands before eating." b. "I make sure they have good teeth by giving them calcium and phosphorus." c. "Food is so expensive, we always make our children eat everything on their plates." d. "Even if the weather is cool and cloudy, our children play outside every day."
c. "Food is so expensive, we always make our children eat everything on their plates." 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. Firm guidance and direction is important with the school-aged child. Calcium and phosphorus are important to healthy teeth. Exercise each day is important, especially outdoor exercise.
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? a. "Your child doesn't seem to be overweight, so it isn't a concern." b. "We see most children of this age in our clinic gaining similar amounts." c. "Normal growth and development for this age results in an average weight gain of 7 pounds per year." d. "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain."
c. "Normal growth and development for this age results in an average weight gain of 7 pounds per year." 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. Simply comparing them to other children seen in the clinic doesn't mean it is a normal expectation. While activity is important, the nurse must first address the parent's concern.
The parents of a 9-year-old child voice concern that the child seems to be gaining weight rapidly. The nurse reviews the medical record and notes the child has increased weight by 6 or 7 lb (2.7 to 3.2 kg) per year for the past 2 years. What response by the nurse is indicated? a. "Your child does seem to be rapidly gaining weight." b. "Children in this age range on average gain about 5 lb (2.3 kg) per year." c. "Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." d. "On the contrary, your child's annual weight gain is somewhat low for this age."
c. "Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." Children who are between the ages of 6 and 12 years usually gain about 7 lb (3.2 kg) per year. The child in the scenario is gaining weight at a normal rate.
The school nurse is meeting with a 10-year-boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestion should the nurse prioritize to help him maintain a healthy weight? a. Encourage portion control at each meal b. Change to a very low-fat and no-carbohydrate diet. c. Encourage activities that will increase his physical activity. d. Encourage the child to not worry about weight until he is older.
c. Encourage activities that will increase his physical activity. Encouraging daily physical activity and following the dietary standards (such as ChooseMyPlate guidelines) will help the child meet necessary nutritional guidelines. Following popular fad diets or using weight-loss supplements must be avoided because they do not supply adequate nutrients for the growing child. The child is aware of the weight problem, but it would not be beneficial to just ignore it because the child may develop harmful eating habits such as bingeing.
The nurse is conducting a support group for parents of 9- and 10-year-olds. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide? a. time to remain dependent on their parents b. an opportunity for children to become self sufficient c. a sense of security as children gain independence d. time to establish relationships with the opposite sex
c. a sense of security as children gain independence Nine-year-olds take their peer group seriously. They are more interested in how other children dress than what their parents want them to wear. This is the age where groups are formed and others are excluded from the club. This age group is imitating their peers as they develop their own identity and separate from their parents. Groups are fluid as they change regularly due to many reasons: each member lives on the same street, each member plays on the same ball team, or one member has fewer material things than the others, etc. Security is gained through these clubs because it helps the school-age child develop independence away from the family. Most of the time in the school-age child, peer group relationships are with same-sex friends. Children do not become self-sufficient through these clubs. They remain dependent on their families for their physical needs.
The nurse is preparing a variety of projects for the pediatric clients on the unit to work on in the playroom. In deciding on projects, the nurse determines the 8-year-old will be best suited to work on which activity? a. stack blocks in a tower b. build a sandcastle with a water-filled moat c. form vases from blocks of clay d. put together a model plane
c. form vases from blocks of clay At about age 7, the child enters the concrete operational stage (as identified by Piaget). The skills of conservation (the ability to recognize that a change in shape does not necessarily mean a change in amount or mass) are significant in this stage. This begins with the conservation of numbers (when the child understands that the number of cookies does not change even though they may be rearranged) and the conservation of mass (when the child can see that an amount of cookie dough is the same whether in ball form or flattened for baking). This is followed by conservation of weight, in which the child recognizes that a pound is a pound, regardless of whether plastic or bricks are weighed. Conservation of volume (for instance, understanding that a cup of water is the same amount regardless of the shape of the container) does not come until late in the concrete operational stage at about 11 or 12 years of age.
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: a. at this age, children are not afraid of death. b. discussing death and dying may hint at a psychological disorder. c. consistent thoughts of death and dying at this age lead to the later development of depression. d. preoccupation with death and dying is common in the school-aged child.
d. preoccupation with death and dying is common in the school-aged child. School-aged children are often preoccupied with thoughts of death and dying. There is no indication these thoughts will lead to mental health issues or the development of depression. School-aged children fear death but are fascinated by death and dying.
