Prep U chapter 28

While treating a minor playground injury for an 8-year-old girl, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action?

Assess the situation with the help of the school staff and parents.

An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health?

Ensure that the child brushes his teeth after each meal and snacks.

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:

preoccupation with death and dying is common in the school-aged child.

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?

"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior."

The mother of a 7-year-old girl is asking the nurse's advice about getting her daughter a 2-wheel bike. Which response by the nurse is most important?

"Be sure to get the proper size bike."

The parents of a 10-year-old girl voice concern to the nurse because their daughter seems to "have a higher amount of body fat" than they expect based on the healthy eating habits and high activity level of the family. What is the best response by the nurse?

"Before adolescence the body fat composition of school-age children increases earlier and in greater amounts in girls than in boys."

The nurse is teaching a group of school-age children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching?

"I will grow an average of 2.5 in (6.5 cm) per year."

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

Participating on the school soccer team Praising the child for their academic efforts Allowing the child to assist her teacher in straightening up the classroom

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?

form vases from blocks of clay

The nurse is talking with a school-aged child about her interests. In which interest do most school-aged children place the most focus?

school

The nurse is discussing home safety with the parents of a 10-year-old client. Which statement by the client's parents most concerns the nurse?

"Our child swims alone before we get home from work."

A 7-year-old child has taken money from a sibling's dresser on two occasions. When counseling the parent about this behavior, what would the nurse advise?

"You may need to remind your child about property rights."

During a routine wellness examination, the nurse is trying to determine how well a 5-year-old boy communicates and comprehends instructions. What is the best specific trigger question to determine the preschooler's linguistic and cognitive progress?

"How well does your son communicate or follow instructions?"

In teaching school-aged children and their parents, what facts would be valuable for the nurse to emphasize? Select all that apply.

Dental checkups are recommended twice a year. Education about the unhealthy aspects of tobacco and alcohol should begin in elementary school. For nutritional recommendations, a good resource for parents is choosemyplate.gov.

A mother states that her 6-year-old has starting biting nails and regressing to baby talk since beginning school. What instructions are best for the nurse to give the mother regarding this behavior?

Make time each day to spend with the child individually.

The parents of a 7-year-old girl report concerns about her seemingly low self-esteem. The parents question how self-esteem is developed in a young girl. Which response by the nurse is best?

"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."

An 8-year-old male child is being seen for a well-child visit. His weight at his visit last year was 50 lb (22.7 kg) and his height was 47 in (119 cm). If he is developing normally, which finding will the nurse expect to note this year?

Height 49.5 in (124 cm)

The school-age child develops the ability to recognize that if a block of clay is in a round ball and then is flattened, the shape changes but not the amount of clay. What understanding has this child developed?

conservation

A parent brings a 6-year-old to the clinic and informs the nurse that the child is tired all the time, even though the child sleeps 7 to 8 hours each night. What is the best response by the nurse?

"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."

The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents?

"Is there a family history of hypertension, heart disease, or diabetes?"

An 8-year-old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step?

Industry

The parents of a 10-year-old child are experiencing problems with their child having fears when faced with new experiences. Which action(s) by the parents will be beneficial in helping the child effectively manage new experiences? Select all that apply.

The parents should acknowledge the child's feelings. The parents should teach the child relaxation techniques to use when feeling anxious. The parents should encourage the child to use positive self-talk, such as saying, "I can do this" when faced with new experiences.

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.

Risk for caregiver role strain Risk for infection Knowledge deficit regarding disease process Knowledge deficit regarding use of inhaler medication for asthma

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which statement made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child?

"My child sleeps between 11 and 12 hours a night."

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

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

The parents of a 10-year-old tell the clinic nurse that they are concerned because they noticed that their child has gained about 10 pounds over the past 2 years. What is the best response by the nurse?

"Normal growth and development for this age results in an average weight gain of 7 pounds per year."

A nurse is caring for a hospitalized 7-year-old child whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group?

A paint-by-numbers activity creating a picture

The nurse is caring for a hospitalized 10-year-old client. Which nursing action is most appropriate?

Consistently reinforce the child's self-worth.

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.

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

The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child?

Needs 10 to 12 hours of sleep per night

A nurse is caring for a hospitalized 10-year-old child. What would be an appropriate activity for this child to meet the developmental tasks of this age group?

Participating in a craft project

The school nurse is reviewing the chart of a 12-year-old student who has had excessive absences due respiratory infections. What is the best action by the nurse?

Speak with the parents about the unusual increased number of respiratory infections.

The nurse has taken a health history and performed a physical exam for a 12-year-old boy. Which finding is the most likely?

The child has a leaner body mass than a girl at this age.

Which behavior(s) involving a 11-year-old child warrants further education to the family? Select all that apply.

The child is allowed to sit in the front seat of the car. The child wears a lap belt when riding in the car. The child uses a backpack to carry books when riding their bike to and from school.

The mother of an 11-year-old child tells the nurse that her child seems to be "hungry all of the time" and seems to "never get full." The nurse suspects a physiologic developmental problem. What is the rationale for the nurse suspecting a physiologic developmental issue? Select all that apply.

The stomach capacity increases, which should permit retention of food for longer periods of time. The caloric needs of the school-age child are lower than in the earlier years of life.

A parent tells the nurse that the 6-year-old child has been biting his fingernails since beginning first grade. After analysis, the cause is determined to be increased stress. What advice would the nurse give the parent regarding this behavior?

Allow some time every day for the child to talk about new experiences

The nurse is caring for a 11-year-old girl who has been identified as weighing 10% more than recommended for her age and height. When developing the plan of care, which intervention is of the highest initial priority?

Assess readiness to learn in the child and parents.

Parents of an 8-year-old client report the child struggles with the chore of cleaning their bedroom. What advice will the nurse give to assist with this challenge for a child at this stage of development?

Break the chore into smaller tasks that the child can accomplish more easily.

The school nurse is monitoring children as they arrive at school riding their bicycles. Which child(ren) should the nurse speak with about their riding habits? Select all that apply.

the child who is wearing flip flops when riding the bicycle to school the child who is wearing a book bag hanging off one shoulder the child who is wearing a stocking cap under the helmet during cold weather

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

industry versus inferiority.

A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to:

make her child attend school every day.

The parent of an 8-year-old child requests information from the nurse on proper nutrition for his child. Which is the best statement by the nurse?

"An 8-year-old needs 800 to 1,000 mg of calcium daily.

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?

"Are you able to supervise your child's brushing?"

The parents of an 8-year-old boy report their son is being bullied and teased by a group of boys in the neighborhood. Which response by the nurse is best?

"Bullying can have lifelong effects on the self-esteem of a child."

The parents of a 10-year-old child tell the nurse that they don't understand how their child falls into the obesity category. They state that they are consistent with good nutrition and their child is very active in sports and clubs. What would be appropriate questions for the nurse to ask? Select all that apply.

"Can you give me an idea of a typical day for you and your child?" "Given your busy schedules does your family eat a lot of meals late in the evening?" "Could you keep a food diary over a 2 to 3 days time for us to review?" "Does your child consume soda and other fluids high in sugars?"

The mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse?

"Children this age sometimes can't distinguish between fantasy and reality."

The nurse is teaching a group of school-aged children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching?

"Girls typically experience a rapid growth spurt before boys."

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.

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

The nurse is caring for a 6-year-old child. During the course of a routine wellness examination, the parent proudly reports that the child eats whatever the parent puts on the plate. The nurse wants to emphasize the importance of allowing the child to make some choices regarding the types of foods eaten. How should the nurse communicate this to the parent?

"Now is the time to let your child choose some of the meals."

During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be?

"Play helps children to develop cognitively, socially, physically, and emotionally."

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

"Remind her in simple terms what will happen in the dentist's office."

An overly tired school-aged child enters the school clinic. The nurse asks the child to state the times he/she usually goes to bed at night and wakes up in the morning. The child answers 11:00 PM and 6:00 AM. Which is the best response made by the nurse?

"That is not enough sleep. You should get at least 9 to 12 hours of sleep each night."

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

During an annual visit of a 6-year-old boy, the nurse observes dental caries on two of the child's primary teeth. Which response by the parents suggests more education is needed regarding the importance of primary teeth?

"These are only his baby teeth so we are not worried."

The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory?

A sense of competence, mastery, and worth

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.

Educate the parents and the child on the need to decrease TV/computer/device time. Educate the parents and child on the need to increase the amount of daily exercise. Interview the parents about their eating and exercising habits. Plot out the child's height, weight, and BMI to detect weight loss or gain. Correct response:

The nurse is conducting a support group for parents of 9- and 10-year-olds. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide?

a sense of security as children gain independence

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

appropriate social development

A 9-year-old child is feeling conflict from seeing other children in her class engaging in behaviors she senses are not appropriate. When making decisions about what actions are most appropriate, a child of this age will rely most heavily on which party of influence?

parents