Prep-U Chapter 28

The school-age child needs consistent rules, positive attention, and clear expectations in order to develop self-confidence.

Although peers are important, caregivers have more influence over the school-age child relating to building confidence.

A mother calls the advance practice pediatric nurse practitioner about her 7-year-old daughter's dental hygiene. The daughter has had three cavities. She does not know what to do and asks the nurse for guidance. How should the nurse respond?

"Are you able to supervise her brushing?"

The nurse is working with a group of caregivers of 6-year-olds. One of the mothers states her son has been lying and making up stories; she asks for some advice about how to address the issue. Which of the following would be an appropriate response by the nurse?

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

The nurse is teaching a group of caregivers of school-age children on various topics. Which of the following statements made by the caregivers indicates a need for further teaching?

"Food is so expensive, we always make our children eat everything on their plate."

The nurse is discussing the topic of obesity with a group of mothers of school-age children. Which of the following statements made by the caregivers indicates the best understanding of factors that contribute to obesity?

"I always cook foods that are low in fat."

The nurse is discussing nutrition with the mother of a 6-year-old boy. Which of the following responses by the boy's mother indicates a need for further discussion?

"I make him eat some of everything I put on his plate."

The nurse is discussing the topic of psychosocial development with a group of caregivers of school-age children. Which of the following statements made by the caregivers is most appropriate related to the development of self-confidence in this age child?

"If my husband and I have consistent rules and expectations, he will be confident."

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

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

During a well-child visit, an 11-year-old girl complains to the nurse that she looks different from her friends who are wearing bras. Which of the following is an appropriate response?

"It is normal for there to be differences in the time and rate girls your age develop."

The mother of a 6-year-old Hispanic boy tells the pediatric nurse practitioner at the public health clinic that she is unable to read English. She wants to help her son so he does not have to struggle when he starts school. She wants to know how she can promote literacy even though she cannot read herself. How should the nurse respond?

"Look at books together and make up stories to go with the pictures."

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 of the following statements 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."

The nurse is caring for an 8-year-old girl. She is reviewing her nutritional requirements and describing interventions that promote healthy eating habits. Which of the following responses by the girl's mother indicates a need for further discussion?

"My daughter must stay at the table until she has cleaned her plate."

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

"Now is the time to let him choose some of his meals."

During a visit to the nurse practitioner for a sports physical, the father of a 9-year-old boy tells you that there is no need for his son to engage in physical activity because he plays soccer in the local soccer league. What is the best response from the nurse?

"Organized sports should serve as complementary activities and not replace activity."

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."

The nurse is conducting teaching with families of school-age children. Which of the following statements made by the nurse is most appropriate related to topics that would be covered with this group of individuals?

"The school-age child needs 10 to 12 hours of sleep per night."

The nurse is conducting a routine well-child evaluation for a family with five children. The mother seems frazzled, and the two oldest boys are engrossed in their hand-held video games. The other three children—all preschoolers—are gathered around a portable DVD player watching a movie while they wait for their appointment. The nurse suspects that the children spend a great deal of time in front of electronic screens and that her values greatly differ from this family's. How should the nurse approach the issue of television exposure during this evaluation?

"Would you like a pamphlet telling how TV watching affects children's health?"

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."

A school-aged child develops school phobia. When counseling her mother, you would advise her that the accepted therapy for this is to

make her child attend school every day.

The school-age child should visit the dentist at least

twice a year for a cleaning and application of fluoride.

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

A nurse is caring for a hospitalized 7 year old 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.Between the ages of 6 and 8 years, children begin to enjoy participating in real-life activities, such as helping with gardening, housework, and other chores. They love making things, such as drawings, paintings, and craft projects.

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

A sense of competence, mastery, and worth

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.

The parents of a school-aged child with school phobia have taken her to three different psychiatrists trying to resolve this problem. Based on this, which of the following nursing diagnoses would be most appropriate?

Compromised parental coping related to inability to enforce school attendance

An anxious 12-year-old girl receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, "Is it hard to give someone an injection?" This girl's question is evidence that she has developed which cognitive skill?

Decentering

A nurse is carrying on a conversation with a 7-year-old girl during an office visit. Which of the following is an example of the level of language development the nurse should expect in this child?

Difficulty understanding the concept of "half past" in reference to time

Erikson's developmental task for this age group is industry versus inferiority. In developing industry, the child learns to start and complete projects and, if unsuccessful in completing activities, develops a feeling of inferiority.

During this stage the child enjoys engaging in meaningful projects and seeing them through to completion

Eight-year-old Ted's foster mother is discussing her concerns about Ted's recent dental checkup in which three cavities were found in his permanent teeth. Ted's mother is concerned because Ted eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. What would the nurse suggest to this mother is the most appropriate in regard to Ted's dental health? The nurse would suggest that the mother

Ensure that Ted brushes his teeth after each meal and snacks

Children can become physically addicted to glue.

False.Children do not become physically addicted to glue but do become psychologically dependent on it.

Eight-year-old Matt is doing well with adding and subtraction. His father asks for suggestions regarding projects that would help increase Matt's understanding of conservation of mass. Of the following projects, which would most help Matt understand conservation of mass?

Form vases from blocks of clay.

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, which is what?

Industry

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. Which of the following should the nurse recommend?

Insist that the child return to school

A father shares with a nurse that his 12-year-old son has begun ejaculating in his sleep and is deeply embarrassed about it. The father says he has tried to explain to his son that this is a normal occurrence in puberty, but the son is still humiliated by it. The nurse recognizes this occurrence as which of the following?

Nocturnal emissions

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

Participating in a craft project

A nurse is speaking with a 7-year-old boy in the hospital. The boy asks the nurse, "Where is the westroom? I need to use the westroom." The nurse recognizes that this developmental problem is which of the following?

Poor articulation

A 10-year-old spends 2 hours by herself every afternoon before her parents arrive home. Which of the following would be the most appropriate safety measure to suggest that the parents teach the child?

Preparing a no-cook snack for herself

Ten-year-old Edgar is above normal weight for a child his age and height. When discussing with him what he likes to eat, he tells the nurse he doesn't eat much candy but he loves to eat fruit, pasta, potatoes, and bread. What would the nurse recommend to Edgar's caregivers as to ways to help him maintain a healthy weight? The caregiver should

Provide activities for Edgar that will increase his physical activity.

The nurse is talking with 6-year-old Jenna at her well-child office visit. Jenna says, "I can't play on teams because I am not as good at doing things as my big sister is." What suggestion might the nurse make to Jenna's caregiver regarding activities to help Jenna increase her feelings of self-confidence? The nurse might suggest that the caregiver

Set up some play dates that include projects or activities in which Jenna can be successful

The school nurse is performing a vision screening for a 7-year-old child. Which finding should trigger a referral?

Slight misalignment of the eyes

The nurse is measuring the weight of 9-year-old Jasmine during her well-child checkup. Jasmine weighed 9.5 lb at birth. She weighs 86 lb now. In noting normal patterns of weight gain, the nurse recognizes that for her age and birth weight, Jasmine is

Slightly overweight

Limiting dietary fat intake to no more than 35 percent of total calories help control the child's weight.

Some children may have a genetic tendency to obesity, but environment and a sedentary lifestyle are a concern related to obesity. Caregivers must carefully supervise children's snacking habits to be sure that snacks are nutritious and not too frequent since this can lead to obesity.

The school nurse is working with a group of 6- to 8-year-old children. Which of the following responsibilities would the school nurse most likely have for this age child? The nurse would be

Testing the children's vision and hearing. Vision and hearing screening should be performed before entrance to school and on a periodic basis -annual or biannual, thereafter

Parents of an 11-year-old boy are bewildered that their son was caught stealing. Which of the following reasons for this behavior would the nurse suggest?

The child had a strong desire to own the item.

In working with the school-age child, the nurse recognizes which of the following as a characteristic of the school-age child?

The child has an increased attention span and can be interested in an activity for a long length of time.

Which of the following demonstrates an example of Erikson's developmental task for the school age child?

The child spends a rainy day putting together a puzzle of a large jungle animal.

Which of the following best describes Erikson's psychosocial development task for the school-age child?

The child wants to successfully complete activities.

Children in the age group 6 to 7 years often engage in magical thinking. They may still believe in the tooth fairy, Santa Claus, monsters under the bed, and other imaginary characters.

These children's keen imaginations may also conjure up fears, especially at night, about remote, fanciful, or imaginary events.

Conformity is vital to school-age children.

True.Parents who enjoyed fostering imagination in a preschooler may feel frustrated when a school-age child chooses to conform to rules and insists on the "right way" to do things. They may feel they have failed to encourage the child's creativity, but conformity is vital to children at this age. It is how they learn more about their world's rules

A 12-year-old girl has recently begun menstruating and is well into puberty. She is visiting the doctor today for a routine physical examination. Which of the following findings should cause concern in the nurse?

Vulvar irritation.Any secretions that cause vulvar irritation should be evaluated by a health care provider, because this does suggest infection.

The nurse is observing a group of 8-year-olds who are being taught the concept of conservation of weight. Which of the following activities would best help these children understand this concept?

Weighing a pound of oranges and a pound of bricks and counting how many of each make a pound.

Children who are unsuccessful in completing activities during the school-age phase, whether from physical, social, or cognitive disadvantages, develop

a feeling of inferiority.

When caring for hospitalized school-aged children, it is important to

consistently reinforce their worth.

the most common problem of a school-age child is

articulation, The child has difficulty pronouncing s, z, th, l, r, and w or substitutes w for r or r for l

Sex education is often limited to one classroom session, usually in the fifth grade,

in which children are shown films about menstruation and their developing bodies.

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

industry versus inferiority.

If a child of this age has trouble distinguishing fantasy from reality,

it may incline them to lie to escape punishment or to boost self-confidence.

The Boy Scouts is an organization that continues to be a favorite with school-aged boys because

merit badges require completing small tasks for rewards.

When you are cleaning the bedside stand of a hospitalized 10-year-old, you find 48 packages of sugar. Your best action in relation to this would be to

put them back in the drawer as they were. At 10 years, children often enter a "collecting" stage, making whatever object they are collecting precious and important to them.

During a physical examination at about the age of 10 to 11 years, the child is initially examined for signs of

scoliosis -lateral curvature of the spine.

A 9-year-old is hospitalized for a long-term illness. The best project to give her to help her achieve her developmental task would be

sewing a purse that will take one afternoon. Small projects that can be completed quickly offer a sense of reward and are best to help children develop a sense of industry.

A 7-year-old has taken money from his brother's dresser on two occasions. When counseling his mother about this, you would advise her that

she may need to remind him of property rights.

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.

Decentering is

the ability to project one's self into other people's situations and see the world from their viewpoint rather than focusing only on their own

Class inclusion is

the ability to understand that objects can belong to more than one classification.

The nurse is providing information to the parents of a 6-year-old boy who has been caught lying at home and at school. Which of the following would the nurse share with the parents? Select all that apply.

• Explain that children this age typically lie to avoid punishment. • Suggest reading a story with the child about the consequences of lying. Correct

A nurse is discussing a 9-year-old girl's obesity with her parents. Which of the following recommendations should she make to the parents? (Select all that apply.)

• Intake of about 1,200 calories a day • Limiting time spent in physical inactivity • Participation in a formal weight-control organization • Participation in formal exercise classes