Ch. 28: Growth and Development of the School-Age Child

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 appear heavier due to an increase in fat production." "I will grow an average of 2.5 in (6.5 cm) per year." "There are not many physical differences among school age boys." "I will have improved gross motor skills."

"I will grow an average of 2.5 in (6.5 cm) per year." RATIONALE: 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 educating a group of parents about childhood nutrition, specifically caloric needs. Which statement, when made by a parent, indicates teaching was successful? "It is convenient that my 8-year-old and 12-year-old children both need to consume the same amount of calories." "My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health." "I will assure that at least 75% of calories for my 10-year-old child's diet come from simple carbohydrate sources." "We will make sure that our 11-year-old child consumes at least 900 calories, primarily through protein sources."

"My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health." RATIONALE: Boys and girls 4 to 8 years old who are moderately active will need about 1,400 to 1,600 calories per day. Boys 9 to 13 years old who are moderately active need about 1,800 to 2,000 calories a day and girls 9 to 13 years old who are moderately active need about 1,600 to 2,000 calories a day. Approximately 45% to 65% of calories should come from carbohydrates.

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? "We see most children of this age in our clinic gaining similar amounts." "Normal growth and development for this age results in an average weight gain of 7 pounds per year." "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain." "Your child doesn't seem to be overweight, so it isn't a concern."

"Normal growth and development for this age results in an average weight gain of 7 pounds per year." RATIONALE: 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 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? an opportunity for children to become self sufficient a sense of security as children gain independence time to remain dependent on their parents time to establish relationships with the opposite sex

a sense of security as children gain independence RATIONALE: 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.

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? immaturity for this age group encouragement for bullying and sexism poor peer relationships appropriate social development

appropriate social development RATIONALE: 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. These groups are not based on the immaturity of the children nor do they encourage sexism and bullying.

A nurse is discussing ways parents can foster the development of self-confidence in their school-aged child. Which action if stated by the parents would lead the nurse to continue the discussion? focusing on what the child is saying in a conversation being accepting of mistakes the child makes having clear expectations of behavior whenever the family is out in public comparing the child to an older sibling regarding academic achievements

comparing the child to an older sibling regarding academic achievements RATIONALE: A school-age child needs consistency, clearly defined expectations, and positive attention in order to develop self-confidence. By being accepting of mistakes the child makes, focusing on the child whenever they are talking, and making sure the child understands behavioral expectations, the parents are fostering self-confidence in the child.

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? arrives to class late from recess and apologizes to the teacher believed that not turning in homework on time was acceptable, but has since decided it is not acceptable enjoys math instruction and decides to join the math club does not understand the phrase "slow as molasses" when used by the teacher

does not understand the phrase "slow as molasses" when used by the teacher RATIONALE: 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.

A mother suspects that her 11-year-old son is experimenting with deliriants with his friends. Which symptoms would the nurse advise the mother to look for that would validate her concerns? unexpected bouts of diarrhea giddiness and coughing hyperactivity having bad breath when returning from school

giddiness and coughing RATIONALE: Inhalation of substances can cause numerous symptoms, including giddiness and coughing. The child will not experience diarrhea, hyperactivity, or develop bad breath from experimenting with inhalants.

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? Determine if there have been other playground bullying incidents. Immediately call the bullied child's parents. Assess the situation with the help of the school staff and parents. Question those responsible for the bullying.

Assess the situation with help of the school staff and parents RATIONALE: Assessing the situation and following the school's bullying protocol will be an important first step. Immediately calling the bullied child's parents may be premature. 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.

What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child? Bagels and cream cheese with sherbet Fish, spinach salad and a glass of milk Chicken sandwich with pretzels and apple juice Hamburger and a cherry Coke

Fish, spinach salad and a glass of milk RATIONALE: 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? Have a routine physical exam every 6 months Needs 10 to 12 hours of sleep per night Be screened for scoliosis once a year Should brush their teeth at bedtime

Needs 10 to 12 hours of sleep per night RATIONALE: 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 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? "On the contrary, your child's annual weight gain is somewhat low for this age." "Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." "Children in this age range on average gain about 5 lb (2.3 kg) per year." "Your child does seem to be rapidly gaining weight."

"Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." RATIONALE: 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.

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? "What type of toothbrush does your child use?" "Are you able to supervise your child's brushing?" "Did you teach your child how to brush the teeth?" "Is there fluoride toothpaste available for use?"

"Are you able to supervise your child's brushing?" RATIONALE: 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 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." "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." "If cheating is noted at this age, referral to a family counselor is highly recommended." "Perhaps the academic environment is too easy for your child, causing the cheating."

"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." RATIONALE: 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? "She won't need a helmet if she has training wheels." "Teach her where she'll land on the grass if she falls." "Be sure to get the proper size bike." "Learning to ride the bike will improve her coordination."

"Be sure to get the proper size bike." RATIONALE: 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.

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? "Your son is at high risk for bullying other children as a result of this situation." "Bullying can have lifelong effects on the self-esteem of a child." "Perhaps teaching your son self-defense courses will help him to have a greater sense of control and safety." "Fortunately the scars of being picked on will fade as your son grows up."

"Bullying can have lifelong effects on the self-esteem of a child." RATIONALE: The child can be permanently scarred by negative experiences such a bullying. Activities such as self-defense and sports can promote a sense of accomplishment but don't relate directly to the problem of bullying. There is no indication the child in the scenario will become a bully.

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? "I make sure they have good teeth by giving them calcium and phosphorus." "Sometimes we have to be firm, but our children wash their hands before eating." "Even if the weather is cool and cloudy, our children play outside every day." "Food is so expensive, we always make our children eat everything on their plates."

"Food is so expensive, we always make our children eat everything on their plates." RATIONALE: 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 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." "I always remind my sister to look right, then left, then right again before we cross the street." My friends and I like to walk on the side of the road because our sidewalk is very uneven." "My mom always says she looks around really well to be sure I'm not playing behind our car before she leaves." "I think it is funny to hide behind my dad's car before he leaves for work and scare him."

"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." RATIONALE: 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. Children should always walk on sidewalks because cars may not see children walking in the streets or be distracted while driving. Children should stay away from vehicles when a vehicle is about to be driven and definitely not behind a vehicle.

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? "What beverages are preferred?" "Is there a family history of hypertension, heart disease, or diabetes?" "Is breakfast eaten regularly?" "How important is exercise?"

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

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? "That is so horrible that you are afraid of the dark. Can you sleep at night at all?" "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?" "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?" "I was afraid of the dark at your age. You will grow out of that fear soon."

"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?" RATIONALE: 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 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." "You need to make sure your child has input regarding the food eaten." "I want you to give your child choices about the food eaten." "You must let your child make some choices for oneself."

"Now is the time to let your child choose some of the meals." RATIONALE: Diet preferences are established in the preschool years and continue to develop as the child ages. The diet is influenced by family, peers, and media. Because of these influences and the child striving for independence, it is important to involve the child in helping select the food choices and guiding the child to healthy food choices. With parents, as well as children, it is more effective and less a matter of personal opinion to say "now is the time" rather than "you need," "I want you to," or "you must" do something. The nurse can emphasize the importance of the child participating in meal selection while encouraging the child's independence in a gentle manner.

After teaching the parents of a 9-year-old child about safety, which statement indicates the need for additional teaching? "Our child should ride the bike on the same side of the road and in the same direction as traffic." "We need to buy our child a helmet so the child can ride a scooter." "We signed our child up for swim lesions at the local community center." "Our child can ride in the front seat of the car once reaching 10 years of age."

"Our child can ride in the front seat of the care once reaching 10 years of age." RATIONALE: Children younger than 12 years of age must sit in the back seat of the car. Laws in most states require helmets for riding bicycles and scooters. When riding a bike, the child should ride on the side of the road traveling with the traffic. Children should know how to swim. If swimming skills are limited, the child must wear a life preserver at all times.

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? "I see now we need to use a fluoride toothpaste for our child." "I guess we better look for a pediatric dentist for our son." "These are only his baby teeth so we are not worried." "I guess we will need to supervise our son while he brushes."

"These are only his baby teeth so we are not worried." RATIONALE: Parents need to understand the value of the primary teeth and not see them only as temporary and soon-to-be replaced. 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. Fluoride supplementation is not necessary if fluoride is part of the local water supply.

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 at least 9 hours of sleep per night." "Your child should be getting 8 to 9 hours of sleep per night." "We should ask the health care provider to run some tests; with that much sleep, the child should not be tired." "Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."

"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school." RATIONALE: Sleep needs for children change according to their ages. A 6- to 8-year-old child needs 12 hours of sleep per night. The 8- to 10-year-old child needs 10 to 12 hours of sleep per night. The 10- to 12-year-old child needs between 9 and 10 hours of sleep per night. Many younger children need a nap or to be provided with quiet time after school to recharge after a busy day in the classroom. Increasing the child's sleeping hours should be attempted before asking for medical intervention.

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? "The peers of a child at this age are the greatest influence on self-esteem." "A child's self-esteem is greatly inborn and environmental influences guide it." "Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age." "Several interrelated factors are to blame for low self-esteem."

"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age." RATIONALE: Self-esteem is developed early in childhood. The feedback a child receives from those perceived in authority such as parents and educators impacts the child's sense of self-worth. As the child ages, the influence of peers and their treatment of the child begin to have an increasing influence on self-esteem.

The nurse is preparing to catheterize an 11-year-old child. The nurse correctly recognizes the child's approximate bladder capacity is what amount? 20 ounces 12 ounces 15 ounces 13 ounces

13 ounces RATIONALE: The formula for bladder capacity is age in years plus 2 ounces. If a child is 11 years of age, this would be approximately 13 ounces.

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? An activity focusing on learning fractions A card game such as solitaire A board game such as monopoly A paint-by-numbers activity creating a picture

A paint-by-numbers activity creating a picture RATIONALE: 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 child would need additional instruction to learn fractions, which may not be considered fun. A card game such as solitaire and a board game of monopoly may be too hard for the 7-year-old. In addition, the game of monopoly would require additional players.

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? Encourage the child to drink more milk for stronger nails. Allow some time every day for the child to talk about new experiences Allow the child to choose a reward for not biting the nails. Distract the child by teaching a new skill, such as whistling.

Allow some time every day for the child to talk about new experiences RATIONALE: The developmental task of the school-age child is industry. They are busy learning, achieving, and exploring. With school comes separation from the parents, new people, new activities. Beginning school can be a time of extreme stress for children. Biting the nails can be a symptom that something is concerning the child. Spending time with the child and allowing the child time to discuss these new experiences of school helps the child to put experiences in perspective and begin to deal with them. Allowing the child a reward for not biting the nails does not address the underlying issue of why the child is biting the nails in the first place. The underlying issue is emotionally based, so adding milk or providing a distraction will not correct the problem.

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. Take away any toys or items that are left on the floor if not cleaned up. Provide a consequence of loss of privileges until they complete the chore. Offer a treat as an incentive for completing the chore.

Break the chore into smaller tasks that the child can accomplish more easily. RATIONALE: In the early school-age years, children have the developmental task of achieving a sense of industry. Breaking the job into smaller tasks that they can feel accomplished about provides a "reward" to assist them in completing a larger job. Treats are not required as a reward for children of this age. Providing consequences, such as loss of toys or loss of privileges, does not allow for the development of industry nor support children to learn how to complete the job.

A nursing student is presenting information to the class about abuse of children (child maltreatment). The nursing instructor should intervene when the student presents which information? Select all that apply. The lowest percentage of child abuse (child mistreatment) is due to emotional abuse. The majority of victims of child abuse (child mistreatment) suffer from neglect. Child abuse (child maltreatment) and intimate partner violence are not the same thing. The concepts of "good touch" versus "bad touch" should be taught around the age of 10 years. The nurse should speak with the family first if child abuse (child mistreatment) is suspected.

Child abuse (child maltreatment) and intimate partner violence are not the same thing. The concepts of "good touch" versus "bad touch" should be taught around the age of 10 years. The nurse should speak with the family first if child abuse (child mistreatment) is suspected. RATIONALE: Child abuse (child maltreatment) includes physical and emotional abuse as well as intimate partner violence. Parents should teach children the concept of "good touch" versus "bad touch" prior to the school-age years. If a school-age child's behavior yields suspicion of physical or intimate partner violence, the nurse should report it to the appropriate authorities in his or her state.

A nurse is assigned to care for a 7-year-old child. The child wants to show the nurse a collection of baseball cards. The nurse understands that the collection of objects is common in this age group and is known as what type of thinking? Classification Preoperational thinking Egocentric thinking Decentration

Classification RATIONALE: An important change in thinking during the school-age period is classification. This is the ability to divide things in different sets and identify their relationships to each other. Children in this age group love to collect sports cards, insects, rocks, stamps, coins, etc. These collections may be only a short-term interest, but they are of utmost importance to the child when he or she is collecting them. Decentration occurs in the concrete operational stage from ages 7 to 12 years. It is the ability to consider multiple aspects of a situation. The preoperational stage occurs between ages 2 and 7 years. During this time thinking is at a symbolic level. One part of the preoperational stage is egocentrism. In this stage, the child has the inability to see things from another's point of view.

The student nurse is providing preoperative care to a 9-year-old client scheduled for an appendectomy. Which action by the student will cause the registered nurse to intervene? Allows the child to select which arm will be used for the intravenous site. Explains the surgery using a diagram and simple anatomical terms. Delays preoperative teaching until immediately before the procedure. Provides the child with the opportunity to see and touch intravenous equipment.

Delays preoperative teaching until immediately before the procedure. RATIONALE: The nurse should use developmentally appropriate methods of teaching. Diagrams and seeing medical equipment meet the concrete thinking needs of a school-aged child. Allowing some decision-making by selecting the IV site promotes industry. Education should be provided in advance; delaying this is a strategy for a younger preschool-aged child who cannot conceptualize the passing of time.

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? Encourage the child to not worry about weight until he is older. Encourage activities that will increase his physical activity. Change to a very low-fat and no-carbohydrate diet. Encourage portion control at each meal

Encourage activities that will increase his physical activity. RATIONALE: 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 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. Provide the child with a weekly allowance. Encourage the child to develop new skills. Recommend the child investigate opportunities for volunteering at local charities. Allow the child to begin staying home alone after school when possible. Recommend the child begin to participate in after-school activities.

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

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. Commiserating with the child when he or she does not get selected for the school choir Voicing parental doubts when the child begins a new activity, such as playing a musical instrument to avoid embarrassment Praising the child for their academic efforts Participating on the school soccer team Allowing the child to assist her teacher in straightening up the classroom

Praising the child for their academic efforts Participating on the school soccer team Allowing the child to assist her teacher in straightening up the classroom RATIONALE: School-age children need support in order to achieve attainment of the developmental stage of industry vs. inferiority; parents can play a large role in the child accomplishing this. Encouraging participation in group sports, allowing children to assist their teacher and praising their academic efforts, even though they may not have made the best grade, are all ways to help the child accomplish this task. Expressing doubts about the child's abilities or defending them when they are not successful in accomplishing a skill only increases the chance the child will develop a sense of inferiority.

On physical examination, the nurse discovers that a 6-year-old child's palatine tonsils are somewhat enlarged in the back of the throat. What would be the nurse's best action? Suggest the health care provider examine the child for breathing difficulty. Take the child's temperature; this must be tonsillitis. Record this as a normal finding in an early school-age child. Give the child something for pain.

Record this as a normal finding in an early school-age child. RATIONALE: Lymphoid tissue reaches maximum growth in early school-aged children. The tonsils may decrease in size somewhat from the preschool years but they remain larger than those of adolescents. The tonsils and adenoids may appear larger than normal even in the absence of infection. The nurse would be correct to document this as a normal finding. The child would not need pain medication nor an examination for respiratory problems if this a normal finding.

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. Discuss with the child's teacher to determine if the number of absences has affected academic performance. Ask the child if he really has had respiratory infections during these absences. Continue to monitor the child's absences.

Speak with parents about the unusual increased number of respiratory infections. RATIONALE: 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 nurse is preparing a care plan for a school-age child to address the child's hospitalization. Which factor should the nurse incorporate into this plan? insists he or she can "do it" and then reverts to being dependent Grows and develops skills more rapidly than at any other time in his or her life can take in new information at a rapid rate and asks "why" and "how" a lot increased attention span and interest in an activity for a long length of time

increased attention span and interest in an activity for a long length of time RATIONALE: The school-aged child has a longer attention span and can become absorbed in a craft or activity for several hours. The preschool-aged child soaks in information and asks "why and "how" over and over. The toddler insists he or she can do things one minute and then becomes dependent the next minute. The infant grows and develops skills more rapidly than he or she ever will again.

The school nurse receives a report that a child is having difficulty with grades and always appears hungry. When the nurse is assessing this child, what information would be most important to ascertain? relationship with parents recent illnesses amount of food consumed daily amount of sleep

relationship with parents RATIONALE: Children who live with a parent with alcohol use disorder are at greater risk for having emotional problems than others because of the frequent disruption in their lives. Two symptoms children may exhibit are poor nutrition and decreasing grades in school because the parent's behavior is so erratic that no regular schedule of meal times or bed times exists. The child may experience helplessness to change the situation. Recent illnesses, the amount of sleep the child receives, and the amount of food consumed daily are also important factors, but in order to improve those the nurse would first need to understand the dynamics of the family and any problems with the parents.

The parent of a 13-year-old girl reports she is concerned her daughter is being bullied. What behaviors support the parent's suspicion? Select all that apply. aggression at home toward family members displays of cruelty toward animals reports of frequent headaches reports of stomachaches reports feeling "sad or down"

reports of frequent headaches reports of stomachaches reports feeling "sad or down" RATIONALE: Being bullied can have negative results on children throughout life. These children often have increased episodes of headaches, stomachaches, sleep problems, anxiety, loneliness, depression, and suicidal tendencies. Cruelty toward animals and aggression are not associated with bullying.

Which developmental findings would be considered normal for a 7-year-old child? Select all that apply. eye-hand coordination almost perfect weighs 7 times his birth weight increased in height 1 inch over the last year can see others' point of view engages in same-sex play activities

weighs 7 times his birth weight engages in same-sex play activities RATIONALE: At age 7, most children weigh 7 times their birth weight, grow about 2.5 inches each year and enjoy same-sex activities. Almost perfect eye-hand coordination and seeing others' point of view are not noted until age 9 or 10.