Chapter 18: Care of the School Age Child

A 17-year-old female adolescent informs the primary health care provider they have not yet had a menstrual period. Several diagnostic tests were completed and no pathology has been identified. In preparing for the adolescent's follow-up appointment, the nurse is correct to prepare instruction around which hormone? testosterone progestin growth hormone estrogen

estrogen

A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to: allow her child to decide daily if she wants to go to school or not. make her child attend school every day. ask the teacher to decide if the child should come to school or not each day. keep her child home until this fear passes.

make her child attend school every day.

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? folding clothes raking leaves vacuuming putting books on shelf

putting books on shelf

The parents of an 8 year-old state, "I am happy that our child is healthy," when the nurse says that the child falls into the 95th percentile for BMI. How should the nurse respond? "Being in the 95th percentile for BMI is not a good thing. Your child is on the verge of obesity. It would be a good idea to consider this with meal planning." "The 95th percentile is not an indication of health." "For a child a BMI between the 85th and 95th percentile alerts us to the risk for being overweight. Let's talk about your child's diet and activity level." "I will let the physician know that your child is in the 95th percentile for BMI."

"For a child a BMI between the 85th and 95th percentile alerts us to the risk for being overweight. Let's talk about your child's diet and activity level."

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? "There are not many physical differences between school-aged boys and girls." "Boys normally grow an average of 5 in (12.5 cm) each year." "Girls typically experience a rapid growth spurt before boys." "Menarche is usually the first sign of puberty in school-aged girls."

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

The school nurse is speaking with a child who is a latch-key kid. Which statement by the child would need further investigation? "I always check the caller ID before I answer the phone. I don't answer it if I don't know who the caller is." "I know I'm not allowed to have my friends over until my mom gets home from work." "My dad has every emergency number I could want posted next to the phone." "I answered the door yesterday and the salesman wanted to come in even though my mom wasn't home."

"I answered the door yesterday and the salesman wanted to come in even though my mom wasn't home."

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? "There are not many physical differences among school age boys." "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." "I will have improved gross motor skills."

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

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

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

An adolescent asks the nurse what the term "puberty" means. What is the nurse's best response? "It denotes the beginning of secondary sex characteristics." "It is the time span that denotes the onset of maturity." "It is the age at which one first becomes capable of sexual reproduction." "It is the time span between 12 and 18 years."

"It is the age at which one first becomes capable of sexual reproduction."

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." "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."

"My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health. Explanation: 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 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."

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? "Children in this age range on average gain about 5 lb (2.3 kg) per year." "Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." "Your child does seem to be rapidly gaining weight." "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."

Typical development for the school-aged child includes playing games with friends. At what age are children typically ready for games that include playing on a team that has a winner or loser? 10 years 7 years 5 years 13 years

10 yearsExplanation:Consider growth and development when advising. Erikson's stages can be helpful in determining. Before about 10 years, children are unable to lose a game and still maintain the self-concept that they are good people.

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 sense of mistrust A sense of doubt A feeling of inferiority A sense of shame

A feeling of inferiority

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? Lack of the ability to think abstractly A sense of competence, mastery, and worth The principle of conservation The conventional stage of development

A sense of competence, mastery, and worth

The nurse is educating the parents of a 10-year-old girl in ways to help their child avoid tobacco. Which suggestion should be part of the nurse's advice? "As parents, you need to be good role models." "Keep your cigarettes where she can't get to them." "Tell her only losers smoke and chew tobacco." "Always go outside when you have a cigarette."

As parents, you need to be good role models."

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? being accepting of mistakes the child makes comparing the child to an older sibling regarding academic achievements focusing on what the child is saying in a conversation having clear expectations of behavior whenever the family is out in public

Correct response:Comparing the child to an older sibling regarding academic achievements Explanation: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.

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? Discuss tobacco and alcohol use and effects with the child. Keep any alcohol products in the home in a locked cabinet. Avoid smoking in the house or in front of the child. Encourage the child to avoid having friends who smoke or drink.

Discuss tobacco and alcohol use and effects with the child

The nurse is working with a 15-year-old hospitalized with a chronic illness. Which action by the nurse might help the chronically ill teen thrive while hospitalized? Encourage the teen to talk to friends on the phone and connect with friends on the computer by email. Have the child's caregivers make all treatment and care decisions. Encourage the client to keep his or her limitations foremost in mind when trying a new skill or task at which his or her peers have begun to excel. Make a sticker chart with the teen to encourage the child to reach desired goals.

Encourage the teen to talk to friends on the phone and connect with friends on the computer by emailThe chronically ill child of any age should be encouraged to participate in age-appropriate activities. Contact with peers and friends are an important aspect of normal adolescent growth and development.

The nurse is providing discharge teaching to an adolescent who has been treated for pelvic inflammatory disease (PID). What would the nurse include as a preventive measure? Insisting that sexual partners use condoms Using oral contraceptives as prescribed Suggesting that sexual partners use antibiotic ointment Using a vaginal douche routinely

Insisting that sexual partners use condoms

When providing anticipatory guidance to a group of parents with school-aged children, what would the nurse describe as the most important aspect of social interaction? School Family Temperament Peer relationships

Peer relationships

The parent of an adolescent has called to talk to the pediatric nurse over concern that her daughter is not getting proper nutrition now that she has started following a vegetarian diet. Which response should the nurse prioritize for this parent? Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes. Lacto-ovo vegetarian diets are acceptable for teens but, until the body's growth cycle is complete, she needs some egg and dairy products for good health. A vegetarian diet is unhealthy for growing bodies, and teens are too immature to make a healthy decision. Vegetarian diets can be healthy for teens but should be supplemented with protein drinks and megavitamins.

Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes.

The nurse is inspecting the genitals of a prepubescent girl. What is a normal sign of the onset of puberty? appearance of pubic hair around age 11 to 13 years swelling or redness of the labia minora lesions on the external genitalia presence of labial adhesions

appearance of pubic hair around age 11 to 13 years