Care of the school aged child

The nurse is caring for a 9-year-old boy with episodes of chronic pain. The nurse is educating the parents how to help the child manage pain nonpharmacologically. Which statement indicates a need for further teaching?

"We should start the method after he feels pain."

A parent is concerned about nutrition for her school-age child, voicing questions on how to encourage a healthy diet. The nurse would recommend which action? Select all that apply

Allow the child to voice food dislikes and respect them. Limit fat intake to no more than 35% of total calories to help control weight

What action by a parent would be least likely to foster development of self-confidence in a school-age child?

Comparing the child to an older sibling regarding academic achievements

The nurse is caring for a 10-year-old girl and is trying to obtain clues about the child's state of physical, emotional, and moral development. Which question is most likely to elicit the desired information?

"Tell me about your favorite activity at school?"

The nurse is collecting data on a 9-year-old child being admitted to the pediatric unit. What is the mostappropriate way to gather information from the child's caregiver?

Ask the caregiver questions and document the answers

The nurse is performing a physical assessment of an 11-year-old boy. The nurse notes that during last year's checkup the child weighed 80 lb (36.3 kg). Which assessment finding at this year's check-up is mostconcerning?

weight in the 5th percentile

A group of nursing students are reviewing information about bullying and children who are bullied. The students demonstrate a need for additional review when they identify which as characteristic of a bullied child?

having numerous friends

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

industry versus inferiority

The nurse caring for a hospitalized 8-year-old child recognizes that the child has developed an understanding of reversibility. Which of the following relates to the development of this understanding?

The child understands that his or her illness is probably only temporary

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 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 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

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?

Peer relationships

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 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 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 nurse is assessing the moral developmental level of children being seen in the clinic according to the Kohlberg's conventional stage of moral development. Which children does the nurse determine have met this stage of development? Select all that apply

the 8-year-old child who frequently asks the teacher if he is doing his math correctly the 10-year-old child who visits his elderly neighbor three times per week the 9-year-old child who tells his friends that they shouldn't throw rocks because they will "get in trouble" the 7-year-old child who yells at his mother, "I don't understand why I can't go to the park!" the 10-year-old who states, "I sure wouldn't want to be my friend taking that bad report card home."

After teaching the parents of a 9-year-old child about safety, which statement indicates the need for additional teaching?

"Our child can ride in the front seat of the car once reaching 10 years of age."

The nurse is conducting a health history for a 9-year-old child with stomach pains. What is a recommended guideline when approaching the child for information?

Allow the child to control the pace and order of the health history

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.

A parent has brought the child into the clinic for a routine health assessment. The parent asks when routine screening for back symmetry will begin. Which response by the nurse is most accurate?

School age

A school-aged child goes to the school nurse with a headache and stomachache. The child has normal physical exam findings. The nurse questions the child further, and the child confides experiences of being bullied by another child in the class. What is the best action made by the nurse?

Encourage the child to seek help from the teacher

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

What teaching points would a nurse provide for families of school-aged children to help prevent substance abuse? Select all that apply.

Give the child "what if" examples to situations they may face. Set firm rules regarding alcohol and other drug usage and discuss consequences associated with breaking the rules. Encourage decision-making and discuss family values.

The mother of a 12-year-old boy is talking with the school nurse about her son's clumsiness. She reports that he seems to fall a lot, his writing is horrible, and as much as he practices he can't play his guitar very well. How should the nurse respond to the mother?

Have you spoken with your pediatrician about your observations?

The nurse is caring for a 6-year-old child with burns on both hands. When assessing this child's pain, which technique would be most appropriate for the nurse to use?

Obtaining a self-report

The nurse is interviewing a 9-year-old child and during the interview the child states, "There's this kid at school who is always taking my lunch money and my homework." The nurse interprets this statement as which of the following?

Physical bullying

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 is important for your daughter's overall growth and development."

The nurse is providing anticipatory guidance to a parent of an 8-year-old girl whose weight is 65 lb (29.5 kg) and height is 50.5 in (128.3 cm). Which statement by the parent demonstrates the need for further teaching?

Based on my child's weight and height, I should be concerned my child is overweight

Brad is 8 years old and comes to the doctor with a cough. The diagnosis of pertussis is suspected because of what symptom?

Brad has a high-pitched inspiratory cough

The nurse is performing a health history on a 6-year-old child who is having trouble adjusting to a new school. Which question will elicit valuable information?

What are your new classmates like?

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?

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

The nurse is caring for an 11-year-old girl. The girl's mother reports that the girl does not want to play team sports like soccer or volleyball anymore. Her daughter insists she does not enjoy them. The mother is concerned that her daughter will not get enough physical activity and asks the nurse for guidance. How should the nurse respond?

"Give her some options; it's important to find something she enjoys."

The parents of a first grader ask the nurse for guidance in helping to promote success for their child in school and with his homework. Which suggestion would the nurse provide to help the parents meet that goal? Select all that apply

"Try setting up a specific time for homework to be done." "Be sure that the area for homework is quiet and without distractions." "Provide assistance but avoid doing the homework for your child."

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

The mother and her 8-year-old daughter come to the clinic for a well-child visit. The mother asks the nurse, "About how much sleep should my daughter be getting?" The nurse responds by saying

10-12 hours

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 teaching the parents of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which information would the nurse include in her teaching plan?

Continuous peer relationships provide the most important social interaction for school-age children

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

The nurse is providing education to the parents of a school-aged child. Which information would the nurse include in the teaching plan?

Discussion of the importance of proper use and fit of a helmet for bike riding

The mother of a 13-year-old child with special needs reports concerns with her child's requests to eat lunch in the cafeteria at school with the rest of the children as opposed to eating in the nurse's office. What information should be contained in the nurse's response?

Efforts should be made to accommodate your child's request

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 nurse is performing a physical examination of an 11-year-old girl. What observations would be expected?

The child has grown 2.5 inches since last year

The nurse is examining the heart and peripheral perfusion of an 8-year-old. The nurse will assess the apical impulse at which location?

The fifth intercostal space lateral to the left midclavicular line

The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma?

I'm going to have this hospital worker take a picture of your lungs

A female child has been diagnosed with precocious puberty at the age of 8. Which of the following would be an important teaching priority to tell the parents?

Your daughter is physically able to become pregnant

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