Chapter 28: Growth and Development of the School-Age Child
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? "Learning to ride the bike will improve her coordination." "Teach her where she'll land on the grass if she falls." "She won't need a helmet if she has training wheels." "Be sure to get the proper size bike."
"Be sure to get the proper size bike." 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 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." "Menarche is usually the first sign of puberty in school-aged girls." "Girls typically experience a rapid growth spurt before boys."
"Girls typically experience a rapid growth spurt before boys." Girls typically experience a rapid growth spurt before boys, and are usually taller by about 2 in (5 cm) or more than preadolescent boys. During the school-age years, the child will grow approximately 1 to 2.5 in (2.5 to 6.25 cm) per year. As puberty approaches, there will be significant differences in development between boys and girls. The first sign of puberty for girls is breast changes, not menarche.
A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed? "We will be sure that our daughter wears a life jacket the next time we go boating at the lake." "I will teach my son not to arrange a meeting with someone he met on the Internet." "My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." "I will teach my daughter her full name and phone number."
"My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." Children should be taught ways to stay safe and prevent accidents. All children should wear bicycle helmets; however, unless the bicycle has a sidecar, the bike riding is safe for only one rider. The parents are correct that their children should learn their names and addresses, should not set up a meeting with a person they met on the Internet without parental supervision, and should wear a life jacket when boating.
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? Distract the child by teaching a new skill, such as whistling. Allow the child to choose a reward for not biting the nails. Encourage the child to drink more milk for stronger nails. Allow some time every day for the child to talk about new experiences
Allow some time every day for the child to talk about new experiences 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.
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? classification conservation decentration reversibility
conservation Piaget described concrete operational thought occurring in the child ages 7 to 10 years. During this time the child develops various skills to see objects and the world. The skill of conservation is the ability to recognize that a change in shape does not necessarily mean a change in amount or mass. Using reversibility, the child can understand that processes can be reversed or canceled out by other things. Decentration is developed when the child can pay attention to multiple attributes of an object or situation instead of only one. In classification, the child is able to put objects together by shared qualities or characteristics.
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 peers at school the teacher characters in media such as television
parents All the above have an influence on the actions of the school-age child. The parents have the highest degree of influence on the school-age child's ultimate actions.
The student nurse is preparing a presentation on obesity in children. What information should the student nurse include regarding factors linked to causing obesity? Select all that apply. unsafe neighborhoods lack or reduced amount of recess periods during the school day reduced physical education programs family role modeling structured meals
reduced physical education programs unsafe neighborhoods lack or reduced amount of recess periods during the school day family role modeling Family role modeling, decreased days that school systems offer physical education programs, unsafe neighborhoods, and lack of recess time in school are all factors associated with obesity. Unstructured meals, not structured meals, are another factor associated with obesity.
The nurse is talking with a school-aged child about her interests. In which interest do most school-aged children place the most focus? church family school pets
school The school-age child typically values school attendance and school activities. During school-age, the focus expands from family to teachers, peers, and other outside influences.
The school nurse is speaking with a group of teachers about bullying. Which statement by a teacher would indicate a need for further education by the nurse? "Children who are bullied can have physical and psychological symptoms from being bullied." "Being bullied can have negative effects throughout a child's life." "Boys are twice as likely to be bullies and to be victims of bullying." "Boys bully more often but girls are more likely to be bullied."
"Boys bully more often but girls are more likely to be bullied." Both boys and girls are bullied and can bully others; however, boys are twice as likely to be bullies and victims of bullying. 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.
Parents of an 11-year-old child are bewildered that their child was caught stealing. The nurse best supports the parent by explaining which? This is one way for the child to increase his self-esteem. The child has not attained the ability to understand ownership. The child had a strong desire to have the item with little other way of obtaining it. The child was attempting to escape punishment.
The child had a strong desire to have the item with little other way of obtaining it. The nurse must consider the age of the child and compare with stages in moral development. The nurse would point out that the desire to have an item may have overcome the child's sense of right and wrong. Lying, not stealing, is used to escape punishment. Stealing is not a way to build self-esteem, although it may help the child gain a certain status among peers. The lack of understanding of ownership and property rights are typical of children between 6 and 8 years.
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: discussing death and dying may hint at a psychological disorder. consistent thoughts of death and dying at this age lead to the later development of depression. preoccupation with death and dying is common in the school-aged child. at this age, children are not afraid of death.
preoccupation with death and dying is common in the school-aged child. School-aged children are often preoccupied with thoughts of death and dying. There is no indication these thoughts will lead to mental health issues or the development of depression. School-aged children fear death but are fascinated by death and dying
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? "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." "If cheating is noted at this age, referral to a family counselor is highly recommended." "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior."
"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." 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 nurse is educating a group of parents about childhood nutrition, specifically caloric needs. Which statement, when made by a parent, indicates teaching was successful? "We will make sure that our 11-year-old child consumes at least 900 calories, primarily through protein sources." "I will assure that at least 75% of calories for my 10-year-old child's diet come from simple carbohydrate sources." "My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health." "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." 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 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? "You need to make sure your child has input regarding the food eaten." "Now is the time to let your child choose some of the meals." "You must let your child make some choices for oneself." "I want you to give your child choices about the food eaten."
"Now is the time to let your child choose some of the meals." 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.
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? "Why do you go to bed so late at night?" "Do your parents always let you stay up so late at night?" "That is not enough sleep. You should get at least 9 to 12 hours of sleep each night." "That should be enough sleep. Let's talk about your eating habits."
"That is not enough sleep. You should get at least 9 to 12 hours of sleep each night." The school-aged child needs 9 to 12 hours of sleep per night. Seven hours of sleep is not enough sleep for this child. It is not appropriate to ask judgmental questions concerning parenting skills nor why the child goes to bed at 11:00 PM.
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." You should talk to the child's teacher about putting less pressure on your child." "You should buy your other child a bank that cannot be opened." "Stealing is unusual for a 7-year-old child."
"You may need to remind your child about property rights." Antisocial behaviors develop during the school-age years. Between the ages of 6 and 8 years, the child has difficulty understanding the concept of ownership and property rights. At this age, children often take things because they like the look of an item. By age 9, children learn to respect other's possessions and property. Buying a more secure bank may keep the child from taking the money, but it does not take into consideration the child's developmental level. The behavior is a developmental issue and not an emotional issue of having too much pressure.
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? Playing with a jack-in-the-box Playing with blocks Writing letters to friends Participating in a craft project
Participating in a craft project During this stage, the child is interested in how things are made and run. The child learns to manipulate concrete objects. The child likes engaging in meaningful projects and seeing them through to completion. Playing jack-in-the-box and blocks are for much younger children. If anything, the child would be texting back and forth with friends, not writing a letter.
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? Record this as a normal finding in an early school-age child. Give the child something for pain. 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. 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? Ask the child if he really has had respiratory infections during these absences. 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. Continue to monitor the child's absences.
Speak with the parents about the unusual increased number of respiratory infections. 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 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. The child has different diet preferences than his parents. The child described a somewhat reduced appetite. The child's body fat has decreased since last year
The child has a leaner body mass than a girl at this age. The nurse would have found that the child still has a leaner body mass than girls at this age. Both boys and girls increase body fat at this age. Food preferences will be highly influenced by those of her parents. Although caloric intake may diminish, appetite will increase.
The parents of a 10-year-old boy report they are having problems with their son. The child's mother reports her son is not a talented athlete but her husband continues to encourage him to play and try to excel. The child's father reports sports will help his son build character. What response by the nurse is most appropriate? "Although your son is not a talented athlete, continue to encourage him to try." "Perhaps another pursuit would be better suited for your son." "It is important not to let him quit without trying." "Encouraging involvement in sports can build valuable skills for a child."
"Perhaps another pursuit would be better suited for your son." Children should be encouraged to try new things but, when they are faced with things they are not good at, the pressures can ultimately be counterproductive if they feel they are disappointing their parents or others of importance to them.
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." 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 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? The principle of conservation A sense of competence, mastery, and worth The conventional stage of development Lack of the ability to think abstractly
A sense of competence, mastery, and worth Erikson states that school-agers receive satisfaction from developing new skills and successfully using them to accomplish goals (industry). Failing (without adult support) or being unable to meet expectations that are set too high can result in feelings of inferiority. Lacking the ability for abstract thought is a cognitive skill and part of Piaget's theory, as is the principle of conservation. The conventional stage belongs to Kohlberg's theory of moral development.
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 Should brush their teeth at bedtime Be screened for scoliosis once a year Have a routine physical exam every 6 months
Needs 10 to 12 hours of sleep per night 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.
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? Playing with a jack-in-the-box Writing letters to friends Playing with blocks Participating in a craft project
Participating in a craft project During this stage, the child is interested in how things are made and run. The child learns to manipulate concrete objects. The child likes engaging in meaningful projects and seeing them through to completion. Playing jack-in-the-box and blocks are for much younger children. If anything, the child would be texting back and forth with friends, not writing a letter.
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 guess we better look for a pediatric dentist for our son." "I see now we need to use a fluoride toothpaste for our child." "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." 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.
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. Allowing the child to assist her teacher in straightening up the classroom 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 Commiserating with the child when he or she does not get selected for the school choir
Allowing the child to assist her teacher in straightening up the classroom Participating on the school soccer team Praising the child for their academic efforts 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.
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? Accommodation Perfectionism Industry Conservation
Industry During the early school years, children attempt to master their new developmental step: learning a sense of industry or accomplishment. 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. Perfectionism is the desire to do something perfectly. The boy's desire to apply the band-aid "the right way" is a hallmark of the development of industry. The other answers are not as pertinent.
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? Perfectionism Accommodation Conservation Industry
Industry During the early school years, children attempt to master their new developmental step: learning a sense of industry or accomplishment. 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. Perfectionism is the desire to do something perfectly. The boy's desire to apply the band-aid "the right way" is a hallmark of the development of industry. The other answers are not as pertinent.
The parents of a 9-year-old boy report they have been homeschooling their son and now plan to enroll him in the local public school. They voice concerns about the influence of the other children on their son's values. Which information should the nurse provide the parents? "Values are largely inborn and will be impacted only in a limited way by environmental influences." "At your son's age, values are most influenced by peers." "The values of the family will likely prevail for your son." "The teacher will begin to have the largest influence on a child's values at this age."
"The values of the family will likely prevail for your son." The values of a child are determined largely by the influences of their parents. As the child ages the impact of peers does begin to enter the picture. Children may also begin to test the values with their actions. In most cases the values of the family will prevail.
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 have improved gross motor skills." "I will grow an average of 2.5 in (6.5 cm) per year." "I will appear heavier due to an increase in fat production." "There are not many physical differences among school age boys."
"I will grow an average of 2.5 in (6.5 cm) per year." 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 working with a group of 8-year-olds who are learning about the concept of conservation of numbers. Which activity will help teach this concept to these school-aged children? Measuring the weight of a handful of popcorn and then the weight of a handful of pennies Stacking blocks in a tower and counting how many can be stacked without falling Forming vases from blocks of clay that are of various weights Rearranging a group of coins first into a circle, then a triangle and then a square
Rearranging a group of coins first into a circle, then a triangle and then a square In understanding the concept of conservation of numbers, the child understands that the number of objects does not change even though they may be rearranged. Conservation of weight can be accomplished by weighing different objects. Conversation of mass is demonstrated by forming vases out of clay.
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? "Tell her only losers smoke and chew tobacco." "As parents, you need to be good role models." "Keep your cigarettes where she can't get to them." "Always go outside when you have a cigarette."
"As parents, you need to be good role models." The nurse would recommend that the parents be good role models and quit smoking. Locking up or hiding your cigarettes and going outside to smoke is not as effective as having a tobacco-free environment in the home.
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? "If my child has moderate activity my child needs around 1500 calories per day." "Based on my child's weight and height, I should be concerned my child is overweight." "My child needs 1000 mg of calcium per day." "I should encourage my child to fill half of the plate with fruits and veggies."
"Based on my child's weight and height, I should be concerned my child is overweight." An 8-year-old girl needs between 1400 and 1600 calories per day. Based on the child's weight and height, the child has a body mass index (BMI) of 17.9 (around 75th percentile). To calculate BMI use [wt in lb/{ht in inches}x{ht in inches}] x703. This child is not in the overweight or obese category (>85th percentile is classified as overweight). An 8-year-old needs 1000 mg calcium per day. Children should be encouraged to fill half their plate with fruits and vegetables, to make half of their grains whole grains, and to choose lean proteins and calcium-rich foods.
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? "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." "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?" "That is so horrible that you are afraid of the dark. Can you sleep at night at all?"
"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?" 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 school nurse has completed an educational program for parents at a local elementary school. Which statement by a parent would indicate the need for further education? "My son should wear his helmet whenever he rides his bicycle. " "I need to get childproof locks fixed on the back doors of my car." "I will teach my 8-year-old to watch for cars backing up in parking lots." "It's okay for my 10-year-old to sit in the front seat of the car since he doesn't need a booster seat anymore."
"It's okay for my 10-year-old to sit in the front seat of the car since he doesn't need a booster seat anymore." Children under 12 should ride in the back seat of the car, even if they do not need a booster seat. Wearing helmets when riding, watching for cars backing up in parking lots, and using childproof locks on back doors in cars are all correct statements.
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." "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." "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." 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.
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 doubt A sense of shame A feeling of inferiority A sense of mistrust SUBMIT ANSWER
A feeling of inferiority Children who are unsuccessful in completing activities during the school-age phase, whether from physical, social, or cognitive disadvantages, develop a feeling of inferiority.
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? 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. Break the chore into smaller tasks that the child can accomplish more easily. Offer a treat as an incentive for completing the chore.
Break the chore into smaller tasks that the child can accomplish more easily. 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 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? Decentration Preoperational thinking Classification Egocentric thinking
Classification 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.
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? Encourage the child to abstain from eating sugary snacks at school. Accept that the child is genetically predisposed to having more cavities than most children. Ensure that the child brushes his teeth after each meal and snacks. Have the child's teeth professionally cleaned every 3 months. SUBMIT ANSWER
Ensure that the child brushes his teeth after each meal and snacks. Proper dental hygiene includes a routine inspection and conscientious brushing after meals. A well-balanced diet with plenty of calcium and phosphorus and minimal sugar is important to healthy teeth. Foods containing sugar should be eaten only at mealtimes and should be followed immediately by proper brushing. The school-aged child should visit the dentist at least twice a year for a cleaning and application of fluoride.
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? Weight 62 lb (28.1 kg) Height 49.5 in (124 cm) The child's weight is seven times his birth weight. The child has all of his adult teeth present
Height 49.5 in (124 cm) Normal physical growth for school-age children is a gain in height of 2.5 inches (6.25 cm) each year. Thus, a height of 49.5 in (124 cm) would be expected growth. The growth in weight is not within normal parameters as this is a 12 lb (5.4 kg) weight gain. A 7-year-old child, not 8-year-old child, should weigh seven times his birth weight. Adult teeth do not normally come in until age 10 to 12.
The 12-year-old child speaks with the school nurse about the stomachaches he has been having lately. He tells the nurse that he is upset because his best friend stole something and he knows this isn't acceptable behavior. The nurse identifies that this child is demonstrating which stage of moral development? Erikson's Industry vs. Inferiority Stage Kohlberg's Conventional Stage 4 Freud's Latency Stage Piaget's Concrete Operational Stage
Kohlberg's Conventional Stage 4 Kohlberg's Conventional Stage 4 describes the child as recognizing that acts are judged in terms of intention, not just punishment as in Kohlberg's Stage 3. Piaget's theory focuses on view of objects and abstract thoughts, Erikson's theory focuses on relationships, and Freud's theory focuses on tranquility between the Oedipal phase of early childhood and adolescence. Reference:
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. Peer pressure tends to cause the child to eat less. School-age children typically consume less food than adolescents. The school-age child is very selective in the type of foods they prefer. The caloric needs of the school-age child are lower than in the earlier years of life. The stomach capacity increases, which should permit retention of food for longer periods of time.
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. The stomach capacity increases, which permits retention of food for longer periods of time. In addition, the caloric needs of the school-age child are lower than in the earlier years. These are physiologic developmental reasons that support the nurse questioning if there is a problem.
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 establish relationships with the opposite sex time to remain dependent on their parents
a sense of security as children gain independence 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? encouragement for bullying and sexism immaturity for this age group poor peer relationships appropriate social development
appropriate social development 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.
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? build a sandcastle with a water-filled moat put together a model plane stack blocks in a tower form vases from blocks of clay
form vases from blocks of clay At about age 7, the child enters the concrete operational stage (as identified by Piaget). The skills of conservation (the ability to recognize that a change in shape does not necessarily mean a change in amount or mass) are significant in this stage. This begins with the conservation of numbers (when the child understands that the number of cookies does not change even though they may be rearranged) and the conservation of mass (when the child can see that an amount of cookie dough is the same whether in ball form or flattened for baking). This is followed by conservation of weight, in which the child recognizes that a pound is a pound, regardless of whether plastic or bricks are weighed. Conservation of volume (for instance, understanding that a cup of water is the same amount regardless of the shape of the container) does not come until late in the concrete operational stage at about 11 or 12 years of age.
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. keep her child home until this fear passes. ask the teacher to decide if the child should come to school or not each day. allow her child to decide daily if she wants to go to school or not.
make her child attend school every day. School refusal or phobia may result from both a parent not wanting a child to attend school and a child not wanting to leave a parent. Th nurse's role is to help them work together while keeping the child in school to resolve the issue.
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? "Would you say your son has a vocabulary of about 900 words?" "Does your son speak in complete sentences all the time?" "How well does your son communicate or follow instructions?" "Is your son's speech clear enough that anyone can understand it?"
"How well does your son communicate or follow instructions?" Asking how well the boy communicates and follows instructions is the best trigger question because it is open-ended. Asking if the child uses complete sentences or speaks clearly will elicit a yes or no answer about only those specific areas of development. The parents would have no way of judging the size of their child's vocabulary.
The school nurse is preparing to conduct routine health screenings of the elementary school students. Which screening will the nurse prioritize for students ages 6 to 8? review immunization records nutritional needs vision and hearing signs of scoliosis
vision and hearing Vision and hearing screening are often conducted by the school nurse, who then alerts the caregivers if there is a need for further evaluation from the health care provider. Most states have immunization requirements that must be met when the child enters school. Signs of scoliosis are usually evaluated at about the age of 10 to 11 years. There are no specific tests that the school nurse would use to evaluate nutrition; however, the nurse would be monitoring all students who come to the nurse's office for potential nutritional situations as deemed appropriate.
