Chapter 28: Growth and Development of the School-Age Child - ML3

Correct response: "Now is the time to let your child choose some of the meals." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, HEALTHY PEOPLE 2030, p. 1022.

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? "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." "You need to make sure your child has input regarding the food eaten." "You must let your child make some choices for oneself."

Correct response: school Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, INTRODUCTION, p. 1008.

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 pets school family

Correct response: Needs 10 to 12 hours of sleep per night Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1023.

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

Correct response: A feeling of inferiority Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, TABLE 28.1 Developmental Theories, p. 1010.

A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? A feeling of inferiority A sense of doubt A sense of shame A sense of mistrust

Correct response: Participating in a craft project Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, HEALTHY PEOPLE 2030, p. 1025.

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 Writing letters to friends Playing with a jack-in-the-box Playing with blocks

Correct response: appropriate social development Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1017.

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

Correct response: Classification Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1023.

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? Egocentric thinking Decentration Classification Preoperational thinking

Correct response: "As parents, you need to be good role models." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, TEACHING GUIDELINES 28.2 Addressing Common Developmental Concerns, p. 1027.

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." "Always go outside when you have a cigarette." "Tell her only losers smoke and chew tobacco." "Keep your cigarettes where she can't get to them."

conservation

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? decentration classification conservation reversibility

Correct response: Allow some time every day for the child to talk about new experiences Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSIOLOGIC CHANGES, p. 1009.

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

Correct response: "Play helps children to develop cognitively, socially, physically, and emotionally." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, MOTOR SKILL DEVELOPMENT, pp. 1011-1012.

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? "Wow, that is a lot of stuff for a girl her age." "Play helps children to develop cognitively, socially, physically, and emotionally." "All of these other activities teach you as much as traditional play." "It is understandable not playing any more with all these other activities."

Correct response: "These are only his baby teeth so we are not worried." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1023.

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

Correct response: The child had a strong desire to have the item with little other way of obtaining it. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, TEACHING GUIDELINES 28.2, p. 1026.

Parents of an 11-year-old child are bewildered that their child was caught stealing. The nurse best supports the parent by explaining which? 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 child has not attained the ability to understand ownership. This is one way for the child to increase his self-esteem.

Correct response: 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. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSIOLOGIC CHANGES, p. 1009.

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. The school-age child is very selective in the type of foods they prefer. Peer pressure tends to cause the child to eat less. School-age children typically consume less food than adolescents. 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.

Correct response: The child has a leaner body mass than a girl at this age. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1021.

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's body fat has decreased since last year. The child described a somewhat reduced appetite. The child has different diet preferences than his parents.

Correct response: The child is comforted by participating in the rituals associated with their religion Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, MORAL AND SPIRITUAL DEVELOPMENT, p. 1011.

A 10 year-old child on the oncology unit has attended mass every Sunday in the hospital chapel during every stay in the facility. What does the nurse suspect is the most likely reason for this attendance? The child feels obligated to attend services because the parents feel strongly that religion is important. The child is afraid of dying and feels that going to mass may prolong life. The child likes to have distraction from the hospital environment by going to the chapel. The child is comforted by participating in the rituals associated with their religion

Correct response: parents Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, MORAL AND SPIRITUAL DEVELOPMENT, p. 1011.

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? the teacher characters in media such as television parents peers at school

Correct response: "Are you able to supervise your child's brushing?" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1024.

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?" "Is there fluoride toothpaste available for use?" "Did you teach your child how to brush the teeth?"

Correct response: industry versus inferiority. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PSYCHOSOCIAL DEVELOPMENT, p. 1009.

The developmental task of the school-aged period, according to Erikson, is gaining a sense of: industry versus inferiority. independence versus dependence. autonomy versus shame. identity versus failure.

Correct response: "Children this age sometimes can't distinguish between fantasy and reality." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, COGNITIVE DEVELOPMENT, p. 985.

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? "Is there any possibility he is telling the truth and you just don't know it is the truth?" "Children this age sometimes can't distinguish between fantasy and reality." "The child should have privileges taken away for several days each time he tells a lie." "Your child could be in serious trouble in school if he continues to tell lies."

Correct response: vision and hearing Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, SENSORY DEVELOPMENT, p. 1012.

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 signs of scoliosis nutritional needs vision and hearing

Correct response: Participating on the school soccer team Praising the child for their academic efforts Allowing the child to assist her teacher in straightening up the classroom Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PSYCHOSOCIAL DEVELOPMENT, p. 1009.

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 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

Correct response: "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?" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 1013.

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? "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?"

Correct response: "This may be normal growth of lymphatic tissue for this age." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSIOLOGIC CHANGES, p. 1009.

A mother brings her 8-year-old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that the mother is concerned that her breathing will be obstructed. The girl has no pain, fever or other symptoms. Following this data collection, which instruction is best? "An allergic reaction is often the cause. What type of allergies does she have?" "This may be normal growth of lymphatic tissue for this age." "With the increase in tissue size, tonsillitis is suspected." "A pituitary disorder may be the cause. Blood work may be indicated."

Correct response: Make time each day to spend with the child individually. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1023.

A mother states that her 6-year-old has starting biting nails and regressing to baby talk since beginning school. What instructions are best for the nurse to give the mother regarding this behavior? Get a description of the classroom behavior from the teacher. Make time each day to spend with the child individually. Remind the child to stop each time the behavior is witnessed. Apply a nail biting product to the nails to deter biting.

Correct response: "My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, Teaching Guidelines 28.1, p. 1020.

A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed? "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." "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."

Correct response: A paint-by-numbers activity creating a picture Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, TEACHING GUIDELINES 28.2, p. 1026.

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

Correct response: 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. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1021.

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 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 lowest percentage of child abuse (child mistreatment) is due to emotional abuse. The nurse should speak with the family first if child abuse (child mistreatment) is suspected.

Correct response: "Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1023. The number of hours of sleep required for growth and development decreases with age. Children between the ages of 6 and 8 years require about 12 hours of sleep per night, children between 8 and 10 years of age require 10 to 12 hours of sleep per night, and children between 10 and 12 years of age need 9 to 10 hours of sleep per night. Young school-age children may need an occasional brief nap for an energy boost after being in school for most of the day.

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 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 at least 9 hours of sleep per night."

Correct response: Arrange a conference with the parents, son, and nurse to discuss the child's concerns. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSICAL GROWTH, p. 1008.

An 11-year-old boy is significantly above the 100% percentile for height. The boy tells the school nurse that his parents expect so much out of him when he is playing basketball for the school team that he is thinking of quitting. What action should the nurse take? Remind the boy that being so much taller than the other boys is why others have higher expectations for him. Tell the parents that they should stop putting so much pressure on their son just because he is tall. Arrange a conference with the parents, son, and nurse to discuss the child's concerns. Encourage the boy to talk to his coach to determine if his parents' expectations are realistic.

Correct response: The child has 28 permanent teeth. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSIOLOGIC CHANGES, p. 1009.

An 11-year-old child is preparing to see the dentist to have his teeth cleaned. Which finding would considered most appropriate for this age? The child has 2 primary teeth and 26 permanent teeth. The child has 32 permanent teeth. The child has 4 primary teeth and 24 permanent teeth. The child has 28 permanent teeth.

Correct response: Industry Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 1025.

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 Industry Accommodation Conservation

Correct response: Ensure that the child brushes his teeth after each meal and snacks. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1024.

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? Have the child's teeth professionally cleaned every 3 months. 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. Encourage the child to abstain from eating sugary snacks at school.

Correct response: Height 49.5 in (124 cm) Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSICAL GROWTH, p. 1008

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? The child's weight is seven times his birth weight. The child has all of his adult teeth present. Weight 62 lb (28.1 kg) Height 49.5 in (124 cm)

Correct response: "That is not enough sleep. You should get at least 9 to 12 hours of sleep each night." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, Promoting Healthy Sleep and Rest, p. 1023.

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 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."

Correct response: Record this as a normal finding in an early school-age child. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSIOLOGIC CHANGES, p. 1009. 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.

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. Suggest the health care provider examine the child for breathing difficulty. Give the child something for pain. Take the child's temperature; this must be tonsillitis.

Correct response: Kohlberg's Conventional Stage 4 Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, TABLE 28.1- MORAL AND SPIRITUAL DEVELOPMENT, pp. 1010-1011.

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? Kohlberg's Conventional Stage 4 Piaget's Concrete Operational Stage Erikson's Industry vs. Inferiority Stage Freud's Latency Stage

Correct response: "Be sure to get the proper size bike." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, TEACHING GUIDELINES 28.1, pp. 1019-1020.

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."

Correct response: A sense of competence, mastery, and worth Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PSYCHOSOCIAL DEVELOPMENT, p. 1009.

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 The principle of conservation The conventional stage of development A sense of competence, mastery, and worth

Correct response: Consider an action and its consequences. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, COGNITIVE DEVELOPMENT, p. 1010.

The nurse is about to see a 9-year-old girl for a well-child checkup. Knowing that the child is in Piaget's period of concrete operational thought, which characteristic should the child display? View the world in terms of her own experience. Know lying is bad because she gets sent to her room for it. Consider an action and its consequences. Make generalized assumptions about groups of things.

Correct response: "Your child should grow approximately 10 in (25 cm) over the next 4 years." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSICAL GROWTH, p. 1008.

The nurse is caring for a 9-year-old male child who is being seen for a well-child care visit. During the visit, the child's parent reports the child is one of the shorter children in his class. The parent asks how much more the child will grow in the next few years. Which response by the nurse is appropriate? "It is hard to tell at this point." "Your child should grow approximately 10 in (25 cm) over the next 4 years." "Children in this age range can expect to grow about 1 in (2.5 cm) per year until they are about 15 years old." "Your child will likely get taller; it may take at least 5 years for growth to begin."

Correct response: a sense of security as children gain independence Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 1014. 9 year old take their peer groups seriously. They are more interested in how other children dress than what their parents want them to wear. This is the club age where groups are formed and others are excluded from the club. This age group is imitating their peers as they develop their own identify 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. 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 groups relationships are the same -sex friends. Children do not become self-sufficient through these clubs. They remain dependent on their families for their physical needs.

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? time to establish relationships with the opposite sex an opportunity for children to become self sufficient time to remain dependent on their parents a sense of security as children gain independence

Correct response: "I make him eat some of everything I put on his plate." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 1021-1022. Explanation: Children will usually accept new foods if they aren't forced upon them. It is better to offer new foods and let the child accept them when he is ready. Children will go on "food strikes" and they will also go through periods of wanting the same foods. Preference of how the child eats lets them exert some independence and allows for experimentation.

The nurse is discussing nutrition with the mother of a 6-year-old boy. Which response by the boy's mother indicates a need for further discussion? "He won't eat any kind of meat except for hot dogs." "My son mixes all of his food together when he eats it." "I make him eat some of everything I put on his plate." "All he wants to eat is peanut butter sandwiches."

correct response: "My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1022. 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."

Correct response: Helping the child deal with minor stresses. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 1013. The child with an easy temperament will adapt to school with only minor stresses. The slow-to-warm child will experience frustration. The difficult child will be moody and irritable and may benefit from a preschool visit.

The nurse is educating the parents of a 6-year-old boy how to manage the child's introduction into elementary school. The child has an easy temperament. Which action should the nurse suggest? Helping the child deal with minor stresses. Being firm with episodes of moodiness and irritability. Scheduling several visits to the school before classes start. Comforting the child when he is frustrated.

Correct response: "Based on my child's weight and height, I should be concerned my child is overweight." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, Promoting Nutrition; Calculation of Body Mass Index (BMI) Box 32.1, pp. 1021-1023, 1134.

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." "I should encourage my child to fill half of the plate with fruits and veggies." "My child needs 1000 mg of calcium per day." "Based on my child's weight and height, I should be concerned my child is overweight."

Correct response: "Is there a family history of hypertension, heart disease, or diabetes?" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, BOX 28.2 Dietary Questions, p. 1022.

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

Correct response: "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 1028.

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." "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." "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior."

Correct response: "My child sleeps between 11 and 12 hours a night." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1023.

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which statement made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child? "My child stays up late when she takes a nap after school." "My child does not even know when he is tired." "My child sleeps between 11 and 12 hours a night." "My teenage child does not sleep as much as my 9-year-old does."

Correct response: "I will grow an average of 2.5 in (6.5 cm) per year." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSICAL GROWTH, p. 1008.

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."

You Selected: "Girls typically experience a rapid growth spurt before boys." Correct response: "Girls typically experience a rapid growth spurt before boys." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSIOLOGIC CHANGES, p. 1009.

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." "Girls typically experience a rapid growth spurt before boys." "Menarche is usually the first sign of puberty in school-aged girls." "Boys normally grow an average of 5 in (12.5 cm) each year."

Correct response: They are able to classify objects. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, COGNITIVE DEVELOPMENT, p. 1010.

The nurse is teaching a growth and development class to parents of school-age children. What does the nurse teach the parents about the cognitive abilities of their children? They can make judgements based on scientific facts. They are able to classify objects. They make judgments on what they reason. They have developed the ability to reason abstractly.

Correct response: Discuss tobacco and alcohol use and effects with the child. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 1029.

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

Correct response: Rearranging a group of coins first into a circle, then a triangle and then a square Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, MOTOR SKILL DEVELOPMENT, p. 987.

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 Forming vases from blocks of clay that are of various weights Stacking blocks in a tower and counting how many can be stacked without falling Rearranging a group of coins first into a circle, then a triangle and then a square

Correct response: Encourage the child to develop new skills. Recommend the child begin to participate in after-school activities. Recommend the child investigate opportunities for volunteering at local charities. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, MOTOR SKILL DEVELOPMENT, p. 1011.

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

Correct response: "Perhaps another pursuit would be better suited for your son." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, MOTOR SKILL DEVELOPMENT, p. 1012.

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? "It is important not to let him quit without trying." "Perhaps another pursuit would be better suited for your son." "Although your son is not a talented athlete, continue to encourage him to try." "Encouraging involvement in sports can build valuable skills for a child."

Correct response: "Before adolescence the body fat composition of school-age children increases earlier and in greater amounts in girls than in boys." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1021. Boys have more lean body mass per inch of height than girls during the late school-age years, in preparation for adolescence.

The parents of a 10-year-old girl voice concern to the nurse because their daughter seems to "have a higher amount of body fat" than they expect based on the healthy eating habits and high activity level of the family. What is the best response by the nurse? "Before adolescence the body fat composition of school-age children increases earlier and in greater amounts in girls than in boys." "Her metabolism may be slower than the rest of your family. Try increasing her activity to see if her body fat decreases." "Girls are always heavier than boys it seems. I'm sure she just falls into that category." "Do you think maybe your daughter eats in the evening or when you are monitoring her intake at home? You may want to ask her."

Correct response: "Normal growth and development for this age results in an average weight gain of 7 pounds per year." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PHYSICAL GROWTH, p. 1008.

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." "Your child doesn't seem to be overweight, so it isn't a concern." "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain."

Correct response: "Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 1013.

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? "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." "The peers of a child at this age are the greatest influence on self-esteem."

Correct response: Compromised parental coping related to inability to assist with school fears Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1027.

The parents of a school-aged child with school refusal have received professional guidance by the school psychologist, pediatrician, and three different psychiatrists. Based on this, which nursing diagnosis would be most appropriate? Disturbed thought processes related to delusional behavior Compromised parental coping related to inability to assist with school fears Noncompliance with expected school behavior related to school phobia Ineffective tissue perfusion, cerebral, related to anxiety over attending school

Correct response: "Bullying can have lifelong effects on the self-esteem of a child." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, TEACHING GUIDELINES 28.2 Addressing Common Developmental Concerns, pp. 1026-1027

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." "Fortunately the scars of being picked on will fade as your son grows up." "Perhaps teaching your son self-defense courses will help him to have a greater sense of control and safety."

Correct response: "Remind her in simple terms what will happen in the dentist's office." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 1013.

The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond? "Remind your daughter of the importance of proper oral hygiene." "Wait to tell her about the visit until just before the appointment." "Remind her in simple terms what will happen in the dentist's office." "Tell your daughter that it is just like going to see the pediatrician."

Correct response: The child focuses on being a good girl or boy. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, MORAL AND SPIRITUAL DEVELOPMENT, p. 1011.

When considering the moral development of a 7-year-old child, which actions are most consistent with the anticipated state of development? The child gears his actions to avoid doing the wrong thing and getting "into trouble". The child only gives consideration to how the actions will impact himself. The child focuses on being a good girl or boy. The child considers the impact of actions on others in his environment.

Correct response: does not understand the phrase "slow as molasses" when used by the teacher Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, COGNITIVE DEVELOPMENT, p. 1010.

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 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 arrives to class late from recess and apologizes to the teacher

Correct response: Assess the situation with the help of the school staff and parents. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 28: Growth and Development of the School-Age Child, THE NURSE'S ROLE IN SCHOOL-AGE GROWTH AND DEVELOPMENT, p. 1016. 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.

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