Chapter 28: Growth and Development of the School-Age Child
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? 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. Take away any toys or items that are left on the floor if not cleaned up.
Break the chore into smaller tasks that the child can accomplish more easily. Explanation: 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 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? characters in media such as television peers at school the teacher parents
parents Explanation: 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 nurse is talking with a school-aged child about her interests. In which interest do most school-aged children place the most focus? family church pets school
school Explanation: 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.
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." "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?" "That is so horrible that you are afraid of the dark. Can you sleep at night at all?" "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?"
"It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?" Explanation: The school-age child needs reassurance that his or her fears are normal for this developmental age. Parents, teachers, and other caretakers should discuss the fears and answer questions posed by the child. However, the adult should not embellish the fear in any way. In addition, telling the child that she will "grow out of it" is not reassuring to the child.
The nurse is caring for a hospitalized 10-year-old client. Which nursing action is most appropriate? Structure a competitive environment between clients. Consistently reinforce the child's self-worth. Correct each of the child's mistakes to ensure learning. Discourage the child from assisting with dressing change.
Consistently reinforce the child's self-worth. Explanation: Helping school-aged clients experience satisfaction in projects, social activities, family life, and school helps them gain a sense of industry. Reinforcing self-worth provides this satisfaction. The child should not be discouraged from participating in his or her care. The child's mistakes may need corrected to learn; however, the child has to be allowed to make mistakes in a safe environment to promote learning. Pointing out these mistakes needs to be done with care. Competition between clients will not facilitate growth and development or psychosocial development.
The parents of a 6-year-old client are interested in promoting learning through reading to their child. Which suggestion by the nurse will best promote this goal? Begin reading chapter books to the child. Tell the child to read instead of watching TV. Choose which books the child should read initially. Take the child to the library to check out books.
Take the child to the library to check out books. Explanation: Taking the child to the library can be a positive start to the reading experience. It is best to let the librarian recommend books that will be appropriate for the child, but let the child choose from recommended materials. Parents can set an example by reading instead of watching TV while the child is not in bed. Reading to the child is a valuable parent-child activity that can expose the child to classic works that are beyond the child's present reading ability. Chapter books are recommended for older school-age children.
The school nurse reviews the language development of school-aged children. Which behavior best demonstrates the development of metalinguistic awareness? The child enjoys speaking on the phone. The child enjoys telling jokes and riddles. The child enjoys reading the lyrics to songs. The child enjoys reading books out loud.
The child enjoys telling jokes and riddles. Explanation: Language skills continue to accelerate during the school-age years. School-aged children develop metalinguistic awareness—an ability to think about language and comment on its properties. This enables them to enjoy jokes and riddles due to their understanding of double meanings and play on words and sounds. While the other activities are enjoyed by school-aged children, they do not demonstrate metalinguistic awareness.
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 arrives to class late from recess and apologizes to the teacher believed that not turning in homework on time was acceptable, but has since decided it is not acceptable enjoys math instruction and decides to join the math club
does not understand the phrase "slow as molasses" when used by the teacher Explanation: Piaget's stage of cognitive development for the 7- to 11-year-old is the period of concrete-operational thoughts. In developing concrete operations, the child is able to assimilate and coordinate information about his or her world from different dimensions. Abstract thinking, such as understanding the meaning of the phrase "slow as molasses," is expected at this stage of cognitive development.
The nurse is performing a physical assessment of an 11-year-old boy. The nurse notes that during last year's checkup the child weighed 80 lb (36.3 kg). Which assessment finding at this year's check-up is most concerning? height 56 inches (140 cm) body mass index (BMI) 20 weight in the 5th percentile weight 85 lb (38.6 kg)
weight in the 5th percentile Explanation: A child in the 5th percentile for weight is most concerning. At last year's checkup, the child was 10 years old with a weight of 80 lb (36.3 kg), which placed the child in between the 75th and 90th percentile for weight. A sudden decrease in percentile within a one-year time frame indicates a potential problem with growth or nutrition. From 6 to 12 years of age, an increase of 3 to 7 lb (1.3 to 3.5 kg) on average per year in weight is expected. A BMI of 20 is considered healthy. A height of 56 in (140 cm) is near the 50th percentile and considered normal.
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." "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." "Girls typically experience a rapid growth spurt before boys."
"Girls typically experience a rapid growth spurt before boys." Explanation: 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 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? "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 at least 9 hours of sleep per night." "Your child should be getting 8 to 9 hours of sleep per night." "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." Explanation: 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.
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? Make time each day to spend with the child individually. Remind the child to stop each time the behavior is witnessed. Get a description of the classroom behavior from the teacher. Apply a nail biting product to the nails to deter biting.
Make time each day to spend with the child individually. Explanation: Many first graders are capable of mature action at school but appear less mature when they return home. They may bite their fingernails, suck their thumb, or talk baby talk. Scolding, nagging, threatening, or punishing does not stop the problem and can actually make them worse. Methods such as bad-flavored nail polish or restraining the child's hands make the problems worse. These behaviors stop when the underlying stress is discovered and alleviated. Parents should be urged to spend time with the child after school or in the evening so the child continues to feel secure in the family and does not feel pushed out by being sent to school.
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 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 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 is comforted by participating in the rituals associated with their religion Explanation: While any of these scenarios could be true in some circumstances, the most common reason most children attend services while being hospitalized is that they find comfort in participating in their religious practice rituals.
A nurse is providing anticipatory guidance to the parents of an 8-year-old child, explaining that when the child returns next year for a well check-up, the child will likely undergo which screening? scoliosis lead sexually transmitted infections hepatitis B
scoliosis Explanation: Scoliosis may become apparent for the first time in late childhood. All school-age children older than 8 years should be screened for scoliosis at all health assessments. Lead screening is done earlier. Screening for sexually transmitted infections or hepatitis B is not age-dependent and would not be done unless there is an indication of high risk behavior.
A nurse is assisting with a seat belt clinic at a local community center. Which parents should the nurse speak with after inspecting their seat belt use? Select all that apply. the parents of a 6-year-old who has the shoulder belt behind the back due to the strap lying across the face the parents who ask their 9-year-old child to fasten the seat belt before the parent starts the car the parents of a 10-year-old whose child is sitting in the front seat with the seat belt properly fastened the parents of a 12-year-old who still uses child-proof locks in the back seats the parents of an 8-year-old who check to see if the lap belt portion of the seat belt is lying low on the hips
the parents of a 10-year-old whose child is sitting in the front seat with the seat belt properly fastened the parents of a 6-year-old who has the shoulder belt behind the back due to the strap lying across the face Explanation: Children under 12 years of age should sit in the back seat of the vehicle. Shoulder belts should not be behind the child; the shoulder belt should lie on the shoulder, not the neck or face. If the child is too short for the belt to lie on the shoulder, a booster seat or belt clip should be used.
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 Egocentric thinking Classification Preoperational thinking
Classification Explanation: An important change in thinking during the school-age period is classification. This is the ability to divide things in different sets and identify their relationships to each other. Children in this age group love to collect sports cards, insects, rocks, stamps, coins, etc. These collections may be only a short-term interest, but they are of utmost importance to the child when he or she is collecting them. Decentration occurs in the concrete operational stage from ages 7 to 12 years. It is the ability to consider multiple aspects of a situation. The preoperational stage occurs between ages 2 and 7 years. During this time thinking is at a symbolic level. One part of the preoperational stage is egocentrism. In this stage, the child has the inability to see things from another's point of view.
The nurse is caring for a 7-year-old child who will be in the hospital for several weeks. Which action by the nurse will facilitate the child's psychosocial development? Encourage the child to complete school work and provide guidance. Allow the child's peers to visit often. Quickly come to the room while the child presses the call bell. Ask the child what color gown he or she prefers to wear daily.
Encourage the child to complete school work and provide guidance. Explanation: At this age, Erikson states the child's stage of psychosocial development is industry versus inferiority. To meet this stage, children need to develop a sense of pride and accomplishment for their schoolwork, sports, activities, or social life, or they will feel inferior. The nurse can encourage the child to complete his or her schoolwork and assist the child as needed to help facilitate this stage. An adolescent needs peer interaction. Selecting what to wear facilitates autonomy, a stage for children 2 to 3 years of age. Quickly responding to the call bell facilitates trust, a stage for neonates through their first year.
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? reversibility decentration classification conservation
conservation Explanation: 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 12-year-old child tells the school nurse, "I do not understand why my parents will not allow me to go to concerts without chaperones like some of my friends' parents. I feel like a baby compared to my friends." How will the nurse respond? "Your parents are right. Twelve years of age is too young to be attending concerts without a chaperone." "I am sure your parents are worried about your safety when attending concerts at a young age." "Have you given any thought to why they do not let you go without a chaperone?" "You are so young that you have plenty of time to go to concerts alone. Your parents care about you."
"Have you given any thought to why they do not let you go without a chaperone?" Explanation: Keeping dialogue open with the child and encouraging exploration of feelings is beneficial and therapeutic communication. This will allow the child to identify reasons without being told why the parents have this rule. The nurse would explore reasons and rationales with the client. Peer pressure can be difficult for children to manage. Helping them identify reasons for the parents' actions can help. Telling the child how to feel or that the parents only care does not allow conversation.
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? "That is not enough sleep. You should get at least 9 to 12 hours of sleep each night." "Do your parents always let you stay up so late at night?" "Why do you go to bed 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." Explanation: 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.
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." "These are only his baby teeth so we are not worried." "I see now we need to use a fluoride toothpaste for our child." "I guess we will need to supervise our son while he brushes."
"These are only his baby teeth so we are not worried." Explanation: 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.
The parents of a 9-year-old child voice concern that the child seems to be gaining weight rapidly. The nurse reviews the medical record and notes the child has increased weight by 6 or 7 lb (2.7 to 3.2 kg) per year for the past 2 years. What response by the nurse is indicated? "Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." "Your child does seem to be rapidly gaining weight." "On the contrary, your child's annual weight gain is somewhat low for this age." "Children in this age range on average gain about 5 lb (2.3 kg) per year."
"Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." Explanation: Children who are between the ages of 6 and 12 years usually gain about 7 lb (3.2 kg) per year. The child in the scenario is gaining weight at a normal rate.
A 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." "Stealing is unusual for a 7-year-old child." "You should buy your other child a bank that cannot be opened."
"You may need to remind your child about property rights." Explanation: 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.
The nurse is performing a physical assessment of a 10-year-old child. The nurse notes that 1 year ago the child weighed 80 lb (36.3 kg). Which weight, if noted during this assessment, would alert the nurse to further assess the child for appropriate growth and development? 82 lb (37.2 kg) 87 lb (39.5 kg) 88 lb (40 kg) 86 lb (39 kg)
82 lb (37.2 kg) Explanation: From 6 to 12 years of age, an increase of 7 lb (3 to 3.5 kg) per year in weight is expected, so would be a target weight of 87 lb (39.5 kg). A child weighing near 87 lb, such as 86 lb (39 kg) or 88 lb (40 kg), would be considered appropriate. If the child weighed only 82 lb (37.2 kg), this would alert the nurse to further assess the child for lagging growth.
A nurse is caring for a hospitalized 7-year-old child whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group? An activity focusing on learning fractions A paint-by-numbers activity creating a picture A board game such as monopoly A card game such as solitaire
A paint-by-numbers activity creating a picture Explanation: Between the ages of 6 and 8 years, children begin to enjoy participating in real-life activities, such as helping with gardening, housework, and other chores. They love making things, such as drawings, paintings, and craft projects. The child would need additional instruction to learn fractions, which may not be considered fun. A card game such as solitaire and a board game of monopoly may be too hard for the 7-year-old. In addition, the game of monopoly would require additional players.
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? A sense of competence, mastery, and worth Lack of the ability to think abstractly The principle of conservation The conventional stage of development
A sense of competence, mastery, and worth Explanation: 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.
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? Conservation Industry Perfectionism Accommodation
Industry Explanation: 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 nurse is providing anticipatory guidance for parents of a school-age child on teaching the dangers of drugs and alcohol. What advice might be helpful for these parents? School-age children are not ready to absorb information that deals with drugs and alcohol. Parents must prevent their child from being exposed to messages that are in conflict with their values. Discussions with children should focus on past events and future consequences. School-age children can think critically to interpret messages seen in advertising, media, and sports.
School-age children can think critically to interpret messages seen in advertising, media, and sports. Explanation: School-age children can be taught how to think critically to interpret messages seen in advertising, media, sports, and entertainment personalities. School-age children are ready to absorb information that deals with drugs and alcohol and may be exposed to messages that are in conflict with their parents' values regarding smoking and alcohol. This may occur at school and cannot be prevented. Discussions with children need to be based on facts and focused on the present.
The nurse is preparing an in-service training session on Erikson's theories for the pediatric nurses. Which task should the nurse prioritize as an example for the school-aged child? wants to tie their own shoes no matter how long it takes understands the need for discipline insists on doing things their way instead of their caregivers will work on a picture until it is finished
will work on a picture until it is finished Explanation: The developmental task for the school-aged child is to develop a sense of industry, and completing activities builds that feeling of confidence. This can include working with arts and crafts. The adolescent developing his or her own personality is trying to break from their caregivers' methods. Erikson's psychosocial developmental task for toddlers is to achieve autonomy (independence) and do things on their own. This can include tasks such as tying shoelaces—no matter how long it may take. Understanding the need for discipline is not one of Erikson's theories.
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? "Is there fluoride toothpaste available for use?" "Are you able to supervise your child's brushing?" "What type of toothbrush does your child use?" "Did you teach your child how to brush the teeth?"
"Are you able to supervise your child's brushing?" Explanation: Dental caries is the leading chronic disease in the United States. Children need help with toothbrushing until they are between 7 and 10 years of age. The parent should monitor the toothbrushing to make sure it is thorough, observe for any abnormal tooth alignment, and schedule cleanings every 6 months. Children tend to concentrate on the front teeth, because they can see them easily and "forget" the teeth in the back. Parental oversight is needed to be sure those teeth are brushed carefully.
The nurse is talking with the parents of an 8-year-old child who has been cheating at school. Which comment by the nurse would be appropriate as a first step? "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." "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."
"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." Explanation: 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 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? "Perhaps teaching your son self-defense courses will help him to have a greater sense of control and safety." "Fortunately the scars of being picked on will fade as your son grows up." "Bullying can have lifelong effects on the self-esteem of a child." "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." Explanation: The child can be permanently scarred by negative experiences such a bullying. Activities such as self-defense and sports can promote a sense of accomplishment but don't relate directly to the problem of bullying. There is no indication the child in the scenario will become a bully.
The nurse is presenting information about school-aged children at a community event. Which statement from the group should the nurse prioritize to address with further teaching and more information? "Even if the weather is cool and cloudy, our children play outside every day." "Food is so expensive, we always make our children eat everything on their plates." "Sometimes we have to be firm, but our children wash their hands before eating." "I make sure they have good teeth by giving them calcium and phosphorus."
"Food is so expensive, we always make our children eat everything on their plates." Explanation: Obesity can be an issue in the school-aged child, especially if they are urged to clean their plates even if they have more food than they want or need on the plate. The parents should be encouraged to use smaller plates for the children so they will still appear to have a full plate but smaller portions. Firm guidance and direction is important with the school-aged child. Calcium and phosphorus are important to healthy teeth. Exercise each day is important, especially outdoor exercise.
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?" "How well does your son communicate or follow instructions?" "Does your son speak in complete sentences all the time?" "Is your son's speech clear enough that anyone can understand it?"
"How well does your son communicate or follow instructions?" Explanation: 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 asks a group of school-age children about pedestrian safety. Which comments by the children should the nurse address with either the child or parents of the child? Select all that apply. My friends and I like to walk on the side of the road because our sidewalk is very uneven." "I am 6 years old and I walk my younger brother to the park that is 5 blocks from our house." "I think it is funny to hide behind my dad's car before he leaves for work and scare him." "I always remind my sister to look right, then left, then right again before we cross the street." "My mom always says she looks around really well to be sure I'm not playing behind our car before she leaves."
"I am 6 years old and I walk my younger brother to the park that is 5 blocks from our house." My friends and I like to walk on the side of the road because our sidewalk is very uneven." "I think it is funny to hide behind my dad's car before he leaves for work and scare him." Explanation: Older children and adults should provide supervision of younger children, but 6 years old is not considered an older child, especially for 5 blocks of supervision of a younger sibling. Children should always walk on sidewalks because cars may not see children walking in the streets or be distracted while driving. Children should stay away from vehicles when a vehicle is about to be driven and definitely not behind a vehicle.
The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents? "Is there a family history of hypertension, heart disease, or diabetes?" "Is breakfast eaten regularly?" "What beverages are preferred?" "How important is exercise?"
"Is there a family history of hypertension, heart disease, or diabetes?" Explanation: Parents would be more knowledgeable than the child regarding health problems within the family. The other questions are appropriate for the child to answer and may motivate him to think about meal patterns, diet, and exercise habits. The parents will benefit from listening to these questions since their habits influence the child.
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? "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." "We will make sure that our 11-year-old child consumes at least 900 calories, primarily through protein sources."
"My 12-year-old child, who plays soccer, needs to consume no more than 2,000 calories a day to maintain good health." Explanation: Boys and girls 4 to 8 years old who are moderately active will need about 1,400 to 1,600 calories per day. Boys 9 to 13 years old who are moderately active need about 1,800 to 2,000 calories a day and girls 9 to 13 years old who are moderately active need about 1,600 to 2,000 calories a day. Approximately 45% to 65% of calories should come from carbohydrates.
The nurse is 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 sleeps between 11 and 12 hours a night." "My child stays up late when she takes a nap after school." "My child does not even know when he is tired." "My teenage child does not sleep as much as my 9-year-old does."
"My child sleeps between 11 and 12 hours a night." Explanation: Sleep for the school-age child varies with the age of the child. A child between the ages 6 to 8 years needs 12 hours of sleep each night. The child between the ages of 8 to 10 years needs 10 to 12 hours of sleep each night. The 10 to 12 year old needs 9 to 10 hours of sleep each night. Staying up late after taking an after-school nap, not knowing when the child is tired, and sleeping more than a teenager when compared with a school-age child refer to sleep behaviors and needs of children of younger and older ages.
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." "Tell your daughter that it is just like going to see the pediatrician." "Remind her in simple terms what will happen in the dentist's office." "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." Explanation: Due to the girl's temperament, it is best if the parents talk to the dentist before the first visit to find out exactly what the dentist will be doing and then describe to the child in simple terms what will occur. Reminding the child about the importance of proper oral hygiene is unhelpful. Telling the child that the dental checkup is just like going to see the pediatrician is untrue. It is inappropriate to advise the parents to not prepare the girl in advance.
A nurse is preparing a class for a group of parents of school-age children about language development and problems with speech articulation, specifically difficulty pronouncing specific letters. The nurse would inform the parents that a referral for initiating speech therapy may be necessary for these problems after which which age? 6 years 7 years 8 years 5 years
8 years Explanation: The most common problem of a school-age child is articulation. The child has difficulty pronouncing s, z, th, l, r, and w or substitutes w for r ("westroom" instead of "restroom") or r for l ("radies' room" instead of "ladies' room"). This is most noticeable during the first and second grades (age 6 and 7 respectively); it usually disappears by the third grade, (around 8 years of age).
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 mistrust A sense of shame A sense of doubt
A feeling of inferiority Explanation: Children who are unsuccessful in completing activities during the school-age phase, whether from physical, social, or cognitive disadvantages, develop a feeling of inferiority.
What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child? Fish, spinach salad and a glass of milk Hamburger and a cherry Coke Chicken sandwich with pretzels and apple juice Bagels and cream cheese with sherbet
Fish, spinach salad and a glass of milk Explanation: A well-balanced diet rich in calcium and phosphorus fosters healthy teeth. Minimal sugar, a diet of whole grain breads, and fish and cheeses are all good sources of calcium and/or phosphorus. Sugary soda drinks and juices, pretzels and bagels, beef and sherbet do not provide substantial amounts of calcium or phosphorus.
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) Explanation: 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.
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? Writing letters to friends Participating in a craft project Playing with a jack-in-the-box Playing with blocks
Participating in a craft project Explanation: 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.
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 Participating on the school soccer team Praising the child for their academic efforts
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: 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.
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
a sense of security as children gain independence Explanation: 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 nurse is discussing ways parents can foster the development of self-confidence in their school-aged child. Which action if stated by the parents would lead the nurse to continue the discussion? being accepting of mistakes the child makes focusing on what the child is saying in a conversation comparing the child to an older sibling regarding academic achievements having clear expectations of behavior whenever the family is out in public
comparing the child to an older sibling regarding academic achievements Explanation: A school-age child needs consistency, clearly defined expectations, and positive attention in order to develop self-confidence. By being accepting of mistakes the child makes, focusing on the child whenever they are talking, and making sure the child understands behavioral expectations, the parents are fostering self-confidence in the child.
A mother suspects that her 11-year-old son is experimenting with deliriants with his friends. Which symptoms would the nurse advise the mother to look for that would validate her concerns? hyperactivity giddiness and coughing unexpected bouts of diarrhea having bad breath when returning from school
giddiness and coughing Explanation: Inhalation of substances can cause numerous symptoms, including giddiness and coughing. The child will not experience diarrhea, hyperactivity, or develop bad breath from experimenting with inhalants.
