Peds Pillitteri Chapter 32
11. A mother is concerned that a 7-year-old child has taken money from a sibling's dresser several times. What should the nurse advise the mother about this behavior? A) The child needs to be reminded of property rights. B) Stealing is unusual for a 7-year-old and needs to be investigated. C) The mother should purchase a bank for the other child that cannot be opened. D) The mother should talk to the child's teacher about putting less pressure on the child.
Ans: A Feedback: Early childhood stealing is best handled without a great deal of emotion. A parent should tell the child the money is missing. The importance of property rights should be reviewed: The sibling's money is his, the child's money is the child's, and they are not interchangeable. Stealing is not unusual for a 7-year-old child. The mother does not need to buy the other child a bank. The behavior does not necessarily occur because of school-related stress.
3. The nurse is caring for a 9-year-old patient in the hospital. Which project should the nurse provide to help this child achieve the developmental task of industry? A) Sew a purse that will take one afternoon. B) Watch favorite programs on the television. C) Design a puppet show that will take 2 weeks to plan. D) Work on a scrapbook that will take 3 weeks to complete.
Ans: A Feedback: Hobbies and projects are best enjoyed if they are small and can be finished within a short time. Most school-age children prefer putting together something fairly simple rather than something that is more complicated because the complicated one will delay the reward, and the child may become bored and never complete it. Watching television does not help the child achieve the developmental task of industry.
12. A 9-year-old girl tells the nurse about belonging to a spite club. How does belonging to this group support the child's development? A) Fulfills peer group needs B) Teaches the child leadership skills C) Helps the child develop autonomy D) Encourages the child to learn rules
Ans: A Feedback: Nine-year-olds take the values of their peer group very seriously. This is typically the friend or club age because children form groups, usually "spite clubs." This type of club does not teach the child leadership skills, develop autonomy, or to learn rules.
15. A 10-year-old child spends 2 hours alone every afternoon before the parents arrive home from work. Which safety measure should the nurse suggest the parents teach the child? A) Preparing a no-cook snack after school B) Lighting candles in case there is a power failure C) Wearing the house key prominently around the neck D) Telling people at school about being home alone or added safety
Ans: A Feedback: Parents should plan after-school snacks for the child that does not require cooking to prevent burns. Lighting candles could be a fire hazard if they are left unattended. Wearing the house key around the neck could indicate that the child will be home alone. Telling people at school about being home alone could encourage a break in or other action against the child.
1. While planning care for a 7-year-old patient, the nurse reminds the parents that children at this age are experiencing the "eraser" year. What does this mean? A) The child wants to perform well. B) The child believes in magical thinking. C) The child is learning to write during this year. D) The child tends to "erase" misdeeds or lie excessively.
Ans: A Feedback: Seven-year-olds concentrate on fine motor skills, and this year has been called the "eraser" year because children are never quite content with what they have done. They set too high a standard for themselves and then have difficulty performing at that level. Toddlers believe in magical thinking. The child has already learned how to write. The eraser year does not mean that the child is erasing misdeeds or lying.
16. A mother is concerned that a school-age child will pick up the habit of smoking because so many children in the school smoke. What should the nurse instruct the mother about this behavior? A) Be a role model and do not smoke. B) Remind the child that smoking costs money. C) Discuss other tobacco choices that can be used instead. D) Explain that the child can experiment with smoking when older.
Ans: A Feedback: To discourage use of tobacco by school-age children, parents need to be role models of excellent nonsmoking health behavior in hopes children will follow their good example. Explaining that smoking costs money might not make an impact on a school-age child's decision to start smoking. Discussing other tobacco choices is inappropriate because smokeless tobacco also has associated health risks. The child should be encouraged to refrain from smoking throughout life.
7. The nurse knows that being able to tell time helps a child become more independent. At which age should the nurse expect a school-age child to begin to tell time? A) 6 years old B) 7 years old C) 8 years old D) 9 years old
Ans: B Feedback: Most 7-year-olds can tell the time in hours, but they may have trouble with concepts such as "half past" and "quarter to," especially with the prevalence of digital clocks. Six-year-olds still define objects by use. Eight- and nine-year-olds have moved passed telling time and are interested in mastering other things.
14. The nurse has been caring for a family with a school-age child who has school phobia. Which observation indicates that interventions have been successful? A) The child stays home from school. B) The child attends school every day. C) The child decides daily about attending school. D) The child's teacher is asked if attending school is a requirement.
Ans: B Feedback: Once it has been established that a child is free of any illness and the resistance stems from separation anxiety or phobia, the child should be made to attend school. Reinforcement by parents to go to school this way helps to prevent problems such as school failure, peer ridicule, or a pattern of avoiding difficulties. Some children may benefit from a gradual program of school involvement. Managing school refusal requires coordination among the school, school nurse, and health care provider who identifies the problem. The child should not be permitted to decide not to go to school. Attending school is a requirement, and the teacher does not need to be asked this question.
4. While making a visit to the home of a family with a school-age child, the nurse observes a hunting rifle leaning against the wall in the dining room. Which nursing diagnosis should the nurse use to guide interventions for the family at this time? A) Anxiety B) Risk for injury C) Health-seeking behaviors D) Readiness for enhanced parenting
Ans: B Feedback: The nursing diagnosis appropriate for this situation is risk for injury because the firearm is in the dining room. The parents need instruction about safety precautions with firearms and school-age children. There is no evidence of anxiety. The parents are not asking for health-related information. The parents are not demonstrating readiness to learn more about parenting.
2. The school nurse is reviewing content to include in an assembly planned for school-age children that focuses on the 2020 National Health Goals for safety. What should the school nurse include in this presentation? (Select all that apply.) A) Encourage the children to play outdoors and get exercise everyday. B) Stress the need to sit in age-appropriate seats in cars and wear seatbelts. C) Remind children how important it is to brush the teeth and see the dentist. D) Explain how important it is for children to wear safety helmets when bicycling. E) Offer suggestions to ensure an adequate intake of fruits and vegetables each day.
Ans: B, D Feedback: Nurses can help the nation achieve the 2020 National Health Goals by urging children to follow safety rules for automobile and bicycle safety. Playing outdoors, getting exercise, and having an adequate intake of fruits and vegetables would be appropriate for nutritional goals. Brushing the teeth and seeing the dentist would be appropriate for health promotion goals.
13. The mother of a school-age child is distraught because the child has been diagnosed with obesity. What actions should the nurse suggest to the mother to help the child with this problem? (Select all that apply.) A) Explain that obesity will lead to an early death. B) Maintain a balanced eating approach in the home. C) Purchase books explaining the latest ways to lose weight. D) Seek out a preteen weight loss group for the child to participate. E) Encourage increased activity such as walking the dog after school.
Ans: B, D, E Feedback: Strategies to help the school-age child with obesity include maintaining a healthy eating approach in the home, seeking a weight loss group with other preteens for the child to attend, and encouraging increased activity. Explaining that obesity will lead to an early death could cause the child to become obsessed with dieting and create an eating disorder. The child should not be encouraged to use fad diets to lose weight.
10. The nurse observes a school-age child categorize specific desk and clothing items in his hospital room. What cognitive behavior has this child mastered? A) Decentering B) Conservation C) Class inclusion D) Accommodation
Ans: C Feedback: Class inclusion is the ability to understand that objects can belong to more than one classification. A school-age child can categorize objects in many ways. Decentering is the ability to project oneself into another person's situation. Accommodation is the ability to adapt thought processes to fit what is perceived. Conservation is the ability to appreciate that a change in shape does not mean a change in size.
5. When planning activities for school-age children, the nurse includes games that include competition. At which age are these kinds of games the most preferred by children? A) 7 years old B) 8 years old C) 10 years old D) 12 years old
Ans: C Feedback: During the 10th year, children become very interested in rules and fairness. Before this time, they gave younger children breaks in games, allowing extra turns or hints. Now, they strictly enforce rules. At age 7 years, imaginative play decreases and more props are used. Children who are 8 years old like table games but avoid competitive ones because they hate to lose. Twelve-year-olds enjoy all types of activities that may or may not include competition.
6. Why should the nurse carry information about the Boy Scouts when visiting families with male school-age children? A) No girls are included in the organization. B) Hiking is a favorite school-age activity. C) Merit badges are rewarded for completing small tasks. D) It strengthens relationships with fathers who participate in Boy Scouts.
Ans: C Feedback: Merit badge systems such as the Boy Scouts are geared to the needs of school-age children, offering small but frequent rewards. This action strengthens the developmental task of industry. The Boy Scouts is not attractive because the lack of girls, participating in hiking, or strengthening relationships with fathers.
8. While straightening the top drawer of a 10-year-old patient the nurse finds 48 packets of sugar. What should the nurse do at this time? A) Advise the mother to have the child tested for diabetes. B) Throw out the sugar because this will promote dental caries. C) Place the sugar packets in the drawer as they were found. D) Ask the mother if the child has a history of craving sweets.
Ans: C Feedback: Ten-year-olds like having their own bedroom or at least their own dresser, where they can store a collection and know it is free from parents' or siblings' eyes. One of the best gifts for a 10-year-old is a box which locks. The nurse found the 10-year-old child's collection and needs to return it where it was found. The child does not have diabetes. The nurse should not throw out the child's collection. The mother does not need to be asked about the child's craving sweets.
9. The nurse is talking with a mother who is concerned that a school-age child is experiencing stress and has been biting the fingernails since beginning the first grade. What should the nurse advise the mother to do about this problem? A) Encourage the child to drink more milk for stronger nails. B) Allow the child to choose a reward for not biting the nails. C) Distract the child by teaching a new skill such as whistling. D) Allow some time every day for the child to talk about new experiences.
Ans: D Feedback: Many first-graders are capable of mature action at school but appear less mature when they return home. They may bite their fingernails. Scolding, nagging, threatening, or punishing does not stop nail biting and may make the problem worse. This behavior will stop when the underlying stress is discovered and alleviated. The mother should be encouraged to spend some time with a child after school or in the evening so the child continues to feel secured in the family and does not feel pushed out by being sent to school. Drinking milk will not help alleviate the child's stress. Using rewards or teaching new skills will not relieve the child's stress.
