peds week 4 chapter 33-34

During a community health survey, the nurse is conducting a survey about the language development in preschoolers. What behavior is the nurse able to document in preschoolers?

Preschoolers want to know the reason behind an event. Preschoolers have a vocabulary of 8,000 to 14,000 words. Preschoolers cannot distinguish between phonetically similar words. Preschoolers start to question "Why?" and "How come?" Their vocabulary increases rapidly and they can define their feelings by using 8,000 to 14,000 words. School-aged children are able to understand riddles and jokes. This is not seen in preschool children. School-aged children clearly understand that words have arbitrary meanings. This is not seen in preschoolers. Preschoolers get confused between phonetically similar sounds. They are not able to understand the difference between die and dye or wood or would. Therefore, the nurse will not document this behavior with preschoolers.

The school nurse is conducting a teacher's in-service on signs that may indicate that a child is a victim of bullying. Which sign should the nurse include in the teaching session?

The child asks to go to the nurse's office frequently with vague complaints. Signs that may indicate a child is being bullied are similar to signs of other types of stress, including nonspecific ailments or complaints. Spending inordinate amounts of time in the school nurse's office with vague complaints is a sign that should be included in the teaching session. Withdrawal and deteriorating school performance are often signs of bullying. The child's wanting to participate on the basketball team, asking for extra work, and participating in extracurricular activities are not signs of withdrawal or deterioration in school performance.

Which parental statement indicates accurate understanding of bicycle safety for the school-age client?

"My child should keep as close to the curb as possible when in the street." The parental statement indicating the school-age child should ride as close to the curb as possible when riding a bicycle in the street indicates accurate understanding of bicycle safety. The child should ride with the traffic, not opposite of traffic. The child should walk, not ride, the bicycle through crosswalks. The child should be taught to use, not avoid, hand signals in advance of stopping.

Which statements related to relationships with family should the nurse include in a teaching session for a school-age client and parents?

"Parents of school-age children must learn to let go of control." "Peer groups are highly influential during this stage of development." "Your child may wish to be more involved with peer activities than family activities." "When a conflict between peers and parents occurs, family values will predominate." During the school-age stage of development, parents must learn to let go of control; peer groups are highly influential during this stage of development; the parents must also understand that their child may wish to be more involved with peer activities rather than family activities; and when a conflict occurs between the school-age child's peers and parents their family's values will predominate. Parents of a school-age child best serve their child's interests with understanding and tolerance rather than strict discipline.

Which assessment question is appropriate when collecting a developmental history for an adolescent who is new to the pediatric practice?

"What grades do you get in school?" While all of these assessment questions are appropriate, only the question regarding scholastic performance (grades in school) is a question that is appropriate for a developmental history. Asking questions regarding wisdom tooth eruption and approximate height and weight at 4 and 5 years of age respectively is more appropriate when collecting a growth history.

Which statements should the nurse include in the teaching session for a school-age client's parents based on the concrete operational stage of development?

"Your child will no longer have a rigid, egocentric outlook." "Your child will make judgments based on conceptual ideas." "Your child will evaluate a current situation based on past experiences." During the concrete operational stage of development the school-age child will no longer have a rigid, egocentric outlook; will make judgments based on conceptual ideas; and will evaluate a current situation based on past experiences; therefore, the nurse should include these statements in the teaching session with the school-age child's parents. The school-age child moves away from making judgments based on what is seen during this stage of development. Conservation develops during the school-age stage of development and continues to develop through adolescence.

The nurse administers a second dose of inactivated polio vaccine (IPV) to a 4-month-old child. When does the child receive the third dose of IPV?

6 months of age. IPV is given to children in four doses at 2 months, 4 months, 6 to 18 months, and 4 to 6 years of age. The child has received a second dose at 4 months of age, so the third dose should be given at 6 months of age. After receiving the third dose, the child should receive the fourth dose at 4 to 6 years of age. Receiving the third IPV dose at 4 to 6 years of age, 8 to 9 years of age, or at 12 to 14 years of age would be subtherapeutic and potentially expose the child to contracting the disease.

Which major concern related to temperament should the nurse assess closely when providing care to a preschool-age client who is beginning school?

Adaptability The degree of adaptability to new situations may influence a child's chances for success in school; therefore, the nurse should assess this closely when providing care to a preschool-age client. Socialization, language skills, and fine motor skills are not aspects of temperament; however, these may also influence the child's success at school.

A nurse in the pediatric clinic is assessing a child with a suspected pinworm infestation. What is the first action by the nurse?

Collecting a specimen. A specimen must be obtained and analyzed before treatment is prescribed. The priority is collecting a specimen; after this is done, prevention techniques may be taught. Pinworm infestation is not a reportable communicable disease. Although pinworms can be seen with the naked eye, it is unlikely that they will be evident during a physical examination. Pinworms emerge from the anus at night or early in the morning.

A 6-year-old child is waiting with a family member in the pediatric clinic for a well-child visit. What are the most appropriate play activities for the office nurse to offer the child?

Coloring book Small metal cars Simple card game School-aged children are creative and have the manipulative skills to color in coloring books. School-aged children enjoy collections, and many 6-year-old children collect small metal cars; this option also supports imaginative play. School-aged children enjoy competition and have the skills necessary to manipulate cards. A large jigsaw puzzle is more appropriate for the toddler or preschooler, who is developing fine motor skills. Reading magazines is too passive and ignores the 6-year-old child's developmental needs.

A 5-year-old child is brought to the child health clinic for a routine visit, and the nurse observes the child interacting with other children. What type of play does the nurse expect of the child?

Cooperative Cooperative play is typical of 5-year-olds as they learn to share and take turns without becoming frustrated. Team play is typical of older school-aged children who play games with other children and learn to abide by the rules. Parallel play is typical of the toddler age group; toddlers have not yet learned to interact with other toddlers in a social situation. Initiative play does not typify any age group; it is not a recognized term of social play.

A nurse is making notes on the changing conceptual abilities that accompany the transition of children from the preschool years into the school years. Which action should the nurse expect to be in line with the conceptual abilities of preschoolers?

Correctly arranging a graduated set of circles from largest to smallest on a stick. Preschool children can perform acts that involve ordering, such as correctly arranging a graduated set of circles from largest to smallest on a stick, without being able to articulate the process. School-age children have increasingly flexible conceptual abilities. During the concrete operational period, their rigid, egocentric outlook is replaced by thought processes that allow them to see things from another's point of view. While preschoolers may be able to find their way to a friend's house, they will be unable to verbalize the actions involved in the process. School-age children are able to articulate the process and perform the actions mentally without the need to carry out the behaviors.

At which stage of development should the nurse anticipate that pediatric clients will begin to show differences in play activities that are related to gender?

Late school-age During the late school-age years, the nurse should anticipate that pediatric clients will begin to show differences in play activities that are related to gender. There will be very few differences in play activities related to gender during the preschool stage of development. Adolescence involves different social, not play, activities related to gender. The early school-age client will exhibit the same types of play activities related to gender as the preschool-age child.

Which concern may be specifically seen in middle adolescents?

Physical appearance and peer group acceptance Middle adolescents tend to have health-related concerns regarding physical appearance, peer-group acceptance, and relationship with friends. Young adolescents will be undergoing physical changes of puberty, so their concern will be mostly on growth and development. All adolescents may experience issues with violence within their social environment. Older adolescents are mostly concerned with their school performances and future careers.

How would the nurse explain preschoolers are different from school-aged children?

Preschoolers have imaginary playmates. Preschoolers believe that inanimate objects have lifelike qualities. Preschoolers have imaginary playmates, not school-aged children. Preschoolers believe that inanimate objects have feelings. They think that trees cry when their branches get broken. This thinking is not seen in school-aged children. Both preschoolers and school-aged children are able to relate events to their causes. Preschoolers and school-aged children are curious to know about their surroundings. Preschoolers are able to classify the objects based on size or color, whereas school-aged children understand that the same object can exist in two categories.

The nurse is caring for a child who has attention deficit-hyperactivity disorder (ADHD). Which changes in the child's classroom will be beneficial?

Providing breaks frequently at regular intervals. Writing instructions on the blackboard after verbalization. Scheduling academic subjects for times when the child is under the effect of medication. A child with ADHD will not be able to concentrate properly and experiences difficulty sitting in one place for a prolonged time. Therefore frequent breaks are helpful to improve the child's concentration. Visual representations also help attract attention and improve concentration. Therefore it is appropriate to write instructions after saying them. The child will have increased concentration under the effect of medication, which is generally in the morning. Therefore academic subjects should be scheduled for the morning. A child with ADHD will have dysgraphia, or poor handwriting. Therefore it is appropriate to concentrate on improving the child's computer skills, instead of improving handwriting. It is appropriate to allot more time to take tests and help the child complete tasks rather than giving homework and assignments.

While obtaining the health history of a 15-month-old toddler, the child of a migrant worker, a nurse learns that the infant recently had a fever, runny nose, cough, and white spots in the mouth lasting 3 days. A rash started on the face and spread to the whole body. What communicable disease does the nurse suspect the infant suffered from?

Rubeola White spots in the mouth (Koplik spots) and the rash, combined with increased mucus secretions (coryza), are indicative of measles (rubeola). Rubella (German measles) does not cause Koplik spots. Pertussis (whooping cough) has a distinctive cough, but there are no Koplik spots or rash. Varicella (chickenpox) features skin lesions rather than a rash and lesions in the mouth.

Which type of relationship is most important to the school-age child?

Same-sex peer relationships Same-sex peer relationships are important to the school-age child. Opposite-sex peer relationships become important during adolescence. Parental relationships vary during this stage of development.

Which of these statements regarding adolescents are true?

The United States has the highest rate of teenage pregnancy. Anorexia nervosa and bulimia are two eating disorders found in adolescence. The United States has the highest annual rates of teenage pregnancy and childbearing among the industrialized nations. Anorexia nervosa and bulimia are two eating disorders found in adolescents. Homicide is not infrequent; it is the second leading cause of death among adolescents. Motor vehicle accidents, not suicide, are the leading cause of death among adolescents. Eighty-five percent of adolescents, not 50%, have used alcohol by the end of high school.

A nurse is planning to discuss the importance of following the prescribed course of treatment with a group of adolescent clients. What is the nurse's priority consideration regarding these clients?

They are involved more with the present than with the future. The future seems far away; immediate gratification takes priority. Adolescents are often confused about their feelings. School-age children (7 to 11 years) use concrete operational reasoning ; adolescents are learning to think in abstract terms and use formal operational reasoning. Striving for industry versus inferiority is the developmental stage of children 6 to 12 years of age; identity versus role confusion is the developmental stage of the adolescent.