Quiz #2 Chapter Review Questions
CRITICAL THINKING EXERCISE (CONT.): Ms. Shaw brings in her 11-year-old daughter for a well-child check-up. The school-ager says to the nurse, "I look different from my friends. I do not wear bras and my friends are already wearing bras." What would be an appropriate response to this school-ager?
"During late school-age years, girls begin to develop their secondary sexual characteristics on an individual basis. You are fine and it is normal to be concerned about being different, but you will develop normally over the next few years."
When giving parents guidance for the adolescent years, the nurse would advise the parents to? Select all that apply. A. Accept the adolescent as a unique individual B. Provide strict, inflexible rules C. Listen and try to be open to the adolescent's views D. Screen all of his or her friends E. Respect the adolescent's privacy F. Provide unconditional love
A. Accept the adolescent as a unique individual C. Listen and try to be open to the adolescent's views E. Respect the adolescent's privacy F. Provide unconditional love Adolescents need to be accepted as unique individuals. Parents should provide unconditional love, respect their privacy, and listen to them. Screening all of their friends and providing strict, inflexible rules would only lead to poor interactions between the parents and the adolescent.
What is the best advice about nutrition for the toddler? A. Encourage cup drinking and give water between meals and snacks. B. Encourage unlimited milk intake, because toddlers need the protein for growth. C. Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. D. Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.
A. Encourage cup drinking and give water between meals and snacks. The toddler should wean to the cup by age 12 to 15 months. Limit real fruit juice to 4 to 6 oz per day and milk to 16 to 24 oz per day, and give it with meals and snacks. Offer water between meals and snacks.
The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? A. Hesitancy and dysfluency are normal during this period of development. B. Reading to the child will help model appropriate speech. C. Expressive language concerns warrant a developmental evaluation. D. The mother should ask her child's physician for a speech therapy evaluation.
A. Hesitancy and dysfluency are normal during this period of development. Preschoolers often have a period of dysfluency and hesitancy in their language development, but it usually resolves by about age 4 years.
Which of the following are reasons that stealing occurs in school-age children? Select all that apply. A. To escape punishment B. High self-esteem C. Low expectations of family/peers D. Lack of sense of property E. Strong desire to own something
A. To escape punishment D. Lack of sense of property E. Strong desire to own something Stealing in the school-age years occurs for multiple reasons: to escape punishment, because of a lack of sense of propriety or ownership, and because of a strong desire to own something they do not have because of lack of money or refusal by parents. Stealing also occurs when a school-age child has low self-esteem and high expectations from his family or peers that the child cannot meet.
CRITICAL THINKING EXERCISE: During a sports physical examination, Susan, a 16-year-old, tells her health care provider that she is overweight. What additional information would the nurse obtain?
Additional information the health care provider would obtain include more information about why Susan feels she is overweight, and her weight + height to plot on growth chart to obtain her BMI
CRITICAL THINKING EXERCISE: Develop a plan for educating the parent of a 34-month-old who has been resistant to toilet teaching. Include assessments the nurse will make as well as the plan for teaching.
Assessments: Does the child walk? Know when the diaper is wet/dirty. Have a word for toileting. Take off his pants himself. Teaching: Have the child sit on the potty for 5 minutes after each meal. Give the child a small reward for sitting on the potty and/or for actually voiding or defecating.
The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by? A. Learning from repeating tasks B. Developing a sense of worth and competence C. Using fantasy and magical thinking to cope with problems D. Developing a sense of trust
B. Developing a sense of worth and competence School-age children develop a sense of worth and competence. Toddlers learn from repeating tasks. Preschoolers use fantasy and magical thinking. It is in infancy that the child develops a sense of trust.
What has the most influence in deterring an adolescent from beginning to drink alcohol? A. Drinking habits of parents B. Drinking habits of peers C. Drinking philosophy of adolescent's culture D. Drinking philosophy of adolescent's religion
B. Drinking habits of peers The teenager's peer group has the greatest influence on his or her behavior. If peers are drinking, the teenager will be at greater risk of drinking.
In developing a weight-loss plan for an adolescent, which would the nurse include? Select all that apply. A. Have parents make all of the meal plans. B. Eat slowly and place the fork down between each bite. C. Have the family exercise together. D. Refer to an adolescent weight-loss program. E. Keep a food and exercise diary.
B. Eat slowly and place the fork down between each bite. C. Have the family exercise together. D. Refer to an adolescent weight-loss program. E. Keep a food and exercise diary. These are steps that promote weight loss in adolescents. Adolescents want to be involved in the process, so having parents make all of the meal plans would not promote acceptance by the adolescent.
The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother? A. If spanking is not working, then time-out is not likely to be helpful either. B. Place the child in time-out for 4 minutes. C. Use time-out only if removing privileges is unsuccessful. D. The child should stay in time-out until crying ceases.
B. Place the child in time-out for 4 minutes. The generally accepted guidelines recommend keeping the child in time-out for 1 minute per year of age.
To gain cooperation from a toddler, what is the best approach by the nurse? A. Immediately pick the toddler up from the mother's lap. B. Kneel in front of the toddler while he or she is on the mother's lap. C. Do the nursing tasks quickly so the toddler can play. D. Ask the toddler if it is okay if you begin the needed task.
B. Kneel in front of the toddler while he or she is on the mother's lap. Being at the toddler's level and allowing the toddler to stay with his mother allow him to feel more secure. If the toddler perceives the nurse to be nonthreatening, the nurse is more likely to gain cooperation. Toddlers ordinarily answer "no," so asking the toddler's permission is not helpful. Simply jumping in and starting the task without allowing the toddler to warm up will threaten the child.
The mother of two sons, ages 6 and 9, states they want to play on the same baseball team. As the school nurse, what advice would you give their mother? A. Having the boys on the same team will make it more convenient for the mother. B. Levels of coordination and concentration differ, so the boys need to be on different teams. C. Put the boys on the same team because they are both school-age children. D. It is best to avoid putting the boys on the same team to prevent sibling rivalry.
B. Levels of coordination and concentration differ, so the boys need to be on different teams. With age, concentration and coordination increase, so the 9-year-old would be operating at a higher level of maturity.
The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as? A. Problematic, as it interferes with needed nursing care. B. Normal for this stage of growth and development. C. Normal because the child is hospitalized and out of his routine.
B. Normal for this stage of growth and development. Negativism is characteristic of the stage, no matter what the situation (hospital or home).
Which activities will promote weight loss in an obese school-age child? Select all that apply. A. Unlimited computer and TV time B. Role modeling by family C. Becoming active in sports D. Eating unstructured meals E. Involving child in meal planning and grocery shopping F. Drinking three glasses of water per day
B. Role modeling by family C. Becoming active in sports E. Involving child in meal planning and grocery shopping Inactivity while watching TV and playing computer games leads to weight gain. Sports facilitate the expenditure of calories while the child is participating in age-appropriate activities; unstructured mealtimes lead to increased consumption of fast foods and decreased role modeling by parents. The family needs to eat regular meals. Involving the child in meal preparation and grocery shopping facilitates interest in the weight-loss project. Intake of water increases metabolism and creates a feeling of fullness.
Which is associated with early adolescence? Select all that apply. A. Uses scientific reasoning to solve problems B. Still at times wants to be dependent upon parents C. Incorporates own set of morals and values D. Is influenced by peers and values memberships in cliques
B. Still at times wants to be dependent upon parents D. Is influenced by peers and values memberships in cliques During early adolescence (11 to 14 years of age), adolescents are in conflict over becoming independent from their parents. They still at times want the role of the parents to be as it was during the school-age years. They are influenced by peers and value membership in cliques. Adolescents develop scientific reasoning and incorporate their own set of morals and values in middle and late adolescence.
The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as: A. Problematic; the child is old enough to begin to have a basis in reality. B. Normal, because the child is hospitalized and out of her routine. C. Normal for this stage of growth and development. D. Problematic, as it interferes with needed nursing care.
C. Normal for this stage of growth and development. Imaginary friends help the preschooler cope with stress in his or her life.
The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information? A. The toddler should have a developmental evaluation as soon as possible. B. If the mother would read to the child, then speech would develop faster. C. Receptive language normally develops earlier than expressive language. D. The mother should ask her child's physician for a speech therapy evaluation.
C. Receptive language normally develops earlier than expressive language. Young toddlers understand far more language than they can actually express themselve
As the school nurse conducting screening for vision in a 6-year-old child, you would refer the child to a specialist if the visual acuity in both eyes is? A. 20/20 B. 20/25 C. 20/30 D. 20/50
D. 20/50 Visual acuity of 20/20 is not expected until 7 years of age.
The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? A. A lack of fully developed hearing. B. A less discriminating sense of touch. C. Visual acuity that has not fully developed. D. A less discriminating sense of taste.
D. A less discriminating sense of taste. Less discriminating sense of taste. The young preschooler may have a less discriminating sense of taste than the older child, making him or her at increased risk for accidental ingestion. A less discriminating sense of touch and developing visual acuity would not increase the risk. Hearing is intact at birth and it does not increase the child's risk for accidental ingestion.
A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse? A. Allow the child unlimited access to the sippy cup to ensure adequate hydration. B. Encourage sweets for the extra caloric content. C. Teach the mother about nutritional needs of the preschooler. D. Assess the child's usual intake pattern at home.
D. Assess the child's usual intake pattern at home. The nurse must first assess the child's current intake to determine if there is a deficiency.
A 2-year-old is having a temper tantrum. What advice should the nurse give the mother? A. For safety reasons, the toddler should be restrained during the tantrum. B. Punishment should be initiated, as tantrums should be controlled. C. The mother should promise the toddler a reward if the tantrum stops. D. The tantrum should be ignored as long as the toddler is safe.
D. The tantrum should be ignored as long as the toddler is safe. Ignoring tantrums is the best method for discouraging them. Any additional attention received because of the outburst may only contribute to another occurrence in the future.
CRITICAL THINKING EXERCISE (CONT.): Ms. Sams said she still has the car. What would you advise Ms. Sams to do to make Frank aware of the consequences of his actions?
Suggest Ms. Sams to take Frank back to the store and return the car to the store manager to see the consequences of stealing and use this as a learning experience. Ms. Sams also needs to talk to Frank about other ways he could obtain the toy (such as by doing errands and chores to earn money).
CRITICAL THINKING EXERCISE (CONT.): Sally's mother is asking the nurse for advice about purchasing a two-wheeled bike for her 7-year-old. What guidance should the nurse offer this parent?
The nurse should discuss with the mother whether or not Sally is physically ready to ride a two-wheeled bike. Safety is also a major concern. Bike accidents are one of the major causes of injuries in school-age children. In children of this age, coordination is limited, as is the ability to assess and react to dangers of a situation. In addition to making sure the bike is the right size for Sally, the mother needs to obtain the proper safety equipment. Rules should be made and discussed with Sally about where Sally can ride the bike and the use of the safety equipment. Also, the mother should wear safety equipment when she rides her bike.
CRITICAL THINKING EXERCISE: Jane tells the school nurse that she might be homosexual. What additional information would the nurse obtain?
The nurse would need to find out why Jane feels that she might be homosexual. The nurse needs to be sensitive, open nonjudgmental, and supportive to what Jane is saying.
CRITICAL THINKING EXERCISE: Ms. Sams brings her 8-year-old son, Frank, to the physician's office for his annual examination. She states that she is concerned about his recent behavior. He went to the grocery store with his friend and his friend's mother and he came home with a Matchbox car. The friend's mother stated she had not purchased the car. What would be your response to Ms. Sams?
The nurse's response should be: "Stealing can be a normal action at this time due to the school-age child wanting to own the car. His sense of ownership is developing."
CRITICAL THINKING EXERCISE: Alicia's parents are worried because all of Alicia's friends wear heavy makeup and have multiple piercings and hair colors. What advice would the nurse give Alicia's parents?
The parents should get to know Alicia's friends as individuals before they judge them. Their appearance might not reflect what their values are.
CRITICAL THINKING EXERCISE (CONT.): Johnny is a 9-year-old whose mother and father both work during the day. He returns home after school. How should the parents prepare Johnny for this experience? What safety rules would be included in the education for Johnny?
The parents should provide Johnny with a key to the house and make sure the key is in a secure location. Johnny needs to know the rules of the house, how to reach parents and a neighbor, and how to call 911. He needs access to a specified snack that does not require using the stove. The parents must inform Johnny whether he can play outside or if he must stay inside and complete homework. To keep Johnny safe the parents should talk about fire safety. If weapons are in the home, firearm safety must be discussed. Discuss with Johnny's parents the possibility of after-school programs.
CRITICAL THINKING EXERCISE: Teach a preschool class about bicycle and street safety. Be certain to design the content at an appropriate developmental level.
The teaching plan should be based on a preschooler's developmental level of understanding and include items such as not talking to strangers, always wearing a helmet with trike/bike riding, always holding hands with a grown-up to cross the street, not playing with matches, etc.
CRITICAL THINKING EXERCISE: The parents of Joe, a 14-year-old, talk to the school nurse about Joe's behavior at home. He is moody, fights with his younger siblings, only wants to be on his computer, and does not want to go on the family vacation. What advice would the nurse give the parents?
These behaviors can be typical of an adolescent at this age. To what degree Joe is performing these behaviors needs to be determined. Joe might be doing some of those behaviors because of more serious underlying problems. The parents should have an open discussion with Joe, talking with him about how they perceive his behaviors.