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

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? "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." "There are not many physical differences between school-aged boys and girls." "Girls typically experience a rapid growth spurt before boys."

"Girls typically experience a rapid growth spurt before boys."

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 have improved gross motor skills." "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 grow an average of 2.5 in (6.5 cm) per year."

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? "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." "I want you to give your child choices about the food eaten." "You must let your child make some choices for oneself."

"Now is the time to let your child choose some of the meals."

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."

"These are only his baby teeth so we are not worried."

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 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?

Allow some time every day for the child to talk about new experiences

A nurse is discussing a 9-year-old girl's obesity with her parents. Which nursing instructions are helpful? Select all that apply. Decrease intake of approximately 1,200 calories a day Limit time spent on sedentary activity Participate in a formal weight-control program Adhere to a high-protein diet Encourage fun exercise classes Prepare of a special meal just for the child

Decrease intake of approximately 1,200 calories a day Limit time spent on sedentary activity Participate in a formal weight-control program Encourage fun exercise classes

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 described a somewhat reduced appetite. The child has different diet preferences than his parents. The child's body fat has decreased since last year. The child has a leaner body mass than a girl at this age.

The child has a leaner body mass than a girl at this age.

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 different diet preferences than his parents. The child described a somewhat reduced appetite. 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 has a leaner body mass than a girl at this age.

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?

Appropriate social developmentNine-year old take the values of their peer group seriously. They are interested in being with peers of like minded and activities. Clubs are formed with specific exclusions of peers. Such clubs typically have a secret password and secret meeting places. Membership is generally all girls or all boys. These groups are not based on the immaturity of the children nor do they encourage sexism and bullying

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? Should brush their teeth at bedtime Have a routine physical exam every 6 months Needs 10 to 12 hours of sleep per night Be screened for scoliosis once a year

Needs 10 to 12 hours of sleep per night

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 comforted by participating in the rituals associated with their religion The child likes to have distraction from the hospital environment by going to the chapel. 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

The nurse is talking with the parents of an 8-year-old boy who has been cheating at school. Which comment should be the nurse's primary message?

"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior."

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? "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." "If my child has moderate activity my child needs around 1500 calories per day."

"Based on my child's weight and height, I should be concerned my child is overweight."

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? "If cheating is noted at this age, referral to a family counselor is highly recommended." "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." "Perhaps the academic environment is too easy for your child, causing the cheating."

"Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior."

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? "Your child doesn't seem to be overweight, so it isn't a concern." "Normal growth and development for this age results in an average weight gain of 7 pounds per year." "We see most children of this age in our clinic gaining similar amounts." "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain."

"Normal growth and development for this age results in an average weight gain of 7 pounds per year."

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

a sense of security as children gain independence

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." "Several interrelated factors are to blame for low self-esteem." "Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age." "The peers of a child at this age are the greatest influence on self-esteem."

"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."

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?" "With the increase in tissue size, tonsillitis is suspected." "A pituitary disorder may be the cause. Blood work may be indicated." "This may be normal growth of lymphatic tissue for this age."

"This may be normal growth of lymphatic tissue for this age."

The parents of an 11-year-old are discussing having their child come home after school alone rather than continue attending after-school care. They ask the nurse about the implications of making this decision. What should be included in the information provided by the nurse? Select all that apply. "Maturity and not age should be considered when deciding when a child is ready to stay home alone." "Children who are considered "latch key kids" are at an increased risk for engaging in risky behaviors." "Children who do not come home to an adult do not perform as well in school." "Laws do not support children under the age of 15 years being left home alone." "It is recommended that children interact daily with others of a similar age."

"Maturity and not age should be considered when deciding when a child is ready to stay home alone." "Children who are considered "latch key kids" are at an increased risk for engaging in risky behaviors." "Children who do not come home to an adult do not perform as well in school."

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 should be enough sleep. Let's talk about your eating habits." "Why do you go to bed so late at night?" "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?"

"That is not enough sleep. You should get at least 9 to 12 hours of sleep each night."

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. Praising the child for their academic efforts Commiserating with the child when he or she does not get selected for the school choir Participating on the school soccer team Allowing the child to assist her teacher in straightening up the classroom 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 Allowing the child to assist her teacher in straightening up the classroom

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.

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. Participating on the school soccer team Allowing the child to assist her teacher in straightening up the classroom Praising the child for their academic efforts 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 Allowing the child to assist her teacher in straightening up the classroom Praising the child for their academic efforts

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?

"Based on my child's weight and height, I should be concerned my child is overweight."

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?

"Girls typically experience a rapid growth spurt before boys."

The parents of a 12-year-old boy voice concern to the nurse that their child wants to dress like peers and not the way they prefer. Which responses by the nurse are appropriate? Select all that apply.

"Have you spoken with your son about his concerns and about your concerns? Open dialogue often helps in resolving these issues.""Peer acceptance is an important part of development for children, especially at this age. Maybe talking about it with your son can lead to an agreement."

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?

"How well does your son communicate or follow instructions?"

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? "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain." "We see most children of this age in our clinic gaining similar amounts." "Your child doesn't seem to be overweight, so it isn't a concern." "Normal growth and development for this age results in an average weight gain of 7 pounds per year."

"Normal growth and development for this age results in an average weight gain of 7 pounds per year."

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."

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 8 to 9 hours of sleep per night." "Your child should be getting at least 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."

The nurse is addressing a caregiver's concerns regarding adequate sleep for an 11-year-old child who gets up at 6:30 a.m. each morning. The nurse should point out which time as the most appropriate bedtime for this child? 9:30 p.m. 8:00 p.m. 7:30 p.m. 10:00 p.m.

9:30 p.m.

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 paint-by-numbers activity creating a picture

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? Preoperational thinking Classification Decentration Egocentric thinking

Classification

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? Consider an action and its consequences. Know lying is bad because she gets sent to her room for it. Make generalized assumptions about groups of things. View the world in terms of her own experience.

Consider an action and its consequences.

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

Encourage the child to develop new skills. Recommend the child investigate opportunities for volunteering at local charities. Recommend the child begin to participate in after-school activities.

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

An 8-year-old 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? Height 49 in (124.5 cm) 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 in (124.5 cm)

The school nurse is assessing the nutritional status of an overweight 12-year-old girl. Which question is appropriate for the nurse to ask? What does your family do for exercise? Does your family have rules about foods and how they are prepared? How often does everyone in your family eat together? Have you gained weight recently?

How often does everyone in your family eat together?

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?

Needs 10 to 12 hours of sleep per night

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?

conservation

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

The nurse is caring for a 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child?

Provide age-appropriate toys and games.

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? Give the child something for pain. Take the child's temperature; this must be tonsillitis. Record this as a normal finding in an early school-age child. Suggest the health care provider examine the child for breathing difficulty.

Record this as a normal finding in an early school-age child.

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.

The child had a strong desire to have the item with little other way of obtaining it.

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? enjoys math instruction and decides to join the math club believed that not turning in homework on time was acceptable, but has since decided it is not acceptable does not understand the phrase "slow as molasses" when used by the teacher arrives to class late from recess and apologizes to the teacher

does not understand the phrase "slow as molasses" when used by the teacher

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 peers at school characters in media such as television parents

parents

The school nurse receives a report that a child is having difficulty with grades and always appears hungry. When the nurse is assessing this child, what information would be most important to ascertain?

relationship with parents

The nurse is talking with a school-aged child about her interests. In which interest do most school-aged children place the most focus?

school