School Age Development NCLEX
6. A 7-year-old female is being admitted to the hospital for a diagnosis of acute lymphocytic leukemia. The nurse wants to gather information from the child regarding her feelings about her diagnosis. Which nursing action is most appropriate to gain information about how the child is feeling? 1. The nurse should actively attempt to make friends with the child before asking her about her feelings. 2. The nurse should ask the child's parents what feelings she has expressed in regard to her diagnosis. 3. The nurse should provide the child with some paper to draw a picture of how she is feeling. 4. The nurse should ask the child direct questions about how she is feeling.
3. Often children will include much more detail of their feelings in drawings. They will often express things in pictures they are unable to verbalize.
a nurse is discussing prepubescence and preadolescence with a group of parents of school-age children. Which of the following information should the nurse include in the discussion? a. initial physiologic changes appear during early childhood. B. changes in height and weight occur slowly during this period. c. growth differences between boys and girls become evident. d. Signs of sexual maturation become highly visible in boys.
c. CORRECT: the nurse should include in the discussion that growth differences between boys and girls become evident a. initial physiologic changes appear toward the end of middle childhood, around the age of 9 years. B. changes in height and weight occur rapidly during this time period. d. Visible signs of sexual maturation are minimal in boys.
The nurse caring for an 8-year-old boy is trying to encourage developmental growth. What activity can the nurse provide for the child to encourage his sense of industry? 1. Allow the child to choose what time to take his medication. 2. Provide the child with the homework his teacher has sent in. 3. Allow the child to assist with his bath. 4. Allow the child to help with his dressing change.
1. Giving the child choices while in the hospital is important. However, medications should be kept on schedule. It is essential to give them at the prescribed time. 2. The school-age child is focused on academic performance; therefore the child can achieve a sense of industry by completing his homework and staying on track with his classmates. 3. The child should have already mastered bathing. It is not likely to give him a sense of accomplishment. 4. The child may enjoy assisting with his dressing change, but it is not the best ex- ample of industry. TEST-TAKING HINT: The test taker must have knowledge of Erickson's stages of development. Answer 1 can be eliminated because it could be detrimental to children to allow them to choose medication times. Answers 3 and 4 can be eliminated because they are not activities that help the child achieve a sense of industry.
An 8-year-old girl is at the pediatrician's office for a well-child checkup. Her mother tells the nurse that she has been having some difficulty getting her daughter to complete her chores. The child's mother asks the nurse for techniques for gaining the child's cooperation with chores. Which of the following should the nurse suggest the mother do? 1. Use "grounding" as a technique. 2. Use "time-out" as a technique. 3. Use a reward system as a technique. 4. Use spanking as a technique.
1. Grounding is a technique that generally works well with adolescents. 2. Time-out is a technique that is primarily used for toddler and preschool children. 3. School-age children usually respond very well to a reward system and often enjoy the rewards so much that they will continue chores without continual reminders. 4. Spanking is never a suggestion that should be given to families.
An 11-year-old male is being evaluated in the ER for an inguinal hernia. Which statement accurately describes how the nurse should approach him for his physical assessment? 1. The nurse should ask the child's parents to remain in the room during the physical exam. 2. The nurse should auscultate the child's heart, lungs, and abdomen first. 3. The nurse should explain to the child that the physical exam will not hurt. 4. The nurse should explain to the child what the nurse will be doing in basic understandable terms.
1. Privacy is very important to school-age children. The child should be given the choice whether his parents are present for the exam. 2. School-age children can be assessed in a head-to-toe sequence. 3. The nurse should not promise that the exam will not hurt. Palpation of the area of the hernia may hurt the child, and that may jeopardize the trust relationship between the nurse and the child. 4. School-age children are capable of understanding basic functions of the body and should be taught about their diagnosis in simple, basic terms. TEST-TAKING HINT: Health-care professionals must approach children using developmentally appropriate methods. The test taker must have knowledge of a child's psychosocial development. Answers 1 and 2 can be eliminated because they are methods of assessment used for younger children.
A 9-year-old boy has been hospitalized following a bicycle injury. What should the nurse recommend to the child's parents to prevent future injury? 1. Their son should wear safety equipment while riding bicycles. 2. Their son should read educational material on bicycle safety. 3. Their son should watch a video on bicycle safety. 4. Their son should ride his bike in the presence of adults.
1. Safety equipment is essential for bicycling, skateboarding, and participating in contact sports. Most injuries occur during the school-age years, when children are more active and participate in contact sports. 2. Educational material is a good way to reinforce the use of safety equipment, but the parents must insist that the child use his safety equipment. 3. Video material is a good way to reinforce the use of safety equipment, but the parents must insist that the child use his safety equipment. 4. The child's parents may not always be present when he rides his bike, so the use of safety equipment is the primary concern.
The school nurse is preparing a discussion on nutrition with the fourth-grade class. Based on the childrens' developmental level, what information should she include in her presentation? 1. A review of the number of calories that a fourth-grade child should consume in a day. 2. A review of a list of high-calorie foods that all fourth-graders should avoid. 3. A review of how to read food labels so children know which foods are good for them. 4. A review of nutritious foods with basic scientific information about how they affect the body organs and systems.
1. School-age children do not engage in calorie counting. This is an adult activity. 2. Children may not want to hear this information, as most of them enjoy consuming high-calorie foods that taste good. 3. School-age children do not engage in calorie counting. This is an adult activity. 4. Reviewing nutritious choices keeps the lesson on a positive note, and school-age children are very interested in how food affects their bodies. They are capable of understanding basic medical terminology.
The nurse is caring for a 7-year-old female on the school-age unit. Her mother is concerned that she may have some developmental delays. Which of the following statements would indicate to the nurse that the child is not developmentally on track for her age: 1. The child is able to follow a four-to-five-step command. 2. The child started wetting the bed on this admission to the hospital. 3. The child has an imaginary friend named Kelly. 4. The child enjoys playing board games with her sister.
1. School-age children should be able to follow a four- to five-step command, so this does not indicate that the child has a developmental delay. 2. The child was potty-trained before entering the hospital, and it is important to inform her mother that bedwetting is a common form of regression seen in hospitalized children. The child will likely return to her normal toileting habits when she returns home. 3. Most school-age children do not have imaginary friends. This is much more common for children of 3 and 4 years of age. 4. Most school-age children do enjoy playing board games.
An 8-year-old is NPO while he awaits surgery for central line placement later in the afternoon. The nurse is trying to engage the child in some form of activity to distract him from thinking about his upcoming surgery. Which is the best method of distraction for a child of this age in this situation? 1. Encourage the child to use the telephone to call friends. 2. Encourage the child to watch television. 3. Encourage the child to play a board game. 4. Encourage the child to read the central line pamphlet he was given.
1. Talking to friends may distract the child for some time. However, the conversation could revert to a discussion about the upcoming surgery. 2. Watching television may distract the child for some time, but he may still be thinking about his surgery. 3. A board game is the optimal choice because school-age children enjoy being engaged in an activity with others that will require some skill and challenge. 4. Reading material about the surgery will only increase his thoughts about the surgery.
A 9-year-old girl builds a clubhouse in her backyard. She hangs a sign outside her clubhouse that says "No boys allowed." The child's parents are concerned that she is excluding their neighbor's son, and they are upset. What should the school nurse tell the child's parents? 1. Her behavior is cause for concern and should be addressed. 2. Her behavior is common among school-age children. 3. Her feelings about boys will subside within the next year. 4. They should have their daughter speak with the school counselor.
1. The child's behavior is normal. Girls of 9 and 10 generally prefer to have friends who are of the same gender. 2. This is common behavior. Girls of 9 and 10 generally prefer to have friends who are of the same gender. 3. Girls of 9 and 10 generally prefer to have friends who are of the same gender. The child will likely have the same feelings next year. 4. There is no need for the child to see the counselor. Girls of 9 and 10 generally prefer to have friends who are of the same gender.
The mother of 11-year-old fraternal twins tells the nurse at their well-child checkup that she is concerned because her daughter has gained more weight and height than her twin brother. The mother is concerned that there is something wrong with her son. The nurse's best response is: 1. "I understand your concern. I will talk with the physician, and we can draw some lab work." 2. "I understand your concern. Has your son been ill lately?" 3. "It is normal for girls to grow a little taller and gain more weight than boys at this age." 4. "It is normal for you to be concerned, but I am sure your son will catch up with your daughter eventually."
1. This is not an appropriate response. The nurse should be aware that it is normal for girls to grow taller and gain more weight than boys near the end of middle childhood. 2. This is not an appropriate response. The nurse should be aware that it is normal for girls to grow taller and gain more weight than boys near the end of middle childhood. 3. This is the appropriate response. The nurse understands that it is normal for girls to grow taller and gain more weight than boys near the end of middle childhood. 4. This is not the best response. The boy will likely surpass his sister when he reaches adolescence.
a nurse is providing education about age-appropriate activities for the parents of a 6-year-old child. Which of the following activities should the nurse include in teaching? a. Jumping rope B. Playing card games c. Solving jigsaw puzzles d. Joining competitive sports
A: Correct
A nurse is teaching the parents of a school-age child. Which teaching topic should take priority? 1. Accident prevention 2. Keeping a night light on to allay fears 3. Normalcy of fears about body integrity 4. Encouraging the child to dress without help
Answer: 1. Accidents are the major cause of death and disability during the school-age years. Therefore accident prevention should take priority when teaching parents of school-age children. Preschool children are afraid of the dark, have fears concerning body integrity, and should be encouraged to dress without help (with the exception of tying shoes), but none of these should take priority over accident prevention.
8. A mother asks the nurse how she will know when her son is entering puberty. The nurse tells the mother to watch for which sign? 1. Appearance of pubic hair 2. Appearance of axillary hair 3. Testicular enlargement 4. Nocturnal emissions
Answer: 3. Testicular enlargement signifies the onset of puberty in the male adolescent. Then sexual development progresses, causing the appearance of pubic hair and axillary hair and the onset of nocturnal emissions
A nurse is conducting a well-child visit with a child who is scheduled to receive the recommended immunizations for 11- to 12-year olds. Which of the following immunizations should the nurse administer? (Select all that apply.) a. trivalent inactivated influenza (tiV) B. Pneumococcal (PcV) c. meningococcal (mcV4) d. tetanus and diphtheria toxoids and pertussis (tdap) e. rotavirus (rV)
a. CORRECT: tiV is a recommended immunization for 11- to 12-year-olds, and should be administered by the nurse. B. PcV is recommended as a series of immunizations in the first 15 months of life. c. CORRECT: mcV4 is a recommended immunization for 11- to 12-year-olds, and should be administered by the nurse. d. CORRECT: tdap is a recommended immunization for 11- to 12-year-olds, and should be administered by the nurse. e. rV is recommended as a series of immunizations in the first 6 months of life.
a nurse is teaching a course about safety during the schoolage years to a group of parents. Which of the following information should the nurse include in the course? (Select all that apply.) a. gating stairs at the top and bottom B. Wearing helmets when riding bicycles or skateboarding c. riding safely in bed of pickup trucks d. implementing firearm safety e. Wearing seat belts
a. gating stairs at the top and bottom should not be included in the teaching. this is appropriate information to include when teaching about safety during infant and toddler years. B. CORRECT: When teaching about safety in the schoolage years, the nurse should include information about wearing helmets when riding bicycles or skateboarding. c. the nurse should teach that it is never safe to ride in the bed of a pickup truck. d. CORRECT: the nurse should include information about implementing firearm safety when teaching about safety in the school-age years. e. CORRECT: the nurse should include information about wearing seat belts when teaching about safety in the school-age years.
