Chapter 28: Growth and Development of the School-Age Child
The mother of an 11-year-old child tells the nurse that her child seems to be "hungry all of the time" and seems to "never get full." The nurse suspects a physiologic developmental problem. What is the rationale for the nurse suspecting a physiologic developmental issue? Select all that apply. a) The caloric needs of the school-age child are lower than in the earlier years of life. b) The school-age child is very selective in the type of foods they prefer. c) School-age children typically consume less food than adolescents. d) The stomach capacity increases, which should permit retention of food for longer periods of time. e) Peer pressure tends to cause the child to eat less.
Answers: a, d Explanation: The stomach capacity increases, which permits retention of food for longer periods of time. In addition, the caloric needs of the school-age child are lower than in the earlier years. These are physiologic developmental reasons that support the nurse questioning if there is a problem.
Which behavior(s) involving a 11-year-old child warrants further education to the family? Select all that apply. a) The child utilizes a lap and shoulder belt when riding in the car. b) The child rides in the third row of the car seats. c) The child wears a lap belt when riding in the car. d) The child uses a backpack to carry books when riding their bike to and from school. e) The child is allowed to sit in the front seat of the car.
Selected answers: C, D, E Explanation: When riding in the car children under the age of 12 should ride in the back seat and not the front seat. Safety belts consisting of a lap and shoulder harness should be employed. Front baskets on a bike should be used to carry heavy objects. Using a backpack can cause balance issues leading to a fall and should be avoided.
The nurse is educating the parents of a 10-year-old girl in ways to help their child avoid tobacco. Which suggestion should be part of the nurse's advice? a) "As parents, you need to be good role models." b) "Tell her only losers smoke and chew tobacco." c) "Keep your cigarettes where she can't get to them." d) "Always go outside when you have a cigarette."
a) "As parents, you need to be good role models." Explanation: The nurse would recommend that the parents be good role models and quit smoking. Locking up or hiding your cigarettes and going outside to smoke is not as effective as having a tobacco-free environment in the home.
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? a) "Based on my child's weight and height, I should be concerned my child is overweight." b) "My child needs 1000 mg of calcium per day." c) "I should encourage my child to fill half of the plate with fruits and veggies." d) "If my child has moderate activity my child needs around 1500 calories per day."
a) "Based on my child's weight and height, I should be concerned my child is overweight." Explanation: An 8-year-old girl needs between 1400 and 1600 calories per day. Based on the child's weight and height, the child has a body mass index (BMI) of 17.9 (around 75th percentile). To calculate BMI use [wt in lb/{ht in inches}x{ht in inches}] x703. This child is not in the overweight or obese category (>85th percentile is classified as overweight). An 8-year-old needs 1000 mg calcium per day. Children should be encouraged to fill half their plate with fruits and vegetables, to make half of their grains whole grains, and to choose lean proteins and calcium-rich foods.
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? a) "Girls typically experience a rapid growth spurt before boys." b) "Boys normally grow an average of 5 in (12.5 cm) each year." c) "There are not many physical differences between school-aged boys and girls." d) "Menarche is usually the first sign of puberty in school-aged girls."
a) "Girls typically experience a rapid growth spurt before boys." Explanation: Girls typically experience a rapid growth spurt before boys, and are usually taller by about 2 in (5 cm) or more than preadolescent boys. During the school-age years, the child will grow approximately 1 to 2.5 in (2.5 to 6.25 cm) per year. As puberty approaches, there will be significant differences in development between boys and girls. The first sign of puberty for girls is breast changes, not menarche.
During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be? a) "Play helps children to develop cognitively, socially, physically, and emotionally." b) "Wow, that is a lot of stuff for a girl her age." c) "All of these other activities teach you as much as traditional play." d) "It is understandable not playing any more with all these other activities."
a) "Play helps children to develop cognitively, socially, physically, and emotionally." Explanation: It is important to recognize that the child is busy with other activities but that this does not replace the need to engage in play. Children need time to play because it helps them to develop cognitively, socially, physically, and emotionally. Play at this age embodies the needs for rules and structures. Engaging in group activities allows children to be part of a social group.
The nurse is teaching parents of an 11-year-old child how to deal with the issue of peer pressure regarding the use of tobacco and alcohol. Which suggestion by the nurse provides the best course of action for the parents? a) Discuss tobacco and alcohol use and effects with the child. b) Encourage the child to avoid having friends who smoke or drink. c) Avoid smoking in the house or in front of the child. d) Keep any alcohol products in the home in a locked cabinet.
a) Discuss tobacco and alcohol use and effects with the child. Explanation: Parents are major influences on school-age children and should discuss the dangers of tobacco and alcohol use with the child. Not smoking in the house and hiding alcohol send mixed messages to the child. Open and honest discussion is the best approach rather than discouraging the child from making friends with kids that use tobacco or alcohol.
What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child? a) Fish, spinach salad and a glass of milk b) Bagels and cream cheese with sherbet c) Hamburger and a cherry Coke d) Chicken sandwich with pretzels and apple juice
a) Fish, spinach salad and a glass of milk Explanation: A well-balanced diet rich in calcium and phosphorus fosters healthy teeth. Minimal sugar, a diet of whole grain breads, and fish and cheeses are all good sources of calcium and/or phosphorus. Sugary soda drinks and juices, pretzels and bagels, beef and sherbet do not provide substantial amounts of calcium or phosphorus.
The nurse is teaching a growth and development class to parents of school-age children. What does the nurse teach the parents about the cognitive abilities of their children? a) They are able to classify objects. b) They can make judgements based on scientific facts. c) They have developed the ability to reason abstractly. d) They make judgments on what they reason.
a) They are able to classify objects. Explanation: The period from 5 to 11 years is a transitional stage where children undergo a shift from preoperational thought to concrete operational thought. During this stage, children decenter (have the ability to project one's self into other people's situations), accommodate (develop an understanding there can be more than one reason for people's actions), conserve (the ability to appreciate a change in shape does not necessarily mean a change in size), and develop class inclusion (the ability to understand objects can belong to more than one classification). Class inclusion is necessary for learning mathematics and reading. Children do not develop abstract thinking until adolescence. Cognitive development includes the child's ability to reason through any problem he or she can actually visualize.
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? a) conservation b) classification c) reversibility d) decentration
a) conservation Explanation: Piaget described concrete operational thought occurring in the child ages 7 to 10 years. During this time the child develops various skills to see objects and the world. The skill of conservation is the ability to recognize that a change in shape does not necessarily mean a change in amount or mass. Using reversibility, the child can understand that processes can be reversed or canceled out by other things. Decentration is developed when the child can pay attention to multiple attributes of an object or situation instead of only one. In classification, the child is able to put objects together by shared qualities or characteristics.
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? a) does not understand the phrase "slow as molasses" when used by the teacher b) believed that not turning in homework on time was acceptable, but has since decided it is not acceptable c) enjoys math instruction and decides to join the math club d) arrives to class late from recess and apologizes to the teacher
a) does not understand the phrase "slow as molasses" when used by the teacher Explanation: Piaget's stage of cognitive development for the 7- to 11-year-old is the period of concrete-operational thoughts. In developing concrete operations, the child is able to assimilate and coordinate information about his or her world from different dimensions. Abstract thinking, such as understanding the meaning of the phrase "slow as molasses," is expected at this stage of cognitive development.
A parent calls the health care provider about the 7-year-old child's dental hygiene. The child has had three cavities. The parent does not know what to do and asks the nurse for guidance. How should the nurse respond? a) "Did you teach your child how to brush the teeth?" b) "Are you able to supervise your child's brushing?" c) "Is there fluoride toothpaste available for use?" d) "What type of toothbrush does your child use?"
b) "Are you able to supervise your child's brushing?" Explanation: Dental caries is the leading chronic disease in the United States. Children need help with toothbrushing until they are between 7 and 10 years of age. The parent should monitor the toothbrushing to make sure it is thorough, observe for any abnormal tooth alignment, and schedule cleanings every 6 months. Children tend to concentrate on the front teeth, because they can see them easily and "forget" the teeth in the back. Parental oversight is needed to be sure those teeth are brushed carefully.
The school nurse is speaking with a group of teachers about bullying. Which statement by a teacher would indicate a need for further education by the nurse? a) "Being bullied can have negative effects throughout a child's life." b) "Boys bully more often but girls are more likely to be bullied." c) "Boys are twice as likely to be bullies and to be victims of bullying." d) "Children who are bullied can have physical and psychological symptoms from being bullied."
b) "Boys bully more often but girls are more likely to be bullied." Explanation: Both boys and girls are bullied and can bully others; however, boys are twice as likely to be bullies and victims of bullying. Being bullied can have negative results on children throughout life. These children often have increased episodes of headaches, stomachaches, sleep problems, anxiety, loneliness, depression, and suicidal tendencies.
he mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse? a) "Is there any possibility he is telling the truth and you just don't know it is the truth?" b) "Children this age sometimes can't distinguish between fantasy and reality." c) "Your child could be in serious trouble in school if he continues to tell lies." d) "The child should have privileges taken away for several days each time he tells a lie."
b) "Children this age sometimes can't distinguish between fantasy and reality." Explanation: Children in the age group 6 to 7 years often engage in magical thinking. They may still believe in the tooth fairy, Santa Claus, monsters under the bed, and other imaginary characters. These keen imaginations may also conjure up fears-especially at night-about remote, fanciful, or imaginary events. If a child of this age has trouble distinguishing fantasy from reality, it may incline them to A lie to escape punishment or to boost self-confidence. The other choices do not consider this child's stage of development or give the mother the most appropriate information for the situation.
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? a) "I understand why you are concerned. Is your child sedentary quite a bit? Encouraging activity may limit weight gain." b) "Normal growth and development for this age results in an average weight gain of 7 pounds per year." c) "We see most children of this age in our clinic gaining similar amounts." d) "Your child doesn't seem to be overweight, so it isn't a concern."
b) "Normal growth and development for this age results in an average weight gain of 7 pounds per year." Explanation: Children of school-age grow an average of 2.5 inches (6 to 7 centimeters) per year and gain an average of 7 pounds per year; therefore, the 10 pounds over 2 years is normal and it is important for the parents to know this, regardless if they are not overweight. Simply comparing them to other children seen in the clinic doesn't mean it is a normal expectation. While activity is important, the nurse must first address the parent's concern.
The nurse is preparing to catheterize an 11-year-old child. The nurse correctly recognizes the child's approximate bladder capacity is what amount? a) 12 ounces b) 13 ounces c) 20 ounces d) 15 ounces
b) 13 ounces Explanation: The formula for bladder capacity is age in years plus 2 ounces. If a child is 11 years of age, this would be approximately 13 ounces.
An 11-year-old boy is significantly above the 100% percentile for height. The boy tells the school nurse that his parents expect so much out of him when he is playing basketball for the school team that he is thinking of quitting. What action should the nurse take? a) Encourage the boy to talk to his coach to determine if his parents' expectations are realistic. b) Arrange a conference with the parents, son, and nurse to discuss the child's concerns. c) Tell the parents that they should stop putting so much pressure on their son just because he is tall. d) Remind the boy that being so much taller than the other boys is why others have higher expectations for him.
b) Arrange a conference with the parents, son, and nurse to discuss the child's concerns. Explanation: The best action is for the nurse to speak with the parents and the child together to discuss concerns in order to establish open dialogue and possible resolution. During the conference, the nurse can point out that physical maturity is not necessarily associated with emotional and social maturity and that the expectations placed on these children are unrealistic and can impact the self-esteem and competence of the child.
An 8-year-old male 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? a) The child's weight is seven times his birth weight. b) Height 49.5 in (124 cm) c) Weight 62 lb (28.1 kg) d) The child has all of his adult teeth present.
b) Height 49.5 in (124 cm) Explanation: Normal physical growth for school-age children is a gain in height of 2.5 inches (6.25 cm) each year. Thus, a height of 49.5 in (124 cm) would be expected growth. The growth in weight is not within normal parameters as this is a 12 lb (5.4 kg) weight gain. A 7-year-old child, not 8-year-old child, should weigh seven times his birth weight. Adult teeth do not normally come in until age 10 to 12.
An 8-year-old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step? a) Perfectionism b) Industry c) Conservation d) Accommodation
b) Industry Explanation: During the early school years, children attempt to master their new developmental step: learning a sense of industry or accomplishment. Accommodation is the ability to adapt thought processes to fit what is perceived, such as understanding there can be more than one reason for other people's actions. Conservation is the ability to appreciate that a change in shape does not necessarily mean a change in size. Perfectionism is the desire to do something perfectly. The boy's desire to apply the band-aid "the right way" is a hallmark of the development of industry. The other answers are not as pertinent.
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? a) Remind the child to stop each time the behavior is witnessed. b) Make time each day to spend with the child individually. c) Apply a nail biting product to the nails to deter biting. d) Get a description of the classroom behavior from the teacher.
b) Make time each day to spend with the child individually. Explanation: Many first graders are capable of mature action at school but appear less mature when they return home. They may bite their fingernails, suck their thumb, or talk baby talk. Scolding, nagging, threatening, or punishing does not stop the problem and can actually make them worse. Methods such as bad-flavored nail polish or restraining the child's hands make the problems worse. These behaviors stop when the underlying stress is discovered and alleviated. Parents should be urged to spend time with the child after school or in the evening so the child continues to feel secure in the family and does not feel pushed out by being sent to school.
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. Which factor does this best represent? a) immaturity for this age group b) appropriate social development c) poor peer relationships d) encouragement for bullying and sexism
b) appropriate social development Explanation: During the school-age years, peer groups tend to be same-sex. This helps children learn to work together and to see viewpoints different than their own. Being part of a peer group helps with positive socialization of the school-age child. The other choices are not represented by this scenario.
A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to: a) ask the teacher to decide if the child should come to school or not each day. b) make her child attend school every day. c) keep her child home until this fear passes. d) allow her child to decide daily if she wants to go to school or not.
b) make her child attend school every day. Explanation: School refusal or phobia may result from both a parent not wanting a child to attend school and a child not wanting to leave a parent. Th nurse's role is to help them work together while keeping the child in school to resolve the issue.
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? a) "Why do you go to bed so late at night?" b) "Do your parents always let you stay up so late at night?" c) "That is not enough sleep. You should get at least 9 to 12 hours of sleep each night." d) "That should be enough sleep. Let's talk about your eating habits."
c) "That is not enough sleep. You should get at least 9 to 12 hours of sleep each night." Explanation: The school-aged child needs 9 to 12 hours of sleep per night. Seven hours of sleep is not enough sleep for this child. It is not appropriate to ask judgmental questions concerning parenting skills nor why the child goes to bed at 11:00 PM.
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? a) "Your child should be getting at least 9 hours of sleep per night." b) "Your child should be getting 8 to 9 hours of sleep per night." c) "Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school." d) "We should ask the health care provider to run some tests; with that much sleep, the child should not be tired."
c) "Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school." Explanation: Sleep needs for children change according to their ages. A 6- to 8-year-old child needs 12 hours of sleep per night. The 8- to 10-year-old child needs 10 to 12 hours of sleep per night. The 10- to 12-year-old child needs between 9 and 10 hours of sleep per night. Many younger children need a nap or to be provided with quiet time after school to recharge after a busy day in the classroom. Increasing the child's sleeping hours should be attempted before asking for medical intervention.
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) A sense of doubt b) A sense of shame c) A feeling of inferiority d) A sense of mistrust
c) A feeling of inferiority Explanation: Children who are unsuccessful in completing activities during the school-age phase, whether from physical, social, or cognitive disadvantages, develop a feeling of inferiority.
The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory? a) The conventional stage of development b) Lack of the ability to think abstractly c) A sense of competence, mastery, and worth d) The principle of conservation
c) A sense of competence, mastery, and worth Explanation: Erikson states that school-agers receive satisfaction from developing new skills and successfully using them to accomplish goals (industry). Failing (without adult support) or being unable to meet expectations that are set too high can result in feelings of inferiority. Lacking the ability for abstract thought is a cognitive skill and part of Piaget's theory, as is the principle of conservation. The conventional stage belongs to Kohlberg's theory of moral development.
While treating a minor playground injury for an 8-year-old girl, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action? a) Immediately call the bullied child's parents. b) Question those responsible for the bullying. c) Assess the situation with the help of the school staff and parents. d) Determine if there have been other playground bullying incidents.
c) Assess the situation with the help of the school staff and parents. Explanation: Assessing the situation and following the school's bullying protocol will be an important first step. Immediately calling the bullied child's parents may be premature. Questioning those responsible for the bullying and determining if there have been other playground incidents of bullying may be part of the overall assessment, but would not be the first action taken.
Parents of an 8-year-old client report the child struggles with the chore of cleaning their bedroom. What advice will the nurse give to assist with this challenge for a child at this stage of development? a) Take away any toys or items that are left on the floor if not cleaned up. b) Provide a consequence of loss of privileges until they complete the chore. c) Break the chore into smaller tasks that the child can accomplish more easily. d) Offer a treat as an incentive for completing the chore.
c) Break the chore into smaller tasks that the child can accomplish more easily. Explanation: In the early school-age years, children have the developmental task of achieving a sense of industry. Breaking the job into smaller tasks that they can feel accomplished about provides a "reward" to assist them in completing a larger job. Treats are not required as a reward for children of this age. Providing consequences, such as loss of toys or loss of privileges, does not allow for the development of industry nor support children to learn how to complete the job.
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? a) Know lying is bad because she gets sent to her room for it. b) View the world in terms of her own experience. c) Consider an action and its consequences. d) Make generalized assumptions about groups of things.
c) Consider an action and its consequences. Explanation: The child will be able to consider an action and its consequences in Piaget's period of concrete operational thought. However, she is now able to empathize with others. She is more adept at classifying and dividing things into sets. Defining lying as bad because she gets punished for it is a Kohlberg characteristic.
The developmental task of the school-aged period, according to Erikson, is gaining a sense of: a) autonomy versus shame. b) identity versus failure. c) industry versus inferiority. d) independence versus dependence.
c) industry versus inferiority. Explanation: The school-age years, according to Erickson, are the stage of industry versus inferiority. The developmental stage helps increase the child's sense of self worth. Industry is associated with the child's increased interest in knowledge and the development of social skills. Autonomy versus shame is the developmental tasks of 1 to 3 year old children. Erickson's stages do not include the developmental tasks of independence versus dependence nor identity versus failure.
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? a) "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." b) "If cheating is noted at this age, referral to a family counselor is highly recommended." c) "Perhaps the academic environment is too easy for your child, causing the cheating." d) "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior."
d) "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." Explanation: Because they are role models for their children, parents must first realize the importance of their own behaviors. If the academic environment is too difficult, not too easy, the child may be cheating to keep up with the increased rigor. Punishment should be geared toward discussion and helping the child understand the seriousness of cheating, and not be a subtle approach. After a discussion with the child, a review of the child's academic situation (is the work too hard? Is tutoring needed?) and positive role-modeling is assured, then referral to a counselor would be indicated but not as the first step in the resolution.
The mother of a 7-year-old girl is asking the nurse's advice about getting her daughter a 2-wheel bike. Which response by the nurse is most important? a) "Learning to ride the bike will improve her coordination." b) "She won't need a helmet if she has training wheels." c) "Teach her where she'll land on the grass if she falls." d) "Be sure to get the proper size bike."
d) "Be sure to get the proper size bike." Explanation: It is very important to get a bike of the proper size for the child. Getting a bike that the child can "grow into" is dangerous. Training wheels and grass to fall on are not acceptable substitutes for the proper protective gear. The child should already demonstrate good coordination in other playing skills before attempting to ride a bike.
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? a) "I will have improved gross motor skills." b) "I will appear heavier due to an increase in fat production." c) "There are not many physical differences among school age boys." d) "I will grow an average of 2.5 in (6.5 cm) per year."
d) "I will grow an average of 2.5 in (6.5 cm) per year." Explanation: During the school-age years, the child will grow an average of 2.5 in (6.5 cm). As puberty approaches, there will be significant differences in development between boys and girls. As development occurs, weight does increase, but it is not directly related to fat production. This is an area where much education needs to occur with young girls because "dieting" can be detrimental to the child's health and increased size is tied to the child's body image and self-esteem. By 10 years of age, brain growth is complete, and fine motor coordination is refined.
The nurse is taking a health history for a 12-year-old child whose BMI is greater than 30. Which general question should the nurse ask the child's parents? a) "What beverages are preferred?" b) "How important is exercise?" c) "Is breakfast eaten regularly?" d) "Is there a family history of hypertension, heart disease, or diabetes?"
d) "Is there a family history of hypertension, heart disease, or diabetes?" Explanation: Parents should be more knowledgeable than the child regarding health problems within the family. The other questions are appropriate for the child to answer and may motivate the child to think about meal patterns, diet, and exercise habits. The parents will benefit from listening to these questions, because their habits influence the child.
A 10-year-old child tells the school nurse that she is embarrassed that she is afraid of the dark. Which is the best response by the nurse? a) "That is so horrible that you are afraid of the dark. Can you sleep at night at all?" b) "I was afraid of the dark at your age. You will grow out of that fear soon." c) "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?" d) "It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?"
d) "It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?" Explanation: The school-age child needs reassurance that his or her fears are normal for this developmental age. Parents, teachers, and other caretakers should discuss the fears and answer questions posed by the child. However, the adult should not embellish the fear in any way. In addition, telling the child that she will "grow out of it" is not reassuring to the child.
A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed? a) "I will teach my son not to arrange a meeting with someone he met on the Internet." b) "I will teach my daughter her full name and phone number." c) "We will be sure that our daughter wears a life jacket the next time we go boating at the lake." d) "My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets."
d) "My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." Explanation: Children should be taught ways to stay safe and prevent accidents. All children should wear bicycle helmets; however, unless the bicycle has a sidecar, the bike riding is safe for only one rider. The parents are correct that their children should learn their names and addresses, should not set up a meeting with a person they met on the Internet without parental supervision, and should wear a life jacket when boating.
The mother of two children ages 6 and 12 reports that her 6-year-old child seems to have "cold after cold" while her older child never seems to be ill. She questions if there is something wrong with her younger child. What is the best response by the nurse? a) "All children have differing levels of immunity." b) "It is most likely coincidental and there is little to worry about." c) "Your younger child likely has a greater tendency toward illness." d) "The immune system of your younger child is less mature and may result in having more infections."
d) "The immune system of your younger child is less mature and may result in having more infections." Explanation: The immune system of the school-aged child is not fully mature. Lymphatic tissues continue to grow until the child is 9 years old; immunoglobulins A and G (IgA and IgG) reach adult levels at around 10 years of age.
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? a) "You should buy your other child a bank that cannot be opened." b) "Stealing is unusual for a 7-year-old child." c) You should talk to the child's teacher about putting less pressure on your child." d) "You may need to remind your child about property rights."
d) "You may need to remind your child about property rights." Explanation: Antisocial behaviors develop during the school-age years. Between the ages of 6 and 8 years, the child has difficulty understanding the concept of ownership and property rights. At this age, children often take things because they like the look of an item. By age 9, children learn to respect other's possessions and property. Buying a more secure bank may keep the child from taking the money, but it does not take into consideration the child's developmental level. The behavior is a developmental issue and not an emotional issue of having too much pressure.
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) A card game such as solitaire b) A board game such as monopoly c) An activity focusing on learning fractions d) A paint-by-numbers activity creating a picture
d) A paint-by-numbers activity creating a picture Explanation: Between the ages of 6 and 8 years, children begin to enjoy participating in real-life activities, such as helping with gardening, housework, and other chores. They love making things, such as drawings, paintings, and craft projects. The child would need additional instruction to learn fractions, which may not be considered fun. A card game such as solitaire and a board game of monopoly may be too hard for the 7-year-old. In addition, the game of monopoly would require additional players.
An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health? a) Accept that the child is genetically predisposed to having more cavities than most children. b) Have the child's teeth professionally cleaned every 3 months. c) Encourage the child to abstain from eating sugary snacks at school. d) Ensure that the child brushes his teeth after each meal and snacks.
d) Ensure that the child brushes his teeth after each meal and snacks. Explanation: Proper dental hygiene includes a routine inspection and conscientious brushing after meals. A well-balanced diet with plenty of calcium and phosphorus and minimal sugar is important to healthy teeth. Foods containing sugar should be eaten only at mealtimes and should be followed immediately by proper brushing. The school-aged child should visit the dentist at least twice a year for a cleaning and application of fluoride.
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? a) Writing letters to friends b) Playing with blocks c) Playing with a jack-in-the-box d) Participating in a craft project
d) Participating in a craft project Explanation: During this stage, the child is interested in how things are made and run. The child learns to manipulate concrete objects. The child likes engaging in meaningful projects and seeing them through to completion. Playing jack-in-the-box and blocks are for much younger children. If anything, the child would be texting back and forth with friends, not writing a letter.
The school nurse is reviewing the chart of a 12-year-old student who has had excessive absences due respiratory infections. What is the best action by the nurse? a) Discuss with the child's teacher to determine if the number of absences has affected academic performance. b) Ask the child if he really has had respiratory infections during these absences. c) Continue to monitor the child's absences. d) Speak with the parents about the unusual increased number of respiratory infections.
d) Speak with the parents about the unusual increased number of respiratory infections. Explanation: In the school-age child, the respiratory system continues to mature with the development of the lungs and alveoli, resulting in fewer respiratory infections. Because the child is absent excessively for respiratory infections the nurse should speak with the parents to aid in determining if there is an underlying cause, or suggest the child visit the pediatrician to discuss the issue.
During a well-child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group, the nurse understands that: a) discussing death and dying may hint at a psychological disorder. b) consistent thoughts of death and dying at this age lead to the later development of depression. c) at this age, children are not afraid of death. d) preoccupation with death and dying is common in the school-aged child.
d) preoccupation with death and dying is common in the school-aged child.
The nurse is talking with a school-aged child about her interests. In which interest do most school-aged children place the most focus? a) family b) pets c) church d) school
d) school Explanation: The school-age child typically values school attendance and school activities. During school-age, the focus expands from family to teachers, peers, and other outside influences.
