Pediatrics chapters 18 & 19

typical characteristics of a 6 yr old child

- attention span is brief - loss of primary teeth; along with eruption of permanent teeth - greater exposure of infection occurs with entry into school - needs 11-13 hrs of sleep at night

behavior changes of 11-12 year olds

- complete disorganization - less ability to concentrate - child has 24-26 permanent teeth

typical characteristics of a 9 year old

- needs 10 hrs sleep a night - have tensions, worries & compulsions, - recreational activities may include competitive sports, reading, music, watching tv, computer games

typical characteristics of an 8 year old

- prefers friends of the same sex - enjoys competitive sports; takes losing poorly - secret clubs, have strict rules

Concrete operations involve_____ thinking and an understanding of cause and effect.

logical

Concrete operations

logical thinking and an understanding of cause and effect

Androgynous

sex role concept that incorporates both masculine & feminine qualities

According to Erikson, the school-age period is referred to as the stage of

Industry

What is the most appropriate advice for the nurse to offer parents who are concerned about their preschooler's masturbation ? 1) remove the child's hands from the genitals 2) try to interest the child in another activity 3) tell the child not to touch himself there 4) ask the child why he is rubbing that area

2) try to interest the child in another activity

at age 5, height increases by ____ inches

2-3

Which theorist stated that the school-age child is in a time of sexual latency?

Freud

list the major tasks of the preschool child

- preparation to enter school - dev. of cooperative play - control of body functions - acceptance of separation - increase in communication skills, memory, attention span

typical characteristics of a 10 year old

- strives for independence, but will take suggestions, - ideas of a group are more important than those ideas of individuals - takes greater interest in his or her appearance

Choose the best example of egocentric thinking 1) "The airplane takes me to grandma's." 2) "Water is blue bc someone colored it." 3) "The big box is a truck." 4) "The moon sleeps during the daytime."

1) "The airplane takes me to grandma's."

A healthy preschool girl asks her parents if she will die. The best response is to tell her that: 1) people do not usually die until they are old 2) she does not need to worry about dying 3) parents usually die before their children 4) she will not die for a long time

1) people do not usually die until they are old

describe the two types of enuresis

1) primary: Occurs in a child who has never been dry during sleep 2) secondary: The recurrence of bedwetting after thechild has been dry during sleep for 1 yearor more

One effective method of discipline for a preschool child is to: 1) reward the child for good behavior 2) give the child a light spanking 3) review the reasons for discipline 4) stop interacting with the child

1) reward the child for good behavior

the preadolescent girl should have supplies for menstruation 1. before her first menstrual period 2. as soon as she knows how heavy her flow is 3. when her friends are prepared for theirs 4. about 6 months after breast development begins

1. before her first menstrual period

A preschool child falls off the swing & cries, "Bad swing! You made me fall!" This child's response is an example of: 1. egocentrism 2. artificialism 3. animism 4. centering

1. egocentrism

the most significant physical development at age 6 yrs. is 1. loss of the primary teeth 2. round, moon shaped face 3. better infection resistance 4. rapid growth in height

1. loss of the primary teeth

a preadolescent is more likely to accept her parents decision if 1. she understands why her parents made the decision 2. the parents do not change decisions once they are made 3. the parents carefully control the child's friends 4. her friends have values similar to her own family's

1. she understands why her parents made the decision

a group of 8-9 year old boys has formed a "club". the boys have a secret password and handshake before they meet. Parents should interpret this behavior as: 1. typical for children in this age group 2. a way to avoid being around adults 3. preceding criminal type gang membership 4. rebellion against bossy older children

1. typical for children in this age group

Choose the most effective way for parents to deal with a preschool child's jealousy of her new brother. 1) help her choose toys to share with the new baby 2) remind her of things she can do that the baby cannot 3) explain that she will soon love her new brother 4) ask her to share her room with the new baby at first

2) remind her of things she can do that the baby cannot

choose the normal characteristics of vital signs that the nurse should expect when assessing a 9 year old girl 1. BP & pulse are higher than those of boys the same age 2. BP, pulse & respirations are close to adult levels 3. BP is higher, but pulse & respirations are lower than the adult 4. BP, pulse & respirations are higher than those of a 6 year old girl

2. BP, pulse & respirations are close to adult levels

How would the nurse advise parents regarding a school age child's questions about sex? 1. initiate discussion before the child asks any questions 2. answer questions at the child's level of understanding 3. assure parents the topic will be part of the school curriculum 4. select terms that are used by school aged children

2. answer questions at the child's level of understanding

An example of therapeutic play activity for a preschool child who is recovering from an appendectomy would be: 1. a Wii game of bowling 2. blowing bubbles 3. reading a storybook 4. coloring with crayons

2. blowing bubbles

When selecting play activities for a healthy 4-year-old, the parent should be guided to understand that the 4-year-old enjoys: 1. solitary play, sitting next to a friend 2. cooperative play with friends 3. competitive play with teams 4. observing rather than participating

2. cooperative play with friends

A school age child has an adult " hero" of the same sex. what is the most appropriate interpretation of this behavior? 1. the child feels insecure & inadequate around other children 2. identifying with adults of the same sex is common at this time 3. molestation or sexual abuse by the adult should be considered 4. the child is exploring various career & lifestyle options

2. identifying with adults of the same sex is common at this time

the school age child who has few experiences of success is likely to develop a sense of 1. dependence 2. inferiority 3. trust 4. industry

2. inferiority

The nurse is guiding a parent concerning techniques of handling a child with enuresis. The most appropriate suggestion by the nurse would be to: 1. wake the child often during the night and take him to the bathroom to void 2. limit liquids after dinner and have the child void before going to bed 3. use a consistent technique of discipline whenever the bed is wet 4. keep the child in diapers until bed-wetting is no longer a problem

2. limit liquids after dinner and have the child void before going to bed

which best describes physical growth of the school age child? 1. rapid growth continues from 6-9 years of age then slows 2. slow growth continues until just before puberty 3. height increases faster than weight 4. height & weight remain stable until onset of puberty

2. slow growth continues until just before puberty

normal RR during relaxation of the preschool child

20 breaths/min

Choose the approx. age when children begin playing games that have simple rules. 1) 3 years 2) 4 years 3) 5 years 4) 6 years

3) 5 years

When planning to read with a 5-year-old child, the nurse understands that favorite stories of preschool children are those that relate to their: 1) aggressive tendencies 2) self-centeredness 3) daily experiences 4) relationship to others

3) daily experiences

According to Erikson, the developmental task of the preschool period is to achieve a sense of: 1) trust 2) autonomy 3) initiative 4) industry

3) initiative

Choose the most appropriate teaching for parents of a child with enuresis 1) enuresis is suggestive of emotional instability in a child 2) the child's fluid intake should be restricted during the day 3) the child should empty his bladder before going to bed 4) a relapse during treatment for enuresis is uncommon

3) the child should empty his bladder before going to bed

a child from age ____ years is often referred to as the preschool child

3-5 years

at age 5, weight increases by ____ lb.

3-6

Which statement made by a 10 year old child indicates the need for teaching about living a healthy lifestyle? 1. "I go to the dentist twice a year." 2. "I wear a helmet when I ride my bike." 3. "I have 4 hrs of screen time after school." 4. "I go to bed at 9:00PM & get up at 7:00AM

3. "I have 4 hrs of screen time after school."

A 9 year old practicing the piano continues to have difficulty playing the theme song from a popular movie. She starts to pound on the piano keys in frustration. The best response would be to enter the room and say: 1. "just what do you think you're doing? That piano cost money!" 2. "that's not difficult. Pull yourself together or you'll never amount to anything." 3. "that piece sounds hard. I can see how you could be discouraged." 4. "Here, let me show you how to play that."

3. "that piece sounds hard. I can see how you could be discouraged."

The pulse of the school age child is approximately: 1. 100-120 bpm 2. 95-100 bpm 3. 85-100 bpm 4. 60-80 bpm

3. 85-100 bpm

worries and minor compulsions are more common at the age of 1. 6 years 2. 7 years 3. 9 years 4. 11 years

3. 9 years

A parent asks the nurse if it is healthy to allow her school age child to play computer games after school every day. The best response of the nurse would be that computer and video games: A. interest the school age child & they will keep him off the streets B. can challenge the intellect but should be balanced with active play, with no more than 2 hrs of screen time per day C. should only be played on weekends & not on school days D. some programs teach new skills & are appropriate for school age children 1. A & B 2. A & C 3. B & D 4. all of the above

3. B & D B.can challenge the intellect but should be balanced with active play, with no more than 2 hrs of screen time per day D. some programs teach new skills & are appropriate for school age children

The parent of an 8 year old seeks advice from the nurse because her child is overweight. What would the nurse advise the parent to do? 1. provide a reward for the child when he avoids between meal snacks for a full week 2. limit privileges when the child eats sweets or junk food 3. include the child in meal planning & preparation 4. limit party going activities where sweets will be served

3. include the child in meal planning & preparation

A 4-year-old child is in Erikson's stage of 1. autonomy 2. industry 3. initiative 4. identity

3. initiative

A father is concerned because his 9 yr old son has developed the habit of wrinkling his nose unconsciously. The nurse should tell the father that his son: 1. may have a nerve problem & should be seen by a health care provider 2. cannot get adequate adult attention without taking this action 3. is probably doing this because of unresolved tension 4. should be corrected any time he is caught doing this action

3. is probably doing this because of unresolved tension

____ year-olds are more aggressive and like to show off their newly refined motor skills

4

a ____year-old child can use scissors with success

4

Bedtime for the preschool child should include: 1) flexibility in the time the child goes to bed 2) a period of exercise after dinner 3) warm milk 4) a quiet activity such as a story

4) a quiet activity such as a story

a major cause of health problems in preschool children is: 1) immunization reactions 2) communicable diseases 3) environmental allergies 4) accidental injuries

4) accidental injuries

Which is the best choice for a play activity for a 4-year-old child? 1) watch a DVD 2) play a computer game 3) ride a bicycle 4) build with blocks

4) build with blocks

The nurse would explain to parents that fears of preschool children are usually: 1) similar to those of older children 2) a result of the child's easy distraction 3) less intense than when they were younger 4) greater than those they had as toddlers

4) greater than those they had as toddlers

A child who sucks his thumb is unlikely to have damage to the mouth if the thumb sucking stops before: 1) all deciduous teeth are erupted 2) speech is established 3) the first teeth erupt 4) the permanent teeth erupt

4) the permanent teeth erupt

which statement characterizes the 8 year old child? 1. 8 year olds are totally disorganized 2. they are beginning to take an increased interest in their appearance 3. at this age, children are quieter & more modest than the year before 4. they like competitive sports, but are poor losers

4. they like competitive sports, but are poor losers

jealous of a new sibling is strongest in children less than ____ years of age

5

typical systolic BP of the preschool child

85-90 mm Hg

normal pulse rate of the preschool child

90-110 beats/min

What is the best suggestion by the nurse for an appropriate toy for a hospitalized 6-year-old boy? a. Handheld video game b. MP3 player c. Adventure book d. Jigsaw puzzle

ANS: A Rationale: The 6-year-old child can perform numerous feats that require muscle coordination. At this age, the handheld video game will offer competition without overexertion.

A 9-year-old boy is often cranky and irritable, and his school performance has declined. What is the most probable factor causing this behavior? a. He sleeps only 6 to 7 hours a night. b. He eats eggs every day. c. He has a new dog. d. He plays about 1 to 3 hours each evening.

ANS: A Rationale: The 9-year-old child requires about 10 hours of sleep per night.

The parents of an 8-year-old child tell the nurse the child wakes the household crying out during his frequent nightmares. What is the nurse's most helpful response to explain nightmares? a. They are a normal extension of the child's fear of mutilation. b. They are an abnormal response to repressed feelings. c. They are a common result of latent sexuality. d. They are a side effect of overactivity and stimulation.

ANS: A Rationale: The nightmares experienced by an 8-year-old child are an extension of their characteristic fear of mutilation.

The nurse is assessing a school-age child. What will the nurse expect in regard to physical development of this child? a. Growth of 3 to 6 inches per year b. Gain of 5 to 7 pounds per year c. Increase of head circumference by 1 inch per year d. A visual acuity of 20/20 by 9 years of age

ANS: B Rationale: During the school-age period, the average weight gain per year is generally 5.5 to 7 pounds.

The nurse is advising parents of a 10-year-old boy about the most developmentally supportive experiences for their son. What is the best experience for this child according to Erikson's theory? a. Constant variety of activities b. Successful performance in Little League c. Feeling healthy and strong d. Having a girlfriend

ANS: B Rationale: The child who is successful in activities will feel positively about himself or herself.

A parent asked the nurse, "At what age are children capable of assuming more responsibility for personal belongings?" What is the nurse's best response based on knowledge of growth and development? a. 6 years b. 7 years c. 9 years d. 12 years

ANS: C Rationale: The 9-year-old child is dependable and assumes more responsibility for personal belongings.

What should the nurse keep in mind when planning to teach a class on nutrition to fourth-grade students? a. School-age children can concentrate on only one aspect of a situation. b. School-age children can think abstractly. c. School-age children are egocentric in their thinking. d. School-age children think logically and concretely.

ANS: D Rationale: Piaget refers to the thought process of this period as concrete operations, which involves logical thinking and an understanding of cause and effect.

What type of relationships are the preferred social interactions for the school-age child? a. Heterosexual interest groups b. Association with one "best friend" c. Rigidly organized groups with complex rules d. Same-sex peer groups

ANS: D Rationale: The preferred social interaction of the school-age child is in same-sex peer groups or cliques.

The nurse discusses preparation for school with the parents of a 6-year-old girl who will soon be starting first grade. What statement by the girl's father leads the nurse to determine that the parents understood the information? a. "We should put a stop to her thumb-sucking." b. "We'll have a talk about what school is like." c. "We will let her walk to the bus stop by herself." d. "We'll have her meet some children who will be in her class."

ANS: D Rationale: To prepare a child for school, parents can arrange for the child to meet other children who will be entering school with her.

Which of the following would be the most likely playmate choice for an 8-year-old girl?

Another 8-year-old girl

Describe info school age children need in preparation for puberty (boys)

Erections, nocturnal emissions (wet dreams)

A child with an allergy to animal dander has asked his parents for a pet. What would be the best response from the nurse?

Having an allergy to animal dander does not rule out pet ownership.

the ____ age, rather than the ______ age of the intellectually disabled child should be considered when selecting toys for the child

Mental or developmental

Enuresis (Bedwetting)

Primary: The child has never been dry. Secondary: Bedwetting recurrence in a child who has been dry for a period of 1 year or more. More common in boys than girls Medications:Desmopressin hydroacetate - taper & withdraw slowly after 6 months Imipramine hydrochloride (Tofranil)

what purpose can an imaginary friend serve for a preschool-age child?

Relief from loneliness, mastery of feats, or "scapegoat"

True or false Latchkey children are at higher risk for accidents

True

list possible causes of enuresis

Urinary tract infections Diabetes mellitus Diabetes insipidus Seizure disorders Obstructive uropathy Abnormalities of the urinary tract Sleep disorders Maturational delay of the nervous system Small bladder capacity

typical diastolic BP of the preschool child

about 60 mm Hg

term to describe attributing lifelike qualities to inanimate objects

animisin

how would the nurse advise parents to answer the school age childs questions about sex?

answer the childs questions simply and at his level of understanding and use the correct names to describe body parts.

term to describe the beliefs that everything is created by people

artificialism

why might hospitalization be frightening to preschool children?

bc they are egocentric

term to describe concentrating on a single aspect of an object

centering

list some suitable toys for the pre-school child

construction sets number or alphabet games crayons play tools housekeeping toys musical toys pop-up booksl arge puzzles clay

at age 5, children may begin losing ____ teeth

deciduous

term to describe viewing everything in reference to oneself

egocentrism

term to describe involuntary urination after the age at which bladder control should have been established

enuresis

The school aged child differs from the preschool child in that he/she is more interested in______ than in fantasy

fact

masturbation in the preschool child is considered harmless as long as the child ____

is not preoccupied with it and has no inflammation of genitals

what types of play are typical for the 3-year-old?

parallel and associative play

Preadolescent

period immediately preceding adolescence

humb-sucking will not have a detrimental effect on a child's teeth if the habit is d/c before ____

permanent teeth erupt

the 7 year old child prefers toys that are

realistic and active

at age 5, children are more ____ and have more ____

responsible, patience

a 3-year-old child may have a(n) ____ attachment to the parent of the opposite sex

romantic

at age 5, children can play games that have _____

rules

School age children prefer friends of the _____ sex.

same

a 4-year-old child plays with friends of the ____ sex

same

___ is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there

symbolic functioning

purpose of disciplining the preschool child

to teach and to gradually shift control from parents to the child, that is, to develop self-discipline or self-control.

True or false belonging to a group is important to school age children

true

Describe info school age children need in preparation for puberty (girls)

understanding of menarche and preparation with necessary supplies

Latchkey child

unsupervised children left at home after school