Chapter 19: The School-Age Child Nursing School Test Banks

Chapter 19: The School-Age Child

MULTIPLE CHOICE

1. 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
During the school-age period, the average weight gain per year is generally 5.5 to 7 pounds.

DIF: Cognitive Level: Knowledge REF: Page 435 OBJ: 3
TOP: Physical Growth KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

2. 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
Piaget refers to the thought process of this period as concrete operations, which involves logical thinking and an understanding of cause and effect.

DIF: Cognitive Level: Comprehension REF: Page 434, Box 19-1
OBJ: 3 TOP: Cognitive Development
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

3. 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
The preferred social interaction of the school-age child is in same-sex peer groups or cliques.

DIF: Cognitive Level: Analysis REF: Page 435 OBJ: 3
TOP: Social DevelopmentPlay KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

4. 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 Eriksons theory?
a. Constant variety of activities
b. Successful performance in Little League
c. Feeling healthy and strong
d. Having a girlfriend
ANS: B
The child who is successful in activities will feel positively about himself or herself.

DIF: Cognitive Level: Analysis REF: Page 435 OBJ: 3
TOP: Psychosocial Development KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

5. The parents of an 8-year-old tell the nurse the child wakes the household crying out during his frequent nightmares. What is the nurses most helpful response to explain nightmares?
a. They are a normal extension of the childs 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
The nightmares experienced by an 8-year-old are an extension of their characteristic fear of mutilation.

DIF: Cognitive Level: Comprehension REF: Page 444, Table 19-3
OBJ: 3 TOP: Eight-Year-Old
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

6. 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
The 6-year-old child can perform numerous feats that require muscle coordination. At this age, the handheld video game will offer nonaggressive competition.

DIF: Cognitive Level: Analysis REF: Page 444, Table 19-3
OBJ: 3 TOP: Six-Year-Old KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. 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 girls father leads the nurse to determine that the parents understood the information?
a. We should put a stop to her thumb-sucking.
b. Well have a talk about what school is like.
c. We will let her walk to the bus stop by herself.
d. Well have her meet some children who will be in her class.
ANS: D
To prepare a child for school, parents can arrange for the child to meet other children who will be entering school with her.

DIF: Cognitive Level: Application REF: Page 438, Patient Teaching
OBJ: 4 TOP: Parental Guidance for Starting School
KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

8. 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
The 9-year-old child requires about 10 hours of sleep per night.

DIF: Cognitive Level: Application REF: Page 441 OBJ: 3
TOP: Nine-Year-Old KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. A parent asked the nurse, At what age are children capable of assuming more responsibility for personal belongings? What is the nurses best response based on knowledge of growth and development?
a. 6 years
b. 7 years
c. 9 years
d. 12 years
ANS: C
The 9-year-old is dependable and assumes more responsibility for personal belongings.

DIF: Cognitive Level: Comprehension REF: Page 440 OBJ: 3
TOP: Nine-Year-Old KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

10. The school nurse is preserving a tooth that was knocked out on the school playground. What will the nurse be especially careful to do?
a. Wrap the tooth loosely in a clean cloth.
b. Rinse the tooth with alcohol.
c. Handle the tooth only by the crown.
d. Place the tooth in a warm environment.
ANS: C
When a permanent tooth is avulsed, the tooth should be picked up by the crown to prevent any further damage to the root and placed in milk until the child can be examined by a dentist.

DIF: Cognitive Level: Application REF: Page 439, Nursing Tip
OBJ: 7 TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk

11. A parent states, My 7-year-old really wants a dog. His 10-year-old brother has allergies to animal dander. I dont know what to do. What type of pet should the nurse suggest as the best choice?
a. A small breed of dog because the large dogs produce more allergens
b. An older unneutered dog that produces fewer allergens than a younger one
c. A cat because it requires less care and is less allergenic
d. A poodle, which does not shed, making it a good choice for people with allergies
ANS: D
The poodle does not have a shed cycle and so it may be the least offensive pet for the allergic child.

DIF: Cognitive Level: Analysis REF: Page 448 OBJ: 8
TOP: Pet Ownership KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. When asked about her activities, a 10-year-old girl responded, I like school. I play the flute in the school band, and I take tennis lessons. What does the nurse know these activities will help this child develop?
a. Initiative
b. Industry
c. Identity
d. Intimacy
ANS: B
The school-age period is referred to by Erikson as the stage of industry. Successful participation in activities facilitates the childs sense of industry.

DIF: Cognitive Level: Application REF: Page 434 OBJ: 3
TOP: Psychosocial Development KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

13. A mother reports that she has a new job and her 12-year-old child is home alone for a time after school. Which statement made by the parent alerts the nurse to a potentially unsafe situation for this child?
a. I told him that he could invite a few friends after school.
b. I put a list of emergency numbers next to the telephone.
c. Last week we made a first aid kit together.
d. There is a neighbor available in case of an emergency.
ANS: A
Latchkey children are subject to a higher rate of accidents. Permitting school-age children and their friends to be home alone in an unsupervised environment is an unsafe situation.

DIF: Cognitive Level: Application REF: Page 439 OBJ: 4
TOP: Latchkey Children KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

14. A mother is concerned because her 9-year-old boy has developed the habit of twitching his eyes and flipping his hair while communicating with anyone. What is the best nursing response to this parent?
a. This may indicate that he needs eyeglasses.
b. Children sometimes do these things for attention.
c. This behavior suggests low self-esteem.
d. Tics appear when a child is under stress.
ANS: D
The child cannot help such actions and should not be scolded for them because they are mainly a result of tension.

DIF: Cognitive Level: Application REF: Page 441 OBJ: 3
TOP: Nine-Year-Old KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

15. A seventh-grade girl tells the school nurse that her art teacher, a woman, is her hero. What is the most appropriate interpretation of the girls comment?
a. The student may be exploring her career options.
b. The comment is cause for concern about sexual abuse.
c. The child may have difficulty interacting with her peers.
d. Hero worship is a normal phenomenon.
ANS: D
School-age children tend to admire their teachers and adult companions. For the 11- to 12-year-old, hero worship is a normal phenomenon.

DIF: Cognitive Level: Comprehension REF: Page 446, Table 19-3
OBJ: 3 TOP: Social Development
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

16. Which stage of cognitive development is a 9-year-old child in according to Piaget?
a. Formal operations
b. Preoperational
c. Concrete operations
d. Sensorimotor
ANS: C
School-age children are in the concrete operations stage of cognitive development.

DIF: Cognitive Level: Knowledge REF: Page 434 OBJ: 3
TOP: Cognitive Development KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

17. What statement by an 11-year-old leads the nurse to determine he has moved from the mind set of egocentrism?
a. I am a member of the best Cub Scout group in the world.
b. I must do my homework before I can play.
c. My dad can do anything!
d. Im sorry. I bet that hurt your feelings.
ANS: D
The ability to see anothers point of view indicates moving away from egocentrism into a more altruistic mind-set.

DIF: Cognitive Level: Analysis REF: Page 444, Table 19-3
OBJ: 3 TOP: Increasing Understanding
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

18. A school-age child becomes frustrated with a school assignment and says, I cant do this! What is the most developmentally supportive response from the parent?
a. Ask, What is it that is so difficult?
b. Allow the child to quit the effort.
c. Call in older siblings to help.
d. Finish the project for them.
ANS: A
Helping the child focus on the problem that is keeping him from mastery can limit frustration. Quitting or having someone else finish is detrimental to the development of industry.

DIF: Cognitive Level: Analysis REF: Page 434 OBJ: 3
TOP: Industry KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

19. What is best for the nurse to suggest to the parents of an overweight 9-year-old to help prevent obesity?
a. Use whole milk as a between-meal snack because it is more filling than skim milk.
b. Feed the child before family meal times to monitor intake more closely.
c. Encourage the child to engage in physical activity for at least an hour a day.
d. Remove all sweets and junk food from the house.
ANS: C
Regular physical activity reduces weight.

DIF: Cognitive Level: Comprehension REF: Page 443, Nursing Tip
OBJ: 7 TOP: Prevention of Obesity
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

20. A parent confides in the school nurse that her 8-year-old twins argue and bicker constantly. What is the best response by the nurse?
a. Express alarm at the constant aggression.
b. Voice concern and investigate referral for counseling.
c. Inquire about what punitive action the parents have taken to stop it.
d. Offer reassurance that such behavior is normal for 8-year-olds.
ANS: D
Argumentative and competitive behavior is normal in 8-year-olds.

DIF: Cognitive Level: Application REF: Page 440 OBJ: 3
TOP: Argumentative Behavior KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

21. The school nurse is planning sex education classes for school-age children. What should the nurse be sure to do?
a. Use simple terms.
b. Avoid slang or street words and concepts.
c. Keep topics on biological aspects of sexual development.
d. Limit questions to keep content clear.
ANS: A
Using simple terms is essential but slang and street terms need to be clarified. Apply age-specific information across broad aspects of biological, social, and current attitudes.

DIF: Cognitive Level: Application REF: Page 436-437, Nursing Tip
OBJ: 7 TOP: Sex Education
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

22. Parents ask the pediatric nurse how school life might influence their growing child. What area of development will the nurse indicate that school affects the least?
a. Moral development
b. Social development
c. Physical development
d. Cognitive development
ANS: C
Physical development is the least affected by school life. Moral development occurs as they have experience with, and understand, rules and fairness in the school setting. Schools have a profound influence on the socialization of children, who bring to school what they have learned and experienced in the home. Success in school requires an integration of cognitive, receptive, and expressive (language) skills.

DIF: Cognitive Level: Application REF: Page 437 OBJ: 5
TOP: Impact of School Life KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

MULTIPLE RESPONSE

23. What basic feeling words should the nurse use in attempting to help a 7-year-old girl express her feelings about being in a new school? (Select all that apply.)
a. Mad
b. Glad
c. Sad
d. Scared
e. Jealous
ANS: A, B, C, D
The words mad, glad, sad, and scared are basic feeling words that can prompt a young child to better express his or her feelings.

DIF: Cognitive Level: Application REF: Page 443, Nursing Tip
OBJ: 3 TOP: Expression of Feelings
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

24. The school nurse is preparing an educational program for new teachers regarding school-age children. What information is accurate for the nurse to include? (Select all that apply.)
a. Participation in group activity increases
b. Egocentricity prevails
c. Thinking is logical
d. Preference is toward family interaction
e. Understand cause and effect
ANS: A, C, E
Piaget refers to the thought processes of the school age period as concrete operations.
Concrete operations involve logical thinking and an understanding of cause and effect.
The egocentric view of the preschool child is replaced by the ability to understand the point of view of another person. Between 6 and 12 years of age, children prefer friends of their own sex and usually prefer the company of their friends to that of their brothers and sisters.

DIF: Cognitive Level: Comprehension REF: Page 434 OBJ: 2
TOP: Personality Development KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

25. The pediatric nurse is presenting school-age children with information on safety issues to follow when going home alone. What guidelines should they be educated to follow? (Select all that apply.)
a. Ask for identification before letting someone in the house.
b. Never accept rides with strangers.
c. Keep doors locked.
d. Do not enter house if door is ajar.
e. Walk to and from school with friends.
ANS: B, C, D, E
Strangers should never be allowed in the house. Children should be instructed never to accept rides with strangers, to keep doors locked, not to enter the house if the door is ajar, and to walk to and from school with friends.

DIF: Cognitive Level: Comprehension REF: Page 439, Health Promotion
OBJ: 6 TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

26. A 10-year-old child with disabilities is begging her parents for a dog. When at the pediatric clinic, the parents inquire about possible benefits pet ownership may provide to their child. What benefits of pet ownership should the nurse indicate? (Select all that apply.)
a. Decrease the need for physical therapy
b. Lower blood pressure
c. Improve communication
d. Foster trust
e. Ease path to socialization
ANS: B, C, D, E
Studies have documented the positive influence of pet ownership on improving the medical and psychological outcome after illness or surgery. Disabled children especially benefit from interacting with pets. The interaction with animals can lower blood pressure and heart rate, reduce loneliness and feelings of isolation, improve communication, foster trust, and motivate participation in physical therapy. Pets allow the ill child who feels separated from other people to feel companionship and acceptance. Shy children often find pet ownership eases the path to socialization with others who initiate contact because of the pet.

DIF: Cognitive Level: Comprehension REF: Page 447-448
OBJ: 8 TOP: Pet Ownership
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

COMPLETION

27. The nurse advises the parents of a 6-year-old to try and ensure at least ______ hours of sleep daily for the child.

ANS:
11

The 6-year-old school-age child needs at least 11 hours of sleep.

DIF: Cognitive Level: Comprehension REF: Page 440 OBJ: 3
TOP: Sleep Needs KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

28. The nurse reminds the parents who are trying to select a dog for their allergic child that the best selection would be a female dog that is ______________ and _______________.

ANS:
young, spayed

Young, neutered female dogs produce less allergens.

DIF: Cognitive Level: Comprehension REF: Page 447-448
OBJ: 8 TOP: Pet Selection for Allergic Child
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

29. When the fifth-grade class collected geckos in a special aquarium in the classroom, the school nurse cautioned the teacher to be alert for symptoms of ____________________ that can be carried by the reptiles.

ANS:
Salmonella

Geckos can infect humans with Salmonella.

DIF: Cognitive Level: Comprehension REF: Page 447, Table 19-4
OBJ: 8 TOP: Salmonella KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

30. The pediatric nurse assesses the 9-year-old child who has been diagnosed with diabetes to ensure that he does not come to believe that his disease is a form of _________________.

ANS:
punishment

School-age children may come to believe their illness is a form of punishment for bad behavior or bad thoughts.

DIF: Cognitive Level: Comprehension REF: Page 435 OBJ: 3
TOP: Disease as Punishment KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

31. The nurse explains that the term _______________ refers to a sex role that incorporates both male and female traits.

ANS:
androgynous

Sex roles that involve male and female qualities lead to better human functioning.

DIF: Cognitive Level: Knowledge REF: Page 436 OBJ: 7
TOP: Sex Education KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

32. The nurse is aware that by the age of _____, the first permanent teeth erupt.

ANS:
6

At the age of 6, the first permanent teeth erupt: the 6-year molars.

DIF: Cognitive Level: Knowledge REF: Page 435 OBJ: 3
TOP: Eruption of Permanent Teeth KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

33. The _____________________________maintains that every sex education program should present the topic from six aspects: biological, social, health, personal adjustment and attitudes, interpersonal associations, and establishment of values.

ANS: Sexuality Information and Education Council of the United States (SIECUS)

DIF: Cognitive Level: Knowledge REF: Page 436 OBJ: 1
TOP: Sex Education KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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