Deck 7: Developmental Management of School-Age Children

Question 1

The primary care pediatric nurse practitioner is examining a school­age child who
complains of frequent stomach pain and headaches. The parent reports that the child misses several days of school each month. The child has a normal exam. Before proceeding with further diagnostic tests, what will the nurse practitioner initially ask the parent?
A. About the timing of the symptoms each day and during the week
B. How well the child performs in school and in extracurricular activities
C. If the parent feels a strong need to protect the child from problems
D. Whether there are any unusual stressors or circumstances at home

Answer 1

About the timing of the symptoms each day and during the week

Question 2

During a well child exam of a school­age child, the primary care pediatric nurse
practitioner learns that the child has been having angry episodes at school. The nurse practitioner observes the child to appear withdrawn and sad. Which action is appropriate?
A. Ask the child and the parent about stressors at home
B. Make a referral to a child behavioral specialist
C. Provide information about anger management
D. Suggest consideration of a different classroom

Answer 2

Ask the child and the parent about stressors at home

Question 3

The primary care pediatric nurse practitioner is preparing to conduct a well child assessment of an 8­year­old child. How will the nurse practitioner begin the exam?
A. Ask the child about school, friends, home activities, and sports
B. Discuss the purpose of the visit and explain the procedures that will be performed
C. Offer age­appropriate information about usual developmental tasks
D. Provide information about healthy nutrition and physical activities

Answer 3

Ask the child about school, friends, home activities, and sports

Question 4

The parent of a 5­year­old child who has just begun kindergarten expresses concern
that the child will have difficulty adjusting to the birth of a sibling. What will the primary care pediatric nurse practitioner recommend?
A. Allowing the child opportunities to discuss feelings about the baby
B. Giving the child specific baby care tasks to promote sibling bonding
C. Having snack time with the child each day to discuss the school day
D. Providing reassurance that the sibling will not replace the child

Question 5

A school­age child has begun refusing all cooked vegetables. What will the primary care pediatric nurse practitioner recommend to the parent?
A. Allow the child to make food choices since this is usually a phase
B. Ensure that the child has three nutritious meals and two nutritious snacks each day
C. Prepare vegetables separately for the child to encourage adequate intake
D. Teach the child how important it is to eat healthy fruits and vegetables

Question 6

The primary care pediatric nurse practitioner is examining a 6­year­old child who
attends first grade. The child reports "hating" school. The parent states that the child pretends to be sick frequently in order to stay home from school. To further assess this situation, the nurse practitioner will first ask the child
A. about school performance and grades.
B. why school is so distressing.
C. to name one or two friends.
D. whether bullying is taking place.

Question 7

During a well child exam on a 5­year­old child, the primary care pediatric nurse
practitioner assesses the child for school readiness. Which finding may be a factor in limiting school readiness for this child?
A. Adherence to daily family routines and regular activities
B. Having two older siblings who attend the same school
C. Parental concerns about bullying in the school
D. The child's ability to recognize four different colors

Question 8

The parents of a 12­year­old child are concerned that some of the child's older
classmates may be a bad influence on their child, who, they say, has been raised to believe in right and wrong. What will the primary care pediatric nurse practitioner tell the parent?
A. Allowing the child to make poor choices and accept consequences is important for learning values
B. Children at this age have a high regard for authority and social norms, so this is not likely to happen
C. Moral values instilled in the early school­age period will persist throughout childhood
D. The pressures from outside influences may supersede parental teachings and should be confronted

Question 9

The parent of a 6­year­old child expresses concern that the child may have ADHD.
Which screening tool will the primary care pediatric nurse practitioner use to evaluate this possibility?
A. Behavioral and Emotional Screening System for Children (BESS­2)
B. Behavioral Assessment for Children - 2nd ed. (BASC­2)
C. Conner's 3 Parent and Teacher Rating Scale
D. Pediatric Symptom Checklist (PSC)

Question 10

The primary care pediatric nurse practitioner performs a physical examination on a
12­year­old child and notes poor hygiene and inappropriate clothes for the weather. The child's mother appears clean and well dressed. The child reports getting 6 to 7 hours of sleep each night because of texting with friends late each evening. What action by the nurse practitioner will help promote healthy practices?
A. Discuss setting clear expectations about self­care with the mother
B. Give the child information about sleep and self­care
C. Reassure the mother that this "non­compliance" is temporary
D. Tell the mother that experimenting with self­care behaviors is normal

Question 11

The primary care pediatric nurse practitioner is evaluating recurrent stomach pain in
a school­age child. The child's exam is normal. The nurse practitioner learns that the child reports pain most evenings after school and refuses to participate in sports but does not have nausea or vomiting. The child's grandmother recently had gallbladder surgery. Which action is correct?
A. Encourage the child to keep a log of pain, stool patterns, and dietary intake
B. Order radiologic studies and laboratory tests to rule out systemic causes
C. Reassure the child and encourage resuming sports when symptoms subside
D. Refer the child to a counselor to discuss anxiety about health problems

Question 12

The parent of a 10­year­old boy tells the primary care pediatric nurse practitioner
that the child doesn't appear to have any interest in girls and spends most of his time with a couple of other boys. The parent is worried about the child's sexual identity. The nurse practitioner will tell the parent
A. children at this age who prefer interactions with same­gender peers usually have a homosexual orientation.
B. children experiment with sexuality at this age as a means of deciding later sexual orientation.
C. this attachment to other same­gender children is how the child learns to interact with others.
D. to encourage mixed­gender interactions in order to promote development of sexual values.