Deck 11: Growth and Development of the School-Aged Child

Question 1

A parent asks the pediatric nurse, "How tall is the average 6-year-old boy, and how much does the average 6-year-old boy weigh?" After advising the parent that each child is unique and growth is affected by many factors, the nurse would give the average height and weight for a 6-year-old boy as:

A) 36 inches tall and 37 pounds
B) 46 inches tall and 45 pounds
C) 50 inches tall and 54 pounds
D) 60 inches tall and 63 pounds

Answer 1

46 inches tall and 45 pounds

Question 2

When working with school-aged children, the nurse should keep in mind that these children will increase their weight by how many pounds per year?

A) 1-2
B) 3-4
C) 5-6
D) 7-8

Answer 2

5-6

Question 3

The nurse in the pediatric clinic measures a 9-year-old child's height and finds that the child has grown 4 inches in 1 year. The nurse will discuss this increase in height with the caregivers, keeping in mind that an increase of 4 inches in 1 year, when compared to the usual increase for a school-aged child, is:

A) just below average
B) average
C) slightly above average
D) double the average

Answer 3

double the average

Question 4

The school nurse is talking with a group of parents about the growth and development of their school-aged children. A parent asks the nurse, "Just what are growing pains?" Which of the following is the best response?

A) "The bones hurt when calcium builds up and the bones are stretching out in length."
B) "When the long bones are growing faster than the attached muscle, pain can occur."
C) "The nerves are chemically irritated when the bones are elongating in growth."
D) "As the bones get longer, the skin has to grow and stretch and this hurts."

Question 5

A parent asks the school nurse to explain there children usually feel growing pains. The nurse explains that the discomfort is usually in the:

A) toes, feet, and ankles
B) knees, calves, and thigh
C) hip and pelvis
D) fingers, wrists, and elbows

Question 6

The pediatric nurse is working with the parents of a school-aged child who has growing pains. The nurse recommends that the parents try which of the following as comfort measures?

A) sandal-type shoes without enclosed toes or backs
B) ice packs, cold showers, and no heat
C) analgesics, gentle massage, and warm baths
D) exercise, hot packs, and herbal teas

Question 7

When parents select or approve physical activities for their children, they most need to select activities according to the:

A) interests of the child
B) abilities of the child
C) child's potential for improvement
D) child's potential for building lifelong skills

Question 8

The nurse working on the pediatric unit checks the apical pulse of a school-aged child and finds a rate of 95 beats per minute while the child is lying in bed. The best action on the part of the nurse is to:

A) Chart the apical pulse of 95 as it is in the normal range.
B) Recheck the apical pulse for a full minute, as it is somewhat high.
C) Call the pediatrician.
D) Have another nurse recheck the apical pulse.

Question 9

The pediatrician is doing a routine physical exam on a school-aged child and tells the parents that their child has an innocent heart murmur. The parents ask the nurse what this means. The best answer is:

A) "The mitral valve is not closing tightly and some blood is getting through when the heart is not contracting."
B) "If the child's heart is not overworked for the next few years, this problem will cure itself."
C) "This is a minor congenital anomaly and is nothing to worry about as it will cause no problems."
D) "This is the sound of blood normally flowing through the heart and is not associated with any heart problem."

Question 10

Parents ask the nurse if their child will always have this innocent heart murmur. Which of the following is the best answer?

A) "Yes, this murmur will not disappear and your child will have it throughout life."
B) "No, this murmur will no longer be heard when your child becomes an adolescent."
C) "Most children are lucky and the murmur goes away after a year or two."
D) "This murmur will usually be cured with a period of rest, diet, and medication."

Question 11

During the school-age years a child will lose 20 deciduous or baby teeth. Which of the following factors determine the rate at which children lose these teeth?

A) calcium in the diet
B) how much sugar the child eats
C) regularity of brushing and flossing
D) genetics and gender

Question 12

A parent asks the nurse why his school-aged child, who was ill so often during the preschool years, is now healthy and seldom ill. Which of the following is the nurse's best response?

A) "The production of antibodies is at a peak by age 7 with the increase in body size and the maturity of the immune system."
B) "School-aged children usually eat a healthier diet, sleep better, and are less stressed than younger children."
C) "The school-aged child is exposed to the same people every day and has little exposure to new pathogens."
D) "School-aged children have had all their vaccinations and have had most health problems corrected by this time."

Question 13

The pediatrician has been speaking with a mother about the "prepubescent period." Later the mother asks the nurse, "What does prepubescence mean?" Which of the following is the nurse's best response?

A) "It is the 2 years before puberty with puberty being when secondary sex characteristics start to develop and girls begin menstruation."
B) "It is the period of time from birth until the time when the individual has the ability to reproduce."
C) "It is the months in which the child is developing secondary sexual characteristics up until sexual development is sufficient for reproduction."
D) "It is the time period starting with interest in a sexual partner to the time of the first sexual mating."

Question 14

What is the average age of puberty for females in the United States?

A) 9
B) 10
C) 11
D) 12

Question 15

A father asks the nurse to explain what people mean when they use the term latency, because someone recently referred to his 7-year-old child as being in "latency." Which of the following is the most accurate response the nurse could give?

A) "When children are gaining weight or height slower than the average child, this is referred to as latency growth."
B) "Beginning at age 6 and lasting throughout the school-aged years, the child has a calm period in sexual development that is called latency."
C) "When children are experiencing physical and emotional changes preparing them for puberty, this is latency."
D) "This is a developmental period between the preschool period and the prepubescent period."

Question 16

The nurse assessing a young school-aged child finds that this child has the skill of classification. Having this skill means the child will be able to do which of the following?

A) Add by 2s up to 10 and subtract back to 0.
B) Name the capitals of the 50 states in the United States.
C) Sort animals according to dogs, cats, horses, and other types.
D) Understand and use the Dewey decimal system in the library.

Question 17

The nurse assessing a young school-aged child finds that the child has the skill of conservation. When the nurse tells the parents that their child has the skill of conservation, they ask what this means. The nurse explains that conservation is the ability to:

A) save objects or money
B) recycle and take care of the environment
C) recognize that a change in shape does not mean a change in amount
D) recognize that actions can move in a reverse as well as forward manner

Question 18

The nurse is assessing a 6-year-old child's thought processes. The nurse will find which of the following types of thinking?

A) concrete and in present-time frame
B) concrete and focused in the past
C) abstract and in future-time frame
D) abstract and focused in the past

Question 19

The pediatric nurse is assigned to care for a 7-year-old child in the hospital. The child is going to have surgery in the morning. The child asks the nurse if this surgery will hurt. Which of the following is the nurse's best response?

A) "An anesthetist will put you to sleep so you won't feel anything."
B) "You will sleep through the surgery so it won't hurt. When you wake up, we will give you medicine to make any hurting better."
C) "The doctor who specializes in sleep is going to knock you out real good, so don't worry about feeling any pain."
D) "A stick in the arm to give you medicine to sleep is all you will feel."

Question 20

The nurse is assessing a school-aged child and finds that this child is involved in working on a school project with peers, is on a swimming team, and collects dolls from around the world. The child mentions an interest in learning karate. The nurse's initial impression is that this child:

A) is over-scheduled, as children this age need more rest and sleep
B) is an extreme extrovert engaging in extrovert behaviors
C) may be hypomanic and the family psychiatric history should be explored
D) is meeting Erikson's major developmental task of this age period

Question 21

Which of the following behaviors by a child is an example of positive self-esteem?

A) initiating a conversation
B) playing quietly by oneself
C) working on the computer
D) combing one's hair

Question 22

High self-esteem can best be identified in which of the following instances?

A) A child is respectful of the parents and other adult and authority figures.
B) A child keeps quiet around others and displays good listening skills.
C) A child perceives him- or herself to be close to how he or she would like to be.
D) A child is asked if he or she has high self-esteem, and the child answers "yes."

Question 23

According to Kohlberg's theory of moral development, school-aged children are at Stage 3 of the conventional level of moral development. Which of the following statements best describes what these children's morality is based on?

A) imitating what they see their role models display in terms of behavior
B) avoiding the disapproval of others and maintaining positive relationships
C) following the lead of older siblings and peers in deciding what is right and wrong
D) doing the right thing and showing respect for authority figures

Question 24

The nurse is teaching children about teeth brushing and flossing. Which of the following statements can 11- to 12-year-olds best relate to and are more likely to agree with?

A) "Bad kids fail to brush their teeth as they are told, and they won't floss either."
B) "Your teeth are going to rot and fall out if you don't brush them at least twice a day and floss them before bedtime."
C) "The dentist will be mad at you if you don't brush your teeth twice a day and floss before you go to bed at night."
D) "The right thing to do is to take care of your teeth by brushing at least twice a day and flossing before bedtime."

Question 25

A parent asks the nurse in the pediatric clinic how often school-aged children need to have a routine medical exam. The nurse, following the American Academy of Pediatrics recommendation for routine medical exams, will give which of the following responses?

A) every year at approximately the same time of year
B) at least every 2 years preferably at ages 5, 6, 8, 10, 11, and 12
C) every 3 years preferably at ages 5, 8, and 11
D) before entering kindergarten, 5th grade, and 7th grade

Question 26

Routine physical examinations on children include height, weight, vital signs, physical examination, vision and hearing screening, diet assessment, screening for alcohol and other drug use, and screening for which of the following?

A) scoliosis
B) sickle-cell anemia
C) myasthenia gravis
D) parasites

Question 27

The nurse is working in an immunization clinic and is assessing the immunization records of the children presenting there to see what immunizations they need. When the nurse finds a child who has not received a measles-mumps-rubella (MMR) booster or a tetanus, diphtheria and pertussis (DTaP) booster between ages 4 and 6, the nurse will tell the parents to have this booster or boosters given to their child at what age?

A) 8
B) 8 to 10
C) 11 to 12
D) 13

Question 28

The nurse is helping an obese child learn about healthy food choices. The child shares with the nurse that he usually drinks a half a gallon of whole milk a day and often has a toasted cheese sandwich or macaroni and cheese for lunch and sometimes has a bowl of ice cream or yogurt for dessert. Based on knowledge of the nutritional needs of the school-aged child, the nurse's response to the amount of milk this child drinks each day would be which of the following?

A) "You can drink all the milk and eat all the milk products you want, as they are very healthy."
B) "You need to reduce your milk intake to a glass at each meal and at bedtime."
C) "The recommended daily amount of milk and milk products such as cheese or ice cream is two to three servings a day."
D) "If you drink a half a gallon of milk a day, you need to omit cheese and other milk products."

Question 29

The teacher refers a 9-year-old student to the school nurse for a sleep assessment. The student is often asleep in class and is failing in several areas. The teacher suspects the child is not getting enough sleep. The nurse finds out that the child is going to bed at midnight and getting up at 7 AM. Which of the following is the best action for the nurse to take?

A) Have the child take a nap sometime during the day at school.
B) Tell the child to get more sleep on the weekend to catch up on sleep.
C) Ask the child to go to bed earlier at night, if at all possible, so the child won't fall asleep in class and will be able to pay attention.
D) Talk to the family about a 9-year-old's need for 9 to 10 hours of sleep per night so the child will grow and can pay attention at school.

Question 30

A child talks to the school nurse about the fact she is sleep talking at night. The child wants to know if there is something seriously wrong with her and if she needs to go to a physician. Which of the following is the nurse's best response?

A) "Sleep talking can be a sign of intestinal parasites, so your parents do need to take you to the doctor."
B) "Sleep talking does not indicate a health problem, and it does not require that anything be done."
C) "I will call your parents and have them come in so we can all talk about this problem together."
D) "This problem can be caused by any number of things including stress, and I wonder if you are under any stress."

Question 31

During the school-age years, a malocclusion can occur. Which of the following statements best describes a malocclusion?

A) The upper and lower teeth come together in a way that the permanent upper and lower teeth do not approximate.
B) A permanent tooth cannot come through the gum due to a baby tooth still being in place.
C) The teeth and jaws are aligned in such a manner as to prevent the lips from coming together.
D) The tag of skin under the tongue is so tight that until it is cut the tongue cannot work properly in concert with the teeth.

Question 32

When a school-aged child has a malocclusion, the parents need to:

A) advise the school nurse
B) do nothing, as this will be outgrown
C) take the child to an orthodontist
D) take the child to the pediatrician

Question 33

The school nurse is called to the playground to attend to a child who has had a tooth knocked out during a playground fight. Which of the following would be the best action for the nurse to take?

A) Have the child gargle with hot salt water and put the tooth in an envelope so the child can put it under his or her pillow.
B) Apply an ice pack to the side of the face there the tooth came out, and have the child rinse the mouth several times with ice-cold water.
C) Gently rinse the tooth with water, put the tooth back into the socket, and call the caregivers to take the child to the dentist.
D) Call the parents immediately so they can contact the dentist to find out what the dentist wants them to do.

Question 34

Which of the following best identifies how Piaget described play during the school-age years?

A) work that is fun
B) interactive socialization
C) a moral character builder
D) games with rules

Question 35

The school nurse is working with a child who has a crisis-oriented family, which is in crisis mode at the present time. Which of the following methods would be most productive for the nurse to use in helping this child release tension?

A) play
B) talk
C) singing
D) back rub

Question 36

The school nurse has identified a school-aged girl who has been bullying other children on the way home from school. The nurse realizes that this girl most needs which of the following interventions?

A) punishment
B) anger management training
C) talk therapy
D) social skills training

Question 37

A school-aged child is repeatedly sent to the nurse's office for complaints of headache, sleep disturbances, and stomachache. The nurse will most likely suspect that this child:

A) just wants to spend time with the nurse because the nurse is nice
B) is trying to get out of class because of difficulty with schoolwork
C) has school phobia
D) is the victim of bullying

Question 38

A situation is considered stressful for a child when:

A) the child perceives that he or she is unable to meet the demands placed on him or her
B) a child's behavior changes from the usual behavior to new and different behaviors
C) the child exhibits any of the symptoms normally associated with stress
D) it would normally be considered stressful for a child

Question 39

A mother expresses amazement that her school-aged son, who was somewhat slow to crawl and walk, is now riding a bicycle and in-line skating. The nurse would explain that the child is able to do these new activities well because of which of the following? Select all that apply.

A) Taking longer to crawl and walk provides a much better balance and coordination system.
B) Improved balance and coordination are part of the growth and development of this age.
C) Children who are slower in developing initial skills seem to have more high-risk behaviors later.
D) This child has developed the muscles needed for bicycling and in-line skating.

Question 40

When a child is found on physical examination to have an innocent murmur, the nurse will recommend to the caregivers that they do which of the following? Select all that apply.

A) Do not mention this to others, because it often frightens people who do not understand.
B) Tell other caregivers so that in an emergency those going to the emergency room with the child will know.
C) Provide medical documentation about the innocent heart murmur to the school nurse, coaches, and administration.
D) Say very little or nothing about the heart murmur because it only scares the child who will soon outgrow it anyway.