Question 1

The school nurse has been asked to begin teaching sex education in the fifth grade.The nurse should recognize that:

Accepted Answer

When sexual information is presented to school-age children,sex should be treated as a normal part of growth and development.Fifth-graders are usually 10 or 11 years old.This age is not too young to speak about physiologic changes in their bodies.They should be encouraged to ask questions.Preadolescents need precise and concrete information.

Question 2

A nurse is teaching parents of kindergarten children general guidelines to assist their children in school.Which statement by the parents indicates they understand the teaching?

Accepted Answer

General guidelines for parents to help their child in school include sharing an interest in reading.The library should be used frequently and books the child is reading should be discussed.Hobbies should be encouraged.The parents should not expect all As.They should focus on growth more than grades.

Question 3

Generally,the earliest age at which puberty begins is _____ years in girls,_____ in boys.

Accepted Answer

Puberty signals the beginning of the development of secondary sex characteristics.This begins earlier in girls than in boys.Usually a 2-year difference occurs in the age of onset.Girls and boys do not usually begin puberty at the same age.Girls generally begin puberty 2 years earlier than boys.

Question 4

A 9-year-old girl often comes to the school nurse complaining of stomach pains.Her teacher says she is completing her school work satisfactorily but lately has been somewhat aggressive and stubborn in the classroom.The school nurse should recognize this as:

Accepted Answer

Signs of stress include stomach pains or headache,sleep problems,bed-wetting,changes in eating habits,aggressive or stubborn behavior,reluctance to participate,or regression to early behaviors.This child is exhibiting signs of stress.

Question 5

The father of a 12-year-old child tells the nurse that he is concerned about his son getting "fat." His son is at the 50th percentile for height and the 75th percentile for weight on the growth chart.The most appropriate nursing action is to:

Accepted Answer

This is a characteristic pattern of growth in preadolescent boys,where the growth in height has slowed in preparation for the pubertal growth spurt,but weight is still gained.The nurse should review this with both the father and the child and develop a plan to maintain physical exercise and a balanced diet.It is false reassurance to tell the father that his son is not fat.His weight is high for his height.The child needs to maintain his physical activity.The father is concerned,so an explanation is required.A nutritional diet with physical activity should be sufficient to maintain his balance.

Question 6

The school nurse is conducting a class on bicycle safety.Which statement made by a participant indicates a need for further teaching?

Accepted Answer

Children should not ride double.Most injuries result from falls.The most important aspect of bicycle safety is to encourage the rider to use a protective helmet.Head injuries are the major cause of bicycle-related fatalities.The child should always wear a properly fitted helmet approved by the U.S.Consumer Product Safety Commission and should replace the helmet at least every 5 years.

Question 7

Which statement characterizes moral development in the older school-age child?

Accepted Answer

Older school-age children are able to judge an act by the intentions that prompted the behavior rather than just by the consequences.Rules and judgments become less absolute and authoritarian.Rule violation is likely to be viewed in relation to the total context in which it appears.The situation and the morality of the rule itself influence reactions.

Question 8

Which describes moral development in younger school-age children?

Accepted Answer

Children who are ages 6 and 7 years know the rules and behaviors expected of them but do not understand the reasons for these rules and behaviors.Young children do not believe that standards of behavior come from within themselves,but that rules are established and set down by others.Younger school-age children learn standards for acceptable behavior,act according to these standards,and feel guilty when they violate them.Misfortunes and accidents are viewed as punishment for bad acts.

Question 9

Which is characteristic of dishonest behavior in children ages 8 to 10 years?

Accepted Answer

Older school-age children may lie to meet expectations set by others to which they have been unable to measure up.Cheating usually becomes less frequent as the child matures.In this age group,children are able to distinguish between fact and fantasy.Young children may lack a sense of property rights; older children may steal to supplement an inadequate allowance,or it may be an indication of serious problems.

Question 10

Teasing can be common during the school-age years.The nurse should recognize that which applies to teasing?

Accepted Answer

Teasing in this age group is common and can have a long-lasting effect.Increasing awareness of differences,especially when accompanied by unkind comments and taunts from others,may make a child feel inferior and undesirable.Physical impairments such as hearing or visual defects,ears that "stick out," or birth marks assume great importance.

Question 11

A group of boys ages 9 and 10 years have formed a "boys-only" club that is open to neighborhood and school friends who have skateboards.This should be interpreted as:

Accepted Answer

One of the outstanding characteristics of middle childhood is the creation of formalized groups or clubs.Peer-group identification and association are essential to a child's socialization.Poor relationships with peers and a lack of group identification can contribute to bullying.A boys-only club does not have a direct correlation with later gang activity.

Question 12

A school nurse is teaching dental health practices to a group of sixth-grade children.How often should the nurse recommend the children brush their teeth?

Accepted Answer

Teeth should be brushed after meals,after snacks,and at bedtime.Children who brush their teeth frequently and become accustomed to the feel of a clean mouth at an early age usually maintain the habit throughout life.Twice a day,three times a day or after meals would not be often enough.

Question 13

A child has an evulsed (knocked-out)tooth.Which medium should the nurse instruct the parents to place the tooth in for transport to the dentist?

Accepted Answer

An evulsed tooth should be placed in a suitable medium for transplant,either cold milk or saliva (under the child or parent's tongue).Cold milk is a more suitable medium for transport than cold water,warm salt water,or a dry,clean jar.

Question 14

Which statement best describes fear in the school-age child?

Accepted Answer

During the school-age years,children experience a wide variety of fears,but new fears relate predominantly to school and family.During the middle-school years,children become less fearful for body safety than they were as preschoolers.Parents and other persons involved with children should discuss children's fears with them individually or as a group activity.Sometimes school-age children hide their fears to avoid being teased.Hiding their fears does not end them and may lead to phobias.

Question 15

The nurse is teaching a group of 10- to 12-year-old children about physical development during the school-age years.Which statement made by a participant,indicates the correct understanding of the teaching?

Accepted Answer

In middle childhood,growth in height and weight occurs at a slower pace.Between the ages of 6 and 12 years,children grow 2 inches per year.In middle childhood,children's weight will almost double; they gain 3 kg/year.At the end of middle childhood,girls grow taller and gain more weight than boys.Children take on a slimmer look with longer legs in middle childhood.

Question 16

An 8-year-old girl tells the nurse that she has cancer because God is punishing her for "being bad." She shares her concern that if she dies,she will go to hell.The nurse should interpret this as:

Accepted Answer

Children at this age may view illness or injury as a punishment for a real or imagined misdeed.The belief in divine punishment is common for an 8-year-old child.

Question 17

Parents ask the nurse whether it is common for their school-age child to spend a lot of time with peers.The nurse should respond,explaining that the role of the peer group in the life of school-age children provides:

Accepted Answer

Peer-group identification is an important factor in gaining independence from parents.Children learn how to relate to people in positions of leadership and authority and how to explore ideas and the physical environment.Becoming defiant in a peer-group relationship may lead to bullying.Peer-group identification helps in gaining independence rather than remaining dependent.One-on-one opposite sex relationships do not occur until adolescence.School-age children form peer groups of the same sex.

Question 18

A school nurse observes school-age children playing at recess.Which is descriptive of the play the nurse expects to observe?

Accepted Answer

Play involves increased physical skill,intellectual ability,and fantasy.Children form groups and cliques and develop a sense of belonging to a team or club.At this age,children begin to see the need for rules.Conformity and ritual permeate their play.Their games have fixed and unvarying rules,which may be bizarre and extraordinarily rigid.With team play,children learn about competition and the importance of winning,an attribute highly valued in the United States.

Question 19

Which describes the cognitive abilities of school-age children?

Accepted Answer

In Piaget's stage of concrete operations,children have the ability to group and sort and make conceptual decisions.Children cannot reason abstractly and logically until late adolescence.Making judgments based on what they reason to making judgments based on what they see is not a developmental skill.

Question 20

When teaching injury prevention during the school-age years,what should the nurse include?

Accepted Answer

Water safety instruction is an important source of injury prevention at this age.The child should be taught to swim,select safe and supervised places to swim,swim with a companion,check for sufficient water depth before diving,and use an approved flotation device.Teach stranger safety,not fear of strangers.This includes instructing children to not go with strangers,not wear personalized clothing in public places,tell parents if anyone makes child feel uncomfortable,and say "no" in uncomfortable situations.Teach child safe cooking.Caution against engaging in hazardous sports such as those involving trampolines.

Quiz 15: Health Promotion of the School-Age Child and Family