Question 1

When providing safety education for parents of school-age children, the community health nurse would focus interventions on which as the priority?

Accepted Answer

For the 1- to 9-year-old age group, motor vehicle/traffic injury, drowning, and fire/burn injuries were the top three causes of injury death. For the 10- to 19-year-old age group, motor vehicle/traffic injuries, drowning, and poisoning are the three leading causes of injury death. Thus, the priority would be to focus interventions on motor vehicle safety. Although water and fire safety and poisoning prevention would be important, motor vehicle safety would be most important.

Question 2

A community health nurse is presenting a program to a local elementary parent-teacher association on the topic of pediculosis. The nurse determines that the group needs additional teaching when they identify which action as a likely mode of transmission?

Accepted Answer

Head lice are most often transmitted by direct contact (head-to-head) or may be passed from infected to uninfected children through shared items such as combs and brushes, hats, scarves, sheets, and towels (called fomites). Contrary to some popular myths, lice do not fly or jump, and they cannot be contracted from animals-they live only on humans.

Question 3

A community health nurse who is participating in a nutritional screening program with school-age children measures their body mass index (BMI). The majority of children fall within the 45th to 65th percentile for their age. How would the nurse classify these children?

Accepted Answer

A BMI between the 45th and 95th percentile for age is considered healthy weight. Underweight refers to a BMI below the 45th percentile. At risk for overweight refers to children with a BMI between the 85th and 94th percentile. Overweight refers to children with a BMI equal to or greater than the 95th percentile.

Question 4

Which measure would be most appropriate for a community health nurse to include when developing programs to address childhood obesity?

Accepted Answer

Research has demonstrated an association between poor eating habits and physical inactivity. Low levels of physical activity and more than 2 hours of watching television per day were found to be predictors of overweight status in a large longitudinal study of children. Therefore, interventions should focus on increasing levels of physical activity and encouraging limited television for school-age children, encouraging families to eat more meals together at home, advocating for increased physical education in the school setting, and for more safe recreational opportunities in all neighborhoods. In addition, healthy eating habits such as using unsaturated oils in cooking need to be stressed.

Question 5

Which program would be least effective to implement for a community of school-age children who are experiencing dental caries?

Accepted Answer

Regular brushing and flossing is important for dental hygiene. However, once daily is not enough. Fluoridated drinking water, school-based fluoride rinse or gel, and dental sealant programs are cost-effective proven methods of reducing dental caries in school-age children.

Question 6

Which would a community health nurse expect to attribute in the adolescent population with an eating disorder?

Accepted Answer

Adolescents with eating disorders typically have a disturbed body image, low levels of peer support, distorted self-concept, and low self-esteem. In addition, they have issues with control, such that they used eating as a means for control.

Question 7

A community health nurse is teaching a group of parents about attention deficit hyperactivity disorder. Which statement by the parents would indicate the need for additional teaching?

Accepted Answer

While a number of parents feel that sugar and food coloring or additives may worsen ADHD symptoms in their children, research shows no behavioral or learning differences in double-blind studies with sugar and sugar substitutes. Medications are commonly used, with the primary goal of improving academics. New research is focusing on inherited tendencies for problems with dopamine receptors and transporter genes, supporting a neurologic basis for the condition. Children with ADHD are more prone to accidents and injuries.

Question 8

A community health nurse is working with local community agencies to provide services for children and adolescents with disabilities. Based on the nurse's knowledge of the most common disabilities affecting this group, the nurse would advocate for which service to address the largest group?

Accepted Answer

In descending order, the most common disabilities found in school-age children and adolescents are learning disorders; speech or language impairment; mental retardation; serious emotional disturbances and other disabilities, such as autism; deaf-blindness; orthopedic problems; traumatic brain injury; and other health impairments, such as asthma, diabetes, and epilepsy. Thus, advocating for special education services would address the most common disability, learning disorders.

Question 9

Which of statement about children's health status and academic achievement are most accurate?

Accepted Answer

Physical and emotional health can affect academic achievement in children and adolescents. Not all health problems that can affect learning and achievement in school-age children are preventable. Behavioral health problems can affect learning and achievement in school-age children, but other types of health problems can also affect learning and achievement in school-age children. Poverty is a health problem that also affects learning and achievement in school-age children.

Question 10

A community health nurse is providing immunizations to school-age children at a local health department. At which age would the nurse expect to administer the first dose of human papillomavirus (HPV) vaccine?

Accepted Answer

The current recommendation is to administer the first dose of HPV vaccine at age 11. However, the earliest age that the vaccine can be given is age 9. The HPV vaccine is administered to females at age 13 to 18 if they have not been previously vaccinated.

Question 11

A community health nurse is speaking to a group of parents of incoming college freshmen students who will be living in the dormitories. The focus of the program is on the college health program, health issues, and immunizations. Which immunization would the nurse most strongly encourage the students to receive if they have not received it previously?

Accepted Answer

The meningococcal vaccine is a catch-up vaccine that is recommended for all previously unvaccinated college freshmen living in dormitories. Adolescents who have not had chickenpox and have not received prior vaccination should receive the varicella vaccines. The HPV vaccine is given to females only. The influenza vaccine should be given only to those who are considered high risk.

Question 12

When preparing a program to address violence among school-age children and adolescents, the community health nurse integrates knowledge of:

Accepted Answer

Homicide is the third leading cause of death for adolescents (ages 10 to 24) behind suicide and is more common in males than in females. Adolescents between the ages of 15 and 19 years account for almost 85% of all firearm injuries treated in emergency departments or hospitals. Serious youth violence is part of a constellation of risk-taking behaviors that also includes precocious sex, drugs, and guns.

Question 13

When working with community groups to develop appropriate programs for adolescent health promotion, the nurse integrates knowledge of the Healthy People 2030 objectives. Which is addressed by many of those objectives?

Accepted Answer

Healthy People 2030 objectives are geared to improve the health of all Americans. Twenty-one specific objectives have been ranked as critical for this population. The objectives focus on issues involving mortality and morbidity in this age group that stems primarily from risk-taking behaviors. Many of the objectives relate to reduction in alcohol-related unintentional injuries, declines in violent behaviors, suicide and mental health issues, as well as more responsible reproductive health behaviors.

Question 14

When working with school districts, which school-based approach would the community health nurse encourage as the most effective to solve the problem of teenage suicide?

Accepted Answer

Programs and interventions by counselors and school nurses that are focused on determining adolescent suicide intentions are the most effective approaches. Teachers do not feel comfortable or prepared to assess suicide risk, and this alone will not prevent teen suicide. Peer pressure is strong, and parent concerns are not as important to the teen. Teens are seeking independence, and stronger parental control is not an effective method of reducing teen suicide. This approach is inappropriate for any school-age child or teen behavior.

Question 15

A community health nurse is working with local schools to help address teen pregnancy. The nurse would develop interventions based on:

Accepted Answer

Although contraceptives, parenting skills, and nutrition may be areas of focus for teen pregnancy, research has shown that the downward trend for teen pregnancy rates has been attributed largely to better contraceptive use rather than less sexual activity. Therefore, interventions should focus on the area of decreasing sexual activity.

Question 16

Which would the community health nurse most commonly need to address when planning programs for children with chronic illness?

Accepted Answer

Although autism education, diabetic regimens, and seizure control are common issues related to chronic disease in children, asthma is the most common chronic disease. Thus, asthma control would be a priority.

Question 17

A community health nurse is working with a group of school nurses to develop interventions for a 10-year-old girl exhibiting signs and symptoms of school refusal. Which intervention would be most appropriate?

Accepted Answer

The most effective interventions for school refusal include early return to school with parental involvement in school, systematic desensitization (gradual exposure to the classroom), relaxation training, and counseling.

Question 18

A community health nurse is working with the local health department on screening for sexually transmitted infections. Which infection would the nurse identify as the most common?

Accepted Answer

Chlamydia is the most common STI in adolescents and should be a major focus of the screening. Syphilis, gonorrhea, and herpes simplex virus also are common among adolescents but less than Chlamydia.

Question 19

When preparing a program about substance abuse prevention for adolescents, the community health nurse would focus on which substance as the most frequently used?

Accepted Answer

Alcohol is the most frequently used substance for adolescents in the United States. Marijuana is the most commonly used drug among 14- to 17-year-olds. Ecstasy and ketamine are other drugs used by adolescents and young adults.

Question 20

A community health nurse is engaged in a community-wide program for promoting nutrition in adolescents. Which information would lead the nurse to target the program to adolescent girls?

Accepted Answer

Girls are more at risk for problems with nutrition for several reasons: they tend to diet inappropriately, to have more finicky eating habits, and to be less physically active than teenage boys. Boys typically eat large quantities of food, which increases the likelihood of obtaining adequate nutrients, and they also tend to be more physically active than girls.

Quiz 20: School-Age Children and Adolescents