Question 1

The school nurse is planning an education program for fourth-grade children regarding prepubescent changes. What is an action the nurse should include to make the educational program successful?

Accepted Answer

Prior to the program, discussing program content with the parents will ensure that the nurse addresses any concerns or questions the parents may have and will also help the nurse tailor the program to the specific needs of the children in that particular school. This will increase the effectiveness of the program overall. Talking to all fourth-grade classes at one time, planning the program for after school, or having the parents present during the program may not necessarily contribute to the success of the educational program.

Question 2

A nurse observes the parent-child interaction during a 6-year-old's well child checkup and notes that the parent speaks harshly to the child and uses negative remarks when speaking with the nurse. Which statement by the nurse would be most beneficial?

Accepted Answer

The best choice is to address the parent directly and suggest discussing the situation in private, while offering support and suggestions for improving their interactions with their child. This approach allows for open communication and the potential for positive change, without being accusatory or judgmental. Referring the parent for counseling without their consent may also create a negative dynamic and may not be the best approach without further assessment. Asking the child directly about their feelings in front of the parent can also escalate the situation and may not be appropriate for the child's well-being.

Question 3

The school health nurse is evaluating the home environments of several children as they relate to child safety. The nurse visits the home of each child and gathers the following data. Which of these activities places a child at the greatest risk for bodily harm?

Accepted Answer

All of the options listed are concerning, but allowing a child to engage in target practice with a revolver unsupervised is the greatest risk for bodily harm. This activity involves the use of a deadly weapon and should never be done without appropriate adult supervision and safety measures in place. The other options, while also concerning, do not involve immediate physical danger to the child.

Question 4

A report from the school psychologist indicates that a 10-year-old child often is teased by his classmates. The child said to the psychologist, "I know I am not as good as them, so I just play by myself at recess every day." The nurse knows that the child most likely has:

Accepted Answer

The child's statement and behavior suggest a lack of confidence, which is indicative of decreased self-esteem. The child feels inferior to their peers and copes by isolating themselves during recess.

Question 5

A nurse obtains a nutritional health history from a 10-year-old child. Which of these food selections, if consumed on a regular basis, should lead the nurse to become concerned about the need for improving oral hygiene?

Accepted Answer

Gummy bears and licorice are sticky and sugary, and when consumed regularly, can lead to increased risk of tooth decay and cavities. Sorbet and yogurt are lower in sugar and do not stick to the teeth as much. Fluoridated water can actually aid in preventing tooth decay. Peanuts and crackers are not high in sugar and do not stick to the teeth, so they do not pose as much of a risk for poor oral hygiene.

Question 6

The mother of a 12-year-old child informs the nurse that the child's father died from sudden cardiac death at 44 years old. Which of these laboratory tests should the nurse anticipate the physician to order?

Accepted Answer

With a family history of sudden cardiac death at a relatively young age, the physician may order a lipid profile to assess the child's risk for cardiovascular disease. High levels of cholesterol and triglycerides in the blood may contribute to the development of atherosclerosis and increase the risk for sudden cardiac death. Chest x-rays, CBC with differential, and EEGs are not typically ordered in response to a family history of sudden cardiac death.

Question 7

A nurse who is the manager of an ambulatory pediatric health care center is planning protocols for the routine health care visits of the children. Children at this care center have a high incidence of obesity. The nurse should ask all nurses to calculate the body mass index (BMI) for all pediatric clients at which age?

Accepted Answer

The American Academy of Pediatrics recommends that BMI should be calculated and plotted at least annually for all children aged 2 years and older as part of routine health care visits. Therefore, starting at 24 months (option B) is the correct protocol for monitoring and addressing obesity in pediatric clients.

Question 8

Parents of a preschool-age child report that they find it necessary to spank the child at least once a day. Which response should the nurse make to the parents?

Accepted Answer

Spanking has been shown to have negative long-term effects on children and can lead to more behavioral problems. It is important to discuss alternative forms of discipline with the parents that have a more positive effect on the child's behavior.

Question 9

The school health nurse is working with a parent-child group discussing sex education. Which statement by a parent or child requires further teaching by the nurse?

Accepted Answer

The answer of The school health nurse is working with...

Question 10

An overweight 11-year-old girl tells the school nurse that she would like to be more active, but her parents do not have time to take her places. What would be one suggestion that the nurse could make for this child to promote health?

Accepted Answer

Encouraging the parents to investigate the option of ride sharing with a classmate's family would be a helpful suggestion as it would allow the child to participate in more activities outside of school. This would provide the child with opportunities to be more active and improve her overall health. The other options do not directly address the issue of promoting physical activity for the child. Option A refers to seeking help with the weight issue rather than promoting physical activity, option B focuses on monitoring food intake rather than increasing physical activity, and option D suggests an activity that does not necessarily involve physical activity.

Question 11

The nurse in a hospital unit must develop a comprehensive plan of care for a school-age child. The question the nurse will ask the child that will be most helpful in data collection related to nutrition is:

Accepted Answer

The answer of The nurse in a hospital unit must...

Question 12

The school health nurse recognizes that children who display certain characteristics are at risk for poor school performance. The nurse will therefore observe each school-age child for which of the following characteristics? Select all that apply.

Accepted Answer

A) Decreased auditory stimulation can result in difficulty hearing the teacher or classmates, which can lead to poor performance in school.

B) Decreased muscle tone can affect a child's ability to sit still and stay focused during class, which can also lead to poor performance.

C) Multiple dental caries may cause pain and discomfort, but they are not directly related to school performance.

D) Visual tracking is important for reading and other activities in school. A child who has difficulty with this skill may struggle with reading and other academic tasks.

E) Chronic tonsillitis may lead to absences from school or difficulty participating in physical activities, but it is not directly related to academic performance.

Question 13

A 2-year-old has trouble going to bed at night. The parents ask what can be done to help with the transition to bed each evening. Which of the following would be the nurse's best response?

Accepted Answer

Reading a book to the child just before bedtime each night can help establish a consistent routine and promote relaxation before sleep. Letting the child cry herself to sleep or fall asleep while playing can create negative associations with bedtime and disrupt healthy sleep patterns. Allowing the child to watch a video at bedtime on a television in the child's room can also disrupt healthy sleep patterns and interfere with falling asleep.

Question 14

A nurse is preparing to perform a physical assessment on a toddler. Which of these actions should the nurse take?

Accepted Answer

Intrusive procedures can be distressing for toddlers, so it's best to leave them until the end to minimize anxiety and ensure cooperation during the rest of the assessment.

Quiz 36: Health Promotion and Maintenance: the Toddler, the Preschooler, and the School-Age Child