Question 1

A mother calls the school nurse saying that her daughter has developed a school phobia.She has been out of school for 3 days.What action should the nurse recommend?

Accepted Answer

The primary goal is to return the child to school.Parents must be convinced gently but firmly that immediate return is essential,and that it is their responsibility to insist on school attendance.Telling the child that this is the last day she can stay home will increase her fear.She must play a role in preparing for her return to school.Beginning with half days might be beneficial.The child may not be able to identify the cause for the phobia.Treatment will depend on the cause,if it is known,but relaxation techniques are commonly used.Professional counselling is usually not necessary to resolve this condition.

Question 2

What is characteristic of dishonest behaviour in children aged 8 to 10 years?

Accepted Answer

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

Question 3

Which statement best describes the play of school-age children?

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,attributes that are highly valued in Canada.

Question 4

What is the role of the peer group in the life of school-age children?

Accepted Answer

Peer group identification is an important factor that allows children to gain independence from their parents.Through peer relationships,children learn ways to deal with dominance and hostility.They also learn how to relate to people in positions of leadership and authority,and they can explore ideas and the physical environment.A child's concept of appropriate sex roles is influenced by relationships with peers.

Question 5

A 9-year-old girl often comes to the school nurse complaining of stomach pains.Her teacher says that she is completing her schoolwork satisfactorily,but lately she has been somewhat aggressive and stubborn in the classroom.Which does the school nurse attribute these complaints to?

Accepted Answer

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

Question 6

What is one important consideration for the school nurse who is planning a class on bicycle safety?

Accepted Answer

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.Although motor vehicle collisions do cause injuries to bicyclists,most injuries result from falls.Children should always wear a properly fitted helmet approved by the Canadian Paediatric Society.They should not ride double.

Question 7

Which is the cause of Turner's syndrome?

Accepted Answer

Turner's syndrome is caused by the absence of one of the X chromosomes.Most girls who have this disorder have one X chromosome missing from all cells.The Y chromosome is not part of the genetic makeup of girls.In girls with this syndrome,puberty is delayed and amenorrhea is a clinical manifestation.They often need hormone therapy to increase their levels of androgen and estrogen hormones.

Question 8

Which statement accurately describes physical development during the school-age years?

Accepted Answer

In middle childhood,growth in height and weight occur at a slower pace.Between the ages of 6 and 12,children grow 5 cm per year.Children's weight will almost double during this stage;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 9

Generally,what is the earliest age when puberty begins?

Accepted Answer

Secondary sex characteristics start to develop with the onset of puberty,which begins earlier in girls than it does in boys.Usually there is a 2-year difference in the age at onset between the sexes.

Question 10

Which sentence best describes the cognitive abilities of school-age children?

Accepted Answer

In Piaget's stage of concrete operations,children have the ability to group,sort,and make conceptual decisions.Children cannot reason abstractly until late adolescence.Scientific reasoning and formal logic are also skills of adolescents.Making judgements based on what the child sees versus what they reason is not a developmental skill.

Question 11

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.How should the nurse interpret this concern?

Accepted Answer

Children at this age may view illness or injury as a punishment for real or imagined acts and thoughts.Belief in divine punishment is common at this age.It is not indicative of pressure from the family or that the girl has failed to develop a conscience.

Question 12

The nurse expects a child with post-traumatic stress disorder (PTSD)to be in the intense arousal response for what duration of time?

Accepted Answer

The initial response involves intense arousal,which usually lasts for a few minutes to 1 or 2 hours.

Question 13

Which is an important consideration when the nurse is discussing enuresis with the parents of a young child?

Accepted Answer

Organic causes that may be related to enuresis should be ruled out before psychogenic factors are considered.Enuresis is more common in boys,and has a strong familial tendency.Nocturnal bed-wetting usually ceases long before adulthood.

Question 14

Which statement best describes fear in school-age children?

Accepted Answer

During the school-age years,children experience a wide variety of fears,but new fears related predominantly to school and family bother children during this time.During the middle-school years,children become less fearful of body safety than they were as preschoolers.Parents and other people involved with children should discuss their fear with them individually or as a group activity.Sometimes school-age children hide their fears to avoid being teased.Hiding fears does not resolve them and may lead to the development of phobias.

Question 15

Which statement describes moral development in younger school-age children?

Accepted Answer

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

Question 16

The father of 12-year-old Ryan tells the nurse that he is concerned about his son getting "fat." Ryan's body mass index for his age is at the sixtieth percentile.Which action is the most appropriate for the nurse to take?

Accepted Answer

This is a characteristic pattern of growth in preadolescent boys;growth in height has slowed in preparation for the pubertal growth spurt,but the child still gains weight.This reality should be reviewed with both the father and Ryan,and a plan should be developed to maintain physical exercise and a balanced diet.Saying that Ryan is not "fat" is false reassurance,because his weight is high for his height.Ryan needs to maintain or increase his physical activity.The father is concerned,so an explanation is required.A nutritional diet with physical activity should be sufficient to maintain a healthy weight balance.

Question 17

Which statement best describes moral development in older school-age children?

Accepted Answer

Older school-age children are able to judge and act according to the intentions that prompted the behaviour rather than just the consequences.For this group,rules and judgements become less absolute and authoritarian,and rule violation is likely to be viewed in relation to the total context in which it appears.Both the situation and the morality of the rule itself influence reactions.

Question 18

A group of boys,ages 9 and 10 years,have formed a "boys-only" club that is open to neighbourhood and school friends who have skateboards.How should this be interpreted?

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 behaviours.There is no evidence that children who form a boys-only club later become involved with gang activity.

Question 19

What should the nurse include in her lesson when teaching injury prevention to school-age children?

Accepted Answer

Water safety instruction is an important source of injury prevention at this age.The child should be taught how to swim,to select safe and supervised places to swim,to always swim with a companion,to check for sufficient water depth before diving,and to use an approved flotation device.The nurse should teach stranger safety,not fear of strangers.This includes not going with strangers,not having personalized clothing in public places,having children tell parents if anyone makes them uncomfortable,and teaching children to say "no" in uncomfortable situations.The nurse can also teach children safe cooking methods,and may caution against engaging in hazardous sports,such as those involving trampolines.

Question 20

The school nurse has been asked to begin teaching sex education in grade 5.What should the nurse recognize about this grade level and sex education?

Accepted Answer

When sex information is presented to school-age children,sex should be treated as a normal part of growth and development.Fifth-graders are usually ages 10 to 11 years,so this group is not too young to speak about the physiological changes in their bodies.Preadolescents should be encouraged to ask questions,and they need precise and concrete information.

Quiz 38: The School-Age Child and Family