Chapter 07: Health Promotion for the School-Age Child My Nursing Test Banks

Chapter 07: Health Promotion for the School-Age Child

Test Bank

MULTIPLE CHOICE

1. Which statement made by a mother of a school-age boy indicates a need for further teaching?

a.

My child is playing soccer this year.

b.

He is always busy with his friends playing games. He is very active.

c.

I limit his television watching to about 2 hours a day.

d.

I am glad his coach emphasizes the importance of winning in todays society.

ANS: D

Team sports are important for the development of sportsmanship and teamwork and for exercise and refinement of motor skills. A coach who emphasizes winning and strict discipline is not appropriate for children in this age group. Team sports such as soccer are appropriate for exercise and refinement of motor skills. School-age children need to participate in physical activities, which contribute to their physical fitness skills and well-being. Limiting television to 2 hours a day is an appropriate restriction. School-age children should be encouraged to participate in physical activities.

DIF: Cognitive Level: Comprehension REF: p. 132

OBJ: Nursing Process Step: Evaluation MSC: Health Promotion and Maintenance

2. A nurse has completed a teaching session for parents on school-age childrens expected developmental milestones. The parents need further teaching if they indicate which behavior is expected in a school-age child?

a.

Experiments with profanity and dirty jokes

b.

Laughs at silly jokes and enjoys using words

c.

Understands the concept of conservation

d.

Engages in fantasy and magical thinking

ANS: D

The preschool child engages in fantasy and magical thinking. The school-age child moves away from this type of thinking and becomes more skeptical and logical. Belief in Santa Claus or the Easter Bunny ends in this period of development. The school-age child goes through a period in which profanity and dirty jokes are explored. This behavior is not unusual for the school-age child. The school-age child has a sense of humor. His increased language mastery and increased logic allow for appreciation of plays on words, jokes, and incongruities. The school-age child understands conservation or that properties of objects do not change when their order, form, or appearance does.

DIF: Cognitive Level: Application REF: p. 133

OBJ: Nursing Process Step: Implementation

MSC: Health Promotion and Maintenance

3. The ability to mentally understand that 1 + 3 = 4 and 4 1 = 3 occurs in which stage of cognitive development?

a.

Concrete operations stage

b.

Formal operations stage

c.

Intuitive thought stage

d.

Preoperations stage

ANS: A

By 7 to 8 years of age, the child is able to retrace a process (reversibility) and has the skills necessary for solving mathematical problems. This stage is called concrete operations. The formal operations stage deals with abstract reasoning and does not occur until adolescence. Thinking in the intuitive stage is based on immediate perceptions. A child in this stage often solves problems by random guessing. In preoperational thinking, the child is usually able to add 1 + 3 = 4 but is unable to retrace the process.

DIF: Cognitive Level: Comprehension REF: p. 133

OBJ: Nursing Process Step: Assessment MSC: Health Promotion and Maintenance

4. Which activity is most appropriate for developing fine motor skills in the school-age child?

a.

Drawing

b.

Singing

c.

Soccer

d.

Swimming

ANS: A

Activities such as drawing, building models, and playing a musical instrument increase the school-age childs fine motor skills. Singing is an appropriate activity for the school-age child, but it does not increase fine motor skills. The school-age child needs to participate in group activities to increase both gross motor skills and social skills but group activities do not increase fine motor skills. Swimming is an activity that also increases gross motor skills.

DIF: Cognitive Level: Comprehension REF: p. 133

OBJ: Nursing Process Step: Evaluation MSC: Health Promotion and Maintenance

5. A school nurse is teaching a health class for fifth grade children. The nurse plans to include which statement to best describe growth in the early school-age period?

a.

Boys grow faster than girls do until around age 10.

b.

Puberty occurs earlier in boys than in girls.

c.

Puberty occurs at the same age for all races and ethnicities.

d.

It is a period of rapid physical growth.

ANS: A

During the school-age developmental period, boys are approximately 1 inch taller and 2 pounds heavier than girls. Puberty occurs 1.5 to 2 years later in boys, which is developmentally later than puberty in girls (not unusual in 9- or 10-year-old girls). Puberty occurs approximately 1 year earlier in African-American girls than white girls. Physical growth is slow and steady during the school-age years.

DIF: Cognitive Level: Application REF: p. 130

OBJ: Nursing Process Step: Implementation

MSC: Health Promotion and Maintenance

6. The comment that is most developmentally typical of a 7-year-old boy is:

a.

I am a Power Ranger, so dont make me angry.

b.

I dont know whether I like Mary or Joan better.

c.

My mom is my favorite person in the world.

d.

Jimmy is my best friend.

ANS: D

School-age children form friendships with peers of the same sex. Magical thinking is developmentally appropriate for the preschooler. Opposite-sex friendships are not typical for the 7-year-old child. Seven-year-old children socialize with their peers, not their parents.

DIF: Cognitive Level: Comprehension REF: p. 135

OBJ: Nursing Process Step: Assessment MSC: Health Promotion and Maintenance

7. A school nurse is conducting a class on safety for parents of school-age children. Which statement indicates the parents need further teaching?

a.

Our child needs to wear sunscreen when playing soccer.

b.

Our young school-age child will continue to ride belted in the back seat.

c.

We will monitor the volume when our child is listening to music on the i-Pod with ear buds.

d.

Were glad our child will be home after school to let repairmen in while we are working.

ANS: D

Safety teaching for school-age children includes sun protection and wearing sunscreen when participating in sports, having the child belted in the back seat of the car away from airbags, and avoidance of listening to loud music through earphones. A child home alone should not allow others into the home if the parent is not there.

DIF: Cognitive Level: Application REF: p. 138

OBJ: Nursing Process Step: Evaluation MSC: Health Promotion and Maintenance

8. Identify the statement that is the most accurate about moral development in the 9-year-old school-age child.

a.

Right and wrong are based on physical consequences of behavior.

b.

The child obeys parents because of fear of punishment.

c.

The school-age child conforms to rules to please others.

d.

Parents are the determiners of right and wrong for the school-age child.

ANS: C

The 7- to 12-year-old child bases right and wrong on a good-boy or good-girl orientation in which the child conforms to rules to please others and avoid disapproval. Children 4 to 7 years of age base right and wrong on consequences; consequences are the most important consideration for the child between 4 and 7 years of age. Parents determine right and wrong for the child younger than 4 years of age.

DIF: Cognitive Level: Knowledge REF: p. 135

OBJ: Nursing Process Step: Assessment MSC: Health Promotion and Maintenance

9. Which parental behavior is the most important in fostering moral development?

a.

Telling the child what is right and wrong

b.

Vigilantly monitoring the child and her peers

c.

Weekly family meetings to discuss behavior

d.

Living as the parents say they believe

ANS: D

Parents living what they believe give nonambivalent messages and foster the childs moral development and reasoning. Telling the child what is right and wrong is not effective unless the child has experienced what he or she hears. Parents need to live according to the values they are teaching to their children. Vigilant monitoring of the child and his or her peers is an inappropriate action for the parent to initiate. It does not foster moral development and reasoning in the child. Weekly family meetings to discuss behaviors may or may not be helpful in the development of moral reasoning.

DIF: Cognitive Level: Comprehension REF: p. 135

OBJ: Nursing Process Step: Assessment MSC: Health Promotion and Maintenance

10. Which behavior by parents or teachers will best assist the child in negotiating the developmental task of industry?

a.

Identifying failures immediately and asking the childs peers for feedback

b.

Structuring the environment so the child can master tasks

c.

Completing homework for children who are having difficulty in completing assignments

d.

Decreasing expectations to eliminate potential failures

ANS: B

The task of the caring teacher or parent is to identify areas in which a child is competent and to build on successful experiences to foster feelings of mastery and success. Structuring the environment to enhance self-confidence and to provide the opportunity to solve increasingly more complex problems will promote a sense of mastery. Asking peers for feedback reinforces the childs feelings of failure. When teachers or parents complete childrens homework for them, it sends the message that you do not trust them to do a good job. Providing assistance and suggestions and praising their best efforts are more appropriate. Decreasing expectations to eliminate failures will not promote a sense of achievement or mastery.

DIF: Cognitive Level: Application REF: p. 134

OBJ: Nursing Process Step: Implementation

MSC: Health Promotion and Maintenance

11. A nurse is assessing an older school-age child recently admitted to the hospital. Which assessment indicates the child is in an appropriate stage of cognitive development?

a.

Addition and subtraction ability

b.

Ability to classify

c.

Vocabulary

d.

Play activity

ANS: B

The ability to classify things from simple to complex and to identify differences and similarities are cognitive skills of the older school-age child; this demonstrates use of classification and logical thought processes. Subtraction and addition are appropriate cognitive activities for the young school-age child. Vocabulary is not as valid an assessment of cognitive ability as is the childs ability to classify. Play activity is not as valid an assessment of cognitive function as is the ability to classify.

DIF: Cognitive Level: Application REF: pp. 133-134

OBJ: Nursing Process Step: Evaluation MSC: Health Promotion and Maintenance

12. Which is an appropriate disciplinary intervention for the school-age child?

a.

Time-out periods

b.

A consequence that is consistent with the inappropriate behavior

c.

Physical punishment

d.

Lengthy dialog about inappropriate behavior

ANS: B

A consequence that is related to the inappropriate behavior is the recommended discipline. Time-out periods are more appropriate for younger children. Physical intervention is an inappropriate form of discipline. It does not connect the discipline with the childs inappropriate behavior. Lengthy discussions typically are not helpful.

DIF: Cognitive Level: Comprehension REF: pp. 137-138

OBJ: Nursing Process Step: Implementation

MSC: Health Promotion and Maintenance

MULTIPLE RESPONSE

1. Which demonstrates the school-age childs developing logic in the stage of concrete operations? Select all that apply.

a.

Ability to recognize that 1 pound of feathers is equal to 1 pound of metal

b.

Ability to recognize that he can be a son, brother, or nephew at the same time

c.

Understands the principles of adding, subtracting, and reversibility

d.

Thinking characterized by egocentrism, animism, and centration

ANS: A, B, C

The school-age child understands that the properties of objects do not change when their order, form, or appearance does. Conservation occurs in the concrete operations stage. Comprehension of class inclusion occurs as the school-age childs logic increases. The child begins to understand that a person can be in more than one class at the same time. This is characteristic of concrete thinking and logical reasoning. The school-age child is able to understand principles of adding, subtracting, and the process of reversibility, which occurs in the stage of concrete operations. Egocentrism, animism, and centration occur in the intuitive thought stage, not the concrete operations stage of development.

DIF: Cognitive Level: Comprehension REF: p. 133

OBJ: Nursing Process Step: Evaluation MSC: Health Promotion and Maintenance

2. Which strategies can a nurse teach to parents of a child experiencing uncomplicated school refusal? Select all that apply.

a.

The child should be allowed to stay home until the anxiety about going to school is resolved.

b.

Parents should be empathetic yet firm in their insistence that the child attends school.

c.

A modified school attendance may be necessary.

d.

Parents need to pick the child up at school whenever the child wants to come home.

e.

Parents need to communicate with the teachers about the situation.

ANS: B, C, E

In uncomplicated cases of school refusal, the parent needs to return the child to school as soon as possible. If symptoms are severe, a limited period of part-time or modified school attendance may be necessary. For example, part of the day may be spent in the counselors or school nurses office, with assignments obtained from the teacher. Parents should be empathetic yet firm and consistent in their insistence that the child attend school. Parents should not pick the child up at school once the child is there. The principal and teacher should be told about the situation so that they can cooperate with the treatment plan.

DIF: Cognitive Level: Application REF: p. 143

OBJ: Nursing Process Step: Implementation

MSC: Health Promotion and Maintenance

SHORT ANSWER

1. A nurse is planning a class for school-age children on obesity. Which percentile does the BMI need to exceed for a child to be assessed as obese?

ANS:

95

95th

When intake of food exceeds expenditure, the excess is stored as fat. Obesity is an excessive accumulation of fat in the body and is assessed in children as a BMI that exceeds the 95th percentile for age.

DIF: Cognitive Level: Comprehension REF: p. 143

OBJ: Nursing Process Step: Evaluation MSC: Health Promotion and Maintenance

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