# CHAPTER 11: GROWTH AND DEVELOPMENT OF THE SCHOOL-AGED CHILD My Nursing Test Banks

CHAPTER 11: GROWTH AND DEVELOPMENT OF THE SCHOOL-AGED CHILD

MULTIPLE CHOICE

1.A parent asks the pediatric nurse, How tall is the average 6-year-old boy, and how much does the average 6-year-old boy weigh? After advising the parent that each child is unique and growth is affected by many factors, the nurse would give the average height and weight for a 6-year-old boy as:

 a. 36 inches tall and 37 pounds c. 50 inches tall and 54 pounds b. 46 inches tall and 45 pounds d. 60 inches tall and 63 pounds

ANS: B

 Feedback A Incorrect: This value is not identified as being consistent with the average height and weight of a 6-year-old boy. B Correct: At 6 years, the average boy weighs 45 pounds and is 46 inches tall. C Incorrect: This value is not identified as being consistent with the average height and weight of a 6-year-old boy. D Incorrect: This value is not identified as being consistent with the average height and weight of a 6-year-old boy.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Comprehension

2.When working with school-aged children, the nurse should keep in mind that these children will increase their weight by how many pounds per year?

 a. 1-2 c. 5-6 b. 3-4 d. 7-8

ANS: C

 Feedback A Incorrect: This value is not consistent with the identified weight gain per year in this population. B Incorrect: This value is not consistent with the identified weight gain per year in this population. C Correct: During the school-aged years, the childs weight increases by 5-6 pounds per year. D Incorrect: This value is not consistent with the identified weight gain per year in this population.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Comprehension

3.The nurse in the pediatric clinic measures a 9-year-old childs height and finds that the child has grown 4 inches in 1 year. The nurse will discuss this increase in height with the caregivers, keeping in mind that an increase of 4 inches in 1 year, when compared to the usual increase for a school-aged child, is:

 a. just below average c. slightly above average b. average d. double the average

ANS: D

 Feedback A Incorrect: This option underestimates the increase experienced for this child. B Incorrect: This option underestimates the increase experienced for this child. C Incorrect: This option underestimates the increase experienced for this child. D Correct: The average childs height increases by 2 inches per year. Therefore, an increase of 4 inches in 1 year is twice the average increase.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Comprehension

4.The school nurse is talking with a group of parents about the growth and development of their school-aged children. A parent asks the nurse, Just what are growing pains? Which of the following is the best response?

 a. The bones hurt when calcium builds up and the bones are stretching out in length. b. When the long bones are growing faster than the attached muscle, pain can occur. c. The nerves are chemically irritated when the bones are elongating in growth. d. As the bones get longer, the skin has to grow and stretch and this hurts.

ANS: B

 Feedback A Incorrect: Growing pains are not the result of calcium building up or the bones are stretching out in length. B Correct: Growing pains are the result of the long bones growing faster than the attached muscles. C Incorrect: Growing pains are not the result of the nerves being irritated D Incorrect: Growing pains are not related to the stretching of skin.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Application

5.A parent asks the school nurse to explain there children usually feel growing pains. The nurse explains that the discomfort is usually in the:

 a. toes, feet, and ankles c. hip and pelvis b. knees, calves, and thigh d. fingers, wrists, and elbows

ANS: B

 Feedback A Incorrect: Growing pains are not typically experienced in the toes, feet, and ankles. B Correct: The discomfort of growing pains is typically located in the knees, calves, and thighs. C Incorrect: Growing pains are not typically experienced in the hip and pelvis. D Incorrect: Growing pains are not typically experienced in the fingers, wrists, or elbows.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Application

6.The pediatric nurse is working with the parents of a school-aged child who has growing pains. The nurse recommends that the parents try which of the following as comfort measures?

 a. sandal-type shoes without enclosed toes or backs b. ice packs, cold showers, and no heat c. analgesics, gentle massage, and warm baths d. exercise, hot packs, and herbal teas

ANS: C

 Feedback A Incorrect: Sandal-type shoes without enclosed toes and back are not identified as treatment modalities for growing pains. B Incorrect: Ice packs, cold showers, and no heat are not identified as treatment modalities for growing pains. C Correct: Treatment measures for growing pains include analgesics, gentle massage, and warm baths. D Incorrect: Exercise, hot packs, and herbal teas are not identified as treatment modalities for growing pains.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Application

7.When parents select or approve physical activities for their children, they most need to select activities according to the:

 a. interests of the child b. abilities of the child c. childs potential for improvement d. childs potential for building lifelong skills

ANS: B

 Feedback A Incorrect: Physical activities should not be selected based solely upon the interests of the child. B Correct: Due to the potential for muscles to be easily injured in the school-aged child, it is necessary to select physical activities that match the abilities of the child. C Incorrect: Physical activities should not be selected based solely upon the childs potential for improvement. D Incorrect: Physical activities should not be selected based solely upon the childs potential for building lifelong skills.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Application

8.The nurse working on the pediatric unit checks the apical pulse of a school-aged child and finds a rate of 95 beats per minute while the child is lying in bed. The best action on the part of the nurse is to:

 a. Chart the apical pulse of 95 as it is in the normal range. b. Recheck the apical pulse for a full minute, as it is somewhat high. c. Call the pediatrician. d. Have another nurse recheck the apical pulse.

ANS: A

 Feedback A Correct: The average apical rate for the school-aged child is 90-95 beats per minute. Therefore, the nurse should chart the apical pulse of 95 as it is within the normal range. B Incorrect: An apical rate of 95 beats per minute in the school-aged child would not warrant rechecking the apical pulse for a full minute. C Incorrect: An apical rate of 95 beats per minute in the school-aged child would not warrant calling the pediatrician. D Incorrect: An apical rate of 95 beats per minute in the school-aged child would not warrant having another nurse recheck the apical pulse.

PTS:1REF:p. 333 Physiological Development

OBJ: Cognitive Level: Application

9.The pediatrician is doing a routine physical exam on a school-aged child and tells the parents that their child has an innocent heart murmur. The parents ask the nurse what this means. The best answer is:

 a. The mitral valve is not closing tightly and some blood is getting through when the heart is not contracting. b. If the childs heart is not overworked for the next few years, this problem will cure itself. c. This is a minor congenital anomaly and is nothing to worry about as it will cause no problems. d. This is the sound of blood normally flowing through the heart and is not associated with any heart problem.

ANS: D

 Feedback A Incorrect: Innocent heart murmurs are not associated with the mitral valve not closing tightly. B Incorrect: It is not necessary to rest the heart for several years for the problem to cure itself. C Incorrect: Innocent heart murmurs are not associated with congenital anomalies. D Correct: An innocent heart murmur is created from the sound of the blood flowing through the heart and can be heard if the childs chest wall is thin. They are not clinically significant.

PTS:1REF:p. 333 Physiological Development

OBJ: Cognitive Level: Application

10.Parents ask the nurse if their child will always have this innocent heart murmur. Which of the following is the best answer?

 a. Yes, this murmur will not disappear and your child will have it throughout life. b. No, this murmur will no longer be heard when your child becomes an adolescent. c. Most children are lucky and the murmur goes away after a year or two. d. This murmur will usually be cured with a period of rest, diet, and medication.

ANS: B

 Feedback A Incorrect: Innocent heart murmurs will not be heard when the child reaches adolescence; therefore, it will not continue throughout life. B Correct: As many as 50% of all school-aged children have an innocent heart murmur between the ages of 6 and 10 years of age. Such murmurs are not associated with heart disease and will not be heard when the child reaches adolescence. C Incorrect: It is not completely accurate to suggest that most children are lucky, with the murmur going away after a year or two. While the murmur may resolve within a few years, it is prudent to explain the pathophysiology of the resolution, rather than to simply suggest it is grounded in luck. D Incorrect: The murmur is not cured as a result of rest, diet, and medication.

PTS:1REF:p. 333 Physiological Development

OBJ: Cognitive Level: Application

11.During the school-age years a child will lose 20 deciduous or baby teeth. Which of the following factors determine the rate at which children lose these teeth?

 a. calcium in the diet c. regularity of brushing and flossing b. how much sugar the child eats d. genetics and gender

ANS: D

 Feedback A Incorrect: Calcium in the diet is not a factor in determining the rate at which children lose their teeth. B Incorrect: How much sugar children eat is not a factor in determining the rate at which they lose their teeth. C Incorrect: The regularity of brushing and flossing is not a factor in determining the rate at which children lose their teeth. D Correct: When children start to lose their teeth, the rate of loss is determined by genetics and gender. It is common for girls to lose their teeth earlier than boys.

PTS:1REF:p. 340 Health Promotion and Maintenance

OBJ: Cognitive Level: Comprehension

12.A parent asks the nurse why his school-aged child, who was ill so often during the preschool years, is now healthy and seldom ill. Which of the following is the nurses best response?

 a. The production of antibodies is at a peak by age 7 with the increase in body size and the maturity of the immune system. b. School-aged children usually eat a healthier diet, sleep better, and are less stressed than younger children. c. The school-aged child is exposed to the same people every day and has little exposure to new pathogens. d. School-aged children have had all their vaccinations and have had most health problems corrected by this time.

ANS: A

 Feedback A Correct: The school-age years are often among the healthiest phases of life. Antibodies are produced by the lymphatic system and reach their peak by age 7 years. Because of the increase in body size and maturity of the immune system, the school-age child is able to respond to illnesses similar to adults. B Incorrect: This is not the best response because the statement is incorrect. In fact, the opposite is true. C Incorrect: This is not the best response because the statement is incorrect. With the introduction of peers and school into school-age childrens lives, they are exposed to more new people with the potential for greater exposure to new pathogens. D Incorrect: This is not the best response because it may not be accurate for all school-age children.

PTS:1REF:p. 333 Physiological Development

OBJ: Cognitive Level: Application

13.The pediatrician has been speaking with a mother about the prepubescent period. Later the mother asks the nurse, What does prepubescence mean? Which of the following is the nurses best response?

 a. It is the 2 years before puberty with puberty being when secondary sex characteristics start to develop and girls begin menstruation. b. It is the period of time from birth until the time when the individual has the ability to reproduce. c. It is the months in which the child is developing secondary sexual characteristics up until sexual development is sufficient for reproduction. d. It is the time period starting with interest in a sexual partner to the time of the first sexual mating.

ANS: A

 Feedback A Correct: The last years of the school-age period are called prepubescence, meaning the 2 years before puberty. B Incorrect: This is not the correct definition of prepubescence. C Incorrect: This is not the correct definition of prepubescence. D Incorrect: This is not the correct definition of prepubescence.

PTS:1REF:p. 333 Physiological Development

OBJ: Cognitive Level: Application

14.What is the average age of puberty for females in the United States?

 a. 9 c. 11 b. 10 d. 12

ANS: D

 Feedback A Incorrect: This is not the correct age. B Incorrect: This is not the correct age. C Incorrect: This is not the correct age. D Correct: The average age of puberty is 12 years for females in the United States.

PTS:1REF:p. 334 Psychosexual Development

OBJ: Cognitive Level: Knowledge

15.A father asks the nurse to explain what people mean when they use the term latency, because someone recently referred to his 7-year-old child as being in latency. Which of the following is the most accurate response the nurse could give?

 a. When children are gaining weight or height slower than the average child, this is referred to as latency growth. b. Beginning at age 6 and lasting throughout the school-aged years, the child has a calm period in sexual development that is called latency. c. When children are experiencing physical and emotional changes preparing them for puberty, this is latency. d. This is a developmental period between the preschool period and the prepubescent period.

ANS: B

 Feedback A Incorrect: This is not the correct definition of latency. B Correct: According to Freuds psychosexual theory, starting at age 6 years and throughout school-age, the child enters a calm period in the development of sexuality called latency. C Incorrect: This is not the correct definition of latency. D Incorrect: This is not the correct definition of latency.

PTS:1REF:p. 334 Psychosexual Development

OBJ: Cognitive Level: Application

16.The nurse assessing a young school-aged child finds that this child has the skill of classification. Having this skill means the child will be able to do which of the following?

 a. Add by 2s up to 10 and subtract back to 0. b. Name the capitals of the 50 states in the United States. c. Sort animals according to dogs, cats, horses, and other types. d. Understand and use the Dewey decimal system in the library.

ANS: C

 Feedback A Incorrect: The skill of reversibility is important when the child learns addition and subtraction. B Incorrect: This is not an example of classification. C Correct: The skill of classification means the child has the ability to group items according to common characteristics. D Incorrect: This is not an example of classification.

PTS:1REF:p. 335 Psychosocial Development

OBJ: Cognitive Level: Comprehension

17.The nurse assessing a young school-aged child finds that the child has the skill of conservation. When the nurse tells the parents that their child has the skill of conservation, they ask what this means. The nurse explains that conservation is the ability to:

 a. save objects or money b. recycle and take care of the environment c. recognize that a change in shape does not mean a change in amount d. recognize that actions can move in a reverse as well as forward manner

ANS: C

 Feedback A Incorrect: Conservation is not related to saving objects or money. B Incorrect: Conservation is not related to recycling and taking care of the environment. C Correct: According to Piaget, conservation is the ability to acknowledge that a change in shape does not mean a change in amount. D Incorrect: This statement is the definition of reversibility.

PTS:1REF:p. 335 Psychosocial Development

OBJ: Cognitive Level: Comprehension

18.The nurse is assessing a 6-year-old childs thought processes. The nurse will find which of the following types of thinking?

 a. concrete and in present-time frame c. abstract and in future-time frame b. concrete and focused in the past d. abstract and focused in the past

ANS: A

 Feedback A Correct: A 6-year-old child is limited to thinking concretely and in the present time frame. B Incorrect: A 6-year-old childs thinking is concrete but not focused in the past or the future. C Incorrect: A 6-year-old childs thinking is not abstract and in future-time frame. D Incorrect: A 6-year-old childs thinking is not abstract and focused in the past.

PTS:1REF:p. 335 Psychosocial Development

OBJ: Cognitive Level: Comprehension

19.The pediatric nurse is assigned to care for a 7-year-old child in the hospital. The child is going to have surgery in the morning. The child asks the nurse if this surgery will hurt. Which of the following is the nurses best response?

 a. An anesthetist will put you to sleep so you wont feel anything. b. You will sleep through the surgery so it wont hurt. When you wake up, we will give you medicine to make any hurting better. c. The doctor who specializes in sleep is going to knock you out real good, so dont worry about feeling any pain. d. A stick in the arm to give you medicine to sleep is all you will feel.

ANS: B

 Feedback A Incorrect: Children of this age may interpret each word literally, so it is best to avoid terms like Put you to sleep. B Correct: When caring for school-age children, it is important to use correct terminology they will understand. Children of this age may interpret each word literally. It is best to explain the sequence of events the child will experience and exactly what will happen. C Incorrect: Children of this age may interpret each word literally, so it is best to avoid terms like Knock you out real good. D Incorrect: Children of this age may interpret each word literally, so it is best to avoid terms like A stick in your arm.

PTS:1REF:p. 336 Cognitive Development

OBJ: Cognitive Level: Application

20.The nurse is assessing a school-aged child and finds that this child is involved in working on a school project with peers, is on a swimming team, and collects dolls from around the world. The child mentions an interest in learning karate. The nurses initial impression is that this child:

 a. is over-scheduled, as children this age need more rest and sleep b. is an extreme extrovert engaging in extrovert behaviors c. may be hypomanic and the family psychiatric history should be explored d. is meeting Eriksons major developmental task of this age period

ANS: D

 Feedback A Incorrect: This child is meeting Eriksons major developmental task, and these activities bring a sense of accomplishment and forth. B Incorrect: This child is meeting Eriksons major developmental task. These activities are not related to extroversion or extrovert behaviors. C Incorrect: This child is meeting Eriksons major developmental task. These activities are not related to hypomania, and it would be inappropriate to explore the family psychiatric history. D Correct: The major developmental task of this age period is industry versus inferiority. Energy is channeled into activities such as school projects, sports, and hobbies. Therefore, this child is meeting Eriksons major developmental task.

PTS:1REF:p. 334 Psychosexual Development

OBJ: Cognitive Level: Application

21.Which of the following behaviors by a child is an example of positive self-esteem?

 a. initiating a conversation c. working on the computer b. playing quietly by oneself d. combing ones hair

ANS: A

 Feedback A Correct: Examples of positive self-esteem include the ability to express an opinion, work cooperatively with others, and initiate a conversation. B Incorrect: Playing quietly by oneself is not an example of positive self-esteem. C Incorrect: Working on the computer is not an example of positive self-esteem. D Incorrect: Combing ones hair is not an example of positive self-esteem.

PTS:1REF:p. 335 Psychosocial Development

OBJ: Cognitive Level: Application

22.High self-esteem can best be identified in which of the following instances?

 a. A child is respectful of the parents and other adult and authority figures. b. A child keeps quiet around others and displays good listening skills. c. A child perceives him- or herself to be close to how he or she would like to be. d. A child is asked if he or she has high self-esteem, and the child answers yes.

ANS: C

 Feedback A Incorrect: High self-esteem is not best identified with a child being respectful of the parents and other adult and authority figures. B Incorrect: High self-esteem is not best identified with a child keeping quiet around others and displaying good listening skills. C Correct: The closer the perceived self is to the ideal self (how the child would like to be) the higher the childs self-esteem. D Incorrect: Although a child who answers yes if asked if he or she has high self-esteem may have a positive self-concept, this is not the best indicator of high self-esteem.

PTS:1REF:p. 335 Psychosocial Development

OBJ: Cognitive Level: Application

23.According to Kohlbergs theory of moral development, school-aged children are at Stage 3 of the conventional level of moral development. Which of the following statements best describes what these childrens morality is based on?

 a. imitating what they see their role models display in terms of behavior b. avoiding the disapproval of others and maintaining positive relationships c. following the lead of older siblings and peers in deciding what is right and wrong d. doing the right thing and showing respect for authority figures

ANS: B

 Feedback A Incorrect: This statement does not best describe the basis of the school-age childs morality. B Correct: At this level of Kohlbergs theory of moral development, the school-age childs morality is based on avoiding the disapproval of others and maintaining positive relationships with friends, family, and teachers. C Incorrect: This statement does not best describe the basis of the school-age childs morality. D Incorrect: During stage 4 the child is concerned with doing the right thing and showing respect for authority figures.

PTS:1REF:p. 336 Cognitive Development

OBJ: Cognitive Level: Application

24.The nurse is teaching children about teeth brushing and flossing. Which of the following statements can 11- to 12-year-olds best relate to and are more likely to agree with?

 a. Bad kids fail to brush their teeth as they are told, and they wont floss either. b. Your teeth are going to rot and fall out if you dont brush them at least twice a day and floss them before bedtime. c. The dentist will be mad at you if you dont brush your teeth twice a day and floss before you go to bed at night. d. The right thing to do is to take care of your teeth by brushing at least twice a day and flossing before bedtime.

ANS: D

 Feedback A Incorrect: This statement is not the one 11- to 12-year-old children can best relate to and are more likely to agree with. B Incorrect: This statement is not the one 11- to 12-year-old children can best relate to and are more likely to agree with. C Incorrect: This statement is not the one 11- to 12-year-old children can best relate to and are more likely to agree with. D Correct: 11- to 12-year-old children can best relate to and are more likely to agree with the statement The right thing to do is to take care of your teeth by brushing at least twice a day and flossing before bedtime. At this age they may agree with suggestions in order to do the right thing.

PTS:1REF:p. 336 Cognitive Development

OBJ: Cognitive Level: Application

25.A parent asks the nurse in the pediatric clinic how often school-aged children need to have a routine medical exam. The nurse, following the American Academy of Pediatrics recommendation for routine medical exams, will give which of the following responses?

 a. every year at approximately the same time of year b. at least every 2 years preferably at ages 5, 6, 8, 10, 11, and 12 c. every 3 years preferably at ages 5, 8, and 11 d. before entering kindergarten, 5th grade, and 7th grade

ANS: B

 Feedback A Incorrect: This is not the recommendation of the AAP for the school-age child. B Correct: The American Academy of Pediatrics (AAP) recommends routine medical exams for the school-age child at least every 2 years and suggests they occur at ages 5, 6, 8, 10, 11, and 12. C Incorrect: This is not the recommendation of the AAP for the school-age child. D Incorrect: This is not the recommendation of the AAP for the school-age child.

PTS:1REF:p. 341 Health Promotion and Maintenance

OBJ: Cognitive Level: Comprehension

26.Routine physical examinations on children include height, weight, vital signs, physical examination, vision and hearing screening, diet assessment, screening for alcohol and other drug use, and screening for which of the following?

 a. scoliosis c. myasthenia gravis b. sickle-cell anemia d. parasites

ANS: A

 Feedback A Correct: Routine physical examinations on children include all of the above including screening for scoliosis. B Incorrect: Routine physical examinations on children include all of the above, but not screening for sickle-cell anemia. C Incorrect: Routine physical examinations on children include all of the above, but not screening for myasthenia gravis. D Incorrect: Routine physical examinations on children include all of the above, but not screening for parasites.

PTS:1REF:p. 341 Health Promotion and Maintenance

OBJ: Cognitive Level: Comprehension

27.The nurse is working in an immunization clinic and is assessing the immunization records of the children presenting there to see what immunizations they need. When the nurse finds a child who has not received a measles-mumps-rubella (MMR) booster or a tetanus, diphtheria and pertussis (DTaP) booster between ages 4 and 6, the nurse will tell the parents to have this booster or boosters given to their child at what age?

 a. 8 c. 11 to 12 b. 8 to 10 d. 13

ANS: C

 Feedback A Incorrect: This is not the correct age for the booster. B Incorrect: This is not the correct age for the booster. C Correct: When the nurse finds a child who has not received a measles-mumps-rubella (MMR) booster or a tetanus, diphtheria and pertussis (DTaP) booster between ages 4 and 6, the nurse will tell the parents to have this booster or boosters given to their child at ages 11-12 years. D Incorrect: This is not the correct age for the booster.

PTS:1REF:p. 341 Health Promotion and Maintenance

OBJ: Cognitive Level: Comprehension

28.The nurse is helping an obese child learn about healthy food choices. The child shares with the nurse that he usually drinks a half a gallon of whole milk a day and often has a toasted cheese sandwich or macaroni and cheese for lunch and sometimes has a bowl of ice cream or yogurt for dessert. Based on knowledge of the nutritional needs of the school-aged child, the nurses response to the amount of milk this child drinks each day would be which of the following?

 a. You can drink all the milk and eat all the milk products you want, as they are very healthy. b. You need to reduce your milk intake to a glass at each meal and at bedtime. c. The recommended daily amount of milk and milk products such as cheese or ice cream is two to three servings a day. d. If you drink a half a gallon of milk a day, you need to omit cheese and other milk products.

ANS: C

 Feedback A Incorrect: This is not the best response because it exceeds the recommended daily amount of milk. B Incorrect: This is not the best response because it exceeds the recommended daily amount of milk. C Correct: The recommended daily amount of milk and milk products is two to three servings a day, so this is the best response. One serving is equal to one cup of milk or yogurt or 1 1/2 ounces of cheese. D Incorrect: This is not the best response because half a gallon of milk is about three times more than the recommended daily amount of milk

PTS:1REF:p. 339 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

29.The teacher refers a 9-year-old student to the school nurse for a sleep assessment. The student is often asleep in class and is failing in several areas. The teacher suspects the child is not getting enough sleep. The nurse finds out that the child is going to bed at midnight and getting up at 7 AM. Which of the following is the best action for the nurse to take?

 a. Have the child take a nap sometime during the day at school. b. Tell the child to get more sleep on the weekend to catch up on sleep. c. Ask the child to go to bed earlier at night, if at all possible, so the child wont fall asleep in class and will be able to pay attention. d. Talk to the family about a 9-year-olds need for 9 to 10 hours of sleep per night so the child will grow and can pay attention at school.

ANS: D

 Feedback A Incorrect: This is not the best action for the nurse to take because there is no time during the day at school for a nap for a 9-year old. B Incorrect: This is not the best action for the nurse to take because the child needs 9 hours of sleep every night, and it is not possible to catch up on sleep on the weekend. C Incorrect: This is not the best action for the nurse to take. D Correct: Nine hours a night is the recommended amount of sleep for the school-age child. Therefore, this is the best action for the nurse to take.

PTS:1REF:p. 340 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

30.A child talks to the school nurse about the fact she is sleep talking at night. The child wants to know if there is something seriously wrong with her and if she needs to go to a physician. Which of the following is the nurses best response?

 a. Sleep talking can be a sign of intestinal parasites, so your parents do need to take you to the doctor. b. Sleep talking does not indicate a health problem, and it does not require that anything be done. c. I will call your parents and have them come in so we can all talk about this problem together. d. This problem can be caused by any number of things including stress, and I wonder if you are under any stress.

ANS: B

 Feedback A Incorrect: This is not a correct response. B Correct: Sleep talking or somniloquy can occur at any age across the life span and does not indicate a health concern or need for intervention. C Incorrect: Sleep talking does not indicate a health concern and is not a problem; therefore, there is no need to discuss it with a childs parents. D Incorrect: This is not a correct response.

PTS:1REF:p. 340 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

31.During the school-age years, a malocclusion can occur. Which of the following statements best describes a malocclusion?

 a. The upper and lower teeth come together in a way that the permanent upper and lower teeth do not approximate. b. A permanent tooth cannot come through the gum due to a baby tooth still being in place. c. The teeth and jaws are aligned in such a manner as to prevent the lips from coming together. d. The tag of skin under the tongue is so tight that until it is cut the tongue cannot work properly in concert with the teeth.

ANS: A

 Feedback A Correct: A malocclusion is an abnormality of the coming together of the teeth and occurs when the permanent upper and lower teeth do not approximate, leaving them crowded or uneven. B Incorrect: This statement does not describe a malocclusion. C Incorrect: This statement does not describe a malocclusion. D Incorrect: This statement does not describe a malocclusion.

PTS:1REF:p. 340 Health Promotion and Maintenance

OBJ: Cognitive Level: Comprehension

32.When a school-aged child has a malocclusion, the parents need to:

 a. advise the school nurse c. take the child to an orthodontist b. do nothing, as this will be outgrown d. take the child to the pediatrician

ANS: C

 Feedback A Incorrect: A malocclusion requires an evaluation by an orthodontist because braces may be needed. B Incorrect: A malocclusion requires an evaluation by an orthodontist. The child will not outgrow it. C Correct: When a school-aged child has a malocclusion, the parents need to take the child to an orthodontist. D Incorrect: A malocclusion requires an evaluation by an orthodontist, not a pediatrician, since it is a dental problem.

PTS:1REF:p. 340 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

33.The school nurse is called to the playground to attend to a child who has had a tooth knocked out during a playground fight. Which of the following would be the best action for the nurse to take?

 a. Have the child gargle with hot salt water and put the tooth in an envelope so the child can put it under his or her pillow. b. Apply an ice pack to the side of the face there the tooth came out, and have the child rinse the mouth several times with ice-cold water. c. Gently rinse the tooth with water, put the tooth back into the socket, and call the caregivers to take the child to the dentist. d. Call the parents immediately so they can contact the dentist to find out what the dentist wants them to do.

ANS: C

 Feedback A Incorrect: This is not the best action for the nurse to take. B Incorrect: This is not the best action for the nurse to take. C Correct: An evulsed tooth (tooth that is knocked out) should be picked up, rinsed gently under water, and placed back in the socket. The child should hold the tooth in place, and a dentist should be contacted immediately. If the tooth cannot be held in place, it should be put in cold milk or held in the mouth, under the childs or caregivers tongue, until seen by a dentist. D Incorrect: This is not the best action for the nurse to take.

PTS:1REF:p. 340 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

34.Which of the following best identifies how Piaget described play during the school-age years?

 a. work that is fun c. a moral character builder b. interactive socialization d. games with rules

ANS: D

 Feedback A Incorrect: For toddlers play is their work. It is how they learn about the environment. B Incorrect: Piaget did not describe play during the school-age years as interactive socialization. C Incorrect: Piaget did not describe play during the school-age years as a moral character builder. D Correct: Piaget described play during the school-age years as games with rules as the child is able to think more objectively, thus making group activities a possibility.

PTS:1REF:p. 343 Health Promotion and Maintenance

OBJ: Cognitive Level: Comprehension

35.The school nurse is working with a child who has a crisis-oriented family, which is in crisis mode at the present time. Which of the following methods would be most productive for the nurse to use in helping this child release tension?

 a. play c. singing b. talk d. back rub

ANS: A

 Feedback A Correct: Play is the most productive method for tension reducing and the release of frustrations in this child. B Incorrect: Talk is not the most productive method for the nurse to use in helping this child release tension. C Incorrect: Singing is not the most productive method for the nurse to use in helping this child release tension. D Incorrect: A back rub is not the most productive method for the nurse to use in helping this child release tension.

PTS:1REF:p. 343 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

36.The school nurse has identified a school-aged girl who has been bullying other children on the way home from school. The nurse realizes that this girl most needs which of the following interventions?

 a. punishment c. talk therapy b. anger management training d. social skills training

ANS: D

 Feedback A Incorrect: Punishment is not the best intervention for this girl who bullies others. B Incorrect: Anger management training is not the best intervention for this girl who bullies others. C Incorrect: Talk therapy is not the best intervention for this girl who bullies others. D Correct: Developing social skills is one of the primary tasks of the school-age child. For children who lack such skills, one of the ways to express their anger is by bullying others or inflicting verbal or physical harm on another. Children who bully should be provided with alternative means of interacting with peers, including social skills training.

PTS:1REF:p. 345 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

37.A school-aged child is repeatedly sent to the nurses office for complaints of headache, sleep disturbances, and stomachache. The nurse will most likely suspect that this child:

 a. just wants to spend time with the nurse because the nurse is nice b. is trying to get out of class because of difficulty with schoolwork c. has school phobia d. is the victim of bullying

ANS: D

 Feedback A Incorrect: The nurse should not most likely suspect that this child just wants to spend time with the nurse because the nurse is nice. This childs complaints are more indicative of signs of stress or a psychological issue. B Incorrect: The nurse should not most likely suspect that this child is trying to get out of class because of difficulty with schoolwork. C Incorrect: The nurse should not most likely suspect that this child has school phobia. D Correct: Reactions to bullying can include physical scratches and bruises, requests for extra money for school, and resistance to attend school. If bullying continues, the child may become depressed, withdrawn, and suicidal. This childs complaints could result from being the victim of bullying.

PTS:1REF:p. 345 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

38.A situation is considered stressful for a child when:

 a. the child perceives that he or she is unable to meet the demands placed on him or her b. a childs behavior changes from the usual behavior to new and different behaviors c. the child exhibits any of the symptoms normally associated with stress d. it would normally be considered stressful for a child

ANS: A

 Feedback A Correct: A situation is considered stressful for a child when there is a discrepancy between demands placed on her or him and the individuals perceived ability to meet these demands. B Incorrect: This is not the best description of a situation considered stressful for a child. C Incorrect: This is not the best description of a situation considered stressful for a child. D Incorrect: This is not the best description of a situation considered stressful for a child.

PTS:1REF:p. 346 Health Promotion and Maintenance

OBJ: Cognitive Level: Application

MULTIPLE RESPONSE

1.A mother expresses amazement that her school-aged son, who was somewhat slow to crawl and walk, is now riding a bicycle and in-line skating. The nurse would explain that the child is able to do these new activities well because of which of the following? Select all that apply.

 a. Taking longer to crawl and walk provides a much better balance and coordination system. b. Improved balance and coordination are part of the growth and development of this age. c. Children who are slower in developing initial skills seem to have more high-risk behaviors later. d. This child has developed the muscles needed for bicycling and in-line skating.

ANS: B, D

 Feedback Correct Improved balance and coordination enable the school-aged child to engage in these activities. Muscle strength and size increase at a gradual rate during school-age years and gross motor skills continue to be refined, such as bike riding and in-line skating. Incorrect Taking longer to crawl and walk is not associated with providing better balance and coordination. Children who are slower in the development of initial skills are not associated with more high-risk behaviors later.

PTS: 1 REF: p. 332 Growth and Development of the School-Age Child

OBJ: Cognitive Level: Application

2.When a child is found on physical examination to have an innocent murmur, the nurse will recommend to the caregivers that they do which of the following? Select all that apply.

 a. Do not mention this to others, because it often frightens people who do not understand. b. Tell other caregivers so that in an emergency those going to the emergency room with the child will know. c. Provide medical documentation about the innocent heart murmur to the school nurse, coaches, and administration. d. Say very little or nothing about the heart murmur because it only scares the child who will soon outgrow it anyway.

ANS: B, C

 Feedback Correct For the child with an innocent heart murmur, the family should be encouraged to notify other caregivers of the condition so that in an emergency those going to the emergency room with the child will know. The family should be encouraged to provide the school nurse and athletic coaches with medical documentation confirming the presence of an innocent heart murmur. Incorrect It would not be prudent to not mention the murmur. Discussing the heart murmur should not frighten the child, as the family can provide information about the condition to the child, letting the child know the condition will resolve.

PTS:1REF:p. 333 Physiological Development

OBJ: Cognitive Level: Application