Chapter 14- Health Promotion of the School-Age Child and Family PDF

Preview

Summary

Multiple choice questions with select all that applies questions too. Rationales also included. Chapter 14 Health promotion of the school age child...

Description

Chapter 14: Health Promotion of the School-Age Child and Family Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition MULTIPLE CHOICE

The nurse is teaching a group of 10- to 12-year-old children about physical development during the school-age years. Which statement made by a participant, indicates the correct understanding of the teaching? a. “My body weight will be almost triple in the next few years.” b. “I will grow an average of 2 inches per year from this point on.” c. “There are not that many physical differences among school-age children.” d. “I will have a gradual increase in fat, which may contribute to a heavier appearance.” 1.

ANS: B

In middle childhood, growth in height and weight occurs at a slower pace. Between the ages of 6 and 12 years, children grow 2 inches per year. In middle childhood, children’s weight will almost double; 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. DIF: Cognitive Level: Apply REF: p. 429 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 2. a. b. c. d.

What is the earliest age at which puberty begins? 9 10 11 12

ANS: A

There is no universal age at which children assume the characteristics of prepubescence. The first physiologic signs appear at about 9 years of age (particularly in girls) and are usually clearly evident in 11- to 12-year-old children. DIF: Cognitive Level: Understand REF: p. 430 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 3. a.

Which describes the cognitive abilities of school-age children? Have developed the ability to reason abstractly

b.

Are capable of scientific reasoning and formal logic Progress from making judgments based on what they reason to making judgments based on what they see Are able to classify, to group and sort, and to hold a concept in their minds while making decisions based on that concept

c.

d.

ANS: D

In Piaget’s stage of concrete operations, children have the ability to group and sort and make conceptual decisions. Children cannot reason abstractly and logically until late adolescence. Making judgments based on what they reason to making judgments based on what they see is not a developmental skill. DIF: Cognitive Level: Understand REF: p. 431 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 4. a. b. c.

d.

Which describes moral development in younger school-age children? The standards of behavior now come from within themselves. They do not yet experience a sense of guilt when they misbehave. They know the rules and behaviors expected of them but do not understand the reasons behind them. They no longer interpret accidents and misfortunes as punishment for misdeeds.

ANS: C

Children who are ages 6 and 7 years know the rules and behaviors expected of them but do not understand the reasons for these rules and behaviors. Young children do not believe that standards of behavior come from within themselves, but that rules are established and set down by others. Younger school-age children learn standards for acceptable behavior, act according to these standards, and feel guilty when they violate them. Misfortunes and accidents are viewed as punishment for bad acts. DIF: Cognitive Level: Understand REF: p. 431 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 5.

Which statement characterizes moral development in the older school-age

child? a.

They are able to judge an act by the intentions that prompted it rather than just by the consequences.

b.

Rules and judgments become more absolute and authoritarian. They view rule violations in an isolated context. They know the rules but cannot understand the reasons behind them.

c. d. ANS: A

Older school-age children are able to judge an act by the intentions that prompted the behavior rather than just by the consequences. Rules and judgments become less absolute and authoritarian. Rule violation is likely to be viewed in relation to the total context in which it appears. The situation and the morality of the rule itself influence reactions. DIF: Cognitive Level: Understand REF: p. 431 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance

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 statement? a. A common belief at this age b. A belief that forms the basis for most religions c. Suggestive of excessive family pressure d. Suggestive of a failure to develop a conscience 6.

ANS: A

Children at this age may view illness or injury as a punishment for a real or imagined misdeed. The belief in divine punishment is common for an 8-year-old child. DIF: Cognitive Level: Analyze REF: p. 432 TOP: Integrated Process: Nursing Process: Evaluation MSC: Area of Client Needs: Health Promotion and Maintenance 7. Parents ask the nurse whether it is common for their school-age child to spend a lot of time with peers. The nurse should respond, explaining that the role of the peer group in the life of school-age children provides: a. opportunity to become defiant. b. time to remain dependent on their parents for a longer time. c. time to establish a one-on-one relationship with the opposite sex. d. security as they gain independence from their parents. ANS: D

Peer-group identification is an important factor in gaining independence from parents.

Children learn how to relate to people in positions of leadership and authority and how to explore ideas and the physical environment. Becoming defiant in a peer-group relationship may lead to bullying. Peer-group identification helps in gaining independence rather than remaining dependent. One-on-one opposite sex relationships do not occur until adolescence. School-age children form peer groups of the same sex. DIF: Cognitive Level: Understand REF: p. 433 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 8. A group of boys ages 9 and 10 years have formed a “boys-only” club that is open to neighborhood and school friends who have skateboards. How should this be interpreted? a. Behavior that encourages bullying and sexism b. Behavior that reinforces poor peer relationships c. Characteristic of social development at this age d. Characteristic of children who later are at risk for membership in gangs ANS: C

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. A boys-only club does not have a direct correlation with later gang activity. DIF: Cognitive Level: Analyze REF: p. 433 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 9. A school nurse observes school-age children playing at recess. Which is descriptive of the play the nurse expects to observe? a. Individuality in play is better tolerated than at earlier ages. b. Knowing the rules of a game gives an important sense of belonging. c. They like to invent games, making up the rules as they go. d. Team play helps children learn the universal importance of competition and winning. ANS: B

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, an attribute highly valued in the United States. DIF: Cognitive Level: Understand REF: p. 437 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 10. Bullying can be common during the school-age years. The nurse should recognize that which applies to bullying? a. Can have a lasting effect on children b. Is not a significant threat to self-concept c. Is rarely based on anything that is concrete d. Is usually ignored by the child who is being bullied ANS: A

Bullying in this age group is common and can have a long-lasting effect. Increasing awareness of differences, especially when accompanied by unkind comments and taunts from others, may make a child feel inferior and undesirable. Physical impairments such as hearing or visual defects, ears that “stick out,” or birth marks assume great importance. DIF: Cognitive Level: Understand REF: p. 439 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 11.

Which is characteristic of dishonest behavior in children ages 8 to 10

years? a. b. c. d.

Cheating during games is now more common. Lying results from the inability to distinguish between fact and fantasy. They may steal because their sense of property rights is limited. They may lie to meet expectations set by others that they have been unable to attain.

ANS: D

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

DIF: Cognitive Level: Understand REF: p. 439 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance

A 9-year-old girl often comes to the school nurse complaining of stomach pains. Her teacher says she is completing her schoolwork satisfactorily but lately has been somewhat aggressive and stubborn in the classroom. How should the nurse interpret this behavior? a. A sign of stress b. A developmental delay c. A physical problem d. A lack of adjustment to school 12.

ANS: A

Signs of stress include stomach pains or headache, sleep problems, bed-wetting, changes in eating habits, aggressive or stubborn behavior, reluctance to participate, or regression to early behaviors. This child is exhibiting signs of stress. DIF: Cognitive Level: Apply REF: p. 439 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 13. a. b. c. d.

Which statement best describes fear in the school-age child? They are increasingly fearful for body safety. Most of the new fears that trouble them are related to school and family. They should be encouraged to hide their fears to prevent ridicule by peers. Those who have numerous fears need continuous protective behavior by parents to eliminate these fears.

ANS: B

During the school-age years, children experience a wide variety of fears, but new fears relate predominantly to school and family. During the middle-school years, children become less fearful for body safety than they were as preschoolers. Parents and other persons involved with children should discuss children’s fears with them individually or as a group activity. Sometimes school-age children hide their fears to avoid being teased. Hiding their fears does not end them and may lead to phobias. DIF: Cognitive Level: Analyze REF: p. 439 TOP: Integrated Process: Nursing Process: Evaluation MSC: Area of Client Needs: Health Promotion and Maintenance

The father of a 12-year-old child tells the nurse that he is concerned about his son getting “fat.” His son is at the 50th percentile for height and the 75th percentile for weight on the growth chart. What is the most appropriate nursing action? 14.

a. b.

Reassure the father that his child is not fat Reassure the father that his child is just growing Suggest a low-calorie, low-fat diet Explain that this is typical of the growth pattern of boys at this age

c. d. ANS: D

This is a characteristic pattern of growth in preadolescent boys, where the growth in height has slowed in preparation for the pubertal growth spurt, but weight is still gained. The nurse should review this with both the father and the child and develop a plan to maintain physical exercise and a balanced diet. It is false reassurance to tell the father that his son is not fat. His weight is high for his height. The child needs to maintain his physical activity. The father is concerned, so an explanation is required. A nutritional diet with physical activity should be sufficient to maintain his balance. DIF: Cognitive Level: Apply REF: p. 440 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 15. A child has an evulsed (knocked-out) tooth. Which medium should the nurse instruct the parents to place the tooth in for transport to the dentist? a. In cold milk b. In cold water c. In warm salt water d. In a dry, clean jar ANS: A

An evulsed tooth should be placed in a suitable medium for transplant, either cold milk or saliva (under the child or parent’s tongue). Cold milk is a more suitable medium for transport than cold water, warm salt water, or a dry, clean jar. DIF: Cognitive Level: Apply REF: p. 441 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Physiologic Integrity

The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize about this age group? a. Children in fifth grade are too young for sex education. b. Children should be discouraged from asking too many questions. c. Correct terminology should be reserved for children who are older. d. Sex can be presented as a normal part of growth and development. 16.

ANS: D

When sexual information is presented to school-age children, sex should be treated as a normal part of growth and development. Fifth-graders are usually 10 or 11 years old. This age is not too young to speak about physiologic changes in their bodies. They should be encouraged to ask questions. Preadolescents need precise and concrete information. DIF: Cognitive Level: Apply REF: p. 445 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance

The school nurse is conducting a class on bicycle safety. Which statement made by a participant indicates a need for further teaching? a. “Most bicycle injuries occur from a fall off the bicycle.” b. “Head injuries are the major causes of bicycle-related fatalities.” c. “I should replace my helmet every 5 years.” d. “I can ride double with a friend if the bicycle has an extra-large seat.” 17.

ANS: D

Children should not ride double. Most injuries result from falls. 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. The child should always wear a properly fitted helmet approved by the US Consumer Product Safety Commission and should replace the helmet at least every 5 years. DIF: Cognitive Level: Apply REF: p. 445 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Safe and Effective Care Environment: Safety and Infection Control 18. When teaching injury prevention during the school-age years, what should the nurse include? a. Teach children to fear strangers. b. Teach basic rules of water safety. c. Avoid letting child cook in microwave ovens. d. Caution child against engaging in competitive sports. ANS: B

Water safety instruction is an important source of injury prevention at this age. The child should be taught to swim, select safe and supervised places to swim, swim with a companion, check for sufficient water depth before diving, and use an approved flotation device. Teach stranger safety, not fear of strangers. This includes instructing children to not go with strangers, not wear personalized clothing in public places, tell parents if anyone makes child feel uncomfortable, and say “no” in uncomfortable situations. Teach

child safe cooking. Caution against engaging in hazardous sports such as those involving trampolines. DIF: Cognitive Level: Apply REF: p. 444 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Safe and Effective Care Environment: Safety and Infection Control 19. A nurse is teaching parents of kindergarten children general guidelines to assist their children in school. Which statement by the parents indicates they understand the teaching? a. “We will only meet with the teacher if problems occur.” b. “We will discourage hobbies so our child focuses on schoolwork.” c. “We will plan a trip to the library as often as possible.” d. “We will expect our child to make all As in school.” ANS: C

General guidelines for parents to help their child in school include sharing an interest in reading. The library should be used frequently, and books the child is reading should be discussed. Hobbies should be encouraged. The parents should not expect all As. They should focus on growth more than grades. DIF: Cognitive Level: Apply REF: p. 438 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 20. A school nurse is teaching dental health practices to a group of sixth-grade children. How often should the nurse recommend the children brush their teeth? a. Twice a day b. Three times a day c. After meals d. After meals, after snacks, and at bedtime ANS: D

Teeth should be brushed after meals, after snacks, and at bedtime. Children who brush their teeth frequently and become accustomed to the feel of a clean mouth at an early age usually maintain the habit throughout life. Twice a day, three times a day, or after meals would not be often enough. DIF: Cognitive Level: Comprehend REF: p. 441 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 21. Parents of a 12-year-old child ask the clinic nurse, “How many hours of sleep should our child get?” The nurse should respond that 12-year-old children need how

many hours of sleep at night? a. b. c. d.

8 9 10 11

ANS: B

School-age children usually do not require naps, but they do need to sleep approximately 11 hours at age 5 years and 9 hours at age 12 years each night. DIF: Cognitive Level: Apply REF: p. 440 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 22. A nurse planning care for a school-age child should take into account that which thought process is seen at this age? a. Animism b. Magical thinking c. Ability to conserve d. Thoughts are all-powerful ANS: C

One cognitive task of school-age children is mastering the concept of conservation. At an early age (5 to 7 years), children grasp the concept of reversibility of numbers as a basis for simple mathematics problems (e.g., 2 + 4 = 6 and 6 – 4 = 2). They learn that simply altering their arrangement in space does not change certain properties of the environment, and they are able to resist perceptual cues that suggest alterations in the physical state of an object. Animism, magical thinking, and believing that thoughts are all powerful are thought processes seen in preschool children. DIF: Cognitive Level: Apply REF: p. 432 TOP: ...