Maternity TB CH 19

1. The nurse is assessing a school-age child.
What will the nurse expect in regard to physical

development of this child?
a. Growth of 3 to 6 inches per year
b. Gain of 5 to 7 pounds per year
c. Increase of head circumference by 1 inch per year
d. A visual acuity of 20/20 by 9 years of age
ANS: B
During the school-age period, the average weight gain per year is generally 5.5 to 7 pounds.
DIF: Cognitive Level: Knowledge REF: Page 435 OBJ: 3
TOP: Physical Growth KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
2. What should the nurse keep in mind when planning to teach a class on nutrition to fourth-grade
students?
a. School-age children can concentrate on only one aspect of a situation.
b. School-age children can think abstractly.
c. School-age children are egocentric in their thinking.
d. School-age children think logically and concretely.
ANS: D
Piaget refers to the thought process of this period as concrete operations, which involves logical
thinking and an understanding of cause and effect.
DIF: Cognitive Level: Comprehension REF: Page 434, Box 19-1
OBJ: 3 TOP: Cognitive Development
KEY: Nursing Process Step: Planning
3. What type of relationships are the preferred social interactions for the school-age child?
a. Heterosexual interest groups
b. Association with one best friend
c. Rigidly organized groups with complex rules
d. Same-sex peer groups
ANS: D
The preferred social interaction of the school-age child is in same-sex peer groups or cliques.
DIF: Cognitive Level: Analysis REF: Page 435 OBJ: 3
TOP: Social DevelopmentPlay KEY: Nursing Process Step: Implementation
4. The nurse is advising parents of a 10-year-old boy about the most developmentally supportive
experiences for their son. What is the best experience for this child according to Eriksons theory?
a. Constant variety of activities
b. Successful performance in Little League
c. Feeling healthy and strong
d. Having a girlfriend
ANS: B
The child who is successful in activities will feel positively about himself or herself.
TOP: Psychosocial Development KEY: Nursing Process Step: Implementation
5. The parents of an 8-year-old tell the nurse the child wakes the household crying out during his
frequent nightmares. What is the nurses most helpful response to explain nightmares?
a. They are a normal extension of the childs fear of mutilation.
b. They are an abnormal response to repressed feelings.
c. They are a common result of latent sexuality.
d. They are a side effect of overactivity and stimulation.
ANS: A
The nightmares experienced by an 8-year-old are an extension of their characteristic fear of
mutilation.
DIF: Cognitive Level: Comprehension REF: Page 444, Table 19-3
OBJ: 3 TOP: Eight-Year-Old
KEY: Nursing Process Step: Implementation
6. What is the best suggestion by the nurse for an appropriate toy for a hospitalized 6-year-old boy?
a. Handheld video game
b. MP3 player
c. Adventure book
d. Jigsaw puzzle
ANS: A
The 6-year-old child can perform numerous feats that require muscle coordination. At this age, the
handheld video game will offer nonaggressive competition.
DIF: Cognitive Level: Analysis REF: Page 444, Table 19-3
OBJ: 3 TOP: Six-Year-Old KEY: Nursing Process Step: N/A
7. The nurse discusses preparation for school with the parents of a 6-year-old girl who will soon be
starting first grade. What statement by the girls father leads the nurse to determine that the parents
understood the information?
a. We should put a stop to her thumb-sucking.
b. Well have a talk about what school is like.
c. We will let her walk to the bus stop by herself.
d. Well have her meet some children who will be in her class.
ANS: D
To prepare a child for school, parents can arrange for the child to meet other children who will be
entering school with her.
DIF: Cognitive Level: Application REF: Page 438, Patient Teaching
OBJ: 4 TOP: Parental Guidance for Starting School
KEY: Nursing Process Step: Evaluation
8. A 9-year-old boy is often cranky and irritable, and his school performance has declined. What is
the most probable factor causing this behavior?
a. He sleeps only 6 to 7 hours a night.
b. He eats eggs every day.
c. He has a new dog.
d. He plays about 1 to 3 hours each evening.
ANS: A
The 9-year-old child requires about 10 hours of sleep per night.
DIF: Cognitive Level: Application REF: Page 441 OBJ: 3
TOP: Nine-Year-Old KEY: Nursing Process Step: Data Collection
9. A parent asked the nurse, At what age are children capable of assuming more responsibility for
personal belongings? What is the nurses best response based on knowledge of growth and
development?
a. 6 years
b. 7 years
c. 9 years
d. 12 years
ANS: C
The 9-year-old is dependable and assumes more responsibility for personal belongings.
DIF: Cognitive Level: Comprehension REF: Page 440 OBJ: 3

TOP: Nine-Year-Old KEY: Nursing Process Step: Implementation
10. The school nurse is preserving a tooth that was knocked out on the school playground. What will
the nurse be especially careful to do?
a. Wrap the tooth loosely in a clean cloth.
b. Rinse the tooth with alcohol.
c. Handle the tooth only by the crown.
d. Place the tooth in a warm environment.
ANS: C
When a permanent tooth is avulsed, the tooth should be picked up by the crown to prevent any
further damage to the root and placed in milk until the child can be examined by a dentist.
DIF: Cognitive Level: Application REF: Page 439, Nursing Tip
OBJ: 7 TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
11. A parent states, My 7-year-old really wants a dog. His 10-year-old brother has allergies to animal
dander. I dont know what to do. What type of pet should the nurse suggest as the best choice?
a. A small breed of dog because the large dogs produce more allergens
b. An older unneutered dog that produces fewer allergens than a younger one
c. A cat because it requires less care and is less allergenic
d. A poodle, which does not shed, making it a good choice for people with allergies
ANS: D
The poodle does not have a shed cycle and so it may be the least offensive pet for the allergic child.
TOP: Pet Ownership KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
12. When asked about her activities, a 10-year-old girl responded, I like school. I play the flute in the
school band, and I take tennis lessons. What does the nurse know these activities will help this child
develop?
a. Initiative
b. Industry
c. Identity
d. Intimacy
ANS: B
The school-age period is referred to by Erikson as the stage of industry. Successful participation in
activities facilitates the childs sense of industry.
TOP: Psychosocial Development KEY: Nursing Process Step: Data Collection
13. A mother reports that she has a new job and her 12-year-old child is home alone for a time after
school. Which statement made by the parent alerts the nurse to a potentially unsafe situation for this
child?
a. I told him that he could invite a few friends after school.
b. I put a list of emergency numbers next to the telephone.
c. Last week we made a first aid kit together.
d. There is a neighbor available in case of an emergency.
ANS: A
Latchkey children are subject to a higher rate of accidents. Permitting school-age children and their
friends to be home alone in an unsupervised environment is an unsafe situation.
TOP: Latchkey Children KEY: Nursing Process Step: Evaluation
14. A mother is concerned because her 9-year-old boy has developed the habit of twitching his eyes
and flipping his hair while communicating with anyone. What is the best nursing response to this
parent?
a. This may indicate that he needs eyeglasses.
b. Children sometimes do these things for attention.
c. This behavior suggests low self-esteem.
d. Tics appear when a child is under stress.
ANS: D
The child cannot help such actions and should not be scolded for them because they are mainly a
result of tension.
TOP: Nine-Year-Old KEY: Nursing Process Step: Implementation
15. A seventh-grade girl tells the school nurse that her art teacher, a woman, is her hero. What is the
most appropriate interpretation of the girls comment?
a. The student may be exploring her career options.
b. The comment is cause for concern about sexual abuse.

c. The child may have difficulty interacting with her peers.
d. Hero worship is a normal phenomenon.
ANS: D
School-age children tend to admire their teachers and adult companions. For the 11- to 12-year-old,
hero worship is a normal phenomenon.
OBJ: 3 TOP: Social Development
KEY: Nursing Process Step: Data Collection
16. Which stage of cognitive development is a 9-year-old child in according to Piaget?
a. Formal operations
b. Preoperational
c. Concrete operations
d. Sensorimotor
ANS: C
School-age children are in the concrete operations stage of cognitive development.
TOP: Cognitive Development KEY: Nursing Process Step: Data Collection
17. What statement by an 11-year-old leads the nurse to determine he has moved from the mind set
of egocentrism?
a. I am a member of the best Cub Scout group in the world.
b. I must do my homework before I can play.
c. My dad can do anything!
d. Im sorry. I bet that hurt your feelings.
ANS: D
The ability to see anothers point of view indicates moving away from egocentrism into a more
altruistic mind-set.
DIF: Cognitive Level: Analysis REF: Page 444, Table 19-3
OBJ: 3 TOP: Increasing Understanding
KEY: Nursing Process Step: Data Collection
18. A school-age child becomes frustrated with a school assignment and says, I cant do this! What
is the most developmentally supportive response from the parent?
a. Ask, What is it that is so difficult?
b. Allow the child to quit the effort.
c. Call in older siblings to help.
d. Finish the project for them.
ANS: A
Helping the child focus on the problem that is keeping him from mastery can limit frustration. Quitting
or having someone else finish is detrimental to the development of industry.
TOP: Industry KEY: Nursing Process Step: N/A
19. What is best for the nurse to suggest to the parents of an overweight 9-year-old to help prevent
obesity?
a. Use whole milk as a between-meal snack because it is more filling than skim milk.
b. Feed the child before family meal times to monitor intake more closely.
c. Encourage the child to engage in physical activity for at least an hour a day.
d. Remove all sweets and junk food from the house.
ANS: C
Regular physical activity reduces weight.
DIF: Cognitive Level: Comprehension REF: Page 443, Nursing Tip
OBJ: 7 TOP: Prevention of Obesity
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
20. A parent confides in the school nurse that her 8-year-old twins argue and bicker constantly. What
is the best response by the nurse?
a. Express alarm at the constant aggression.
b. Voice concern and investigate referral for counseling.
c. Inquire about what punitive action the parents have taken to stop it.
d. Offer reassurance that such behavior is normal for 8-year-olds.
ANS: D
Argumentative and competitive behavior is normal in 8-year-olds.
TOP: Argumentative Behavior KEY: Nursing Process Step: Implementation
21. The school nurse is planning sex education classes for school-age children. What should the
nurse be sure to do?
a. Use simple terms.
b. Avoid slang or street words and concepts.
c. Keep topics on biological aspects of sexual development.
d. Limit questions to keep content clear.
ANS: A
Using simple terms is essential but slang and street terms need to be clarified. Apply age-specific
information across broad aspects of biological, social, and current attitudes.
DIF: Cognitive Level: Application REF: Page 436-437, Nursing Tip
OBJ: 7 TOP: Sex Education
KEY: Nursing Process Step: Planning
22. Parents ask the pediatric nurse how school life might influence their growing child. What area of
development will the nurse indicate that school affects the least?
a. Moral development
b. Social development
c. Physical development
d. Cognitive development
ANS: C
Physical development is the least affected by school life. Moral development occurs as they have
experience with, and understand, rules and fairness in the school setting. Schools have a profound
influence on the socialization of children, who bring to school what they have learned and
experienced in the home. Success in school requires an integration of cognitive, receptive, and
expressive (language) skills.
TOP: Impact of School Life KEY: Nursing Process Step: Planning
MULTIPLE RESPONSE
23. What basic feeling words should the nurse use in attempting to help a 7-year-old girl express
her feelings about being in a new school? (Select all that apply.)
a. Mad
b. Glad
c. Sad
d. Scared
e. Jealous
ANS: A, B, C, D
The words mad, glad, sad, and scared are basic feeling words that can prompt a young child to
better express his or her feelings.
DIF: Cognitive Level: Application REF: Page 443, Nursing Tip
OBJ: 3 TOP: Expression of Feelings
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
24. The school nurse is preparing an educational program for new teachers regarding school-age
children. What information is accurate for the nurse to include? (Select all that apply.)
a. Participation in group activity increases
b. Egocentricity prevails
c. Thinking is logical
d. Preference is toward family interaction
e. Understand cause and effect
ANS: A, C, E
Piaget refers to the thought processes of the school age period as concrete operations.
Concrete operations involve logical thinking and an understanding of cause and effect.
The egocentric view of the preschool child is replaced by the ability to understand the point of view of
another person. Between 6 and 12 years of age, children prefer friends of their own sex and usually
prefer the company of their friends to that of their brothers and sisters.
TOP: Personality Development KEY: Nursing Process Step: Data Collection
25. The pediatric nurse is presenting school-age children with information on safety issues to follow
when going home alone. What guidelines should they be educated to follow? (Select all that apply.)
a. Ask for identification before letting someone in the house.
b. Never accept rides with strangers.
c. Keep doors locked.
d. Do not enter house if door is ajar.
e. Walk to and from school with friends.
ANS: B, C, D, E
Strangers should never be allowed in the house. Children should be instructed never to accept rides
with strangers, to keep doors locked, not to enter the house if the door is ajar, and to walk to and
from school with friends.
DIF: Cognitive Level: Comprehension REF: Page 439, Health Promotion

OBJ: 6 TOP: Safety KEY: Nursing Process Step: Implementation
26. A 10-year-old child with disabilities is begging her parents for a dog. When at the pediatric clinic,
the parents inquire about possible benefits pet ownership may provide to their child. What benefits of
pet ownership should the nurse indicate? (Select all that apply.)
a. Decrease the need for physical therapy
b. Lower blood pressure
c. Improve communication
d. Foster trust
e. Ease path to socialization
ANS: B, C, D, E
Studies have documented the positive influence of pet ownership on improving the medical and
psychological outcome after illness or surgery. Disabled children especially benefit from interacting
with pets. The interaction with animals can lower blood pressure and heart rate, reduce loneliness
and feelings of isolation, improve communication, foster trust, and motivate participation in physical
therapy. Pets allow the ill child who feels separated from other people to feel companionship and
acceptance. Shy children often find pet ownership eases the path to socialization with others who
initiate contact because of the pet.
DIF: Cognitive Level: Comprehension REF: Page 447-448
OBJ: 8 TOP: Pet Ownership
COMPLETION
27. The nurse advises the parents of a 6-year-old to try and ensure at least ______ hours of sleep
daily for the child.
ANS:
11
The 6-year-old school-age child needs at least 11 hours of sleep.
TOP: Sleep Needs KEY: Nursing Process Step: Implementation
28. The nurse reminds the parents who are trying to select a dog for their allergic child that the best
selection would be a female dog that is ______________ and _______________.
ANS:
young, spayed
Young, neutered female dogs produce less allergens.
DIF: Cognitive Level: Comprehension REF: Page 447-448
OBJ: 8 TOP: Pet Selection for Allergic Child
29. When the fifth-grade class collected geckos in a special aquarium in the classroom, the school
nurse cautioned the teacher to be alert for symptoms of ____________________ that can be carried
by the reptiles.
ANS:
Salmonella
Geckos can infect humans with Salmonella.
OBJ: 8 TOP: Salmonella KEY: Nursing Process Step: Implementation
30. The pediatric nurse assesses the 9-year-old child who has been diagnosed with diabetes to
ensure that he does not come to believe that his disease is a form of _________________.
ANS:
punishment
School-age children may come to believe their illness is a form of punishment for bad behavior or
bad thoughts.
TOP: Disease as Punishment KEY: Nursing Process Step: Data Collection
31. The nurse explains that the term _______________ refers to a sex role that incorporates both
male and female traits.
ANS:
androgynous
Sex roles that involve male and female qualities lead to better human functioning.
TOP: Sex Education KEY: Nursing Process Step: Implementation
32. The nurse is aware that by the age of _____, the first permanent teeth erupt.
ANS:
6
At the age of 6, the first permanent teeth erupt: the 6-year molars.
TOP: Eruption of Permanent Teeth KEY: Nursing Process Step: Planning
33. The _____________________________maintains that every sex education program should
present the topic from six aspects: biological, social, health, personal adjustment and attitudes,
interpersonal associations, and establishment of values.
ANS: Sexuality Information and Education Council of the United States (SIECUS)
TOP: Sex Education KEY: Nursing Process Step: Planning

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Maternity TB CH 19

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1. The nurse is assessing a school-age child.

What will the nurse expect in regard to physical

DIF: Cognitive Level: Comprehension REF: Page 440 OBJ: 3

b. The comment is cause for concern about sexual abuse.

DIF: Cognitive Level: Comprehension REF: Page 439, Health Promotion

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