Ch. 20 Schoolage Child

Question 1

The school nurse conducting an in-service program for teachers is asked about general growth and development of school-age children. Which of the following statements would be the best response by the nurse?

A. “By age 11, blood pressure readings are the same as for an adult.”
B. “Because of the rapid growth pattern in this age group, snacks are important to ensure sufficient caloric intake.”
C. “Children in this age group have some difficulty with coordination and balance, so playground supervision is important.”
D. “Overall growth in school-age children is slower than during infancy and adolescence.”

Answer 1

D. “Overall growth in school-age children is slower than during infancy and adolescence.”

Question 2

According to the American Academy of Pediatrics, at what age should blood pressure screening begin?

A. 3
B. 6
C. 9
D. 12

Answer 2

A. 3

Question 3

The school nurse has seen several students in the health office. For which of the following students should the nurse suggest a follow-up exam?

A. A 14-year old girl who has not experienced menarche
B. A 7-year old boy who has grown 2 inches in a year
C. A 10-year old girl who has gained 11 pounds in a year
D. An 8-year old boy who has lost four deciduous teeth in the past year

Answer 3

C. A 10-year old girl who has gained 11 pounds in a year

Question 4

The president of the Parent-Teacher Association asks the school nurse about the appropriateness of sponsoring a health fair that focuses on oral health for school-age children. Which of the following statements indicates the nurse’s correct understanding of this issue?

A. “Dental problems aren’t as prevalent a problem as asthma, so you might want to consider a health fair about respiratory problems instead.”
B. “Over 40% of children age 2 to 11 have dental caries, so a health fair that focuses on oral care is very appropriate.”
C. “Children aren’t usually receptive to learning about dental care, so the topic is not the best choice for a health fair.”
D. “This is not an appropriate focus for a health fair because the incidence of dental caries has dropped dramatically due to the use of sealants.”

Answer 4

B. “Over 40% of children age 2 to 11 have dental caries, so a health fair that focuses on oral care is very appropriate.”

Question 5

Which of the following statements is correct?

A. Tonsils in a school-age child are smaller than in an adult
B. The nervous system generally matures between ages 11 to 13
C. Fractures heal more slowly in a 10-year old child than in an adult
D. Overweight children have muscle pain more often than average-weight children

Answer 5

D. Overweight children have muscle pain more often than average-weight children

Question 6

Which of the following elements is most likely deficient in a school-age child’s diet?

A. Protein
B. Sodium
C. Iron
D. Vitamin B12

Answer 6

C. Iron

Question 7

Which of the following initiatives related to childhood nutrition outlined in Healthy People 2010 was not successful?

A. Reduction of fat consumption
B. Increase in consumption of fruit
C. Adequate food supplies at home
D. Reducing obesity rates

Answer 7

C. Adequate food supplies at home

Question 8

A school nurse is planning a series on nutrition. Which of the following factors should the nurse take into account?

A. Television commercials frequently advertise food-related products
B. Children watch approximately 2 h or television a day
C. Each day, approximately 60% of children eat fast food
D. A child is three times more likely to eat in a restaurant than at home

Answer 8

A. Television commercials frequently advertise food-related products

Question 9

A nurse is planning activities to help children learn about good nutritional practices. Which of the following strategies should the nurse implement?

A. Coordinate a “Try This” food day offering a variety of nutritious snacks
B. Find a book about nutrition to read the students
C. Plan a video using the concept of MyPlate
D. Search online for a video about nutrition to the students

Answer 9

A. Coordinate a “Try This” food day offering a variety of nutritious snacks

Question 10

A child who has a BMI of 34 visits the school nurse. Which of the following factors does the nurse recognize that the child may be experiencing?

A. Increased bullying by peers
B. Increased self-esteem
C. Increased resiliency
D. Increased motivation to lose weight

Answer 10

A. Increased bullying by peers

Question 11

During a well-child visit, parents report to the nurse that they are concerned that their 8-year old son has started wetting the bed at night. Which of the following statements should the nurse make to the parents?

A. “I’ll be sure to mention this to the doctor; we rarely see a child who wets the bed at this age.”
B. “There is not much you can do to stop this problem until he gets older.”
C. “This is a common disease in children his age but there are treatment options.”
D. “I’m going to collect a urine sample from him and then we will talk about bed wetting.”

Answer 11

D. “I’m going to collect a urine sample from him and then we will talk about bed wetting.”

Question 12

Which of the following children is at risk for developing encopresis?

A. A 6-year old child who has occasional bed wetting
B. A 3-year old child who is not fully toilet-trained
C. A 5-year old child who has been in four foster care homes since age 3
D. A 4-year old who passes stool every morning after breakfast

Answer 12

C. A 5-year old child who has been in four foster care homes since age 3

Question 13

A nurse is discussing sleep patterns in school-age children. Which of the following should be stressed by the nurse?

A. Sharing a bed with siblings/parents has a long-lasting psychological impact
B. School-age children need between 6 and 9 h or sleep a night
C. Daytime naps are important in children until they reach the age of 9 or 10
D. School-age children generally agree with and adhere to a regular bedtime

Answer 13

D. School-age children generally agree with and adhere to a regular bedtime

Question 14

Parents of an 8-year old boy tell the nurse that they are concerned about their son because he occasionally sleepwalks. Which of the following is the best response from the nurse?

A. “Sleepwalking is much more common in girls than boys.”
B. “I am glad you mentioned this. Sleepwalking is sometimes a sign of a neurological deficit.”
C. “Nightmares are the cause of most cases of sleepwalking.”
D. “This is not abnormal for a child of this age. He will most likely outgrow this tendency as his nervous system matures.”

Answer 14

D. “This is not abnormal for a child of this age. He will most likely outgrow this tendency as his nervous system matures.”

Question 15

During a school gift fair, a parent asks the school nurse what gift would be most appropriate for her 6-year old child. Which of the following should the nurse encourage the parent to purchase?

A. A box of wooden blocks of various sizes for sorting
B. A jar of sea shells in various shapes, colors, and textures
C. A world map
D. A beginning encyclopedia of animals

Answer 15

B. A jar of sea shells in various shapes, colors, and textures

Question 16

The school nurse has written a grant to obtain funding for a vision screening program and glasses for children in his pre-K to 6th grade elementary school. Which of the following statements should be included with the rationale for the need for funding?

A. Many preschool children are hyperopic and need glasses to prevent headaches
B. Most states require vision screening on entering school
C. Vision screening can diagnose vision/eye problems before they become severe
D. Approximately one in four children has a vision problem

Answer 16

D. Approximately one in four children has a vision problem

Question 17

Which of the following statements concerning hearing in school-age children in correct?

A. The rate of otitis media infections met Healthy People 2010 targets
B. Hearing and visual problems occur with the same frequency
C. All 50 states require routine hearing evaluations
D. The use of tympanograms has improved the accuracy of hearing screenings

Answer 17

A. The rate of otitis media infection met Healthy People 2010 targets

Question 18

A third grade teacher asks the school nurse what she can reasonably expect from children in her classroom related to language ability. Which of the following statements would be the best response from the nurse?

A. “Children in the second grade should have about a 4000-word vocabulary.”
B. “Research has shown that children will learn to read more quickly if you use the whole word approach.”
C. “You can expect that the children will write ‘b’ and ‘d’ without reversing them, and all of the letters in a word will be about the same size.”
D. “You can evaluate the cognitive ability of the children in your classroom by noting how legible their writing is.”

Answer 18

C. “You can expect that the children will write ‘b’ and ‘d’ without reversing them, and all of the letters in a word will be about the same size.”

Question 19

Each of the following children visits the school nurse on a regular basis. Which of these children would the nurse identify as being at risk for a learning disability and suggest follow-up care?

A. 9-year old whose parents recently divorced
B. 10-year old who is inattentive and fidgets constantly
C. 12-year old with a 4000-word vocabulary
D. 11-year old who scored 102 on an IQ test

Answer 19

B. 10-year old who is inattentive and fidgets constantly

Question 20

A parent asks the nurse working in a pediatric clinic how she can help her 6-year old child feel good about himself. Which of the following statements should be made by the nurse?

A. “Doing most things for your child will give the child a sense of security, and the child will have a positive self-image.”
B. “Having your child help around the house with tasks such as setting the table will increase self-esteem.”
C. “Make sure to highly praise even the smallest effort your child makes at completing a task.”
D. “There is little you can do to increase your child’s self-esteem. The child’s peers have much more of an influence than parents at this age.”

Answer 20

B. “Having your child help around the house with tasks such as setting the table will increase self-esteem.”

Question 21

Which of the following statements made by a parent is most helpful when discussing rules of the household?

A. “You did not feed the dog like you promised, so you cannot have ice cream for dessert.”
B. “I was upset when you didn’t feed the dog like you promised. We all need to help take care of him because he depends on us. Let’s talk about what happened.”
C. “Why did you forget to feed the dog? Would you like me to forget to feed you?”
D. “What you did was bad. We all need to care for the dog.”

Answer 21

B. “I was upset when you didn’t feed the dog like you promised. We all need to help take care of him because he depends on us. Let’s talk about what happened.”

Question 22

A nurse has recently accepted a position as a school nurse at a middle school and plans to offer sex education to the students and parents. Which of the following statements is NOT correct concerning how the nurse should implement this program?

A. Offer gender-segregated sex education classes
B. Education on sexually transmitted disease is not advised until high school
C. Determine how this education has been provided in the past, as a first step
D. Survey parents to determine their desire for this education to be provided

Answer 22

B. Education on sexually transmitted diseases is not advised until high school

Question 23

The school nurse has been asked to conduct a community awareness program about accidents that impact the school-age child. Which of the following facts should be included in the program?

A. Poisonings and falls are the leading causes of death
B. Drowning and motor vehicle accidents are the leading causes of fatality
C. The majority of accident happen inside the home
D. Burn accidents are more common in the summer months

Answer 23

B. Drowning and motor vehicle accidents are the leading causes of fatality

Question 24

Which of the following statements is correct regarding firearms?

A. As with video games, toy guns has been shown to increase violence later in life
B. For safety, guns should be stored apart from ammunition
C. The second amendment exempts hand guns
D. All of the above statements are correct

Answer 24

B. For safety, guns should be stored apart from ammunition

Question 25

A school nurse is caring for a child with an upper respiratory tract infection. Which of the following nursing interventions should the nurse implement?

A. Send the child with a mild sore throat back to class
B. Advise the parent of a child with a group A strep throat infection that’s they cannot return to school for 5 days
C. Educate the parent that treatment of group A strep infections usually requires extra fluid intake
D. Ask the parent of a child with a mild fever and mild sore throat to take the child to his or her health care provider

Answer 25

D. Ask the parent of a child with a mild fever and mild sore throat to take the child to his or her health care provider

Question 26

Which of the following statements about smoking is true?

A. Black children begin smoking at an earlier age than do White children
B. Almost 90% of schools prohibit tobacco use in all locations
C. Each day over 6000 children try smoking
D. Tobacco use prevention programs should be initiated in eighth grade

Answer 26

C. Each day over 6000 children try smoking

Question 27

A child’s parents ask the school nurse if there is any help available to help their child receive health insurance. They state they earn too much money to qualify for Medicaid but not enough to purchase health insurance. Which of the following recommendations should the nurse provide?

A. “Currently, there is no health care program available for your child.”
B. “The school district has a health insurance policy that you can access.”
C. “The state has an insurance program to assist you.”
D. “You will need to find coverage through another member of your family.”

Answer 27

C. “The state has an insurance program to assist you.”

Question 28

Which of the following statements is correct concerning vaccinations for the school-aged child?

A. The first of two HPV vaccines is given at age 10; the second given during high school
B. Tetanus booster every 5 years or when an unclean wound is acquired
C. Meningococcal vaccine at age 11 to 12
D. All of the above statements are correct

Answer 28

C. Meningococcal vaccine at age 11 to 12

Question 29

During a parent-nurse conference, the parent tells the nurse that her child sleeps approximately 7 h per night. Which of the following potential health problems would be of concern to the nurse?

A. Hypertension
B. Hyperactivity
C. Obesity
D. Type 2 diabetes

Answer 29

C. Obesity

Question 30

Which of the following children should the school nurse monitor closely for hypertension (HTN)? Select all that apply.

A. 7-year old white male with no known family history of HTN
B. 9-year old white female whose 20 year old brother has HTN
C. 6-year old black child with no family history of HTN
D. 10-year old Mexican American child with known family history of HTN

Answer 30

B. 9-year old white female whose 20 year old brother has HTN
C. 6-year old black child with no family history of HTN
D. 10-year old Mexican American child with known family history of HTN

Question 31

A nurse is planning a flu prevention fair for 9- to 11-year old children. Which of the following activities should be included? Select all that apply.

A. Microscopes set up the show bacteria on common objects
B. Games such as “find the germs” in a cartoon picture
C. Research poster showing germ transmission
D. Hand washing booth with colored soap

Answer 31

A. Microscopes set up to show bacteria on common objects
B. Games such as “find the germs” in a cartoon picture
D. Hand washing booth with colored soap

Question 32

The school nurse has been asked to plan play and recess activities for children in grades 2 through 6. Which of the following activities should be developed by the nurse? Select all that apply.

A. Highly competitive games that focus on individual accomplishment and winning
B. Family activity days that promote nature walks and biking
C. Co-ed organized sports
D. 4-H club activities

Answer 32

B. Family activity days that promote nature walks and biking

D. 4-H club activities

Question 33

Which of the following children may have difficult with Erikson’s “industry vs. inferiority” stage of development? Select all that apply.

A. Poor motor skills and is rarely chosen for team play during recess
B. Difficulty with math homework
C. Difficulty making friends
D. Cannot speak his or her native language fluently

Answer 33

A. Poor motor skills and is rarely chosen for team play during recess
C. Difficulty making friends
D. Cannot speak his or her native language fluently

Question 34

The school nurse is evaluating children for signs and symptoms of depression. Which of the following children may be most at risk for depression? Select all that apply.

A. 11-year old girl who has been involved in fighting during the past month
B. 10-year old boy who no longer wants to play on the school’s soccer team
C. 12-year old boy who has started lifting weights
D. 9-year old girl who visits the nurse on a daily basis for vague complaints

Answer 34

A. 11-year old girl who has been involved in fighting during the past month
B. 10-year old boy who no longer wants to play on the school’s soccer team
D. 9-year old girl who visits the nurse on a daily basis for vague complaints

Question 35

Which of the following is responsible for ensuring that children are up-to-date on their immunizations? Select all that apply.

A. School nurse
B. Parent or caregiver
C. Teacher
D. School principal

Answer 35

A. School nurse

B. Parent or caregiver

Question 36

A nurse is conducting a school-wide in-service program about child abuse and is asked to describe common indicators of abuse. Which of the following signs would the nurse include? Select all that apply.

A. Caregivers and parents who are reluctant to take the child for treatment for an injury
B. Statement by the day care provider that the child was injured by falling off a chair
C. Explanation of the injury from the child and caregiver or parents that is similar
D. Lack of emotional response from child to a playground injury

Answer 36

A. Caregivers and parents who are reluctant to take the child for treatment for an injury
B. Statement by the day care provider that the child was injured by falling off a chair
D. Lack of emotional response from child to a playground injury