Health Promotion of the School-Age Child and Family

1. The nurse is teaching a group of 10- to 12-year-old children about physical development during the school-age years. Which of the following statements, if made by a participant, would indicate 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.”

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.

DIF: Cognitive Level: Analysis REF: Page 493
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

2. Generally, the earliest age at which puberty begins is: a. 13 years in girls, 13 years in boys.
b. 11 years in girls, 11 years in boys.
c. 10 years in girls, 12 years in boys.

d. 12 years in girls, 10 years in boys.

ANS: C
Puberty signals the beginning of the development of secondary sex characteristics. This begins earlier in girls than in boys. Usually a 2-year difference occurs in the age of onset.

DIF: Cognitive Level: Comprehension REF: Page 494
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

3. Which of the following describes the cognitive abilities of school-age children? a. Have developed the ability to reason abstractly
b. Are capable of scientific reasoning and formal logic
c. Progress from making judgments based on what they reason to making

Test Bank 15-2

judgments based on what they see
d. Are able to classify, to group and sort, and to hold a concept in their minds while

making decisions based on that concept

ANS: D
In Piaget’s stage of concrete operations, children have the ability to group and sort and make conceptual decisions.

DIF: Cognitive Level: Comprehension REF: Page 495
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:HealthPromotionandMaintenance:Developmental Stages and Transitions

4. Which of the following describes moral development in younger school-age children?

a. The standards of behavior now come from within themselves.
b. They do not yet experience a sense of guilt when they misbehave.
c. They know the rules and behaviors expected of them but do not understand the

reasons behind them.
d. 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.

DIF: Cognitive Level: Comprehension REF: Page 495
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:HealthPromotionandMaintenance:Developmental Stages and Transitions

5. Which of the following statements characterizes moral development in the older school-age child?

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

the consequences.

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.

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.

DIF: Cognitive Level: Comprehension REF: Page 495
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:HealthPromotionandMaintenance:Developmental Stages and Transitions

Test Bank 15-3

6. 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. The nurse should interpret this as being which of the following?
a. A belief common 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

ANS: A
Children at this age may view illness or injury as a punishment for a real or imagined misdeed.

DIF: Cognitive Level: Comprehension REF: Page 497
TOP: Integrated Process: Nursing Process: Problem Identification
MSC: AreaofClientNeeds:HealthPromotionandMaintenance:Developmental Stages and Transitions

7. What is the role of the peer group in the life of school-age children?
a. Gives them an opportunity to learn dominance and hostility
b. Allows them to remain dependent on their parents for a longer time
c. Decreases their need to learn appropriate sex roles
d. Provides them with security as they gain independence from their parents

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

DIF: Cognitive Level: Comprehension REF: Page 497
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

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. This should be interpreted as which of the following?
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.

DIF: Cognitive Level: Application REF: Page 497
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

Test Bank 15-4

9. Which of the following is descriptive of the play of school-age children? 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.

DIF: Cognitive Level: Comprehension REF: Page 499
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

10. Teasing can be common during the school-age years. The nurse should recognize that which of the following applies to teasing?
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 teased

ANS: A
Teasing in this age-group is common and can have a long-lasting effect.

DIF: Cognitive Level: Comprehension REF: Page 500
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

11. Which of the following is characteristic of dishonest behavior in children ages 8 to 10 years?

a. Cheating during games is now more common.
b. Lying results from the inability to distinguish between fact and fantasy.
c. They may steal because their sense of property rights is limited.
d. 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.

DIF: Cognitive Level: Comprehension REF: Page 501
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and

Test Bank 15-5

Development

12. A 9-year-old girl often comes to the school nurse complaining of stomach pains. Her teacher says she is completing her school work satisfactorily, but lately has been somewhat aggressive and stubborn in the classroom. The school nurse should recognize this as which of the following?

a. Signs of stress
b. Developmental delay
c. Physical problem causing emotional stress d. Lack of adjustment to school environment.

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.

DIF: Cognitive Level: Comprehension REF: Page 504
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

13. Which one of the following statements best describes fear in the school-age child? a. They are increasingly fearful for body safety.
b. Most of the new fears that trouble them are related to school and family.
c. They should be encouraged to hide their fears to prevent ridicule by peers.

d. 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.

DIF: Cognitive Level: Application REF: Page 504
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

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

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

Test Bank 15-6

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 Ryan and develop a plan to maintain physical exercise and a balanced diet.

DIF: Cognitive Level: Comprehension REF:
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

15. A child has an evulsed (knocked-out) tooth. The parents are reluctant to try to reimplant the tooth. Where should the tooth be placed 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).

DIF: Cognitive Level: Comprehension REF: Page 508
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

16. The school nurse has been asked to begin teaching sex education in the fifth grade. The nurse should recognize that:
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.

ANS: D
When sexual information is presented to school-age children, sex should be treated as a normal part of growth and development.

DIF: Cognitive Level: Comprehension REF: Page 508
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

17. The school nurse is planning a class on bicycle safety. Which of the following statements, if made by a participant, would indicate 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.”

Page 500 | Page 502

Test Bank 15-7

ANS: D
Children should not ride double.

DIF: Cognitive Level: Application REF:
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:SafeandEffectiveCareEnvironment:Safetyand Infection Control (Injury Prevention)

18. When teaching injury prevention during the school-age years, which of the following 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.

DIF: Cognitive Level: Application REF:
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:SafeandEffectiveCareEnvironment:Safetyand Infection Control (Injury Prevention)