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Chapter 8: Health Promotion for the School-Age Child
Terms in this set (27)
Which statement made by a mother of a school-age boy indicates a need for further
a. "My child is playing soccer this year."
b. "He is always busy with his friends playing games. He is very active."
c. "I limit his television watching to about 2 hours a day."
d. "I am glad his coach is a good role model. He emphasizes the importance of
winning in today's society. The kids really are disciplined."
A Team sports such as soccer are appropriate for exercise and refinement of motor
B School-age children need to participate in physical activities, which contribute to
their physical fitness skills and well-being.
C Limiting television to 2 hours a day is an appropriate restriction. School-age
children should be encouraged to participate in physical activities.
D Team sports are important for the development of sportsmanship and teamwork
and for exercise and refinement of motor skills. A coach who emphasizes
winning and strict discipline is not appropriate for children in this age-group.
Which behavior is not demonstrated in the 8-year-old child?
a. Understands that his or her point of view is not the only one
b. Enjoys telling riddles and silly jokes
c. Understands that pouring liquid from a small to large container does not change
d. Engages in fantasy and magical thinking
A School-age children enter the stage of concrete operations. They learn that their
point of view is not the only one.
B The school-age child has a sense of humor. The child's increased language
mastery and increased logic allow for appreciation of plays on words, jokes, and
C The school-age child understands that properties of objects do not change when
their order, form, or appearance does.
D The preschool-age child engages in fantasy and magical thinking. The school-age
child moves away from this type of thinking and becomes more skeptical and
logical. Belief in Santa Claus or the Easter Bunny ends in this period of
The ability to mentally understand that 1 + 3 = 4 and 4 - 1 = 3 occurs in which stage of
a. Concrete operations
b. Formal operations
c. Intuitive thought
A By 7 to 8 years of age, the child is able to retrace a process (reversibility) and has
the skills necessary for solving mathematical problems. This stage is called
B The formal operations stage deals with abstract reasoning and does not occur
C Thinking in the intuitive stage is based on immediate perceptions. A child in this
stage often solves problems by random guessing.
D In preoperational thinking, the child is usually able to add 1 + 3 = 4 but is unable
to retrace the process.
Which activity is most appropriate for developing fine motor skills in the school-age child?
A Activities such as drawing, building models, and playing a musical instrument
increase the school-age child's fine motor skills.
B Singing is an appropriate activity for the school-age child, but it does not
increase fine motor skills.
C The school-age child needs to participate in group activities to increase both
gross motor skills and social skills, but group activities do not increase fine
D Swimming is an activity that also increases gross motor skills.
A school nurse is teaching a health class for 5th grade children. The nurse plans to include
which statement to best describe growth in the early school-age period?
a. Boys grow faster than girls.
b. Puberty occurs earlier in boys than in girls.
c. Puberty occurs at the same age for all races and ethnicities.
d. It is a period of rapid physical growth.
A During the school-age developmental period, boys are approximately 1 inch
taller and 2 pounds heavier than girls.
B Puberty occurs 1 1/2 to 2 years later in boys, which is developmentally later than
puberty in girls (not unusual in 9- or 10-year-old girls).
C Puberty occurs approximately 1 year earlier in African-American girls than in
D Physical growth is slow and steady during the school-age years.
Which comment is most developmentally typical of a 7-year-old boy?
a. "I am a Power Ranger, so don't make me angry."
b. "I don't know whether I like Mary or Joan better."
c. "My mom is my favorite person in the world."
d. "Jimmy is my best friend."
A Magical thinking is developmentally appropriate for the preschooler.
B Opposite-sex friendships are not typical for the 7-year-old child.
C Seven-year-old children socialize with their peers, not their parents.
D School-age children form friendships with peers of the same sex, those who live
nearby, and other children who have toys that they enjoy.
A school nurse is conducting a class on safety for a group of school-age children. Which
statement indicates that the children may need further teaching?
a. "My sister and I know two different ways to get out of the house."
b. "I can dial 911 if there is a fire or a burglar in the house."
c. "My mother has told us that if we have a fire, we have to meet at the neighbor's
d. "If there is a fire I will have to go back in for my cat Fluffy because she will be
A All children should know two different escape routes from the house, in case one
B It is important for children to be taught how to call 911 in an emergency.
C All families should have a predetermined meeting place away from the house.
D Children should be taught never to return to a burning house, not even for a pet.
Which statement is the most accurate about moral development in the 9-year-old
a. Right and wrong are based on physical consequences of behavior.
b. The child obeys parents because of fear of punishment.
c. The school-age child conforms to rules to please others.
d. Parents are the determiners of right and wrong for the school-age child.
A Children 4 to 7 years of age base right and wrong on consequences.
B Consequences are the most important consideration for the child between 4 and 7
years of age.
C The 7- to 12-year-old child bases right and wrong on a good-boy or good-girl
orientation in which the child conforms to rules to please others and avoid
D Parents determine right and wrong for the child younger than 4 years of age.
In providing anticipatory guidance to parents, which parental behavior is the most
important in fostering moral development?
a. Telling the child what is right and wrong
b. Vigilantly monitoring the child and her peers
c. Weekly family meetings to discuss behavior
d. Living as the parents say they believe
A Telling the child what is right and wrong is not effective unless the child has
experienced what she hears. Parents need to live according to the values they are
teaching to their children.
B Vigilant monitoring of the child and her peers is an inappropriate action for the
parent to initiate. It does not foster moral development and reasoning in the
C Weekly family meetings to discuss behaviors may or may not be helpful in the
development of moral reasoning.
D Parents living what they believe gives nonambivalent messages and fosters the
child's moral development and reasoning.
Which behavior by parents or teachers will best assist the child in negotiating the
developmental task of industry?
a. Identifying failures immediately and asking the child's peers for feedback
b. Structuring the environment so that the child can master tasks
c. Completing homework for children who are having difficulty in completing
d. Decreasing expectations to eliminate potential failures
A Asking peers for feedback reinforces the child's feelings of failure.
B The task of the caring teacher or parent is to identify areas in which a child is
competent and to build on successful experiences to foster feelings of mastery
and success. Structuring the environment to enhance self-confidence and to
provide the opportunity to solve increasingly more complex problems will
promote a sense of mastery.
C When teachers or parents complete children's homework for them, it sends the
message that you do not trust them to do a good job. Providing assistance and
suggestions and praising their best efforts are more appropriate.
D Decreasing expectations to eliminate failures will not promote a sense of
achievement or mastery.
A nurse is assessing an older school-age child recently admitted to the hospital. Which
assessment indicates that the child is in an appropriate stage of cognitive development?
a. The child's addition and subtraction ability
b. The child's ability to classify
c. The child's vocabulary
d. The child's play activity
A Subtraction and addition are appropriate cognitive activities for the young
B The ability to classify things from simple to complex and the ability to identify
differences and similarities are cognitive skills of the older school-age child; this
demonstrates use of classification and logical thought processes.
C Vocabulary is not as valid an assessment of cognitive ability as is the child's
ability to classify.
D Play activity is not as valid an assessment of cognitive function as is the child's
ability to classify.
Which is an appropriate disciplinary intervention for the school-age child?
a. Using time-out periods
b. Using a consequence that is consistent with the inappropriate behavior
c. Using physical punishment
d. Using lengthy dialog about inappropriate behavior
A Time-out periods are more appropriate for younger children.
B A consequence that is related to the inappropriate behavior is the recommended
C Physical intervention is an inappropriate form of discipline. It does not connect
the discipline with the child's inappropriate behavior.
D Lengthy discussions typically are not helpful.
In general, the earliest age at which puberty begins is ____ years in girls and _____ years
a. 13; 13
b. 11; 11
c. 10; 12
d. 12; 10
A Girls and boys do not usually begin puberty at the same age; girls usually begin
earlier than boys.
B Girls and boys do not usually begin puberty at the same age; girls usually begin
earlier than boys.
C Puberty signals the beginning of the development of secondary sex
characteristics. This begins in girls earlier than in boys. Usually, there is a 2-year
difference in the age at onset.
D Girls and boys do not usually begin puberty at the same age; girls usually begin
earlier than boys.
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
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
A Children at this age may view illness or injury as a punishment for a real or
B The belief in divine punishment is common at this age.
C The belief in divine punishment is common at this age.
D The belief in divine punishment is common at this age.
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
a. Behavior that encourages bullying and sexism
b. Behavior that reinforces poor peer relationships
c. Characteristic of social development of this age
d. Characteristic of children who later are at risk for membership in gangs
A 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
B 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
C One of the outstanding characteristics of middle childhood is the creation of
formalized groups or clubs.
D A boys-only club does not have a direct correlation with later gang activity.
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 she has been
somewhat aggressive and stubborn in the classroom. The school nurse should recognize
a. Signs of stress
b. Developmental delay
c. Physical problem causing emotional stress
d. Lack of adjustment to school environment
A Signs of stress include stomach pains or headache, sleep problems, bedwetting,
changes in eating habits, aggressive or stubborn behavior, reluctance to
participate, or regression to early behaviors.
B This child is exhibiting signs of stress.
C This child is exhibiting signs of stress.
D This child is exhibiting signs of stress.
The school nurse has been asked to begin teaching sex education in the 5th grade. The
nurse should recognize that
a. Children in 5th 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.
A Fifth graders are usually 10 to 11 years old. This age is not too young to speak
about physiologic changes in their bodies.
B They should be encouraged to ask questions.
C Preadolescents need precise and concrete information.
D When sexual information is presented to school-age children, sex should be
treated as a normal part of growth and development.
An important consideration for the school nurse who is planning a class on bicycle safety
a. Most bicycle injuries involve collision with an automobile.
b. Head injuries are the major causes of bicycle-related fatalities.
c. Children should wear bicycle helmets if they ride on paved streets.
d. Children should not ride double unless the bicycle has an extra-large seat.
A Although motor vehicle collisions do cause injuries to bicyclists, most injuries
result from falls.
B 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.
C The child should always wear a properly fitted helmet approved by the U.S.
Consumer Product Safety Commission.
D Children should not ride double.
Which demonstrates the school-age child's developing logic in the stage of concrete
operations? Select all that apply.
a. The school-age child is able to recognize that 1 lb of feathers is equal to 1 lb of
b. The school-age child is able to recognize that he can be a son, brother, or nephew
at the same time.
c. The school-age child understands the principles of adding, subtracting, and
d. The school-age child has thinking that is characterized by egocentrism, animism,
ANS: A, B, C
Correct The school-age child understands that the properties of objects do not
change when their order, form, or appearance does. Conservation occurs in
the concrete operations stage. Comprehension of class inclusion occurs as
the school-age child's logic increases. The child begins to understand that
a person can be in more than one class at the same time. This is
characteristic of concrete thinking and logical reasoning. The school-age
child is able to understand principles of adding and subtracting, as well as
the process of reversibility, which occurs in the stage of concrete
Incorrect This type of thinking occurs in the intuitive thought stage, not the concrete
operations stage of development.
Which interventions are appropriate for preventing childhood obesity? Select all that
a. Establish consistent times for meals and snacks.
b. Eliminate all snacks. Eat three nutritious meals a day.
c. Teach the family and child how to select foods and prepare foods.
d. Encourage schools to provide snack machines with popcorn, cookies, and diet
e. Limit computer and television time.
ANS: A, C, E
Correct Preventing obesity includes encouraging families to establish consistent
times for meals and snacks and discouraging between-meal eating. Parents
and children also need to be taught how to select and prepare healthful
foods. Because snacks are an important aspect in childhood nutrition,
nutritious snacks should be identified. School-age children usually require
a healthful snack after school and in the evening. A child who spends time
with social media has less interest in physical activity and going outdoors.
Incorrect Snacks are an important aspect in childhood nutrition. Nutritious snacks
should be identified, not eliminated. Healthy snack options include fruit,
popcorn, nuts, and yogurt, not cookies and diet soda. In schools with snack
machines, children may use their lunch money to purchase high-calorie
snacks versus a nutritious lunch.
Which strategies can a nurse teach to parents of a child experiencing uncomplicated school
refusal? Select all that apply.
a. The child should be allowed to stay home until the anxiety about going to school
b. Parents should be empathetic yet firm in their insistence that the child attends
c. A modified school attendance may be necessary.
d. Parents need to pick the child up at school whenever the child wants to come
e. Parents need to communicate with the teachers about the situation.
ANS: B, C, E
Correct In uncomplicated cases of school refusal, the parent needs to return the
child to school as soon as possible. If symptoms are severe, a limited
period of part-time or modified school attendance may be necessary. For
example, part of the day may be spent in the counselor's or school nurse's
office, with assignments obtained from the teacher. Parents should be
empathetic yet firm and consistent in their insistence that the child attend
Incorrect Parents should not pick the child up at school once the child is there. The
principal and teacher should be told about the situation so that they can
cooperate with the treatment plan.
Peer victimization is becoming a significant problem for school-age children and
adolescents in the United States. Parents should be educated regarding signs that a child is
being bullied. These might include (select all that apply)
a. The child spends an inordinate amount of time in the nurse's office.
b. Belongings frequently go missing or are damaged.
c. The child wants to be driven to school.
d. School performance improves.
e. The child freely talks about his day.
ANS: A, B, C
Correct Signs that may indicate a child is being bullied are similar to signs of other
types of stress and include nonspecific illness or complaints, withdrawal,
depression, school refusal, and decreased school performance. Children
express fear of going to school or riding the school bus. Very often,
children will not talk about what is happening to them.
Incorrect These are not indications of bullying.
____________________ is the leading cause of death in children of every age-group
beyond 1 year of age.
ANS: Unintentional injury
Children have a total of __________ primary (deciduous) teeth that they begin to lose
when they are school age.
Primary (deciduous) teeth are replaced by permanent teeth. By adulthood the child will
have __________ permanent teeth.
A nurse is planning a class for school-age children on obesity. Which percentile does the
body mass index (BMI) need to exceed for a child to be assessed as obese?
When intake of food exceeds expenditure, the excess is stored as fat. Obesity is an
excessive accumulation of fat in the body and is assessed in children as a BMI that exceeds
the 95th percentile for age.
The number of hours spent sleeping decreases as the child grows older. Children ages 6
and 7 years require approximately 9 or 10 hours of sleep per night. Is this statement true or
Children ages 6 and 7 actually need approximately 12 hours of sleep per night. Some
children also continue to need an afternoon nap or quiet time to restore energy levels. The
12-year-old needs approximately 9 to 10 hours of sleep at night. Adequate sleep is
important for school performance and physical growth. Inadequate sleep can cause
irritability, inability to concentrate, and poor school performance.
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