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The school nurse needs to obtain authorization for a child who requires medications while at school. From whom does the nurse obtain the authorization?
- A. The parents
- B. The pharmacist
- C. The school administrator
- D. The prescribing practitioner
Correct Answer: A
Rationale: A child who requires medication during the school day requires written authorization from the parent or guardian. Most schools also require that the medication be in the original container appropriately labeled by the pharmacist or physician. Some schools allow children to receive over-the-counter medications with parental permission. The pharmacist may be asked to appropriately label the medication for use at the school, but authorization is not required. The school administration should have a policy in place that facilitates the administration of medications for children who need them. The prescribing practitioner is responsible for ensuring that the medication is appropriate for the child. Because the child is a minor, parental consent is required.
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When teaching injury prevention during the school-age years, what should the nurse include?
- A. Teach children about the need to fear strangers.
- B. Teach basic rules of water safety.
- C. Avoid letting children cook in microwave ovens.
- D. Caution children against engaging in competitive sports.
Correct Answer: B
Rationale: Water safety instruction is an important component 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 sufficient water depth for diving, and use an approved flotation device. Teach stranger safety, not fear of strangers. This includes telling the child not to go with strangers, not to wear personalized clothing in public places, to tell parents if anyone makes child feel uncomfortable, and to say no in uncomfortable situations. Teach the child safe cooking. Caution against engaging in dangerous sports such as jumping on trampolines.
What is descriptive of the social development of school-age children?
- A. Identification with peers is minimum.
- B. Children frequently have best friends.
- C. Boys and girls play equally with each other.
- D. Peer approval is not yet an influence for the child to conform.
Correct Answer: B
Rationale: Identification with peers is a strong influence in childrens gaining independence from parents. Interaction among peers leads to the formation of close friendships with same-sex peersbest friends. Daily relationships with age mates in the school setting provide important social interactions for school-age children. During the later school years, groups are composed predominantly of children of the same sex. Conforming to the rules of the peer group provides children with a sense of security and relieves them of the responsibility of making decisions.
A school-age child has begun to sleepwalk. What does the nurse advise the parents to perform?
- A. Wake the child and help determine what is wrong.
- B. Leave the child alone unless he or she is in danger of harming him- or herself or others.
- C. Arrange for psychologic evaluation to identify the cause of stress.
- D. Keep the child awake later in the evening to ensure sufficient tiredness for a full night of sleep.
Correct Answer: B
Rationale: Sleepwalking is usually self-limiting and requires no treatment. The child usually moves about restlessly and then returns to bed. Usually the actions are repetitive and clumsy. The child should not be awakened unless in danger. If there is a need to awaken the child, it should be done by calling the childs name to gradually bring to a state of alertness. Some children, who are usually well behaved and tend to repress feelings, may sleepwalk because of strong emotions. These children usually respond to relaxation techniques before bedtime. If a child is overly fatigued, sleepwalking can increase.
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?
- A. Signs of stress
- B. Developmental delay
- C. Lack of adjustment to school environment
- D. Physical problem that needs medical intervention
Correct Answer: A
Rationale: 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 earlier behaviors. The child is completing school work satisfactorily; any developmental delay would have been diagnosed earlier. The teacher reports that this is a departure from the childs normal behavior. Adjustment issues would most likely be evident soon after a change. Medical intervention is not immediately required. Recognizing that this constellation of symptoms can indicate stress, the nurse should help the child identify sources of stress and how to use stress reduction techniques. The parents are involved in the evaluation process.
What is descriptive of the play of school-age children?
- A. They like to invent games, making up the rules as they go.
- B. Individuality in play is better tolerated than at earlier ages.
- C. Knowing the rules of a game gives an important sense of belonging.
- D. Team play helps children learn the universal importance of competition and winning.
Correct Answer: C
Rationale: 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 but not in all cultures.