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What statement best describes the relationship school-age children have with their families?
- A. Ready to reject parental controls
- B. Desire to spend equal time with family and peers
- C. Need and want restrictions placed on their behavior by the family
- D. Peer group replaces the family as the primary influence in setting standards of behavior and rules
Correct Answer: C
Rationale: School-age children need and want restrictions placed on their behavior, and they are not prepared to cope with all the problems of their expanding environment. Although increased independence is the goal of middle childhood, they feel more secure knowing that an authority figure can implement controls and restriction. In the middle school years, children prefer peer group activities to family activities and want to spend more time in the company of peers. Family values usually take precedence over peer value systems.
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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.
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.
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.
The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize?
- A. Questions need to be discouraged in this setting.
- B. Most children in the fifth grade are too young for sex education.
- C. Sexuality is presented as a normal part of growth and development.
- D. Correct terminology should be reserved for children who are older.
Correct Answer: C
Rationale: When sexual information is presented to school-age children, sex should be treated as a normal part of growth and development. They should be encouraged to ask questions. At 10 to 11 years old, fifth graders are not too young to speak about physiologic changes in their bodies. Preadolescents need precise and concrete information.
The school nurse is discussing after-school sports participation with parents of children age 10 years. The nurses presentation includes which important consideration?
- A. Teams should be gender specific.
- B. Organized sports are not appropriate at this age.
- C. Competition is detrimental to the establishment of a positive self-image.
- D. Sports participation is encouraged if the type of sport is appropriate to the childs abilities.
Correct Answer: D
Rationale: Virtually every child is suited for some type of sport. The child should be matched to the type of sport appropriate to his or her abilities and physical and emotional makeup. At this age, girls and boys have the same basic structure and similar responses to exercise and training. After puberty, teams should be gender specific because of the increased muscle mass in boys. Organized sports help children learn teamwork and skill acquisition. The emphasis should be on playing and learning. Children do enjoy appropriate levels of competition.