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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.
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What is an important consideration in preventing injuries during middle childhood?
- A. Achieving social acceptance is a primary objective.
- B. The incidence of injuries in girls is significantly higher than it is in boys.
- C. Injuries from burns are the highest at this age because of fascination with fire.
- D. Lack of muscular coordination and control results in an increased incidence of injuries.
Correct Answer: A
Rationale: School-age children often participate in dangerous activities in an attempt to prove themselves worthy of acceptance. The incidence of injury during middle childhood is significantly higher in boys compared with girls. Motor vehicle collisions are the most common cause of severe injuries in children. Children have increasing muscular coordination. Children who are risk takers may have inadequate self-regulatory behavior.
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 do nursing interventions to promote health during middle childhood include?
- A. Stress the need for increased calorie intake to meet increased demands.
- B. Instruct parents to defer questions about sex until the child reaches adolescence.
- C. Advise parents that the child will need increasing amounts of rest toward the end of this period.
- D. Educate parents about the need for good dental hygiene because these are the years in which permanent teeth erupt.
Correct Answer: D
Rationale: The permanent teeth erupt during the school-age years. Good dental hygiene and regular attention to dental caries are vital parts of health supervision during this period. Caloric needs are decreased in relation to body size for this age group. Balanced nutrition is essential to promote growth. Questions about sex should be addressed honestly as the child asks questions. The child usually no longer needs a nap, but most require approximately 11 hours of sleep each night at age 5 years and 9 hours at age 12 years.
A parent asks about whether a 7-year-old child is able to care for a dog. Based on the childs age, what does the nurse suggest?
- A. Caring for an animal requires more maturity than the average 7-year-old possesses.
- B. This will help the parent identify the childs weaknesses.
- C. A dog can help the child develop confidence and emotional health.
- D. Cats are better pets for school-age children.
Correct Answer: C
Rationale: Pets have been observed to influence a childs self-esteem. They can have a positive effect on physical and emotional health and can teach children the importance of nurturing and nonverbal communication. Most 7-year-old children are capable of caring for a pet with supervision. Caring for a pet should be a positive experience. It should not be used to identify weaknesses. The pet chosen does not matter as much as the childs being responsible for a pet.
An 8-year-old girl tells the nurse that she has cancer because God is punishing her for being bad. What should the nurse interpret this as?
- A. A common belief at this age
- B. Indicative of excessive family pressure
- C. Faith that forms the basis for most religions
- D. Suggestive of a failure to develop a conscience
Correct Answer: A
Rationale: Children at this age may view illness or injury as a punishment for a real or imagined misbehavior. School-age children expect to be punished and tend to choose a punishment that they think fits the crime. This is a common belief and not related to excessive family pressure. Many faiths do not include a God that causes cancer in response for bad behavior. This statement reflects the childs belief in what is right and wrong.