Chapter 20: School-Age Child
Edelman: Health Promotion Throughout the Life Span, 9th Edition
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MULTIPLE CHOICE
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1. The school nurse conducting an in-service program for teachers is asked about general growth
and development of school-age children. Which of the following statements would be the best
response by the nurse?
a. “By age 11, blood pressure readings are the same as for
an adult.”
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b. “Because of the rapid growth pattern in this age group, snacks are important to
ensure sufficient caloric intake.”
c. “Children in this age group have some difficulty with coordination and balance, so
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playground supervision is important.”
d. “Overall growth in school-age children is slower than during infancy and
adolescence.”
ANS: D
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Children grow (physically) much more slowly during this time period as compared with
growth during infancy and adolescence. Blood pressure readings for children in this age group
are lower than for adults. Growth slows until adolescence.abirb.com/test
Children in this age group
generally have good coordination and balance.
DIF: Cognitive Level: Apply (Application)
REF: p. 502
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2. According to the American Academy of Pediatrics, at what age should blood pressure
screening begin?
a. 3
b. 6
c. 9
d. 12
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ANS: A
Blood pressure screening should begin at 3 years of age and should be measured annually.
DIF: Cognitive Level: Remember (Knowledge)
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REF: p.
503
3. The school nurse has seen several students in the health office. For which of the following
students should the nurse suggest a follow-up exam?
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a. A 14-year-old girl who has not experienced menarche
b. A 7-year-old boy who has grown 2 inches in a year
c. A 10-year-old girl who has gained 11 pounds in a year
d. An 8-year-old boy who has lost four deciduous teeth inabirb.com/test
the past year
ANS: C
The average age of menarche is between 11 and 15 years of age. School-age children grow
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approximately 2 inches a year, gain between approximately
4.4 to 6.6 pounds a year, and lose
four deciduous teeth a year between ages 6 and 13. A weight gain of 11 pounds in 1 year
requires a follow-up because of the rising rate of obesity in children.
DIF: Cognitive Level: Apply (Application)
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REF: p. 503
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4. The president of the Parent–Teacher Association asks the school nurse about the
appropriateness of sponsoring a health fair that focuses onabirb.com/test
oral health for school-age children.
Which of the following statements indicates the nurse’s correct understanding of this issue?
a. “Dental problems are not as prevalent a problem as asthma, so you might want to
consider a health fair about respiratory problems instead.”
b. “Over 40% of children age 2 to 11 have dental caries, abirb.com/test
so a health fair that focuses
on oral care is very appropriate.”
c. “Children are not usually receptive to learning about dental care, so the topic is not
the best choice for a health fair.”
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d. “This is not an appropriate focus for a health fair because the incidence of dental
caries has dropped dramatically due to the use of sealants.”
ANS: B
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Dental caries are present in up to 42% of children 2 to 11 years of age. Dental caries and other
oral health issues remain a problem in the school-age population. Small gains have been made
in the number of children receiving sealants to prevent caries. Dental caries is the most
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common chronic disease of children 5 to 17 years of age, 4 times more prevalent than asthma.
DIF: Cognitive Level: Apply (Application)
REF: p. 503
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5. Which of the following statements is correct?
a. Tonsils in a school-age child are smaller than in an adult.
b. The nervous system generally matures between ages 11 to 13.
c. Fractures heal more slowly in a 10-year-old child thanabirb.com/test
in an adult.
d. Overweight children have muscle pain more often than average-weight children.
ANS: D
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Overweight children are more likely to suffer bone fractures,
have joint pain and more muscle
pain than their normal weight counterparts. Tonsils, which are lymphoid tissues, are larger in
a child than in an adult. The nervous system matures by ages 7 to 8. Fractures heal more
quickly in children than in adults.
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DIF: Cognitive Level: Understand (Comprehension)
REF: p. 504
a school-age child’s diet?
6. Which of the following elements is most likely deficient inabirb.com/test
a. Protein
b. Sodium
c. Iron
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d. Vitamin B12
ANS: C
The diet of school-age children is frequently deficient in calcium,
iron, and vitamin C, while it
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is high in fat and sodium.
DIF: Cognitive Level: Understand (Comprehension)
REF: p. 506
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7. Which of the following initiatives related to childhood nutrition outlined in Healthy People
2010 was most successful?
a. Reduction of fat consumption
b. Increase in consumption of fruit
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c. Adequate food supplies at home
d. Reducing obesity rates
ANS: C
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The target rate of 94% related to household adequate food supplies was surpassed with up to
98% of households found to be “food secure.” Children continue to eat too many foods high
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in fat, obesity rates are increasing, and consumption of fruit
and vegetables is low.
DIF: Cognitive Level: Understand (Comprehension)
REF: p. 506
8. A school nurse is planning a series on nutrition. Which of abirb.com/test
the following factors should the
nurse take into account?
a. Television commercials frequently advertise food-related products.
b. Children watch approximately 2 h of television a day. abirb.com/test
c. Each day, approximately 60% of children eat fast food.
d. A child is three times more likely to eat in a restaurant than at home.
ANS: A
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Children watch over 3 h of television a day. About one-third of children eat fast food each
day, and parents spend approximately 40% of their food budget for restaurant meals,
including fast food restaurants.
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DIF: Cognitive Level: Apply (Application)
REF: p. 506
9. A nurse is planning activities to help children learn about good
nutritional practices. Which of
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the following strategies should the nurse implement?
a. Coordinate a “Try This” food day offering a variety of nutritious snacks.
b. Find a book about nutrition to read the students.
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c. Plan a video using the concept of MyPlate.
d. Search on-line for a video about nutrition to the students.
ANS: A
Children frequently prepare their own snacks and are moreabirb.com/test
likely to learn from activities that
foster active participation rather than passivity. Choices B, C, and D all involve passive
activities.
DIF: Cognitive Level: Apply (Application)
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REF: p. 506
10. A child who has a BMI of 34 visits the school nurse. Which of the following factors does the
nurse recognize that the child may be experiencing?
a. Increased bullying by peers
b. Increased self-esteem
c. Increased resiliency
d. Increased motivation to lose weight
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ANS: A
Children may not be concerned about being overweight/obese and may therefore not be
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motivated to adopt healthier eating/exercise patterns. They may demonstrate impulsive
behavior and have low self-esteem. Obese children are often ridiculed by peers.
DIF: Cognitive Level: Apply (Application)
REF: p.
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507
11. During a well-child visit, parents report to the nurse that they are concerned that their
8-year-old son has started wetting the bed at night. Which of the following statements should
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the nurse make to the parents?
a. “I’ll be sure to mention this to the doctor; we rarely see a child who wets the bed at
this age.”
b. “There is not much you can do to stop this problem until he gets older.”
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c. “This is a common disease in children his age but there are treatment options.”
d. “I’m going to collect a urine sample from him and then we will talk about bed
wetting.”
ANS: D
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Enuresis should not be considered a disease but a variation of normal development.
Evaluation of these children begins with a urine culture to rule out urinary tract infection. If
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no infection exists or symptoms persist after treatment, then
the intervention is focused on
increasing fluid intake to prevent “holding” and establishing a voiding routine of every 2 h,
with a conscious effort to empty the bladder completely.
DIF: Cognitive Level: Apply (Application)
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REF: p. 508
12. Which of the following children is at risk for developing encopresis?
a. A 6-year-old child who has occasional bed wetting abirb.com/test
b. A 3-year-old child who is not fully toilet-trained
c. A 5-year-old child who has been in four foster care homes since age 3
d. A 4-year old child who passes stool every morning after breakfast
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ANS: C
Another elimination problem that may occur in children is encopresis defined as the persistent
voluntary or involuntary passing of stool into the child’s underpants after age 4. There may be
a history of inconsistent toilet training or early life stress inabirb.com/test
affected children. Encopresis is a
common complication of chronic constipation. In most cases, soiling occurs during the day
when the child is awake and active. Soiling at night is uncommon.
Encopresis is diagnosed after age 4. It occurs most frequently
during the day. Triggers are
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chronic constipation and stress or emotional disturbances. The child who had been placed in
multiple foster homes since age 3 would certainly be a candidate for stress and emotional
problems. Bed wetting is not a risk factor for encopresis.
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DIF: Cognitive Level: Apply (Application)
REF: p. 509
13. A nurse is discussing sleep patterns in school-age children.abirb.com/test
Which of the following should be
stressed by the nurse?
a. Sharing a bed with siblings/parents has a long-lasting psychological impact.
b. School-age children need between 6 and 9 h of sleep a night.
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c. Daytime naps are important in children until they reach
the age of 9 or 10.
d. School-age children generally agree with and adhere to a regular bedtime.
ANS: D
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Research has not demonstrated that sharing a bed with siblings/parents
has a long-lasting
psychological impact on the child. Children sleep between 8 and 12 h per night and do not
need daytime naps. Typically parent and child can come to an agreement bedtime with
reasonable adherence to the regimen.
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DIF: Cognitive Level: Apply (Application)
REF: p. 510
14. Parents of an 8-year-old boy tell the nurse that they are concerned
about their son because he
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occasionally sleepwalks. Which of the following is the best response from the nurse?
a. “Sleepwalking is much more common in girls than boys.”
b. “I am glad you mentioned this. Sleepwalking is sometimes a sign of a neurological
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deficit.”
c. “Nightmares are the cause of most cases of sleepwalking.”
d. “This is not abnormal for a child of this age. He will most likely outgrow this
tendency as his nervous system matures.”
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ANS: D
Sleepwalking occurs more frequently in boys than girls, is most likely caused by an immature
CNS. It is not a sign of neurological deficit and it is not typically
caused by or associated with
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nightmares. As the CNS matures, the sleepwalking issue will resolve.
DIF: Cognitive Level: Apply (Application)
REF: p. 510
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15. During a school gift fair, a parent asks the school nurse what gift would be most appropriate
for her 6-year-old child. Which of the following should the nurse encourage the parent to
purchase?
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a. A box of wooden blocks of various sizes for sorting
b. A jar of sea shells in various shapes, colors, and textures
c. A world map
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d. A beginning encyclopedia of animals
ANS: B
Classifying and ordering sea shells according to color, size, shape, and texture will help the
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child learn about classifying and numbering. These two concepts
are necessary in order to
learn to read and so on. A world map and encyclopedia are not age-appropriate as they require
more cognitive skills than would normally be found with a 6-year-old. Similarly, the wooden
blocks would be more suitable for a younger child. The 6-year-old
would likely be bored with
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that activity.
DIF: Cognitive Level: Apply (Application)
REF: p. 511
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16. The school nurse has written a grant to obtain funding for a vision screening program and
glasses for children in his pre-K to 6th grade elementary school. Which of the following
statements should be included with the rationale for the need
for funding?
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a. Many preschool children are hyperopic and need glasses to prevent headaches.
b. Most states require vision screening on entering school.
c. Vision screening can diagnose vision/eye problems before they become severe.
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d. Approximately one in four children has a vision problem.
ANS: D
Preschool children who are farsighted do not need corrective glasses. Their vision will
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improve as they mature. Approximately 33% of children entering
school have had eye exams.
Vision screening does not diagnose vision problems. Only 1/3 of the states require vision
screening on entering school.
DIF: Cognitive Level: Apply (Application)
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REF: p. 511
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17. Which of the following statements concerning hearing in school-age children is correct?
a. The rate of otitis media infections met Healthy Peopleabirb.com/test
2010 targets.
b. Hearing and visual problems occur with the same frequency.
c. All 50 states require routine hearing evaluations.
d. The use of tympanograms has improved the accuracy of hearing screenings.
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ANS: A
Hearing problems occur with less frequency than do vision problems. Many states, but not all,
require routine hearing evaluations. Tympanograms measure how well the tympanic
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membrane vibrates. It is commonly used to diagnose otitis media. The rate of reduction in
otitis media did, in fact, meet the Healthy People 2010 targets.
DIF: Cognitive Level: Understand (Comprehension)
REF: p.
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512
18. A third grade teacher asks the school nurse what she can reasonably expect from children in
her classroom related to language ability. Which of the following statements would be the best
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response from the nurse?
a. “Children in the second grade should have about a 4000-word vocabulary.”
b. “Research has shown that children will learn to read more quickly if you use the
whole word approach.”
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c. “You can expect that the children will write “b” and “d” without reversing them,
and all of the letters in a word will be about the same size.”
d. “You can evaluate the cognitive ability of the children in your classroom by noting
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how legible their writing is.”
ANS: C
The child will not have a 4000-word vocabulary until about the age of 12. Both the whole
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word approach and the phonics approach will help children
learn to read. The legibility of
handwriting has no correlation to intelligence. The statement found in choice C is correct.
DIF: Cognitive Level: Apply (Application)
REF: p. 512
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19. Each of the following children visits the school nurse on a regular basis. Which of these
children would the nurse identify as being at risk for a learning disability and suggest
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follow-up care?
a. 9-year-old whose parents recently divorced
b. 10-year-old who is inattentive and fidgets constantly
c. 12-year-old with a 4000-word vocabulary
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d. 11-year-old who scored 102 on an IQ test
ANS: B
A 10-year-old who displays hyperactive and/or inattentiveabirb.com/test
behavior should have follow-up
care. Hyperactivity may indicate ADHD, which would require follow-up care and potential
educational difficulty. An environmental deficit such as a divorce may cause school difficulty
for a child, but this does not indicate a learning disability. The average vocabulary for a
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12-year-old is 4000 words. A score of 102 on an IQ test falls
within the average range of 90 to
110.
DIF: Cognitive Level: Apply (Application)
REF: pp. 512, 514, Box 20-4
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20. A parent asks the nurse working in a pediatric clinic how she can help her 6-year-old child
feel good about himself. Which of the following statements should be made by the nurse?
a. “Doing most things for your child will give the child aabirb.com/test
sense of security, and the
child will have a positive self-image.”
b. “Having your child help around the house with tasks such as setting the table will
increase self-esteem.”
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c. “Make sure to highly praise even the smallest effort your child makes at
completing a task.”
d. “There is little you can do to increase your child’s self-esteem. The child’s peers
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have much more of an influence than parents at this age.”
ANS: B
When children succeed at age-specific tasks, they increase their sense of self-worth. Doing
everything for a child prevents him or her from becoming abirb.com/test
proficient at a task. Too much
praise makes positive feedback lose its value and gives the child a false sense of mastery.
Although peers are important, at age 6, parents influence their children more than do peers.
DIF: Cognitive Level: Apply (Application)
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REF: p. 515
21. Which of the following statements made by a parent is most helpful when discussing rules of
the household?
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a. “You did not feed the dog like you promised, so you cannot have ice cream for
dessert.”
b. “I was upset when you did not feed the dog like you promised. We all need to help
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take care of him because he depends on us. Let’s talk about
what happened.”
c. “Why did you forget to feed the dog? Would you like me to forget to feed you?”
d. “What you did was bad. We all need to care for the dog.”
ANS: B
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As children mature, they assume more responsibilities within the family and the community.
School-age children learn responsibility for allowance, household chores, self-care, and pets
and acquire a sense of empowerment as an integral part ofabirb.com/test
the family. Talking calmly, being a
good listener, and encouraging negotiation, perhaps in a family meeting, to promote problem
resolution. When correcting a child, explaining how one feels, the consequence of the action
and then listening to the child discuss the situation is more beneficial than punishment and
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labeling the child as “bad.” An open discussion is likely to be more fruitful than approaches
based on punishment. Choice C is likely to produce a defensive reaction as compared to
choice B.
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DIF: Cognitive Level: Analyze (Analysis)
REF: p. 516
22. A nurse has recently accepted a position as a school nurse at a middle school and plans to
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offer sex education to the students and parents. Which of the
following statements is NOT
correct concerning how the nurse should implement this program?
a. Offer gender-segregated sex education classes.
b. Education on sexually transmitted diseases is not advised
until high school.
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c. Determine how this education has been provided in the past, as a first step.
d. Survey parents to determine their desire for this education to be provided.
ANS: B
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Children at this age appear to respond most favorably with gender-segregated classes, based
on their general discomfort with sexual topics and unique needs and questions. Some schools
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appropriately incorporate these classes into school curricula
as part of a health-promotion
curriculum. Other schools have special programs focused only on sex education based on
parental desires or school board policies. Most school-age children have the cognitive skills to
respond to programs on responsible sexuality, including discussions on abstinence and
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condom use, pregnancy, sexually transmitted diseases, and the human immunodeficiency
virus. Given the various approaches to content, i.e., school-determined content vs
parental-driven content, determining how education in the past has been provided is a good
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first step. There is no evidence to support limiting education
on STDs to only HS students. Per
the text, school-aged children have sufficient cognitive skills to learn about this topic.
DIF: Cognitive Level: Apply (Application)
REF: p. 517
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23. The school nurse has been asked to conduct a community awareness program about accidents
that impact the school-age child. Which of the following facts should be included in the
program?
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a. Poisonings and falls are the leading causes of death.
b. Drowning and motor vehicle accidents are the leading causes of fatality.
c. The majority of accidents happen inside the home.
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d. Burn accidents are more common in the summer months.
ANS: B
Most fatal accidents during the school-age period derive from motor vehicle accidents when
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the child (host) is a passenger or pedestrian (walking or riding
a bike). Other fatal accidents
occur from fires and burns, bicycles, drowning, and firearm accidents. Accidents are the
leading cause of death in children over 12 months of age. The majority of accidents occur
outdoors. Burn accidents are more common in the winter, abirb.com/test
especially in lower socioeconomic
families where the use of space heaters is common.
DIF: Cognitive Level: Apply (Application)
REF: p. 520
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24. Which of the following statements is correct regarding firearms?
a. As with video games, toy guns has been shown to increase violence later in life.
b. For safety, guns should be stored apart from ammunition.
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c. The second amendment exempts hand guns.
d. All of the above statements are correct.
ANS: B
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Storing firearms in a locked cabinet apart from ammunition is a recommended strategy for
gun safety. Toy guns do not result in an increase in violence or aggression later in life
although video games have been shown to do so. The second amendment has no exemption
for handguns. They are covered along with other firearms abirb.com/test
as a fundamental right for citizens
of the United States.
DIF: Cognitive Level: Apply (Application)
REF: pp. 521, 522
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25. A school nurse is caring for a child with an upper respiratory tract infection. Which of the
following nursing interventions should the nurse implement?
a. Send the child with a mild sore throat back to class. abirb.com/test
b. Advise the parent of a child with a group A strep throat infection that they cannot
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return to school for 5 days.
c. Educate the parent that treatment of group A strep infections usually requires extra
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fluid intake.
d. Ask the parent of a child with a mild fever and mild sore throat to take the child to
his or her health care provider.
ANS: D
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Untreated strep throat caused by group A bacteria can result in serious complications. Signs
and symptoms may include a mild sore throat. After 24 h on antibiotics, the child can return to
school. Thus, the parents of a child with a mild fever and mild sore throat should be evaluated
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by his or her health care provider.
DIF: Cognitive Level: Apply (Application)
REF: p. 523
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26. Which of the following statements about smoking is true?
a. Black children begin smoking at an earlier age than do White children.
b. Almost 90% of schools prohibit tobacco use in all locations.
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c. Each day over 6000 children try smoking.
d. Tobacco use prevention programs should be initiated in eighth grade.
ANS: C
Every day, more than 6000 school students try to smoke aabirb.com/test
cigarette. Most students who smoke
initiate their habit around 11 years of age. White children begin smoking at an earlier age than
do Black children. Approximately 64% of schools are smoke free. Tobacco use prevention
programs should begin in elementary school.
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DIF: Cognitive Level: Understand (Comprehension)
REF: p. 524
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27. A child’s parents ask the school nurse if there is any help available
to help their child receive
health insurance. They state they earn too much money to qualify for Medicaid but not
enough to purchase health insurance. Which of the following recommendations should the
nurse provide?
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a. “Currently, there is no health care program available for your child.”
b. “The school district has a health insurance policy that you can access.”
c. “The state has an insurance program to assist you.”
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d. “You will need to find coverage through another member
of your family.”
ANS: C
The State Children’s Health Insurance Program was created to assist parents in this economic
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category. This program supports comprehensive care to children
0 to 18 years who do not
meet Medicaid criteria but live in families too poor to afford private insurance.
DIF: Cognitive Level: Apply (Application)
REF: p. 528
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28. Which of the following statements is correct concerning vaccinations for the school-aged
child?
a. The first of two HPV vaccines is given at age 10; the second
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given during high
school.
b. Tetanus booster every 5 years or when an unclean wound is acquired.
c. Meningococcal vaccine at age 11 to 12
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d. All of the above statements are correct.
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ANS: C
Most states require that the child’s immunizations be current before entering kindergarten or
the first grade and that additional tetanus immunization beabirb.com/test
given every 10 years or when an
unclean wound is acquired. Other immunizations recommended by the American Academy of
Pediatrics include a meningococcal vaccination at age 11 or 12 years and the series of three
injections for hepatitis B and human papilloma virus (HPV) during the late school-age and
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early adolescent years
DIF: Cognitive Level: Apply (Application)
REF: p. 523
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29. During a parent–nurse conference, the parent tells the nurse that her child sleeps
approximately 7 h per night. Which of the following potential health problems would be of
concern to the nurse?
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a. Hypertension
b. Hyperactivity
c. Obesity
d. Type 2 diabetes
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ANS: C
Based on the study by Lumeng and colleagues, children who do not get adequate sleep tend to
be less active, which promotes overweight/obesity.
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DIF: Cognitive Level: Analyze (Analysis)
MULTIPLE RESPONSE
REF: p. 508, Box 20-2
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1. Which of the following children should the school nurse monitor closely for hypertension
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(HTN)? (Select all that apply.)
a. 7-year-old White male with no known family history of HTN
b. 9-year-old White female whose 20 year old brother has HTN
c. 6-year-old Black child with no family history of HTN
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d. 10-year-old Mexican American child with known family history of HTN
ANS: B, C, D
A White child with no family history of HTN can receive routine monitoring. The other
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children are in the high-risk category for HTN because of race, ethnicity, or family history.
DIF: Cognitive Level: Apply (Application)
REF: p. 503
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2. A nurse is planning a flu prevention fair for 9- to 11-year-old children. Which of the following
activities should be included? (Select all that apply.)
a. Microscopes set up to show bacteria on common objects
b. Games such as “find the germs” in a cartoon picture abirb.com/test
c. Research poster showing germ transmission
d. Handwashing booth with colored soap
ANS: A, B, D
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Most school-age children perceive symptoms and show an ability to participate in
health-promoting behaviors. Health-promoting behaviors taught at school and home must
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meet the school-age child’s cognitive level (concrete operation)
and moral level (external
rules and forces) to be effective. Teaching strategies using cognitive, psychomotor, and
affective senses can help children learn responsibility for their own health (Shroff, 2015). This
knowledge provides an excellent foundation for health-promotion behaviors during the school
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years.
Age-appropriate interactive activities such as games and demonstrations are effective teaching
strategies. Formal research poster presentations are not appropriate for this age group. This
approach would be more suitable for persons at the youngabirb.com/test
adults or older stage of life.
DIF: Cognitive Level: Apply (Application)
REF: p. 504
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3. The school nurse has been asked to plan play and recess activities
for children in grades 2
through 6. Which of the following activities should be developed by the nurse? (Select all that
apply.)
a. Highly competitive games that focus on individual accomplishment
and winning
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b. Family activity days that promote nature walks and biking
c. Co-ed organized sports
d. 4-H club activities
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ANS: B, D
This desire for peer interaction, usually with one of the same gender, extends beyond school
and carries over to play and outside activities. Organized sports such as baseball teach team
cooperation, competition, and other social skills. Concernsabirb.com/test
exist that young children have
experienced too much physical and psychological pressure to perform in sports. This has
generated a renewed commitment by many parents to focus more on the fun of sports than on
the winning of games. Scouts and 4-H clubs teach childrenabirb.com/test
about group functioning, processes
involved in carrying out a task, and the power of social relationships to create change.
Emphasis should move away from highly competitive activities that promote more of a
feeling of superiority than team work to reach a goal. Family activity days and participation in
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4H clubs are excellent activities to promote healthy interaction with others. Children in this
age group generally prefer to play with children of the same sex.
DIF: Cognitive Level: Apply (Application)
REF: p.
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509
4. Which of the following children may have difficulty with Erikson’s “industry versus
inferiority” stage of development? (Select all that apply.)
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a. Poor motor skills and is rarely chosen for team play during
recess
b. Difficulty with math homework
c. Difficulty making friends
d. Cannot speak his or her native language fluently
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ANS: A, C, D
The “industry versus inferiority” stage of development as described by Erikson is mastered
when the child has a sense of accomplishment, rather thanabirb.com/test
an inability to perform at the
expected level. Children with poor motor skills who are not selected by their peers for a team,
those who find it difficult to make new friends, and those who have difficulty assimilating
into their dominant culture all are likely to have a sense of inferiority. The fact that a child is
having difficulty with math homework may not be noticedabirb.com/test
by his/her peer group.
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DIF: Cognitive Level: Apply (Application)
REF: p. 514
5. The school nurse is evaluating children for signs and symptoms
of depression. Which of the
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following children may be most at risk for depression? (Select all that apply.)
a. 11-year-old girl who has been involved in fighting during the past month
b. 10-year-old boy who no longer wants to play on the school’s soccer team
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c. 12-year-old boy who has started lifting weights
d. 9-year-old girl who visits the nurse on a daily basis for vague complaints
ANS: A, B, D
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Symptoms of depression in school-age children include anorexia,
sleeplessness, lethargy,
changed affect, aggressive behavior, frequent crying, or withdrawal from previously enjoyed
activities.
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DIF: Cognitive Level: Analyze (Analysis)
REF: p. 519
6. Which of the following is responsible for ensuring that children are up-to-date on their
immunizations? (Select all that apply.)
a. School nurse
b. Parent or caregiver
c. Teacher
d. School principal
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ANS: A, B
In many states, the school nurse has a responsibility to ensure
that all students’ immunizations
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are current, and if they are not current, the nurse informs the parents that the children may not
attend school until their immunizations are up to date.
The parent or caregiver bears the major responsibility for ensuring that their child has had all
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of the required immunizations; however, it is also the school
nurse’s responsibility to ensure
that the immunizations are current.
DIF: Cognitive Level: Understand (Comprehension)
REF: p. 524
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7. A nurse is conducting a school-wide in-service program about child abuse and is asked to
describe common indicators of abuse. Which of the following signs would the nurse include?
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(Select all that apply.)
a. Caregivers and parents who are reluctant to take the child for treatment for an
injury
b. Statement by the day care provider that the child was injured by falling off a chair
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c. Explanation of the injury from the child and caregiver or parent that is similar
d. Lack of emotional response from child to a playground injury
ANS: A, B, D
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Signs of abuse may include physical evidence, conflicting stories about the “accident” or
injury from parents or others or an injury or complaint inconsistent with the child’s history or
developmental level. Also suggestive of abuse are inappropriate response of the caregiver or
child, the child’s report of abuse, previous reports of abuseabirb.com/test
in the family, or repeated visits to
emergency facilities with injuries. An inappropriate response such as little or no response to
pain is a red flag. Accordingly, the lack of expected response from the child with the
playground injury is a red flag. Similarly, falling off a chair
is a red flag as this sort of event
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might be expected of a toddler but not a school-aged child.
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DIF: Cognitive Level: Apply (Application)
REF: p. 517, Box 20-7
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