1. Priority Question
The nurse evaluates four school-age children during a health screening.
Which child should the nurse assess first?
A. A 6-year-old who recently lost the first primary tooth
B. A 9-year-old who reports repeated online threats and says, “I do not want
to be alive anymore”
C. A 10-year-old girl who has begun developing breast tissue
D. A 7-year-old who prefers playing with children of the same sex
Correct answer: B
Rationale: The child’s statement suggests suicidal ideation associated with
cyberbullying and requires immediate safety and suicide-risk assessment.
Losing primary teeth, beginning pubertal changes after age 8, and
preferring same-sex peers are expected findings.
2. Correct Understanding
The nurse teaches parents about expected school-age growth. Which parent
statement demonstrates correct understanding?
A. “My child should gain approximately 2 to 3 kilograms each year.”
B. “My child should grow approximately 5 inches each year.”
C. “My child’s weight should remain unchanged until puberty.”
D. “My child should grow at the same rapid rate as during infancy.”
Correct answer: A
Rationale: School-age children generally grow approximately 2 inches and
gain 4.4 to 6.6 pounds each year. Growth is slow and steady until the
prepubertal growth spurt.
3. Select All That Apply
Which physical changes are expected during the school-age years? Select
all that apply.
A. Increasing leg length in relation to height
B. Gradual loss of primary teeth
C. Increasing muscle mass
D. Decreasing heart and respiratory rates
,E. Gradual increase in blood pressure
F. Rapid enlargement of the skull and brain
Correct answers: A, B, C, D, E
Rationale: School-age children develop longer legs, increased muscle
tissue, permanent teeth, lower heart and respiratory rates, and gradually
higher blood pressure. Skull and brain growth slows considerably during
this period.
4. Need for Further Teaching
Which parent statement about physical maturity indicates a need for further
teaching?
A. “My child’s appearance may not match emotional maturity.”
B. “I should base expectations on my child’s developmental age.”
C. “Because my 7-year-old looks 10, I will expect behavior typical of a 10-
year-old.”
D. “Children who mature early may feel uncomfortable about being
different.”
Correct answer: C
Rationale: Physical size does not determine cognitive, emotional, or social
maturity. Unrealistic expectations can harm competence and self-esteem.
5. Priority Question
A school nurse evaluates a 9-year-old athlete who reports severe shoulder
pain after repetitive pitching. Which action should the nurse take first?
A. Encourage the child to continue pitching to strengthen the muscles.
B. Remove the child from activity and assess the injury.
C. Apply heat and return the child to the game.
D. Tell the child that muscle pain is expected during growth.
Correct answer: B
Rationale: School-age muscles and bones remain immature and are
susceptible to overuse injuries. The child should stop the activity and
receive an assessment before returning to play.
, 6. Correct Understanding
Which parent statement demonstrates correct understanding of backpack
safety?
A. “My child should carry the backpack over one shoulder.”
B. “A correctly worn backpack distributes weight more evenly.”
C. “A heavy backpack helps build back muscles.”
D. “My child should carry most books in one hand.”
Correct answer: B
Rationale: A properly fitted backpack worn over both shoulders distributes
weight more evenly. Heavy or uneven loads can strain immature muscles
and bones.
7. Select All That Apply
Which findings are expected during prepubescence? Select all that apply.
A. Girls may begin visible pubertal changes before boys.
B. Considerable variation exists in the timing of physical maturation.
C. Early or late development may cause embarrassment.
D. Puberty may normally begin after age 8.
E. Physical maturity indicates equal emotional maturity.
F. Girls may temporarily surpass boys in height and weight.
Correct answers: A, B, C, D, F
Rationale: Girls commonly begin puberty earlier than boys, and there is
wide variation in onset. Differences may cause self-consciousness. Physical
maturity does not establish emotional maturity.
8. Need for Further Teaching
The parent of a 10-year-old girl discusses pubertal development. Which
statement indicates a need for further teaching?
A. “I will prepare my child for body changes before they occur.”
B. “Differences in maturation among classmates can be expected.”
The nurse evaluates four school-age children during a health screening.
Which child should the nurse assess first?
A. A 6-year-old who recently lost the first primary tooth
B. A 9-year-old who reports repeated online threats and says, “I do not want
to be alive anymore”
C. A 10-year-old girl who has begun developing breast tissue
D. A 7-year-old who prefers playing with children of the same sex
Correct answer: B
Rationale: The child’s statement suggests suicidal ideation associated with
cyberbullying and requires immediate safety and suicide-risk assessment.
Losing primary teeth, beginning pubertal changes after age 8, and
preferring same-sex peers are expected findings.
2. Correct Understanding
The nurse teaches parents about expected school-age growth. Which parent
statement demonstrates correct understanding?
A. “My child should gain approximately 2 to 3 kilograms each year.”
B. “My child should grow approximately 5 inches each year.”
C. “My child’s weight should remain unchanged until puberty.”
D. “My child should grow at the same rapid rate as during infancy.”
Correct answer: A
Rationale: School-age children generally grow approximately 2 inches and
gain 4.4 to 6.6 pounds each year. Growth is slow and steady until the
prepubertal growth spurt.
3. Select All That Apply
Which physical changes are expected during the school-age years? Select
all that apply.
A. Increasing leg length in relation to height
B. Gradual loss of primary teeth
C. Increasing muscle mass
D. Decreasing heart and respiratory rates
,E. Gradual increase in blood pressure
F. Rapid enlargement of the skull and brain
Correct answers: A, B, C, D, E
Rationale: School-age children develop longer legs, increased muscle
tissue, permanent teeth, lower heart and respiratory rates, and gradually
higher blood pressure. Skull and brain growth slows considerably during
this period.
4. Need for Further Teaching
Which parent statement about physical maturity indicates a need for further
teaching?
A. “My child’s appearance may not match emotional maturity.”
B. “I should base expectations on my child’s developmental age.”
C. “Because my 7-year-old looks 10, I will expect behavior typical of a 10-
year-old.”
D. “Children who mature early may feel uncomfortable about being
different.”
Correct answer: C
Rationale: Physical size does not determine cognitive, emotional, or social
maturity. Unrealistic expectations can harm competence and self-esteem.
5. Priority Question
A school nurse evaluates a 9-year-old athlete who reports severe shoulder
pain after repetitive pitching. Which action should the nurse take first?
A. Encourage the child to continue pitching to strengthen the muscles.
B. Remove the child from activity and assess the injury.
C. Apply heat and return the child to the game.
D. Tell the child that muscle pain is expected during growth.
Correct answer: B
Rationale: School-age muscles and bones remain immature and are
susceptible to overuse injuries. The child should stop the activity and
receive an assessment before returning to play.
, 6. Correct Understanding
Which parent statement demonstrates correct understanding of backpack
safety?
A. “My child should carry the backpack over one shoulder.”
B. “A correctly worn backpack distributes weight more evenly.”
C. “A heavy backpack helps build back muscles.”
D. “My child should carry most books in one hand.”
Correct answer: B
Rationale: A properly fitted backpack worn over both shoulders distributes
weight more evenly. Heavy or uneven loads can strain immature muscles
and bones.
7. Select All That Apply
Which findings are expected during prepubescence? Select all that apply.
A. Girls may begin visible pubertal changes before boys.
B. Considerable variation exists in the timing of physical maturation.
C. Early or late development may cause embarrassment.
D. Puberty may normally begin after age 8.
E. Physical maturity indicates equal emotional maturity.
F. Girls may temporarily surpass boys in height and weight.
Correct answers: A, B, C, D, F
Rationale: Girls commonly begin puberty earlier than boys, and there is
wide variation in onset. Differences may cause self-consciousness. Physical
maturity does not establish emotional maturity.
8. Need for Further Teaching
The parent of a 10-year-old girl discusses pubertal development. Which
statement indicates a need for further teaching?
A. “I will prepare my child for body changes before they occur.”
B. “Differences in maturation among classmates can be expected.”
