Which statement best describes fear in school-age children?

They are increasingly fearful of their body integrity.

Most of the new fears that trouble them are related to school and friends.

They should be encouraged to hide their fears to prevent ridicule by peers.

Those who have numerous fears need continuous protective behavior by parents to eliminate these fears.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is not the best description of fear in school-age children. Fear of body integrity is more common in preschoolers, who may worry about losing body parts or being harmed by monsters or animals.

Choice B reason: This is the best description of fear in school-age children. As they develop cognitively and socially, they become more aware of realistic threats and challenges, such as academic performance, peer acceptance, family problems, or natural disasters.

Choice C reason: This is not a good advice for school-age children. Hiding their fears may lead to anxiety, low self-esteem, or isolation. They should be encouraged to express their fears and seek support from trusted adults or peers.

Choice D reason: This is not a healthy way to cope with fear in school-age children. Continuous protective behavior by parents may reinforce the child's fears and prevent them from developing coping skills and resilience. Parents should provide reassurance, guidance, and exposure to the feared situations in a gradual and safe manner.

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Correct Answer is B

Explanation

Choice A reason: Cardiac arrhythmia is an abnormal heart rhythm that can affect the heart's ability to pump blood. However, it is not a direct consequence of a ventricular septal defect (VSD), which is a hole in the wall between the lower chambers of the heart¹.

Choice B reason: Decreased cardiac output is the amount of blood pumped by the heart per minute. It can be reduced by a VSD, as the blood can flow back from the left ventricle to the right ventricle through the hole, instead of being pumped to the body. This can cause the infant to have cool extremities, thready pulses, and low urine output, as the tissues are not receiving enough oxygen and nutrients².

Choice C reason: Increased stroke volume is the amount of blood pumped by the heart per beat. It can be increased by a VSD, as the left ventricle has to work harder to compensate for the blood loss through the hole. However, this does not explain the infant's symptoms, as the stroke volume may not be enough to maintain a normal cardiac output².

Choice D reason: Cyanosis is a bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood. It can be caused by a VSD, as the oxygen-rich blood from the left ventricle can mix with the oxygen-poor blood from the right ventricle through the hole, and then be pumped to the body. However, this is more likely to occur in large VSDs or in infants with other heart defects that cause right-to-left shunting of blood³.

A. Explain that this is normal in preschoolers, especially boys. B. Talk to the preschool teacher to obtain validation for the behavior the parent reports. C. Refer the child for a professional psychosocial assessment. D. Encourage the parent to try more consistent and firm discipline.

Correct Answer is C

Explanation

Choice A reason: This is not an appropriate intervention. Anger and aggression are not normal behaviors in preschoolers, regardless of their gender. They may indicate underlying emotional or developmental issues that need to be addressed.

Choice B reason: This is not an adequate intervention. Talking to the preschool teacher may provide some information about the child's behavior, but it does not address the root cause or offer any solutions. The nurse should collaborate with the teacher and the parents to develop a plan of care for the child.

Choice C reason: This is the most appropriate intervention. A professional psychosocial assessment can help identify the factors that contribute to the child's anger and aggression, such as family stress, trauma, mental health problems, or learning difficulties. The assessment can also provide recommendations for treatment and support for the child and the family.

Choice D reason: This is not a helpful intervention. Consistent and firm discipline is important for any child, but it may not be enough to change the child's behavior if there are other underlying issues. Moreover, harsh or punitive discipline may worsen the child's anger and aggression. The parent should be encouraged to use positive reinforcement, empathy, and problem-solving skills with the child.

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Which statement best describes fear in school-age children?

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Naxlex Comprehensive Predictor Exams

A six-month-old infant is hospitalized for repair of a ventricular septal defect. As you are doing his physical exam, you note that the infant's extremities are cool, he has thready pulses, and his urine output is diminished. These clinical findings are suggestive of which of the following?

Correct Answer is B

Explanation

A boy aged 4 1/2 years has been having increasingly frequent angry outbursts in preschool. He is aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8-10 weeks. His parents ask the nurse for advice. What is the most appropriate intervention?

Correct Answer is C

Explanation

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