School Age: 6 to 12 Years Practice Questions

60 multiple-choice questions on School age: 6 to 12 years for paramedic and EMT students, from Chapter 10 (Life Span Development). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

60 practice questions

1. Vital signs in school-age children:

   1. A. Stay close to newborn and infant values
   2. B. Gradually approach adult values
   3. C. Run faster than toddler values
   4. D. Vary too widely to interpret
   Show answer

   Answer: B. Gradually approach adult values

   A heart rate of 70 to 110 is typical in this range.

2. School-age children's understanding of illness is usually:

   1. A. Fully abstract, like adults
   2. B. More concrete and logical
   3. C. Driven by magical thinking
   4. D. Absent until adolescence
   Show answer

   Answer: B. More concrete and logical

   Simple honest explanations work well. They can follow directions and answer questions about their symptoms.

3. Children in this age group commonly fear:

   1. A. Separation from parents above all else
   2. B. Pain, disfigurement, losing control
   3. C. Strangers more than anything else
   4. D. Very little, as they feel invincible
   Show answer

   Answer: B. Pain, disfigurement, losing control

   They fear pain, disfigurement, and loss of control or independence. Explain what you will do before you do it, and give choices where possible.

4. Self-concept in school-age children is heavily influenced by:

   1. A. Their physical growth rate alone
   2. B. Media figures more than anyone
   3. C. Peers and school performance
   4. D. Family opinion and nothing else
   Show answer

   Answer: C. Peers and school performance

   Comparison with others also matters. Erikson called this stage industry versus inferiority.

5. Moral development in this age group typically means children:

   1. A. Reason about ethics abstractly, like adults
   2. B. Reject rules set by adults
   3. C. Begin to understand rules and fairness
   4. D. Have no real sense of right and wrong
   Show answer

   Answer: C. Begin to understand rules and fairness

   They begin to understand rules, fairness, and consequences. They may worry that the injury is punishment for breaking a rule.

6. Growth during the school-age years is:

   1. A. Nearly absent until puberty begins
   2. B. Explosive, like the pubertal spurt
   3. C. Faster than in the first year of life
   4. D. Steady, about 2 kg and 6 cm per year
   Show answer

   Answer: D. Steady, about 2 kg and 6 cm per year

   The growth spurt comes with puberty.

7. A school-age child's privacy during assessment:

   1. A. Applies only to girls at this age
   2. B. Is unimportant until adolescence
   3. C. Should be respected; modesty emerges
   4. D. Should yield to speed in every case
   Show answer

   Answer: C. Should be respected; modesty emerges

   Modesty develops in this period. Ask before exposing and use a drape.

8. Common injuries in this age group include:

   1. A. Crib and changing-table falls at home
   2. B. Bicycle, playground, and sports injuries
   3. C. Poisoning by household products, mainly
   4. D. Bathtub and bucket drowning, mainly
   Show answer

   Answer: B. Bicycle, playground, and sports injuries

   Pedestrian injuries are also common. Helmets are the highest-yield prevention message for this group.

9. When interviewing a school-age child, the paramedic should:

   1. A. Ask only the parent for the history
   2. B. Use adult-level explanations throughout
   3. C. Avoid any medical terms with the child
   4. D. Ask the child directly, then the parent
   Show answer

   Answer: D. Ask the child directly, then the parent

   Confirm details with the caregiver. They are often the best source for their own symptoms.

10. Chronic illness in a school-age child may affect:

    1. A. Schooling, friendships, and self-esteem
    2. B. Only the family's finances and time
    3. C. Nothing beyond their treatment schedule
    4. D. Only their physical health and growth
    Show answer

    Answer: A. Schooling, friendships, and self-esteem

    These effects come in addition to health. Ask the child and caregiver what is normal for them.

11. School-age heart rate is approximately:

    1. A. 100 to 140
    2. B. 60 to 80
    3. C. 40 to 60
    4. D. 70 to 110
    Show answer

    Answer: D. 70 to 110

    Approaching adult range.

12. School-age respiratory rate is approximately:

    1. A. 30 to 40
    2. B. 18 to 25
    3. C. 12 to 16
    4. D. 8 to 10
    Show answer

    Answer: B. 18 to 25

    Still slightly above adult.

13. School-age systolic blood pressure is approximately:

    1. A. 60 to 80
    2. B. 120 to 140
    3. C. 90 to 110
    4. D. 70 to 90
    Show answer

    Answer: C. 90 to 110

    Rising with age.

14. A 9-year-old's parent says he has gained 25 kg in the past year. How should you interpret this?

    1. A. Normal for the school-age growth spurt
    2. B. Normal, since school-age growth is highly unpredictable
    3. C. Far above typical growth of about 2 to 3 kg a year
    4. D. Expected, since growth stops at age 9
    Show answer

    Answer: C. Far above typical growth of about 2 to 3 kg a year

    Growth in the school-age years is slow and steady, about 2 to 3 kg and 6 cm per year. A 25 kg gain is far outside that range and suggests obesity or an endocrine or medication cause. The major growth spurt comes with puberty, and growth does not stop at 9.

15. Permanent teeth begin erupting around age:

    1. A. 14
    2. B. 10
    3. C. 2
    4. D. 6
    Show answer

    Answer: D. 6

    Losing baby teeth.

16. Brain growth by age 6 is:

    1. A. Fully complete in size and wiring
    2. B. About 50 percent of adult size
    3. C. About 90 percent of adult size
    4. D. Just beginning its main growth
    Show answer

    Answer: C. About 90 percent of adult size

    Connections continue to develop.

17. Which explanation will an 8-year-old most likely understand before you start an IV?

    1. A. 'The cannula provides access for crystalloid administration'
    2. B. 'I'll clean your arm, it will pinch, then medicine goes in'
    3. C. 'Don't worry, this won't hurt at all'
    4. D. 'We need to do this now because of your hemodynamic status'
    Show answer

    Answer: B. 'I'll clean your arm, it will pinch, then medicine goes in'

    School-age children think concretely and logically, so a short, honest, step-by-step explanation in concrete terms works best. Jargon is not understood. Promising no pain breaks trust when it hurts. Abstract medical reasons mean nothing to a concrete thinker.

18. Concrete thinking means school-age children:

    1. A. Grasp tangible explanations best
    2. B. Readily understand hypotheticals
    3. C. Cannot follow explanations at all
    4. D. Think the same way adults do
    Show answer

    Answer: A. Grasp tangible explanations best

    Real, tangible explanations work better than abstract ones. Show them the equipment.

19. School-age children's understanding of illness:

    1. A. Is based on purely magical thinking
    2. B. Includes cause and effect, like germs
    3. C. Is absent until adolescence begins
    4. D. Matches an adult's full understanding
    Show answer

    Answer: B. Includes cause and effect, like germs

    They can participate in care.

20. A 10-year-old with a deep facial laceration is most likely to be worried about:

    1. A. Being separated from his parents at the hospital
    2. B. Being around unfamiliar adults
    3. C. How it will look and whether it will scar
    4. D. Whether he caused it by being bad
    Show answer

    Answer: C. How it will look and whether it will scar

    School-age children commonly fear pain, disfigurement, and loss of control, and they become very aware of how peers see them. Address scarring concerns honestly. Separation and stranger anxiety are the main fears of infants and toddlers, and believing an injury is punishment for being bad is typical preschool magical thinking.

21. You need to examine an 11-year-old girl's abdomen in front of her brothers. What is best?

    1. A. Expose the abdomen fully to speed the exam
    2. B. Examine her through her clothing instead
    3. C. Skip the abdominal exam to avoid embarrassing her
    4. D. Explain, limit exposure, and give her privacy
    Show answer

    Answer: D. Explain, limit exposure, and give her privacy

    Modesty develops in the school-age years. Explain what you will do, expose only what is needed, and give privacy, with a caregiver present. Full exposure ignores her modesty, palpating through clothing can miss findings, and an indicated exam should not be skipped.

22. A 10-year-old with type 1 diabetes hides his glucose meter at school. The most likely reason is:

    1. A. He wants to fit in and not seem different
    2. B. He lacks the fine motor skill to use it
    3. C. He believes the meter caused his diabetes
    4. D. He is mainly trying to make his parents angry
    Show answer

    Answer: A. He wants to fit in and not seem different

    Peer acceptance shapes self-esteem in school-age children, and chronic illness can make them feel different, which leads to hiding or skipping care. Ask without judgment and involve the caregiver. A 10-year-old has the motor skill to use a meter, magical beliefs about what causes illness fade by school age, and the main driver is fitting in, not defiance.

23. Industry in Erikson's model refers to:

    1. A. Unstructured imaginative play
    2. B. Earning money through a first job
    3. C. Feeling inferior to classmates
    4. D. Gaining competence through tasks
    Show answer

    Answer: D. Gaining competence through tasks

    Children develop competence through school and activities. Success breeds confidence.

24. Inferiority develops when:

    1. A. They spend most free time playing
    2. B. They fail often or face criticism
    3. C. They succeed at most of their tasks
    4. D. They receive frequent praise at home
    Show answer

    Answer: B. They fail often or face criticism

    Repeated failure or criticism affects self-esteem.

25. During a game, a 9-year-old insists on 'fair' rules being followed exactly. Which stage of moral development does this reflect?

    1. A. Abstract principles applied flexibly
    2. B. No real understanding of rules at all
    3. C. Purely self-centered, magical thinking
    4. D. Rule-based reasoning, applied rigidly
    Show answer

    Answer: D. Rule-based reasoning, applied rigidly

    School-age children begin to understand rules and fairness but apply them rigidly and literally. Flexible, principle-based reasoning develops in adolescence. Preschoolers think magically and egocentrically. Fairness can help: explain the 'rules' of a procedure and stick to them.

26. School-age children may hide symptoms because:

    1. A. They are healthier than they look
    2. B. They rarely notice their symptoms
    3. C. They fear treatment or missing out
    4. D. They are dishonest with adults by habit
    Show answer

    Answer: C. They fear treatment or missing out

    They may fear treatment, consequences, or missing activities. Ask directly and gently.

27. A 9-year-old fell from a tree and her mother is present. How should you take the history?

    1. A. Ask only the mother, since children are unreliable reporters
    2. B. Ask only the child and ignore the mother
    3. C. Wait until the hospital to ask any questions
    4. D. Ask the child directly, then confirm with her mother
    Show answer

    Answer: D. Ask the child directly, then confirm with her mother

    School-age children can describe what happened and where it hurts, and asking them directly builds trust and cooperation. The caregiver adds history, medications, and baseline. Ignoring either source loses information, and the history should not wait.

28. Offering choices to a school-age child:

    1. A. Gives a sense of control
    2. B. Confuses them and slows down care
    3. C. Is unnecessary once they can reason
    4. D. Delays care with no real benefit
    Show answer

    Answer: A. Gives a sense of control

    It improves cooperation. Which arm?

29. Which mechanism is most typical of serious injury in a 10-year-old?

    1. A. Struck by a car while on a bicycle
    2. B. Falling out of a high chair at home
    3. C. Rolling off a changing table at home
    4. D. A workplace machinery injury on a job
    Show answer

    Answer: A. Struck by a car while on a bicycle

    School-age children are injured mostly by bicycles, playgrounds, sports, and pedestrian crashes, often because they misjudge traffic speed and distance. Falls from high chairs and changing tables are infant and toddler injuries. Workplace injuries are uncommon before adolescence.

30. Bicycle injuries are reduced most by:

    1. A. Avoiding roads
    2. B. Helmet use
    3. C. Training wheels
    4. D. Reflectors
    Show answer

    Answer: B. Helmet use

    Head injury is the main cause of death.

31. Pedestrian injuries in school age occur because children:

    1. A. Walk too slowly across streets
    2. B. Are overly cautious near busy traffic
    3. C. Misjudge vehicle speed and distance
    4. D. Ignore crosswalk signals by habit
    Show answer

    Answer: C. Misjudge vehicle speed and distance

    They may dart into traffic. Judgment develops gradually.

32. Sports injuries in this age group commonly include:

    1. A. Thermal burns from sports equipment
    2. B. Poisoning from sports supplements
    3. C. Fractures, sprains, and concussions
    4. D. Spinal cord injuries in most cases
    Show answer

    Answer: C. Fractures, sprains, and concussions

    Growth plate injuries.

33. Concussion in school-age children:

    1. A. Resolves fully within a few minutes
    2. B. Is rare outside of contact sports
    3. C. Is harmless without loss of consciousness
    4. D. Requires removal from play and evaluation
    Show answer

    Answer: D. Requires removal from play and evaluation

    Second impact syndrome is a risk with early return to play.

34. Childhood obesity:

    1. A. Mostly resolves without intervention
    2. B. Is harmless until adulthood begins
    3. C. Has increased and raises disease risk
    4. D. Is rare among children of this age
    Show answer

    Answer: C. Has increased and raises disease risk

    It raises the risk of diabetes and heart disease. Prevention starts here.

35. Asthma in school-age children:

    1. A. Is the top chronic childhood illness
    2. B. Cannot be controlled with medication
    3. C. Is rare before the teenage years
    4. D. Always resolves completely by puberty
    Show answer

    Answer: A. Is the top chronic childhood illness

    It is a major cause of school absence. Trigger control.

36. Type 1 diabetes often presents in:

    1. A. The first year of life
    2. B. Middle adulthood, after 40
    3. C. Late adulthood, after 65
    4. D. School age and adolescence
    Show answer

    Answer: D. School age and adolescence

    DKA is sometimes the first presentation.

37. Attention and behavioral conditions in school age:

    1. A. Cannot be treated or managed effectively
    2. B. Are always obvious on first contact
    3. C. Are rare in children of this age
    4. D. Are common and may affect communication
    Show answer

    Answer: D. Are common and may affect communication

    Ask caregivers what helps.

38. Bullying affects health by:

    1. A. Building resilience in most children
    2. B. Having no measurable health effect
    3. C. Causing physical injuries only
    4. D. Contributing to anxiety and depression
    Show answer

    Answer: D. Contributing to anxiety and depression

    Somatic complaints are also common. Ask about school.

39. School-age children with chronic illness:

    1. A. May struggle with being different
    2. B. Are emotionally unaffected by it
    3. C. Need no extra support at school
    4. D. Always cope well with their illness
    Show answer

    Answer: A. May struggle with being different

    Self-management begins.

40. Self-esteem in school age is built by:

    1. A. Strict, punishment-based discipline
    2. B. Shielding them from any failure
    3. C. Success, encouragement, and acceptance
    4. D. Comparing them with higher-achieving peers
    Show answer

    Answer: C. Success, encouragement, and acceptance

    Praise effort. In Erikson's industry versus inferiority stage, self-esteem grows from success at tasks, encouragement, and acceptance. Punishment-based discipline and comparison with other children undercut it, and shielding a child from every setback denies the chance to build real competence.

41. School-age children's reasoning about consequences:

    1. A. Absent until the teenage years begin
    2. B. Still developing, so they take risks
    3. C. Already adult-level by about age 8
    4. D. Complete once they begin attending school
    Show answer

    Answer: B. Still developing, so they take risks

    They may take risks without foreseeing outcomes. Supervision still needed.

42. Communicating with a school-age child about a serious diagnosis:

    1. A. Should use full medical detail as with an adult
    2. B. Should be honest, simple, and involve the caregiver
    3. C. Should be withheld entirely to avoid causing fear
    4. D. Should rely on comforting stories instead of facts
    Show answer

    Answer: B. Should be honest, simple, and involve the caregiver

    They sense when something is wrong. Use age-appropriate language and include the caregiver.

43. School-age children's concept of death:

    1. A. Is identical to an adult's understanding
    2. B. Includes permanence, often personified
    3. C. Has not yet formed at this stage
    4. D. Is magical and fully reversible, like sleep
    Show answer

    Answer: B. Includes permanence, often personified

    Death as a skeleton or monster. They understand death is permanent but often personify it.

44. School-age children in a family emergency may:

    1. A. Ignore it and continue normal play
    2. B. Feel responsible or guilty for it
    3. C. Remain unaffected because they lack awareness
    4. D. Fully understand the medical situation
    Show answer

    Answer: B. Feel responsible or guilty for it

    Reassure them.

45. Puberty may begin during late school age in:

    1. A. Both sexes equally at about age 6
    2. B. Neither sex until after age 13
    3. C. Girls, as early as 8 to 10 years
    4. D. Boys first, since they mature earlier
    Show answer

    Answer: C. Girls, as early as 8 to 10 years

    Earlier in girls. Puberty can begin in girls as early as 8 to 10 years, during the late school-age years, while boys typically start 1 to 2 years later than girls. It does not begin at 6 in healthy children of either sex, and girls do not wait until after 13.

46. School-age vital signs should be interpreted:

    1. A. Using infant reference ranges
    2. B. Using age-specific reference ranges
    3. C. By trend only, without reference ranges
    4. D. Using standard adult reference ranges
    Show answer

    Answer: B. Using age-specific reference ranges

    A heart rate of 110 is normal at age 6.

47. School-age blood pressure cuff size:

    1. A. Is always the standard adult cuff
    2. B. Does not affect the reading
    3. C. Must be sized to the child's arm
    4. D. Is always an infant-size cuff
    Show answer

    Answer: C. Must be sized to the child's arm

    Child cuffs exist for a reason. A cuff too small reads falsely high; one too large reads falsely low.

48. School-age children can usually:

    1. A. Cooperate only when a parent holds them
    2. B. Cooperate when steps are explained
    3. C. Cooperate only if given a reward first
    4. D. Not cooperate with any physical exam
    Show answer

    Answer: B. Cooperate when steps are explained

    Explain, then do.

49. The school-age child's role in their own care:

    1. A. Is none; caregivers manage everything
    2. B. Can include simple self-care tasks
    3. C. Is complete independent management
    4. D. Should be discouraged to avoid errors
    Show answer

    Answer: B. Can include simple self-care tasks

    Inhaler use, for example. They can understand their condition and handle tasks such as inhaler use.

50. Which school-age finding is most concerning?

    1. A. Lethargy or refusal to interact
    2. B. Asking many questions about procedures
    3. C. Crying during the examination
    4. D. Nervousness around strangers
    Show answer

    Answer: A. Lethargy or refusal to interact

    Change from normal behavior. Confusion is also concerning.

51. Which school-age injury requires spinal precautions?

    1. A. A scraped knee on the playground
    2. B. An ankle sprain during soccer
    3. C. A fall from standing onto grass
    4. D. A bicycle struck by a car
    Show answer

    Answer: D. A bicycle struck by a car

    Mechanism guides. High-energy mechanisms such as bicycle versus car or a fall from height warrant spinal motion restriction.

52. Growth plate injuries matter because:

    1. A. They can disrupt future bone growth
    2. B. They rarely cause pain or swelling
    3. C. They heal faster than other fractures
    4. D. They are rare in active children
    Show answer

    Answer: A. They can disrupt future bone growth

    Salter-Harris classification.

53. Nutrition in school age should emphasize:

    1. A. Balanced meals and limited sugary drinks
    2. B. Daily vitamin and protein supplements
    3. C. Strict calorie restriction to prevent obesity
    4. D. Fruit juice in place of whole fruit
    Show answer

    Answer: A. Balanced meals and limited sugary drinks

    Habits form here. Pair balanced meals with regular physical activity. Juice adds sugar without the fiber of whole fruit, supplements are rarely needed with a balanced diet, and strict calorie restriction can impair growth.

54. Sleep needs in school age are approximately:

    1. A. About 14 hours
    2. B. About 8 hours
    3. C. About 6 hours
    4. D. 9 to 12 hours
    Show answer

    Answer: D. 9 to 12 hours

    Many children get less. The American Academy of Sleep Medicine recommends 9 to 12 hours a night for children 6 to 12 years old. Six to eight hours is closer to adult needs, and about 14 hours fits infants and toddlers.

55. Screen time in school age:

    1. A. Is harmless if the content is educational
    2. B. Improves attention and fitness
    3. C. Is linked to obesity and poor sleep
    4. D. Has no measurable health effect
    Show answer

    Answer: C. Is linked to obesity and poor sleep

    Limits are recommended. Excessive use also reduces physical activity. Heavy screen time is linked to obesity and poor sleep whatever the content, because much of the harm comes from sedentary time and evening use.

56. Which approach best gains a school-age child's trust?

    1. A. Explaining procedures after they are done
    2. B. Talking only to the parents
    3. C. Promising that nothing will hurt
    4. D. Honesty and respecting their questions
    Show answer

    Answer: D. Honesty and respecting their questions

    They remember being lied to. Explain what you are doing before you do it, not afterward, answer their questions honestly, and talk with the child directly rather than to the parents alone.

57. School-age children's pain reports:

    1. A. Are unreliable at this age
    2. B. Are usually exaggerated for attention
    3. C. Should be confirmed by parents first
    4. D. Are reliable with age-appropriate scales
    Show answer

    Answer: D. Are reliable with age-appropriate scales

    Believe them. Faces scales work well at this age.

58. A school-age child who refuses to let you examine them:

    1. A. Lacks capacity and can be overridden
    2. B. Needs time and caregiver support
    3. C. Should be examined by a parent instead
    4. D. Should be left unexamined
    Show answer

    Answer: B. Needs time and caregiver support

    Patience usually works. Explain each step and let the caregiver comfort the child. Refusal does not mean the child can be overridden by force, a parent cannot substitute for your exam, and leaving the child unexamined risks missing an injury.

59. Which statement about school-age development is accurate?

    1. A. It varies; compare to the child's baseline
    2. B. Development pauses until puberty
    3. C. Development is complete by age 12
    4. D. All children develop at an identical pace
    Show answer

    Answer: A. It varies; compare to the child's baseline

    Ask what is normal for this child.

60. The school-age years are important for:

    1. A. Health habits, self-esteem, and social skills
    2. B. Little beyond academic learning
    3. C. Only physical growth and motor skills
    4. D. Primarily language acquisition
    Show answer

    Answer: A. Health habits, self-esteem, and social skills

    Foundation for adolescence.