# A 9-year-old child is hospitalized for acute appendicitis and will undergo an appendectomy. The child appears anxious and asks many questions about the surgery. Which nursing intervention is most appropriate to address the developmental needs of this school-age child? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=541752 > language: ko > subject: Growth & Development ## 문제 A 9-year-old child is hospitalized for acute appendicitis and will undergo an appendectomy. The child appears anxious and asks many questions about the surgery. Which nursing intervention is most appropriate to address the developmental needs of this school-age child? ## 보기 1. Provide simple, brief explanations and use distraction techniques during procedures 2. Encourage the parents to stay constantly at the bedside to provide comfort and security 3. Use age-appropriate diagrams and models to explain the surgical procedure and encourage questions **✔ 정답** 4. Allow the child to make all decisions about their care to promote independence **정답: 3** ## 해설 School-age children benefit from concrete explanations using visual aids like diagrams to satisfy their curiosity and reduce anxiety about medical procedures. This supports their developmental need for mastery and control, unlike oversimplification or excessive autonomy. ## 심화 해설 Understanding the Developmental Stage A 9-year-old child is in the concrete operational stage of cognitive development, according to Piaget. At this age, children are capable of logical thought but learn best through hands-on, tangible experiences. They have a realistic understanding of their body and can grasp cause-and-effect relationships, but they may still misinterpret medical terms. The child’s anxiety and many questions reflect a developmental need to understand what will happen to their body to gain a sense of control and mastery over the situation. Why the Correct Answer is Best Using age-appropriate diagrams and models to explain the surgical procedure and encouraging questions directly addresses the school-age child’s cognitive capacity and emotional need. This approach transforms an abstract, frightening event into a concrete, understandable process. By seeing a model of the appendix and where the incision will be, the child can logically process the information, which reduces fear of the unknown. Actively encouraging questions validates the child’s concerns and promotes a sense of partnership in care, which is a key developmental task for this age group. The Cochrane protocol [1] underscores the importance of evaluating such non-pharmacological preoperative interventions specifically for reducing anxiety in this population, as they are designed to meet these exact cognitive and emotional needs before surgery under general anaesthesia. Analysis of Incorrect Options Option 1: Providing simple, brief explanations and using distraction techniques is a strategy more suited for a preschooler. A school-age child requires more detailed, logical explanations to satisfy their curiosity and need for understanding. Brief explanations can increase anxiety by leaving too much to the imagination, and distraction alone does not address the child’s active, information-seeking coping style. Option 2: While parental presence is a vital source of security for a hospitalized child, encouraging parents to stay constantly at the bedside does not directly address the child’s own developmental need for information and mastery. For a school-age child, coping is enhanced not just by comfort but by active participation and understanding. This option is more passive and does not empower the child to manage their own anxiety through knowledge. Option 4: Allowing the child to make all decisions about their care is developmentally inappropriate and could increase anxiety. School-age children need clear boundaries and the security of knowing that adults are in control of major decisions. Their need for independence is appropriately met by offering limited, safe choices (e.g., which arm for the IV, which scent for the anesthesia mask), not by giving them responsibility for overarching treatment decisions like whether or not to proceed with a necessary appendectomy.References (research sources) - [1]Preoperative interventions for reducing anxiety in school-age children undergoing surgery: a network meta-analysis.Meta-analysis/systematic reviewMartins Esteves I, Pires R, Pestana-Santos M, Sampaio F, Reis Santos M. (2026) · DOI: 10.1002/14651858.cd016330 ## 임상 시나리오 Preoperative Teaching for the School-Age ChildUsing Concrete Visual Aids to Reduce Anxiety For a 9-year-old in the concrete operational stage, use diagrams, models, and medical equipment to provide a tangible explanation of the surgery. This transforms an abstract threat into a logical, understandable sequence. Explain the procedure using correct body part names and simple cause-and-effect relationships. For an appendectomy, show the location of the appendix on a model and describe the incision site. This promotes a sense of mastery and control. CautionDo not use abstract language or metaphors that can be misinterpreted literally. Avoid giving the child full decision-making authority, which can be overwhelming. Instead, offer structured choices like selecting a bandage flavor or which arm for the IV. ## 핵심 개념 - **Concrete Operational Stage** — Piaget's stage (ages 7-11) where children think logically about concrete objects and events, enabling them to understand explanations using tangible models. - **Preoperative Preparation** — Nursing interventions before surgery to reduce anxiety and improve coping, which for school-age children involves detailed, age-appropriate education. - **Fear of the Unknown** — A primary source of anxiety in hospitalized children, which can be mitigated by providing clear, concrete information about upcoming procedures. ## 같은 주제 문제 - [A 10-year-old child is hospitalized for acute appendicitis and scheduled for an appendecto…](https://mymerci.kr/pages/nclex_q.php?qn_id=541751) - [A 4-year-old preschooler is recovering at home for 5 days following a tonsillectomy. 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