Chapter 30 Toddler PrepU
The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for this age group? Painting by number Putting shapes into appropriate holes Stacking blocks Using crayons to color in a coloring book
Stacking blocks
Parents are asking a pediatric nurse how to deal with separation anxiety every time they try to have an adult night out. Which advice by the nurse sounds like the most appropriate way to handle this situation? "Inform the child that you are going out but the regular babysitter will care for them and put them to bed." "Try to sneak out the back door to avoid the long crying scene at the door." "If your child starts crying, stay a little longer and read a story before leaving." "Note if your child cries as you leave because this may be an indication the babysitter is ignoring the child."
"Inform the child that you are going out but the regular babysitter will care for them and put them to bed."
A mother is concerned because her 14-month-old son, who had a big appetite when breastfeeding a few months ago, seems uninterested in eating solid food. She still breastfeeds him daily but is thinking of weaning him soon. How should the nurse respond to this mother? "It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate." "It is normal for toddlers to lose their appetites; try weaning him all at once so that he will be more interested in the solid food." "It is not normal for toddlers to lose their appetites; spoon feed him yourself to make sure he gets proper nutrition." "It is not normal for toddlers to lose their appetites; have him tested for a gastrointestinal condition."
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."
During the toddler years, the child attempts to become autonomous. Which statement by a 3-year-old toddler's caregiver indicates that the toddler is developing autonomy? "My toddler uses the potty chair and is dry all day long." "When my toddler falls down, they always wants me to pick them up." "My toddler has temper tantrums when we go to the store." "Every night my toddler follows the same routine at bedtime."
"My toddler uses the potty chair and is dry all day long."
A nurse is assessing the nutrition of a toddler. The parents state that the toddler only will eat grilled cheese sandwiches and macaroni and cheese. Which suggestion(s) would be most helpful? Select all that apply. "Try giving foods like casseroles so the toddler gets all the nutrition needed." "Start with a small amount of new foods on the plate at a time." "Allow your toddler to choose among several different types of food." "Do not be alarmed if the child wants to eat the same food repeatedly." "Try to use colorful foods on the plate."
"Start with a small amount of new foods on the plate at a time." "Do not be alarmed if the child wants to eat the same food repeatedly." "Try to use colorful foods on the plate."
The nurse is teaching the parents of a 2-year-old child how to handle the child's temper tantrums. The nurse determines that the teaching was successful if the parents make which statement? "We will offer our child a treat to stop having the tantrum." "We will place our child in time-out for 5 minutes after the tantrum." "We will attempt to reason with our child to limit tantrums." "We will ignore our child while having the tantrum."
"We will ignore our child while having the tantrum."
A group of caregivers are discussing the form of discipline in which the child is placed in a "time-out" chair. Which statement made by these caregivers is appropriate related to this form of discipline? "When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out." "My child is 3 years old now and I put my child in time-out for 5 to 10 minutes when misbehaving." "Our time-out chair is in the master bedroom so my child cannot see anyone else in the family." "We use the time-out chair when our child gets tired but does not want to take a nap."
"When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out."
A mother of a 2-year-old girl is asking her friend when she should start potty training the child. The mother expresses concern about the high cost of diapers and training pants and would really like to have her trained as soon as possible. Which advice by the friend would be considered the best response? "You will just have to condition yourself to take her to the potty chair every hour until they get the hang of it." "I started training my kids when they started to pull themselves up to a standing position." "It doesn't hurt to start when they turn 2 as long as you don't punish them for having many accidents." "When she is uncomfortable in her wet diaper and brings a clean diaper to you, that's a good indication she is ready for potty training."
"When she is uncomfortable in her wet diaper and brings a clean diaper to you, that's a good indication she is ready for potty training."
A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate? "Most children are ready for toilet training by the time they are 18 months old." "You'll probably notice that your daughter is uncomfortable in wet diapers." "Don't worry, your daughter will probably give you very definite signals." "Your daughter can understand holding urine and stool by about 1 year of age."
"You'll probably notice that your daughter is uncomfortable in wet diapers."
The maximum time-out duration is how many minutes for each year of age? 30 seconds 1 minute 90 seconds 2 minutes
1 minute
During a well-child visit, a parent tells the nurse that they use time-out to discipline their 2-year-old child. The nurse determines that the parent understands the concept of time-out when the parent states keeping the child in time-out for how long? 30 seconds 4 minutes 1 minute 2 minutes
2 minutes
When assessing a 33-month-old, the nurse would expect to find how many teeth? 8 12 16 20
20
A pediatric nurse is providing care to several children. The nurse is reviewing the assessment findings for each of the children. Which finding requires the nurse to intervene? 9-month-old infant who can pull self up to a standing position 14-month-old toddler who walks with a parent's assistance 24-month-old toddler who engages in parallel play 3-year-old preschool-aged child who goes up stairs on hands and knees
3-year-old preschool-aged child who goes up stairs on hands and knees
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? A regular routine and rituals will provide stability and security. Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. A sense of control can be provided through offering limited choices. Aggressive behaviors such as hitting and biting are common in toddlers.
A regular routine and rituals will provide stability and security.
The nurse is assessing a toddler's fine motor skills. Which finding by the nurse could be a safety concern? Ability to turn door knobs Put shapes into matching openings Able to use a spoon to self-feed Ability to hold a crayon to write
Ability to turn door knobs
A nurse in a busy pediatric clinic is educating a group of parents with toddlers about the nutritional needs of this age group. Which concepts should be addressed in this educational presentation? Select all that apply. There is no need to worry about the amount of trans fats in a toddler diet. Active, "busy" toddlers may need up to 1,400 cal/day. Children can have as many cookies they want if that is the only thing they will eat from breakfast. Try to limit the fat intake to less than 35% of total calories. Milk is still important to incorporate in the diet for bone health.
Active, "busy" toddlers may need up to 1,400 cal/day. Try to limit the fat intake to less than 35% of total calories. Milk is still important to incorporate in the diet for bone health.
A nurse is presenting a class on discipline for a group of parents of toddlers. What information would be important for the nurse to teach this group? Select all that apply. Toddlers cannot learn self-control until at least 3 to 4 years of age. Consistency in the rules is important so the child understands what is expected. If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. Even at this young age, children need boundaries. If a child hits or bites another child, the parents should scold them, saying such things as "You are very naughty for biting Rachel."
Consistency in the rules is important so the child understands what is expected. If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. Even at this young age, children need boundaries.
The parents of a 3-year-old who had bone cancer that resulted in amputation of the lower left leg ask their health care provider about expected behaviors for their child. Which behavior is expected and acceptable during hospitalization for treatments? During hospitalizations, there should be no regression in their toilet training since many staff members are available to take the child to the restroom. Soiling with feces is unacceptable if the child was toilet trained prior to the hospitalization and should be addressed each time it occurs. Crawling may be their preferred mode of travel because they may not want to wait for help to put the prosthesis on. If the child throws a tantrum, the nurses should also assess for seizures related to the use of pain medication following current treatment modalities.
Crawling may be their preferred mode of travel because they may not want to wait for help to put the prosthesis on.
The nurse is assessing 2-year-old twins. The parent states, "My twins will not play together, only alongside each other." Which action will the nurse take first? Explain that this is normal behavior for toddlers. Encourage the toddlers to play to allow for observation. Document the finding in the medical records. Determine when this form of play was first noted.
Explain that this is normal behavior for toddlers.
A 13-month-old child is brought to the clinic for a well-child visit. The child's parent expresses concern that the child has not started to walk yet. What is the best action should the nurse take? Refer the child to a developmental specialist for evaluation. Explain that the child could start walking any day. Ask the parent if the child has been ill recently. Explain that children can take their first steps as late as 18 months of age.
Explain that children can take their first steps as late as 18 months of age.
The nurse is teaching the parent of a 2-year-old about age-appropriate toys. Which would be of most interest plus stimulating to the growth and development? Giving the child bowls, pot, pans, and large spoons Giving the child a toy vacuum cleaner Offering the child a variety of large stuffed toys Providing a brightly colored plastic bucket and shovel
Giving the child bowls, pot, pans, and large spoons
A mother brings her 2-year-old child to the pediatrician's office, voicing concerns about her toddler's growth over the last year. According to the child's records, the toddler has gained 6 pounds (2.7 kg ) and grown 2.5 in (6.25 cm) since the chld's last visit a year ago. How should the nurse respond to this mother's concerns? Tell her that her child's growth is less than is expected and gather a nutritional history on the child. Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about. Ask the mother if there are other small people in her family. Tell the mother that she needs to return to the pediatrician's office in 3 months to re-weigh the child and measure his height for any changes.
Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about.
The nurse is designing a nursing care plan for a toddler with lymphoma who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan? Limiting visitors to scheduled visiting hours Planning physical therapy for the child Introducing the toddler to other toddlers in the unit Monitoring the toddler for developmental delays
Monitoring the toddler for developmental delays
The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description? Myelinization of the brain and spinal cord is complete at about 24 months. Alveoli reach adult numbers by 3 years of age. Urine output in a toddler typically averages approximately 30 ml/hour. Toddlers typically have strong abdominal muscles by the age of 2.
Myelinization of the brain and spinal cord is complete at about 24 months.
A 2-year-old child is reported to be a "picky eater" by his father. What pointers could the nurse provide the parent to help minimize stress related to mealtime? Select all that apply. Offer small portions of 1 to 2 teaspoons to the child. Food jags needs to be addressed and not given in to. Mealtime for a toddler should not exceed 20 minutes. Do not use sweets as a reward for cleaning their plate. Feed the toddler before the rest of the family.
Offer small portions of 1 to 2 teaspoons to the child. Mealtime for a toddler should not exceed 20 minutes. Do not use sweets as a reward for cleaning their plate.
A parent with a 2-year-old invites a friend with a toddler over for a play date when they notice their children are not really interacting while playing. The children are playing side-by-side when one toddler gets up and grabs a toy car out of the hands of the other toddler, which results in both toddlers crying. To prevent this from occurring again, which intervention should the parents make? Sit the toddlers down and give a lecture about "sharing." Parents should decide that they need to wait about a year when the children are more ready to share toys. Parent of the toddler who started the fight should put this child in "time out." Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy.
Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy.
The nurse is discussing proper discipline with the parent of a 15-month-old toddler. Which teaching is most important? Physical punishment such as spanking is discouraged. Toddlers are unable to follow instructions easily. Rules and limits should be simple and few. Only use praise after the child has corrected a wrong behavior.
Physical punishment such as spanking is discouraged.
The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce siblings to a new member of the family. Which suggestion should the nurse prioritize to help older siblings, especially toddlers, understand the change in the family dynamics? Plan time for the secondary caregiver to focus on the toddler while the primary caregiver focuses on the infant. Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant. Have a grandparent or another special adult in the child's life take the toddler on an errand or a special visit. Move the toddler to a new bedroom with a "grown-up-bed."
Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching? Reasoned with the child to stop the behavior Tried to refocus the child's attention as tantrum behavioral cues appeared Made sure the child was rested and not hungry before going to the mall Remained relatively calm even though embarrassed
Reasoned with the child to stop the behavior
A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply. Reason with the toddler and explain that the candy is not nutritious for her. Remain calm and ignore the tantrum. Acknowledge the behavior by giving into the toddler's demands and buying the candy. Pick the toddler up and take her to the restroom for a spanking. Stay nearby to ensure the child's safety without giving in to the child's desires.
Remain calm and ignore the tantrum. Stay nearby to ensure the child's safety without giving in to the child's desires.
During a wellness care visit, the parents of a 2-year-old toddler report that they are struggling to deal with their toddler's daily and increasing number of tantrums. What information should be provided to the parents? Select all that apply. Tantrums at this age can signal the development of an aggression disorder in a toddler. Tantrums are a common occurrence for a toddler of this age. Maintaining a consistent daily routine can help to reduce tantrums. Ignoring the behavior is often helpful in reducing the duration of the tantrum. Tapping the toddler on the hands and voicing displeasure with the toddler's actions can successfully interrupt the behavior.
Tantrums are a common occurrence for a toddler of this age. Maintaining a consistent daily routine can help to reduce tantrums. Ignoring the behavior is often helpful in reducing the duration of the tantrum.
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? The child has trouble undressing himself. The child is unable to push a toy lawnmower. The child is unable to unscrew a jar lid. The child falls when he bends over.
The child is unable to push a toy lawnmower.
Parents share that their toddler often needs a snack in between meals. Which snack choice is nutritious enough to give the toddler energy but also may help prevent dental caries? Select all that apply. orange slices raisin oatmeal cookies cheese slices yogurt sugar-free candy bars
orange slices cheese slices yogurt
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior? The need for separation and control The need for love and belonging The need for safety and security The need for peer approval
The need for separation and control
A nurse, who is also a mother of a 2-year-old child, attends a party at a friend's house and notes some safety concerns that she would like to share with the other mother privately. Which observations during the party would be considered a safety concern that should be addressed privately when appropriate? Select all that apply. The nurse/mother notes that the toddler's car seat is located in the passenger front seat. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. The toddler was wearing a helmet while riding a tricycle. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove. The safety gate/fence surrounding the pool area is secure and a little hard, even for parents, to unlatch.
The nurse/mother notes that the toddler's car seat is located in the passenger front seat. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.
The nurse is explaining safety precautions for toddlers to the mother of a normal 30-month-old boy. Which activity might the nurse suggest may be done without supervision? Turning on the bath water Undressing himself Playing in the basement Eating a mid-afternoon snack
Undressing himself
If the toddler is following a normal pattern of dentition at 22 months of age, which teeth would have most recently erupted? cuspid central incisor lateral incisor second molar
cuspid
While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their backyard a few days ago. The nurse explains that this is an instance of which of the following? deferred imitation assimilation parallel play autonomy
deferred imitation
The nurse is caring for a toddler in the pediatric unit and notes the child is responding according to expected developmental stages. Which characteristic will the nurse predict this toddler to exhibit while in the hospital? will be interested in an activity for a long period of time learns new things quickly by asking questions insists on doing a new skill and then asking for help will go home knowing how to do more things
insists on doing a new skill and then asking for help
The parent of a 20-month-old toddler reports the toddler has been becoming distraught when the parent leaves. The parent asks the nurse for advice about what is going on and how to best manage it. What information can be provided? Select all that apply. "This is actually a regression for your toddler because separation anxiety normally occurs in infancy." "This is a normal happening for a toddler of this age." "As your toddler begins to learn that you will return, they will become less upset." "Your care providers may be frightening to your toddler." "Establishing a routine for saying goodbye to your toddler will be helpful."
"This is a normal happening for a toddler of this age." "As your toddler begins to learn that you will return, they will become less upset." "Establishing a routine for saying goodbye to your toddler will be helpful."
The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern? "This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech." "This is considered a developmental delay in the 3-year-old and we should consult a speech therapist." "This is a condition known as echolalia and can be corrected if you work with your daughter on language skills." "This is a condition known as stuttering and it is a normal pattern of speech development in the toddler."
"This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech."
A nurse is assessing a 2-year-old's language development. What would the nurse expect to assess? Verbalization of 4 to 6 words Use of a two-word noun-verb sentence Knowledge of full name Ability to name one color
Use of a two-word noun-verb sentence
Parents and their nearly 3-year-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? Uses two-word sentences or phrases Talks about a past event Half of speech understood by outsider Asks "why" often
Uses two-word sentences or phrases
The nurse is caring for a toddler who is in Piaget's sensorimotor stage of cognitive development. Which task would the nurse expect the toddler to be able to perform? Completing puzzles with four pieces Winding up a mechanical toy Playing make-believe with dolls Knowing which are his or her toys
Knowing which are his or her toys
The nurse is supervising a play group of children on the unit. The nurse expects the toddlers will most likely be involved in which activity? Pretending to be mommies and daddies in the play house Playing with the plastic vacuum cleaner and pushing it around the room Painting pictures in the art corner of the room Watching a movie with other children their age
Playing with the plastic vacuum cleaner and pushing it around the room
A grandmother who is the primary caregiver of a 2-year-old is expressing concern about how to best handle the temper tantrums that can occur two or three times a day, often in public places. She explains she spanked her own children for this but she is worried this is not the best way to handle the situation. Which response from the nurse will best address this concern? "Spanking is controversial but sometimes necessary, so use it if it works." "Warn the child that they will be punished when they are back at home then follow through with the punishment." "Remain calm, pick the child up, and move to a quiet and neutral place until the child gains self-control; don't give in to the child's demands." "Remind the child that they are in a public place and ask the child to respect those around them; reward the child if the child responds by calming themself."
"Remain calm, pick the child up, and move to a quiet and neutral place until the child gains self-control; don't give in to the child's demands."
The nurse is preparing to assess a 2-year-old at a well-child visit and notes the child was 22 lb (9.98 kg) and 24 in (60.96 cm) tall at 1 year old. The nurse determines the child is following a normal pattern of growth after obtaining which set of current measurements? 27 lbs (12.27 kg) and 27 in (68.58 cm) tall 32 lbs (14.54 kg) and 30 in (76.20 cm) tall 38 lbs (17.27 kg) and 32 in (81.28 cm) tall 40 lbs (18.18 kg) and 33 in (83.82 cm) tall
27 lbs (12.27 kg) and 27 in (68.58 cm) tall Toddlerhood is a time of slowed growth and rapid development. Each year the toddler gains 4.5 to 6.0 lb (2. to 2.7 kg) and about 3 in (7.62 cm). A child weighing 22 lb (9.98 kg) at age 1 year would be expected to now weigh 26.5 to 28 lb (12.2 to 12.7 kg). A height of 24 in at age 1 year (60.96 cm) should now be approximately 27 in (68.58 cm).
