Chapter 04: Growth and Development of the Toddler
After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching? A)"When my 3-year-old asks 'why?' all the time, this is completely normal." B)"A 15-month-old should be able to point to his eyes when asked to do so." C)"At age 2 years, my son should be able to understand things like under or on." D)"An 18-month-old would most likely use words and gestures to communicate."
A
The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching? A) Telling them either one may demonstrate toilet use B) Assuring them that bladder control occurs first C) Telling them that curiosity is a sure sign of readiness D) Advising them to use praise, not scolding
D
The pediatric nurse is planning quiet activities for hospitalized 18-month-old. What would be an appropriate activity for this age group? A) Painting by number B) Putting shapes into appropriate holes C) Stacking blocks D) Using crayons to color in a coloring book
C
What activity would the nurse expect to find in an 18-month-old? A) Standing on tiptoes B) Pedaling a tricycle C) Climbing stairs with assistance D) Carrying a large toy while walking
C
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? A) 'This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech.' B) 'This is considered a developmental delay in the 3-year-old and we should consult a speech therapist.' C) 'This is a condition known as echolalia and can be corrected if you work with your daughter on language skills.' D) 'This is a condition known as stuttering and it is a normal pattern of speech development in the toddler.'
A
The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this area? A) The child cannot say name, age, and gender. B) The child cannot follow a series of two independent commands. C) The child has a vocabulary of 40 to 50 words. D) The child does not point to named body parts.
D
The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description? A) Myelinization of the brain and spinal cord is complete at about 24 months. B) Alveoli reach adult numbers by 3 years of age. C) Urine output in a toddler typically averages approximately 30 mL/hour. D) Toddlers typically have strong abdominal muscles by the age of 2.
A
The nurse is teaching the parents of an overweight 18-month-old girl about diet. Which intervention will be most effective for promoting proportionate growth? A) Remove high-calorie, low-nutrient foods from the diet. B) Ensure 30 minutes of unstructured activity per day. C) Avoid sharing your snacks and candy with the child. D) Reduce the amount of high-fat food the child eats.
A
The nurse is watching toddlers at play. Which normal behavior would the nurse observe? A) Toddlers engage in parallel play. B) Toddlers engage in solitary play. C) Toddlers engage in cooperative play. D) Toddlers do not engage in play outside the home.
A
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? A) The need for separation and control B) The need for love and belonging C) The need for safety and security D) The need for peer approval
A
The parents of a 1-year-old girl, both of whom have perfect teeth, are concerned about their child getting dental caries. Which is the best advice the nurse can provide? A) Tell the parents to limit the child's eating to meal and snack times. B) Urge the parents to take the child to a dentist for a check-up. C) Advise the parents to reduce carbohydrates in the child's diet. D) Advise the parents to use fluoride toothpaste.
A
During a health history, the nurse explores the sleeping habits of a 3-year-old boy by interviewing his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group? A) 'Our son sleeps through the night, and we insist that he takes two naps a day.' B) 'We keep a strict bedtime ritual for our son, which includes a bath and bedtime story.' C) 'Our son still sleeps in a crib because we feel it is the safest place for him at night.' D) 'Our son occasionally experiences night walking so we allow him to stay up later when this happens.'
B
The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? A) The mother is suffering from depression. B) The child is homeless and has no toys. C) The mother describes an inadequate diet. D) The child is unperturbed by a loud noise.
B
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? A) The child has trouble undressing himself. B) The child is unable to push a toy lawnmower. C) The child is unable to unscrew a jar lid. D) The child falls when he bends over.
B
The nurse is teaching good sleep habits for toddlers to the mother of a 3-year-old boy. Which response indicates the mother understands sleep requirements for her son? A) "I'll put him to bed at 7 p.m., except Friday and Saturday." B) "He needs 12 hours of sleep per day including his nap." C) "I need to put the side down on the crib so he can get out." D) "His father can give him a horseback ride into his bed."
B
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's 'negativism.' Based on Erickson's theory of development, what would be an appropriate intervention for this child? A) Discourage solitary play; encourage playing with other children. B) Encourage the child to pick out his own clothes. C) Use 'time-outs' whenever the child says 'no' inappropriately. D) Encourage the child to take turns when playing games.
B
The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations? A) "Respond in a calm but firm manner." B) "You need to adhere to various routines." C) "Put her in time-out when she misbehaves." D) "It's important to toddler-proof your home."
B
When instructing the parents of a toddler about appropriate nutrition, what would the nurse recommend? A) About 12 to 16 ounces of fruit juice per day B) Approximately 16 to 24 ounces of milk per day C) Fat intake of 30% to 40% of total calories D) An average of 10 to 12 grams of fiber per day
B
The nurse is helping parents prepare a healthy meal plan for their toddler. Which guidelines for promoting nutrition should be followed when planning meals? Select all that apply. A) The child younger than 2 years of age should have his or her fat intake restricted. B) Extending breastfeeding into toddlerhood is believed to be beneficial to the child. C) Weaning from the bottle should occur by 6 to 12 months of age. D) Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. E) The toddler requires an average intake of 500 mg calcium per day. F) Toddlers tend to have the highest daily iron intake of any age group.
B, D, E
The nurse is assessing a 3-year-old boy's development during a well-child visit. Which response by the child indicates the need for further assessment? A) He says a swear word when he hurts himself playing. B) He says "pew" when his sister has soiled her diaper. C) He laughs when his brother cries getting vaccinated. D) He constantly asks "why?" whenever he is told a fact.
C
The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse? A) The toddler gained 4 pounds in weight since last year. B) The toddler gained 3 inches in height since last year. C) The toddler's anterior fontanel is not fully closed. D) The circumference of the child's head increased 1 inch since last year.
C
The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly? A) Telling the child to stop tearing pages from magazines B) Asking the child if he would please quit throwing toys C) Telling the child firmly that we don't scream in the office D) Saying, "Please come over here and sit in this chair. OK?"
C
The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group? A) Remove children's security blankets at this stage to help them assert their autonomy. B) Distract toddlers from exploring their own body parts, particularly their genitals. C) Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior. D) Offer toddlers many choices to foster control over their environment.
C
The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. What might alert the nurse to a potential problem with the child's sensory development? A) The toddler places the nurse's stethoscope in his mouth. B) The toddler's vision tests at 20/50 in both eyes. C) The toddler does not respond to commands whispered in his ear. D) The toddler's taste discrimination is not at adult levels yet.
C
The nurse emphasizes that a toddler younger than the age of 18 months should never be spanked primarily for which reason? A) Spanking in a child this age predisposes the child to a pro-violence attitude. B) The child will become resentful and angry, leading to more outbursts. C) Spanking demonstrates a poor model for problem-solving skills. D) There is an increased risk for physical injury in this age group.
D
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? A) Completing puzzles with four pieces B) Winding up a mechanical toy C) Playing make-believe with dolls D) Knowing which are his or her toys
D
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? A) Limiting visitors to scheduled visiting hours B) Planning physical therapy for the child C) Introducing the toddler to other toddlers in the unit D) Monitoring the toddler for developmental delays
D
The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which safety intervention should the nurse address? A) Encourage parents to enroll toddlers in swimming classes to avoid the need for constant supervision around water. B) Advise parents to keep pot handles on stoves turned outward to avoid accidental burns. C) Encourage parents to smoke only in designated rooms in the house or outside the house. D) Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the backseat of the car.
D
The nurse is teaching the parents of a 2-year-old girl how to deal with common toddler situations. Which is the best advice? A) Discipline the child for regressive behavior. B) Scold the child for public thumb sucking. C) Tell the older sibling to not act like a baby. D) Have the child help clean up a bowel accident.
D
The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply. A) Applesauce B) Avocados C) Broccoli D) Sweet potatoes E) Spinach F) Carrots
D, E, F
