Chapter 32 - the toddler and family (evolve)
The nurse notices that a toddler is more cooperative when taking medicine from a small cup rather than from a large cup. This is an example of which characteristic of preoperational thought? Egocentrism Irreversibility Inability to conserve Transductive reasoning
Inability to conserve
The nurse is teaching the parents of a toddler about toilet training. What is the right age to start toilet training a child? 12 to 16 months 17 to 20 months 21 to 24 months 25 to 30 months
25 to 30 months
When completing the health assessment for a 2-year-old child, what should the nurse expect the child to do? Engage in parallel play Be one third of the adult height Fully dress self with supervision Have a vocabulary of at least 500 words
Engage in parallel play
The nurse is talking with the parents of a toddler to obtain the dietary history. The nurse learns that the child consumes dairy products and has fish sticks on rare occasions but does not eat any other meat at all. Which type of vegetarian diet does the child's family follow? Macrobiotic Semi-vegetarian Lacto-vegetarian Lacto-ovo vegetarian
Lacto-ovo vegetarian
The nurse is assessing a child who is macrobiotic and has inadequate intake of proteins and calories. What is the right nursing intervention to promote protein intake? Assess and refer the child to a pediatrician Plan a diet according to the child's requirements Start administration of supplemental formulations Consider this as age-related change and ignore it
Plan a diet according to the child's requirements
How can poisoning in toddlers best be prevented? Consistently using safety caps Keeping ipecac syrup in the home Storing poisonous substances out of reach Storing poisonous substances in a locked cabinet
Storing poisonous substances in a locked cabinet
The nurse is assessing a 4-year-old child with delayed motor development. The nurse notes that the child stands with a wide base. What does the nurse interpret from this finding? The child has impaired perception of depth. The child has impaired balance of the body. The child has impaired sensation in the foot. The child has very weak lower limb muscles.
The child has impaired balance of the body.
The nurse is assessing a 2-year-old child as part of a general examination. Which phase of cognitive development does the nurse assess? The fifth stage of the sensorimotor phase The final stage of the sensorimotor phase The third stage of the sensorimotor phase The preconceptual stage of the preoperational phase
The preconceptual stage of the preoperational phase
The nurse allows a 2-year-old child to play in the play area of the clinic. Which play items are suitable for this child? Computer Rattle toy Painting set Wood puzzles Soft stuffed toy Construction sets
Wood puzzles Construction sets
The nurse is assessing a 15-month-old girl. The child's mother reports that the child is bed-wetting and throws tantrums when made to sit on the potty seat. Which response by the nurse is appropriate? "Children learn bladder training earlier than bowel training." "You can start toilet training when the child is 18 months old." "Don't worry; bed-wetting is common up to 7 years of age in girls." "Girls start recognizing the urge to urinate 2 months later than boys."
"You can start toilet training when the child is 18 months old."
What does the nurse instruct the parents to keep away from the child's diet when the child is receiving iron supplementation? Antacids Fruit juice Whole milk Meat or fish Tea or coffee
Antacids Whole milk Tea or coffee
The nurse is teaching the parent of a 2-year-old child how to care for the child's teeth. What teaching should be included? Flossing is not recommended at this age. The child is old enough to brush teeth effectively. Brush teeth with plain water if child does not like toothpaste. Toothbrush should be small and have hard, rounded, nylon bristles.
Brush teeth with plain water if child does not like toothpaste.
The parent expresses to the nurse that the child refuses to go to sleep, repeatedly gets out of bed, and wakes up very late in the morning. Which nursing intervention is helpful to manage sleep disturbances in the child? Firmly tell the child to get up early in the morning Enforce consistent limits about the child's bedtime behavior Reassure the parent that this behavioral phase is temporary Arrange a sleeping area separate from other family members
Enforce consistent limits about the child's bedtime behavior
What should the nurse recommend to help a toddler cope with the birth of a new sibling? Discourage the toddler from helping with care of new sibling Give the toddler a doll on which he or she can imitate parenting Explain to the toddler that a new playmate will soon come home Prepare the toddler for upcoming changes about 1 to 2 weeks before birth of the sibling
Give the toddler a doll on which he or she can imitate parenting
The nurse asks the parents to give food to a toddler on the same plate daily. Which characteristic of preoperational thought process is this instruction based on? Centration Egocentrism Global organization Transductive reasoning
Global organization
A parent of a toddler reports to the nurse that the child always says no at mealtimes. Which corrective actions does the nurse suggest to the parent? Meals should be set at regularly scheduled times. Show inconsistency in behavior with their children. Decrease the opportunities for a negative answer. Allow the child to eat whenever the child wants to. Feed the child with the child's favorite plate and spoon.
Meals should be set at regularly scheduled times. Decrease the opportunities for a negative answer. Feed the child with the child's favorite plate and spoon.
After conducting the fine motor skill assessment of a 2-year-old child, the nurse concludes that the child has the fine motor skill development of an 18-month-old child. Which fine motor activities can the child do? Build a tower using eight cubes Use spoon to eat food without spilling Release a pellet in a narrow-necked bottle Use a cup for drinking water without spilling Draw on a paper by holding crayons with fingers
Release a pellet in a narrow-necked bottle Use a cup for drinking water without spilling
The nurse is educating parents about ways to prevent and treat burns to a group of families. What first aid measures does the nurse teach the parents? Remove the burned clothes and jewelry Apply an oil or ointment to the affected skin Cover the burn area, ideally with a cling film Cool the burned area instantly with ice water Put an adhesive dressing on the burned area Remove the person away from the source of the heat
Remove the burned clothes and jewelry Cover the burn area, ideally with a cling film Remove the person away from the source of the heat
The parents of a toddler state their child is having trouble sleeping. What is the nurse's best suggestion to improve sleep habits? Explaining away fears Varying the bedtime ritual Using a transitional object Restricting stimulating activities during the day
Using a transitional object
A pregnant patient says to the nurse, "I don't know how my 3-year-old child will react after the birth of the baby." Knowing that toddlers have sibling rivalry, what does the nurse suggest to the patient? "Inform the child that within 8 months a new playmate is going to come." "Alert your visitors to spend time equally with the child and the newborn." "Encourage the child to sleep in a separate room after the newborn's birth." "Allow your child to spend more time with the newborn by leaving them alone."
"Alert your visitors to spend time equally with the child and the newborn."
The parents of a 2-year-old child are worried and report to the nurse that their child always sleeps on the rocking chair and not the bed. They add that the child is afraid to sleep on the bed due to a fear of a monster under the bed. What does the nurse recommend to the parents? "Arrange the sleeping area for the child alongside other family members." "Encourage the child to look under the bed and explain that monsters do not exist." "If the child starts crying, then allow the child to sleep on a rocking chair for 15 minutes." "Encourage the child to sleep on the child's own bed by putting the child to bed when awake."
"Encourage the child to sleep on the child's own bed by putting the child to bed when awake."
The parent of an 18-month-old child tells the nurse that the child has become a picky eater and is eating less. What does the nurse teach the parent to improve the eating habits of the child? "Administer vitamin supplements to your child regularly to prevent malnutrition." "The plate should look colorful, so completely fill it with salad and other dishes." "Make sure that one type of food does not touch another type on the same plate." "Make the food pleasant and serve it on different colored plates to get the child to eat."
"Make sure that one type of food does not touch another type on the same plate."
The student nurse working in a pediatric ward asks the clinical instructor, "Why do most toddlers have several episodes of tonsillitis and upper respiratory tract infections?" Which response given by the clinical instructor is appropriate? "The respiratory tract of toddlers is short and straight." "The lymphoid tissue of the tonsils is small in toddlers." "Production of antibodies is not well established in toddlers." "The circumference of the respiratory tract is small in toddlers."
"The respiratory tract of toddlers is short and straight."
A parent has a 2-year-old in the clinic for a well-child checkup. Which statement by the parent indicates to the nurse that the parent needs more instruction regarding accident prevention? "We locked all the medicines in the bathroom cabinet." "We turned down the thermostat on our hot water heater." "We stopped using the car seat now that my child is older." "We placed gates at the top and bottom of the basement steps."
"We stopped using the car seat now that my child is older."
The nurse has taught the parents of an 18-month-old child about the behavior of toddlers. Following the teaching session, the nurse asks the parents what they would do if their child accidentally falls down from a staircase and starts scolding the staircase. What response given by the parents indicates effective understanding? "We would join the child in scolding the staircase." "We would say to the child that it's bad to scold someone." "We would advise the child to walk carefully on the stairs." "We would make the child realize that it was the child's mistake."
"We would join the child in scolding the staircase."
Myelination of the spinal cord is almost complete by 2 years of age. As a result of this, what can the toddler gradually achieve? Visual acuity of 20/20 Throwing a ball without falling Slowing of gastrointestinal transit time Control of anal and urethral sphincters
Control of anal and urethral sphincters
The parent of a 26-month-old child reports to the nurse that the child spends most of the time talking to a doll and cares for it as if it is a small baby. The parent also reports that sometimes the child throws toys around with force. What does the nurse interpret about the child's behavior? The child has normal behavior. The child has impaired thinking. The child has impaired thoughts. The child has impulsive behavior.
The child has normal behavior.
The nurse is teaching motor vehicle injury prevention measures to a group of parents. Which statement made by a parent indicates effective learning? The parent will allow the child to ride a tricycle alone. The parent will only use federally approved car restraints. The parent will let the child use only the shoulder restraint. The parent will allow the child to play behind the parked car.
The parent will only use federally approved car restraints.
The nurse is assessing a 14-month-old child. The child's mother is worried as the child is able to say only one word, "Maa." To reduce panic the nurse educates the mother about language development. Which statement made by the nurse is appropriate? "A child's speech is not properly developed until 5 years of age." "At the age of 1 children start using one-word sentences and gestures." "Encourage the child to watch television, as it helps to improve language skills." "Children start using simple sentences and avoid using gestures at the age of 2."
"At the age of 1 children start using one-word sentences and gestures."
What are the factors that increase the absorption of iron in the diet? Tannins Oxalates Phosphates Ascorbic acid Acidity (low pH)
Ascorbic acid Acidity (low pH)
What do characteristics of physical development of a 30-month-old child include? Genital fondling is noted. Anterior fontanel is open. Birth weight has doubled. Sphincter control is achieved. Primary dentition is complete.
Sphincter control is achieved. Primary dentition is complete.
Which statement describes the growth and development in a 24-month-old child? The child can go up and down stairs alone. The child can jump in place using both feet. The child can run clumsily and frequently falls. The child can walk upstairs holding one hand to the side rail.
The child can go up and down stairs alone.
The nurse assesses a toddler who is anxious because the parents are getting divorced. What behaviors does the nurse see when caring for this child? . Separation anxiety Fear and confusion Increased aggression Regressive behaviors Severe panic reactions
Separation anxiety Fear and confusion Regressive behaviors
The nurse is teaching the parent of a 16-month-old child about safety measures that should be taken while storing medications at home. Which statement made by the nurse is most appropriate to prevent accidental poisoning of the child? "If the child has a fever, administer aspirin to the child, as it is safe." "You should keep the ointments and disinfectant in a table drawers." "Always keep lozenges and transdermal patches in a closed locked cabinet." "Medication having caps can be placed bedside as children cannot open the caps."
"Always keep lozenges and transdermal patches in a closed locked cabinet."
A parent of an 18-month-old child reports to the nurse that the child has become a "finicky eater" and is eating less. Knowing that 18-month-old children have physiologic anorexia, what suggestion does the nurse provide to improve the eating habits of the child? "Give vitamin supplements to the child regularly to prevent malnourishment." "Make sure that one variety of food does not touch another variety on the plate." "The plate should look colorful, so completely fill it with salad and other dishes." "To attract the child toward food, serve the food on different colored plates every time."
"Make sure that one variety of food does not touch another variety on the plate."
What is the daily requirement of calcium for children 1 to 3 years of age? Record your answer using a whole number. mg/day
500
The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother breastfeeds her back to sleep. What should the nurse suggest to help them deal with this problem? Putting her in parents' bed to cuddle Letting her cry herself back to sleep Beginning to put her to bed while still awake Giving her a bottle of formula instead of breastfeeding her so often at night
Beginning to put her to bed while still awake
One of the major tasks of toddlerhood is toilet training. In teaching the parents about a child's readiness for toilet training, what is it important for the nurse to emphasize? The toddler must have the gross motor skill to climb up to the adult toilet before training is begun. Bowel control is accomplished before bladder control, so the parent should focus on bowel training first. The universal age for toilet training to begin is 2 years; the universal age for completion is 4 years. Nighttime bladder control develops first, so parents should focus on that in the initial teaching with their toddler.
Bowel control is accomplished before bladder control, so the parent should focus on bowel training first.
The parents of a toddler ask the nurse how to handle their child's increasing number of temper tantrums. Which positive reinforcement methods for reducing the number of tantrums should the nurse include? Suggest that parents provide the child an "all or none" position Encourage the parents to provide comfort once the child has calmed down Ask parents to praise the child for positive behavior when not having a tantrum Tell parents not to give in to the original request that started the temper tantrum Suggest that parents ignore the behavior as long as child is not harming himself
Encourage the parents to provide comfort once the child has calmed down Ask parents to praise the child for positive behavior when not having a tantrum Tell parents not to give in to the original request that started the temper tantrum Suggest that parents ignore the behavior as long as child is not harming himself
What appropriate growth and developmental changes can be observed in a toddler? The birth weight doubles by 30 months of age. The anterior fontanel closes at 18 months of age. The toddler has daytime bowel and bladder control at 18 months. The toddler is able to take a few steps on tiptoes by the age of 30 months. The toddler can run fairly fast with a wide stance by the age of 24 months.
The anterior fontanel closes at 18 months of age. The toddler is able to take a few steps on tiptoes by the age of 30 months. The toddler can run fairly fast with a wide stance by the age of 24 months.
After assessing a 24-month-old child, the nurse tells the child's parent that the child has age-appropriate growth and development. Which characteristics does the nurse observe in the child? The child is able to build a tower of seven cubes. The child is able to turn the pages of a book one at a time. The child is able to kick a ball forward without overbalancing. The child is able to say six words including the parents' names. The child's weight is 11 kg (24 lb) and height is 78.7 cm (31 inches).
The child is able to build a tower of seven cubes. The child is able to turn the pages of a book one at a time. The child is able to kick a ball forward without overbalancing.
The parents report to the nurse that their infant has difficulty sleeping because of prolonged nighttime feedings. What instructions does the nurse give to the parents? Limit the total number of feedings Allow the child to go to sleep early The infant should go to bed awake Increase daytime feeding intervals Offer last feeding as late as possible
The infant should go to bed awake Increase daytime feeding intervals Offer last feeding as late as possible
The nurse notices a child refuses to drink milk at the hospital. When the nurse asks the child about it, the nurse discovers that at home the child drinks milk in a small glass. What is the most acceptable nursing intervention? The nurse compels the child to drink milk as it is healthy. The nurse asks the child's parents to give the milk to the child. The nurse pours the milk into a small glass for the child to drink. The nurse tells the child that both glasses have the same amount.
The nurse pours the milk into a small glass for the child to drink.
The nurse is assessing a toddler and notices that the toddler kicks his/her feet and screams as loud as possible. What type of emotion does the nurse document? Fear Grief Anger Curiosity
anger
The nurse is assessing a 12-month-old child. The child's parent reports, "My child has the habit of having a bedtime bottle and sleeps only when a bottle of milk is given." What does the nurse say to the parents? "You should immediately consult a child psychologist." "It is common to use a bedtime bottle with a 12-month-old child." "You can give a bottle of water rather than a bottle of milk to the child." "You can give honey-coated pacifiers instead of giving a milk bottle to the child
"You can give a bottle of water rather than a bottle of milk to the child."
The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy? Help the toddler complete tasks Help the toddler learn the difference between right and wrong Provide opportunities for the toddler to play with other children Encourage the toddler to do things for himself or herself when he or she is capable of doing them
Encourage the toddler to do things for himself or herself when he or she is capable of doing them
Which statement about early childhood caries (ECC) is correct? The syndrome can be prevented by breastfeeding. Giving the child juice in the bottle instead of milk at bedtime prevents this syndrome. Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome. The syndrome is distinguished by protruding upper front teeth, resulting from sucking on a hard nipple.
Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome.
The nurse finds that a child has several dental caries. The nurse learns that the child refuses to go to sleep without a bottle full of juice. How does the nurse promote dental health in the child? The nurse tells the child to drink juice in a cup. The nurse offers extra transitional objects to the child. The nurse explains to the child about the dental caries. The nurse instructs that dental caries can be prevented. The nurse uses the reward technique to change behavior.
The nurse tells the child to drink juice in a cup. The nurse instructs that dental caries can be prevented. The nurse uses the reward technique to change behavior.
