EAQ C - Toddler

A child in respiratory distress is admitted to the hospital and diagnosed with acute spasmodic laryngitis (spasmodic croup). At the time of discharge, which recommendation would the nurse make to the parent for handling another attack at home? a. "Place them near a cool-mist humidifier." b. "Bring them to the ED." c. "Give them an over-the-counter cough syrup." d. "Offer them warm tea sweetened with honey."

a During a spasmodic croup attack, cool humidified air to decrease inflammation is a fast home remedy. An attempt should be made to interrupt the attack at home first rather than going to the ED. Cough syrup is ineffective because it does not relieve laryngeal spasm. Tea with honey is an ineffective remedy for a spasmodic croup attack, and the tea may present a risk of aspiration.

Which topic would the nurse include in a teaching session for the parent of a 13-month-old child? a. Gradual weaning from the bottle b. Signs of toilet training readiness c. Peer companionship during play d. Development of nighttime fears

a The nurse would include information regarding gradual weaning from the bottle for the parent of a 13-month-old toddler age child. Toilet training readiness, peer companionship during play, and the development of nighttime fears are more appropriate for a toddler-age client between the ages of 18 and 24 months.

Which step would the nurse undertake during the administration of eardrops in children ages 1 to 3 years? a. Pulling the auricle down and backward b. Placing the cotton ball in the innermost part of the canal c. Keeping the toddler in the side-lying position for 10 to 15 minutes d. Holding the dropper 3 cm above the child's ear canal to instill the drops

a To administer eardrops to a toddler, pull the auricle down and back. The cotton ball is placed in the outermost part of the ear canal. The toddler is kept in the side-lying position for 2 to 3 minutes. The dropper is held 1 cm above the ear canal for the instillation of drops.

Which of these diseases is most common in toddlers? a. Influenza b. Lung cancer c. Hypertension d. Angina pectoris

a Toddlers are very prone to developing upper respiratory tract infections; hence, influenza is seen most frequently among toddlers. Lung cancer is seen commonly in younger or middle-age adults from smoking. Hypertension is commonly seen in middle age due to an unhealthy diet, lack of exercise, and stress. Angina is common in young and middle-age adults.

Which is true regarding a toddler's sleep? a. Total sleep averages 12 hours a day. b. In the awake period, a toddler exhibits sleepwalking. c. A toddler normally takes several naps during the day. d. It is uncommon for toddlers to awaken during the night.

a Toddlers sleep 12 hours a day on an average. In the awake period, preschoolers, rather than toddlers, exhibit brief crying, walking around, unintelligible speech, sleepwalking, or bedwetting. An infant normally takes several naps during the day but usually sleeps an average of 8 to 10 hours during the night. It is common for toddlers to awaken during the night.

Which blood pressure would the nurse recognize as normal in toddlers? a. 85/54 mm Hg b. 95/65 mm Hg c. 105/65 mm Hg d. 110/65 mm Hg

b 95/65 mm Hg is the normal blood pressure of toddlers. The normal blood pressure in infants is 85/54 mm Hg. The optimal blood pressure for children above the age of 6 years is 105/65. Between the ages of 10 and 13 years, normal blood pressures is 110/65 mm Hg.

Which gross motor skill would the nurse anticipate when assessing a 15-month-old child during a scheduled health maintenance visit? a. Using a cup well b. Creeping up stairs c. Scribbling spontaneously d. Building a tower of 2 blocks

b Creeping up the stairs is a gross motor skill the nurse expects when assessing a 15-month-old toddler-age client during a scheduled health maintenance visit. Using a cup well, scribbling spontaneously, and building a tower with two blocks are all fine, not gross, motor skills the nurse expects when assessing a 15-month-old toddler-age client.

What clinical condition is associated with lead poisoning? a. Asthma b. Anemia c. Metabolic acidosis d. Systemic infection

b Lead can interfere with the binding of iron onto the heme molecule. This can cause anemia even though the child is not iron deficient. Asthma, metabolic acidosis, and a systemic infection are not associated with lead poisoning.

Which statement is true regarding the importance of play for children? a. Pretend play hampers the cognitive development of children. b. Playing is important because it helps children to release frustration. c. Children should be introduced to reality if they have imaginary playmates. d. Children should completely avoid television, electronic games, and computer programs.

b Playing serves as a medium for children to release frustration. Pretend play allows children to learn to understand others' points of view, develop skills in solving social probems, and become more creative. Some children have imaginary playmates. Imaginary playmates are a sign of health and help children distinguish between reality and fantasy. Television, videos, electronic games, and computer programs support development and the learning of basic skills. There should be limited use of these for preschoolers, but these need not be completely avoided. On the other hand, television, electronic games, and computer programs have lasting negative effects on a toddler's language development, reading skills, and short-term memory.

How does the skeletal system of a toddler differ from that of an older adult? a. Toddlers' bones are less pliable than the bones of older persons. b. Toddlers' bones can withstand falls better than the bones of older adults. c. Toddlers' bones are more susceptible to osteoporosis than the bones of older adults. d. Toddlers' bones are more susceptible to bone loss than the bones of older persons.

b The bones of toddlers can better withstand falls than the bones of older adults. Toddlers' bones are more pliable than the bones of older people. Older adults, especially women, are more prone to developing osteoporosis, which increases the risk of fractures. Older adults, especially women, are more susceptible to bone loss.

How many words would the nurse expect the 3-year-old child to acquire each day? a. 2 to 3 b. 5 to 6 c. 8 to 10 d. 11 to 13

b The nurse would expect the 3-year-old toddler-age child to acquire five to six new words each day. Two to three new words, 8 to 10 new words, and 11 to 13 new words are not expected parameters for language development.

What is the recommended size of the urinary catheter that can be used in a 3-year-old child? a. 5 to 6 Fr b. 8 to 10 Fr c. 14 to 16 Fr d. 16 to 18 Fr

b The recommended size of a urinary catheter that can be used in a 3-year-old child is 8 to 10 Fr. A urinary catheter of 5 to 6 Fr is generally used in infants. A length of 14 to 16 Fr is recommended for most adult clients. A length of 16 to 18 Fr is commonly used in adult males.

Which approach would the nurse take to prepare the parent to adhere to their toddler's dietary restrictions after colorectal surgery? a. Limit restrictions to nonessential foods b. Handle dietary changes in a matter-of-fact way. c. Have the dietitian explain the restrictions to the parents d. Arrange to have an adult other than a parent stay at mealtime.

b Toddlers are ritualistic and do not tolerate change well; therefore, any change in diet should be done in a matter-of-fact way. Limited restrictions on nonessential foods are not always possible. Although the parent could consult with the dietician, this action will not change the toddler's response to the dietary restrictions. The toddler is still dependent on the parent and will respond better to them than to a stranger.

A child has a respiratory tract infection with a low-grade fever. When teaching the parent, which intervention would the nurse emphasize? a. Encouraging high-calorie snacks to prevent weight loss b. Keeping the toddler wrapped in blankets to prevent shivering c. Giving small amounts of clear liquids frequently to prevent dehydration d. Using cool-water baths to prevent the child's fever from increasing further

c Fluid is lost through perspiration and the increased metabolic rate associated with a fever; an intake of small, frequent amounts of fluids will replenish lost fluid and prevent dehydration. Although caloric intake is important, it is not the priority. Keeping the toddler wrapped in blankets to prevent shivering interferes with the radiation of heat from the body; dressing the toddler in light clothing will help reduce the fever. Cool baths may produce shivering; this will increase the fever. A low-grade fever is part of the body's adaptive mechanism that limits the multiplication of microorganisms.

Which statement by the nurse is true about health promotion in infants and toddlers? a. Allow a toddler to sleep on their side. b. Place pillows in the crib of an infant. c. Remove grocery plastic bags from the home. d. Keep pacifiers on a ribbon around a toddler's neck.

c Removing grocery and dry cleaner's plastic bags from the home reduces the risk of suffocation from the plastic bags. Parents should have the infants sleep on their backs to reduce the risk of SIDS. Placing pillows in the crib increases the chances of suffocation. A string or ribbon around the neck increases the risk of choking. Snug-fitted sheets should be used in cribs because the possibility exists for infants to become entwined in sheets and other bedding and suffocate.

Which consideration would the nurse identify as the most important need of a hospitalized toddlers? a. Stimulating play b. Social opportunities c. Contact with their parent d. Gentle discipline from the nurse

c Separation anxiety becomes an issue at this age; toddlers need contact with their parent, who provides a sense of security. Stimulating play may offer a distraction, but the greater need is for parental contact. Toddlers do need social opportunities, but parental contact is more important. Gentle discipline from the nurse may be necessary at times, but the greatest need of hospitalized toddlers is parental conduct.

Which method of medication administration is commonly used in toddlers when the child has poor IV access during an emergency situation? a. Intrathecal b. Intraarterial c. Intraosseous d. Intraperiotoneal

c The intraosseous route is commonly used in toddlers for medication administration in an emergency situation. It is most commonly used in infants and toddlers in whom there is poor access to the intravascular space. Intrathecal administration is often associated with long-term medication administration through surgically implanted catheters. Intraarterial infusions are common in clients who have arterial clots. Chemotherapeutic agents, insulin, and antibiotics are administered via the intraperitoneal route.

Which fine motor skill would the nurse anticipate when assessing a 15-month-old client during a health maintenance visit? a. Kneeling without support b. Standing without support c. Creeping up stairs without assistance d. Holding cubes in one hand without assistance

d Holding cubes in one hand without assistance is a fine motor skill the nurse would anticipate when assessing a 15-month-old client during a health maintenance visit. Kneeling, standing and creeping up stairs without support are all gross, not fine, motor skills.

Which statement is true about an appropriate diet for toddlers? a. Finger foods should not be served. b. Toddlers need 4 to 6 cups of milk per day. c. Low-fat or skim milk should be given until the child is 2 years old. d. Milk should be supplemented with solid food items like vegetables and fruits.

d Parents of toddlers should supplement the child's intake of milk with solid foods, ensuring a balanced diet for adequate growth. Serving finger foods to toddlers allows them to eat by themselves and satisfy their need for independence and control. The intake of milk should be limited to 2 to 3 cups because the consumption of more than a quart of milk per day tends to decrease the child's appetite for essential solid foods and results in adequate iron intake. Children under 2 years of age should not be given low-fat or skim milk because fat is important for physical and intellectual growth.

Which statement is true for collecting a urine sample in toddlers? a. A hat is placed under the toilet seat b. Urine can be squeezed from the diaper. c. Force the child to void in the unfamiliar receptacle. d. Single-use bags can be placed over the child's urethral meatus.

d Single-use bags are placed over the child's urethral meatus for collecting urine in toddlers. A potty chair or specimen hat placed under the toilet seat is usually effective in cases of young children. Specimens obtained by squeezing urine from the diaper are not used because the results will be inaccurate. A young child is often reluctant to void in unfamiliar receptacles. They should not be forced to void.