Growth and Development: Toddlers and Preschoolers

The mother of a 4-year-old boy is concerned because she thinks her son is touching his genitals frequently and asks the nurse if there is anything she can do about it. There are no signs of sexual abuse or urinary issues. What would the nurse's best response be? 1. "You should put him in time-out whenever he touches himself." 2. "Childhood masturbation is common and part of Freud's developmental stage." 3. "Ensure that he has a private space to engage in this type of behavior." 4. "You can give him a toy to distract him from this behavior."

2

The mother of a toddler asks the nurse when she should begin potty training her son. What is the best response from the nurse? 1. "Toilet training should be done between 2 and 3 years of age." 2. "Children typically show signs of readiness to potty train between the ages of 2 and 3." 3. "Choose a time that is convenient for you." 4. "Try some time on the toilet and be persistent if the child shows resistance."

2

A mother brings her 24-month-old daughter to the clinic for her well-child exam. The child will start daycare for the first time and the mother is concerned about separation anxiety. What is the best advice the nurse can give? 1. "When you drop her off at daycare, distract her with a toy, then sneak out the door quickly so she won't notice you leaving." 2. "Practice the leaving process at home by leaving a room when she is distracted with play." 3. "Separation anxiety peaks at 10 to 18 months of age, so it should not be a problem for your child." 4. "Stay calm, be consistent, and give reassurance that you will be back."

4

The parents of a 2-year-old being seen at the clinic state that they give the child a bottle of skim milk at night to help the child go to sleep. What follow-up question would be appropriate for the nurse to ask? 1. "How is your child's food intake during the day?" 2. "At what age did your child transition to skim milk?" 3. "What type of bottle do you use?" 4. "How many ounces of milk does your child drink?"

1

Which skills would the nurse assessing appropriate developmental skills expect to see for a 2 year old? Select all that apply. 1. Climbing up and down stairs 2. Turning a door knob 3. Having conversations using two to three sentences 4. Following simple instructions 5. Demonstrating separation anxiety

1, 2, 4, 5

The mother of an active 3-year-old asks the nurse for some suggestions to prevent an accidental poisoning. Which would the nurse include? Select all that apply. 1. Keep the number of poison control posted clearly and assure that all caregivers know where to locate it. 2. Place all potentially hazardous chemicals into smaller containers so that the child only has access to smaller quantities. 3. Place child-safe locks on all lower cabinets. 4. Keep all medications on a high shelf in upper cabinets. 5. Buy cleaning products with childproof tops.

1, 3, 4, 5

The nurse is teaching parents about normal cognitive development using Piaget's theory. Which actions should the nurse explain as characteristics of toddlers, ages 2 to 7 years? Select all that apply. 1. Egocentrism 2. Independence 3. Magical thinking 4. Concrete thought 5. Conservation

1, 3, 4, 5

Which developmental theories apply to a preschooler? 1. Initiative vs. guilt 2. Operational 3. Phallic 4. Preconventional 5. Preoperational

1, 3, 4, 5

Which physical assessment findings in a child does the nurse identify as demonstrating the anatomical or physiological differences between adults and children? Select all that apply. 1. Proportionally larger head as compared to body 2. A smaller tongue and smaller proportion of soft tissue in and around the airway 3. Less pliable chest 4. Weaker abdominal muscles 5. Belly breathing

1, 4, 5

The nurse is assessing a 4-year-old child who had a tonsillectomy earlier in the day. The client denies any pain when shown the FACES scale, but has elevated heart and respiratory rates. What is the best action for the nurse? 1. Allow the child to rest for 15 minutes then reassess. 2. Medicate the child with the prescribed oral analgesic. 3. Instruct the child that they need to be truthful and indicate whether they are having pain. 4. Switch to a different pain scale for increased accuracy.

2

The nurse is demonstrating proper teeth-brushing techniques to a group of mothers of 2-year-olds. What principle should be included in the presentation? 1. Parents should complete these tasks for their toddler. 2. Parents should be taught to encourage the child to participate under parental supervision. 3. Parents should allow the toddler to choose a time to brush their teeth in order to encourage control. 4. Parents should use only water to brush the child's teeth until the age of 3 in order to prevent the swallowing of toothpaste.

2

The nurse is orienting a new graduate to the unit when she notes the new graduate weigh a 3-year-old with clothing on. What is the best action for the nurse to take? 1. Recognize the new graduate is respecting the child's privacy and record the weight. 2. Ask the new graduate to reweigh the child wearing only underwear or a dry diaper. 3. Quietly reweigh the child in private so as not to embarrass the new graduate. 4. Ask the mother what the last known weight was to compare it with the current value.

2

The nursing student is helping the nurse provide care for a 4-year-old child. The student asks which behavior characterizes the preoperational stage in Piaget's cognitive developmental theory. How should the nurse respond? 1. Object permanence 2. Magical thinking 3. Inductive reasoning 4. Abstract thought

2

he nurse is assessing pain in a 14-month-old who is nonverbal. The nurse observes a child who is crying, tense, and continuously frowning, whose legs are drawn up into the abdomen, and who does not calm when touched or talked to. Based on the FLACC scale, what is the score the nurse would assign to this child?

2

on which topic should the nurse provide parental teaching in order to impact the leading cause of injury deaths in preschoolers and toddlers? 1. Firearm and gun safety 2. Use of lifejackets and floatation devices 3. Secondhand smoke in the home 4. Proper use of a bicycle helmet

2

An 18 month old female is brought to the clinic by her mother for a well-child visit. What components of an assessment would the nurse evaluate in an 18-month-old. Select all that apply. 1. BMI 2. Head circumference 3. Fontanel assessment 4. Developmental screening 5. Weight for length

2, 3, 4

What are the main anatomical differences between children and adults that enhances children's risk of suffocation? 1. Larger head 2. Larger tongue 3. More elastic airway 4. Shorter airway 5. Greater portion of pharyngeal soft tissue

2, 3, 4, 5

In providing discharge instructions for a preschooler recently hospitalized for asthma, the nurse should include monitoring for which signs of respiratory distress? Select all that apply. 1. Clear nasal discharge 2. Inability to complete a sentence 3. Being able to see ribs during inhalation 4. Leaning back in a chair in order to breathe 5. Flaring of the nares or nostrils when breathing in

2, 3, 5

Based on your knowledge of the World Health Organization (WHO) growth chart determination, what would be the weight determination and the health implication for a 2.5-year-old child who weighed 3.5K kg at birth? 1. 7 kg 2. 10.5 kg 3. 14 kg 4. 17.5 kg

3

Following Erikson's theory of psychosocial development, which scenario does the nurse use to describe a toddler in the autonomy vs. shame and doubt stage? 1. A 2-year-old male who allows his mother to cut up his food in bite-size pieces. 2. An 18-month-old female who sleeps with a nightlight. 3. A 28-month-old female who shows interest in using the toilet. 4. A 22-month-old male who only shows interest in playing with his train.

4

The mother of a 14-month-old is concerned that her child does not talk as much as other children in the same day care. What should the nurse understand about normal speech development for this age? 1. The child should be able to speak in sentences with two to three words by this age. 2. The child should be able to use the words, "I" and "me" in a sentence by this age. 3. Language is so individual, so speech delays are not diagnosed until school years. 4. The child should be able to speak approximately five words by this age.

4

The nurse is assessing the pain level for a 4-year-old female with a radial fracture. The child is developmentally delayed and nonverbal. What assessment finding indicates that she is comfortable and does not require a pain-relieving intervention? 1. She has a furrowed brow and is grimacing. 2. She is restless and is having difficulty taking a nap. 3. She is agitated and irritable. 4. She is watching a cartoon and has propped her fractured arm up on a pillow.

4

The nurse is preparing to perform a physical assessment on a 3-year-old toddler. What technique should the nurse use to gain cooperation from the child? 1. Begin with the most invasive parts of the exam to get those done quickly. 2. Use a systematic approach from head to toe to avoid missing any areas. 3. Stop if the child protests or refuses to cooperate. 4. Begin with least invasive parts of the exam then move to more intrusive areas.

4

When taking the dietary history of a preschooler, the nurse is told by the child's mother that the preschooler will go several days eating very little. Other days, the preschooler cannot seem to get enough food. What is the appropriate interpretation of this situation? 1. Preschoolers are expected to eat a more adult-type meal pattern. 2. Preschoolers should consume the same number of calories every day. 3. Preschoolers should not be expected to sit with the family for meals, so should be allowed to snack whenever necessary. 4. This is typical behavior, as preschoolers will fluctuate in the amount of intake at each meal.

4

The nurse is aware that signs of readiness for toilet training in toddlers/preschoolers include which behaviors? Select all that apply. 1. Infrequent bowel movements 2. Not bothered by the feeling of a wet or dirty diaper 3. Wakes from every nap with a wet diaper 4. Ability to follow simple directions 5. Ability to pull pants up and down

4, 5

The nurse caring for a 4 year old is concerned about a low blood pressure reading. What is the lower end of a normal systolic blood pressure for this age group? Include your answer in number format only, do not include any units.

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