NUR 414A Early Childhood Development (Toddler & Preschooler)
vaccinations for entering kindergarten
-have to be given after 4th birthday -5th Dtap, 4th IPV, 2nd MMR, 2nd Varicella -occurs during 4th year well-check usually
growth for preschoolers
slow and steady, gain b/w 4-5 lbs/year
what should you teach your toddler (1-3 yr old) when they begin self-exploration (touching genitals)
-teach names of body parts -teach body privacy -teach that mom, dad, grandparents etc. are the only ppl who can help give bath or help potty and that is the only time when genitals will may be touched -if you or dr needs to examine private areas, verbalize the reason you are touching or looking at that area and have the parent present
Which assessment finding should the nurse identify as a physical readiness cue for a toddler-age client related to toilet training? 1. Having regular bowel movements 2. Willing to invest the time needed 3. Telling a parent that the diaper is wet 4. Expressing a willingness to please parents
1 A toddler-age client who has regular bowel movements is exhibiting a physical readiness for toilet training. Willingness to invest the time needed indicates parental readiness, not a physical readiness by the toddler, to begin toilet training. Telling a parent that the diaper is wet indicates a mental readiness by the toddler-age client for toilet training. Expressing a willingness to please parents indicates the toddler is psychologically ready for toilet training.
At which age would the nurse anticipate the appearance of an imaginary friend for a preschool-age client? 1. 3 year old 2. 4 year old 3. 5 year old 4. 6 year old
1 Imaginary friends typically appear by 3 years of age and can last throughout the preschool stage of development. If an imaginary friend has not appeared by this age, it is unlikely to expect this to surface at 4, 5, or 6 years of age.
what is ritualistic behavior
remaining "sameness" and reliability, provides sense of comfort ex. rituals of going to bed
what is object permanence
the awareness that things continue to exist even when not perceived
safety interventions for preschooler (age 3-6 yrs)
-learn safety habits -teach injury prevention -traffic safety -fire prevention -water safety -stranger safety -need to be in booster seat until they are 80 lbs and a height of 4.9 inches
stressors for preschoolers according to erikson
-moving -illness -school -fear of pain and anxiety -regression is normal
overall gross motor development changes in preschoolers
big increase in strength and fine tuning ability to perform gross motor abilities
A nurse educates a mother about safety measures for preschoolers. Which statement by the mother indicates the need for further education? 1. I should not allow my child to talk to strangers 2. I should not teach my child how to swim until he or she is much older 3. I should teach my child about basic physical safety rules 4. I should remove doors from unused refrigerators and freezers
2 Children should be taught to swim at an early age, but under supervision. The mother should teach the child not to talk to strangers in order to avoid the risk of injury and stranger abduction. Preschoolers should be taught about basic physical safety rules. The mother should be instructed to remove doors from unused refrigerators and freezers because if a child cannot freely exit from appliances, asphyxiation may occur.
Which parental statement regarding the use of car safety seats for a toddler-age child indicates the need for further education by the nurse? 1. I should follow the manufacturer instructions regarding use 2. I should allow my child to ride unrestrained for short car trips 3. I should allow my child to have a toy for quiet play while in the car 4. I should encourage my child to help attach the buckles
2 Toddler-age children should never be allowed to ride in a motor vehicle unrestrained, even for short car trips. This statement indicates the need for further education. The parental statements regarding following manufacturer instructions, allowing the child to have a toy for quiet play, and encouraging the toddler to assist with buckles all indicate correct understanding
At what age is a toddler-age client physiologically and psychologically prepared for toilet training? 1. 13 months 2. 16 months 3. 19 months 4. 22 months
4 The 22-month-old toddler-age client is both physiologically and psychologically prepared for toilet training. The 13-month-old, the 16-month old, and the 19-month old are not yet physiologically and psychologically prepared for toilet training.
age group for erikson's initiative vs. guilt
preschooler (3-6 yr old)
sensory development 18 months to 2 years
use short sentences
when does the anterior fontanel close
18 months
Which age should the nurse anticipate that a toddler-age client will begin to develop awareness of ownership? 1. 15 months 2. 18 months 3. 24 months 4. 30 months
2 A toddler-age client begins to be aware of ownership [1] [2] at the age of 18 months. The nurse would not expect this to begin at 15 months, 24 months, or 30 months.
During which health maintenance visit for a toddler-age client should the nurse assess the ability to throw a ball overhand without losing balance? 1. 12 months 2. 18 months 3. 24 months 4. 30 months
2 A toddler-age client should be able to throw a ball overhand without losing balance by 18 months of age [1] [2]. Twelve months is too young to throw a ball without losing balance. Twenty-four months and 30 months are later than when the nurse anticipates this skill to occur.
language development at 5 years
2100 words
age group for preschoolers
3 years-6 years
when can toddler completely feed themselves
36 months (3 years)
fine motor development at 15 months
uses a cup well, builds tower of 2 blocks
How should a nurse control the negative behavior of a toddler? 1. By allowing for more openness 2. By using invasive methods 3. By limiting his or her opportunities to say no 4. By giving the toddler choices
3
erikson's stage for 1-3 year olds
autonomy vs shame and doubt
fine motor development 30 months
good hand finger coordination
play for preschooler
-associative, enjoys and imitates dramatic play -imitate same sex role in play -provide toys that develop motor and coordination skills: tricycles, sliding boards, paint, clay -parental supervision of TV: no screens until 2 y/o, no more than 1 hr of screen time after 2 y/o, takes things literally so watch media they are consuming -enjoys sing a longs and rhymes
new skills for preschooler according to erikson
-keeping friends -childs world moves from family to the neighborhood community -less negative in demeanor -wants to please adults and authority figures
Which parental statement indicates correct understanding of toddler actions that correspond with the preoperational stage of development? Select all that apply. 1. My child is expected to use past tense verbs 2. My child should begin to imitate animal sounds 3. My child should begin to gesture up and down 4. My child should begin to use two-to-three word phrases 5. My child is expected to find hidden objects in only one location
1, 4 During the preoperational stage of development the toddler-age client is expected to use past tense verbs and two- to three-word phrases. These parental statements indicate correct understanding. Imitating animal sounds, gesturing up and down, and finding hidden objects in only one location is an expectation during the sensorimotor stage of development
The pediatric nurse compares the sources of stress in preschoolers of different ages. Which source creates stress in both 3-year-olds and 4-year-olds? 1. Nap or bedtime 2. Insecurity 3. Questions 4. Fears
4
A nurse is documenting the assessment findings of four preschool children with the help of a chart. Which child does the nurse identify to have a lack of adequate cognitive development? 1. Preschooler A -- no proper understanding of left and right 2. Preschooler B -- unable to understand the cause and effect of an injury 3. Preschooler C -- unable to interpret time 4. Preschooler D -- unable to imitate others
4 Preschoolers have rich imagination and unrestricted ability to invent and imitate others. Therefore preschooler D lacks adequate cognitive development. Preschoolers do not properly understand the concept of left and right. They also have limited understanding of causality and time.
For which clinical manifestations should the nurse monitor the toddler-age client diagnosed with lead toxicity associated with the neurologic system? Select all that apply. 1. Anemia 2. Ketonuria 3. Glycosuria 4. Distractibility 5. hyperactivity
4, 5 Distractibility and hyperactivity are neurologic manifestations associated with lead toxicity. Anemia is a hematological manifestation of lead toxicity. Ketonuria and glycosuria are renal manifestations associated with lead toxicity.
nutritional REQUIREMENT in preschoolers
90 calories/kg/day and protein 13g/day
height for preschoolers
increase of 2-3 inches/year
Which major gross motor development skills would the nurse expect to see demonstrated during a teaching session with parents of a 12-month old client who is entering the toddler stage of development? 1. Walking alone 2. Drawing a stick figure person 3. Showing interest in cooperative play 4. Beginning to develop object permanence
1 A major gross motor development the nurse should include in the teaching session with the parents of a 12-month old client is walking alone [1] [2]. Drawing a stick figure person is a fine motor skill that is not developed until the preschool stage of development. Showing interest in cooperative play does not occur until late in the preschool stage of development. Object permanence occurs during infancy.
play for toddlers
-parallel play! -begin imaginative thinking, make-believe, and imitating adults -ex. play kitchen, house, workbench, etc -ex. puzzles, crayons, blocks, toys with wheels, push toys, repetitive stories and songs with rhymes
safety interventions for toddlers
-still in carseat -supervise all the time during indoor and outdoor play -child proof home, will start to climb on things -be careful about what is out! plastic bags (suffocation), unused refrigerators must be locked (can get stuck in there), toys (do not play w toys that can go inside a toilet paper roll-choking hazard), burns (water, heater), falls, food (aspiration), store poisons and medicines locked in cabinets
Which characteristic related to achieving autonomy does the nurse anticipate when providing care to a toddler-age client? 1. Ritualism 2. Positivity 3. Magical thinking 4. Object permanence
1 The nurse anticipates the toddler-age client to exhibit ritualism during this stage of development in order to achieve autonomy. The nurse would also anticipate the toddler-age client to exhibit negativism, not positivity. Magical thinking is a characteristic the nurse anticipates for the preschool-age, not toddler-age, client. Object permanence is a characteristic that the nurse anticipates for the infant, not the toddler.
For which families should the nurse include information related to safe sleeping habits as a priority during a scheduled health maintenance visit for a toddler-age child? Select all that apply. 1. Irish american 2. Asian american 3. African american 4. Hispanic american 5. Caucasian american
2, 3, 4 Asian American, African American, and Hispanic American families are more likely to co-sleep with their toddler-age children; therefore, it is essential for the nurse to teach information that enhances safety with this practice for these families. Irish American and Caucasian American clients are less likely to engage in co-sleeping with their children.
According to Erikson's theory, what might the nurse suggest to the parent of a preschooler who has conflicts with the child due to strict behaviour standards? 1. Your behavior may induce a feeling of isolation in your child 2. You need to establish a sense of trust or the child may lose trust in you 3. Your child needs support and love or may develop feelings of shame and doubt 4. You need to cooperate with the childs desires within reason, or the child may suffer guilt and frustration
4 According to Erikson, a child between 3 to 5 years of age is in the initiative versus guilt stage. The nurse might tell the parent to cooperate with the child's desires within reason in order to reduce conflicts. Otherwise, the child may have developed a sense of guilt and frustration. If a young adult is not able to develop companionship with others, then this can lead to a feeling of isolation. A feeling of mistrust can be seen in infants less than 1 year of age. Giving harsh punishments to a child may lead to a feeling of shame and doubt in the child and may hamper his or her healthy growth.
age group for toddlers
1 year-3 year
Which statement made by a toddler-age client during a health maintenance visit does the nurse identify is an example of animism? 1. That chair is mean; it made me fall 2. I want that cup of juice because it has more 3. I don't like to eat that because it is green; green is yucky 4. My grandpa died because he yelled at me for making a mess
1 The toddler statement about the chair being mean is an example of animism [1] [2]. The statement related to the grandpa is an example of magical thinking. Wanting another cup of juice because it appears to have more, even though both have the same volume, is an example of lack of conservation. Not wanting to eat a food because it is green is an example of centration.
According to Erikson's theory, which behavior would the student nurse explain that a toddler exhibits? 1. The child gets casual about body appearance 2. The child starts performing self-care activities 3. The child suppresses feelings of the superego 4. The child becomes dependent on his or her siblings
2 According to Erikson's theory, a toddler between 1 to 2 years of age becomes involved in self-care activities like walking, feeding, and toileting. During the identity versus role confusion stage, an adolescent can be seen having a preoccupation with appearance and body image. The child moves to the next stage and develops superego, or conscience, during the initiative versus guilt stage. During the autonomy versus shame and doubt stage, the toddler develops his or her autonomy by making choices and does not depend on siblings.
A nursing instructor asks a nursing student to explain the developmental changes in toddlers. Which statements made by the nurse indicate the need for further teaching? Select all that apply. 1. Toddlers want to be independent 2. Toddlers have a concave-shaped abdomen 3. Toddlers sleep approximately 12 hours a day 4. Toddlers fear separation from parents at night 5. Toddlers have inconspicuous lumbar vertebrae curves
2, 3 The nursing instructor teaches the student that toddlers have a protruding abdomen. The total sleep time of a toddler averages 12 hours a day. Toddlers may not be willing to go to bed at night because they want autonomy. They fear separation from their parents, so they may refuse to go to bed at night. The curves of the cervical and lumbar vertebrae are prominent toward the end of toddlerhood.
Which recommendation should the nurse make to the parents of a preschool-age client who is experiencing frequent nightmares? Select all that apply. 1. Bring the child to the parental bed 2. Allow the child time to settle back into sleep 3. Reassure the child by rubbing his or her back 4. Repeat a nighttime routine, such as reading a story 5. Place a television in the child's room as a distraction
2, 3, 4 Recommendations to the parents of a preschool-age client who is experiencing nightmares include allowing the child time to settle back into sleep, reassuring the child by rubbing his or her back, and repeating a nighttime routine, such as reading a story. It is not recommended for the parent to bring the child to the parental bed as the child may continue to awaken at night to continue this practice. It is also not recommended to place a television in the child's room as a form of distraction for the nightmare.
What is true about a preschooler's imaginary playmates? 1. Imaginary playmates make the preschooler feel inferior to them 2. Imaginary playmates attempt to achieve what the child accomplishes 3. Imaginary playmates cause a child to confuse reality and fantasy 4. Imaginary playmates experience what a preschooler wants to remember
4 Imaginary playmates experience what preschoolers want to remember or forget. Imaginary playmates do not make preschoolers feel inferior. They accomplish what a child attempts to achieve and help preschoolers to distinguish between reality and fantasy.
Which theory helps pediatric nurses to design appropriate therapeutic play interventions for ill toddlers? 1. Grand theories 2. Peplau's theory 3. Descriptive theories 4. Interdisciplinary theory
4 Interdisciplinary theory helps pediatric nurses design appropriate therapeutic play interventions for ill toddlers or school-aged children. Grand theories are systematic and broad in scope, complex, and, therefore, require further specification through research. A grand theory does not provide guidance for specific nursing interventions. Hildegard Peplau's theory (1952) focuses on interpersonal relations between the nurse, the client, and the client's family and developing the nurse-client relationship. Descriptive theories describe phenomena, speculate on why they occur, and describe their consequences.
What are the similarities between infants and toddlers? Select all that apply. 1. Both grow at a similar rate 2. Both have have equal need of sleep 3. Both show resistance to skin irritation 4. Both awaken frequently during the night 5. Both recover easily from upper respiratory infections (URTI)
4, 5 It is common for toddlers to awaken during the night. In infants, awakening commonly occurs early in the morning, although it is not unusual for an infant to awaken during the night. Both are at high-risk of developing URTI because of their weak immune systems, but they recover with little difficulty. The growth rate in toddlers is slower as compared to infants. Toddlers sleep 12 hours a day, whereas infants need around 15 hours. The skin of toddlers shows more resistance to infections and irritations as compared to that of infants. The skin of infants is loose, and bruising occurs easily due to skin friction.
sensory development at 12 months
know their own name and refers to self
piaget stage for ages 2-7 years
pre-operational
sensory development 3 years
remembers and repeats 3 numbers
gross motor development 3 year old
rides a tricycle
sensory development at 18 months
identifies geometric forms
overall fine motor development changes in preschoolers
copying squares and crossing, drawing letters and numbers, ability to work with fine small toys
nutrition in preschoolers
similar to toddlers, but less messy! -food preferences -definite likes and dislikes -influenced by others eating habits -reinforce good dental hygiene and regular dental visits -watch intake of concentrated sugars
weight for toddler
slows considerably, 4x birth weight by 2.5 years
gross motor development 5 year old
throws and catches a ball well, balances on alternate feet
at what stage is object permanence present
toddler - 1-3yr olds
Which statement would the nurse state is true for toddlers? 1. The incidence of poisoning is very common in toddlers 2. An 18-month-old child uses approximately up to 300 words 3. The average toddler gains 2 to 3 pounds (0.9 to 1.4 kg) each year 4. Toddlers prefer to engage in parallel play rather than in solitary play
1 Poisonings occur frequently because children of around 2 years of age place objects or substances in their mouths to learn about them. The 18-month-old child uses approximately 10 words. A toddler gains approximately 5 to 7 pounds (2.3 to 3.2 kg) each year. The toddler begins to engage in parallel play during toddlerhood but also engages in solitary play.
What does the nurse educate the mother of a toddler to do in order to promote safety? 1. Throw plastic grocery bags away 2. Fill the crib with large, stuffed toys 3. Put pacifiers around the neck of the toddler 4. Place the toddler to sleep on his or her back
1 The nurse educates the mother of a toddler to remove plastic grocery or other bags from from the house to reduce the risk of suffocation. The nurse should instruct the mother not to fill the crib with stuffed toys as there is an increased risk of suffocation. Putting pacifiers around the neck of the child attached with a string increases the risk of choking. The nurse should tell the mother to place a newborn on his or her back to sleep; it reduces the risk of sudden infant death syndrome.
Which fine motor skills should the nurse assess for during a health maintenance visit for a toddler-age client? Select all that apply. 1. Throwing a ball 2. Grasping small objects 3. Walking up and down steps 4. Standing on one foot for several seconds 5. Placing a round object in the correctly shaped hole
1, 2, 5 The toddler-age client continues to develop fine motor skills [1] [2], including throwing a ball, grasping small objects, and placing a round object in the correctly shaped hole. Walking up and down steps and standing on one foot for several seconds is also expected during the toddler stage of development; however, these are gross, not fine, motor skills.
Which behavior should the nurse attribute to negativism related to achieving autonomy when providing care to a toddler-age client? 1. Regressing during a hospitalization 2. Saying "no" to each question that is asked 3. Experiencing separation anxiety in new situations 4. Becoming dependent on a comfort item, such as a blanket
2 The toddler-age client will often respond to any question or request with a "no" due to negativism related to achieving autonomy during this stage of development. Regression that occurs during hospitalization, separation anxiety in new situations, and becoming dependent on a comfort item such as a blanket are attributed to ritualism, not negativism.
Which iron-rich foods should the nurse recommend for a toddler-age client who is diagnosed with iron deficiency anemia? Select all that apply. 1. Carrots 2. Chicken 3. Broccoli 4. Lean steak 5. Whole milk
2, 3, 4 Parents should be encouraged to provide an iron-rich diet that includes heme and nonheme iron sources such as poultry (chicken), green leafy vegetables (broccoli), and red meats (lean steak). Carrots are not a source of iron in the diet. Whole milk consumption should be limited as it is a source of oxalates, which decrease the absorption of iron.
height at age 2 (toddler)
50% of future adult height
What would the nurse describe as a similarity between the growth and development of preschoolers and that of toddlers? 1. Both need an equal amount of calories 2. Both prefer to play with other children 3. Both need at least 12 hours of sleep each night 4. Both gain 5 to 7 (2.26 to 3.17 kg) pounds per year
4 Toddlers and preschoolers gain 5 to 7 pounds (2.26 to 3.17 kg) each year. Preschoolers need at least 1800 calories in a day. On the other hand, toddlers need fewer calories and more protein. Preschoolers like to play with other children whereas toddlers play beside other children rather play with them. Preschoolers need 12 hours of sleep during the night, whereas toddlers need 12 hours of sleep during the day.
describe erikson's initiative vs guilt stage
explores physical world with all the senses, initiates new activities, considers new ideas, develops a conscious if successful, develops structure and purpose if unsuccessful, develops lack of purpose and guilt
describe piaget's pre-operational stage
forms symbolic thought exhibit ego-centrism unable to put oneself in place of another unable to understand conversation play is more socialized, can concentrate on one object at a time beginning reasoning skills beginning to learn chores and simple jobs beginning to master self-care: feeding, dressing, toileting highly curious
gross motor development at 24 months
go upstairs with 2 feet on each side, runs fairly well with wide stance
toddler nutrition
growth slows 12-18 months appetite and need for food intake decreases picky, ritualistic eater limit milk to less than 32 oz a day (prevent iron deficiency anemia) avoid large pieces of food no bottle in bed 20 baby teeth in at 2.5-3 yrs 1-3 yrs nutritional need: 102 calories/kg/day and protein 11g/day
fine motor development 24-30 months
hold crayons with fingers
gross motor development at 18 months
jump and pace
gross motor development at 15 months
walk without help
when does self-exploration begin (touching genitals)
toddler - 1-3 yr olds
gross motor development 4 year old
skips and hops on one foot
Which plant, if ingested by a toddler-age client, would necessitate further action by the nurse? 1. Lily 2. Rose 3. Coleus 4. Begonia
1 If a toddler-age client eats a lily, the nurse should tell the parents that the plant is poisonous and to proceed to the emergency department for further care. Rose, coleus, and begonia are not poisonous and would require no further action by the nurse.
The nurse is preparing to conduct a scheduled health maintenance visit for a 15-month-old toddler-age client. Which information should the nurse include in the teaching session with the toddler's parents related to socialization and cognition? 1. Engages in parallel play 2. Limitation of parental activities 3. An elevated fear of strangers 4. Tolerates long periods of parental separation
2 The 15-month-old toddler will imitate parental activities such as cleaning house or sweeping the floors; therefore, this is an appropriate topic for the nurse to include in the teaching session. Engagement in parallel play does not occur until approximately 24 months of age. The 15-month-old toddler will have a decreased, not elevated, fear of strangers. The 15-month-old toddler tolerates some, but not long, periods of parental separation.
Which term should the nurse use to document the decreased appetite that often occurs during the toddler stage of development? 1. Physiologic bulimia 2. Psychological bulimia 3. Physiologic anorexia 4. Psychological anorexia
3 The nurse would use the term physiologic anorexia to describe the decreased appetite that occurs during the toddler stage of development. Physiologic bulimia, psychologic bulimia, and psychologic anorexia are not accurate medical terminology when documenting this phenomenon
Which toddler behavior should the nurse identify as egocentrism, a characteristic of preoperational thought? 1. Yells at the chair for causing a fall 2. Not wanting to eat food due to the color 3. Refusal to sleep in bedroom because the bed has been moved 4. Inability to understand that others have a different perspective
4 Egocentrism causes the toddler-age client to be unable to understand a different perspective. Yelling at the chair for causing a fall is an example of animism. Not wanting to eat food due to the color is an example of centration. Refusal to sleep in a bedroom because the bed has been moved to another location is an example of global organization
sensory development at 15 months
binocular vision is well developed
when a toddler is admitted to the hospital, what should you ask them before bedtime
if they have a bedtime routine (ex. reading 2 books, getting tucked in, certain stuffed animal, etc). this provides a sense of comfort
describe erikson's stage of autonomy vs shame and doubt
increased ability to control self and environment attains new physical skills (autonomy) symbolizes independence by controlling body secretions says no when asked to do something if successful, will develop sense of confidence and willpower if unsuccessful, will develop sense of shame in their ability temper tantrums frequent
overall language development changes in preschooler
should be understandable, pronunciation will start to show up, speech should be clear
what age group responds well to ritualistic behavior
toddlers (1-3 yr olds)
toddlers learning how to do what
use a tricycle, put their feet on pedals
According to the nurse describing Erikson's theory, in which stage does a preschooler start to pretend? 1. Initiative vs guilt stage 2. Integrity vs despair stage 3. Autonomy vs sense of shame and doubt stage 4. Generativity vs self absorption and stagnation stage
1 The initiative versus guilt stage is the third stage of Erikson's theory. During this stage, children like to pretend and try out new roles. Integrity versus despair is the eighth stage of Erikson's theory. At this stage, many older adults view their lives with a sense of satisfaction. The development of self-care activities in a toddler occurs at the stage of autonomy versus sense of shame and doubt. This is the second stage of Erikson's theory. Middle-aged adults achieve success at the stage of generativity versus self-absorption and stagnation. Individuals contribute to future generations through parenthood, teaching, and community involvement.
The nurse is educating the parents of a preschooler on various poisonous plants that children may be exposed to. Which plants does the nurse mention as poisonous? Select all that apply. 1. Plum 2. Azalea 3. Foxglove 4. Gardenia 5. Asparagus fern
1, 2, 3 The pit of plum; all parts of azalea; and leaves, seeds, and flowers of foxglove are all poisonous. Gardenia and asparagus fern are non-poisonous plants.
A nursing instructor asks a nursing student about language development in toddlers. Which statement by the student indicates a need for further learning? 1. A 24 month old child uses pronouns 2. An 18 month old child uses approximately 25 words 3. A 24 month old child has a vocabulary of up to 300 words 4. A 36 month old child can use simple sentences and follow some grammatical rules
2 An 18-month-old child can use approximately 10 words, not 25. A 24-month-old child can use pronouns and has a vocabulary of up to 300 words. A 36-month-old child can use simple sentences and follow some grammatical rules.
What developmental intervention should the nurse provide to the parents of preschoolers? 1. Educating parents about the risk of falls and other accidents 2. Educating parents about the importance of immunization 3. Teaching parents about reducing risks of physical injuries at home and during play 4. Guiding parents in making lifestyle modifications for stress reduction in their child
3 The nurse should educate the parents of preschoolers about reducing the risks of physical injuries at home and during play. The nurse should educate older adults about measures to reduce the risk of falls and other accidents. The nurse should educate the parents of infants and toddlers about the importance of vaccinations. The nurse should educate adults who are preparing to become parents about making lifestyle modifications.
Which should the nurse include in the plan of care for a toddler-age client who follows a vegetarian or vegan diet? 1. Monitoring an arterial blood gas analysis 2. Monitoring serum sodium concentrations 3. Monitoring for hemoglobin and hematocrit 4. Monitoring serum potassium concentrations
3 The toddler-age client who follows a vegetarian or vegan diet is at risk for iron deficiency anemia; therefore, the nurse should plan on monitoring hemoglobin and hematocrit levels. The nurse would not need to monitor an arterial blood gas analysis or serum sodium and potassium concentrations based on this data.
At 2 years of age a child is readmitted to the hospital for additional surgery. What is the most important factor in preparing the toddler for this experience? 1. Gratification of the child's wishes 2. Previous experience of being hospitalized 3. Avoidance of leaving the child with strangers 4. Assurance of continuation of parental affection
4 A 2-year-old toddler is still attached to and dependent on the parents. Fear of separation is a great stress. Gratification of the child's wishes is neither possible nor desirable. A previous experience of being hospitalized will probably not be remembered accurately. It is not possible to avoid leaving a child with strangers in the healthcare setting.
fine motor development 36 months
can copy circles when drawing
when is it appropriate to teach your child about body privacy, who is allowed to touch genitals and when, using proper names for body parts, etc.
when toddler begins self-exploration (1-3 yr old)
A nursing instructor asks a nursing student about the physical changes observed in toddlers. Which statement made by the student indicates the need for further teaching? 1. The average toddler grows 4.2 cm each year 2. There is a rapid development of motor skills 3. Locomotion skills include running, jumping, and kicking 4. Average toddlers gain 5 to 7 pounds (2.3 to 3.2 kg) each year
1 An average toddler grows 6.2 cm each year. Hence, when the student says that the average growth is 4.2 cm, it indicates the need for further teaching. There is a rapid development of motor skills in children, which enables them to perform self-care activities like feeding, dressing, and toileting. Locomotion skills that develop at this age include running, jumping, standing on one foot for several seconds, and kicking a ball. An average toddler gains 5 to 7 pounds (2.3 to 3.2 kg) each year
sensory development 2 years
can follow simple directions, able to speak 300 words
A nurse is educating the parent of a preschooler about protecting her child from exposure to lead. Which statements made by the parent indicate a need for further education? Select all that apply. 1. I will use only hot water for cooking food 2. I will ensure that my child eats regular meals 3. I will regularly vacuum hard-surface floors or windowsills or wells 4. I will ensure that my child's diet contains sufficient iron and calcium 5. I will wash and dry my childs hands and face frequently, especially before eating
1, 3 Protection of children from exposure to lead is essential for lifelong good health. Therefore, parents should be educated to protect their children from lead exposure. Cold water, instead of hot water, should be used for drinking or cooking because hot water dissolves lead more quickly than cold water and thus contains higher levels of lead. Hard-surfaced floors or windowsills or wells should not be vacuumed, because it spreads dust. Parents should ensure that their children eat regular meals because more lead is absorbed on an empty stomach. Parents should also ensure that their children's diet contains sufficient iron and calcium. They should also wash and dry their children's hands and faces frequently, especially before eating, to prevent lead contamination.
For which clinical manifestation should the nurse monitor the toddler-age client diagnosed with lead toxicity associated with the hematologic system? 1. Anemia 2. Glycosuria 3. Distractibility 4. hyperactivity
1 Anemia is a clinical manifestation associated with lead toxicity due to the effects that lead has on the hematologic system. Glycosuria is a clinical manifestation caused by the effects of lead toxicity on the renal system. Distractibility and hyperactivity are clinical manifestations caused by the effects of lead toxicity on the neurologic system.
What situation would the nurse instruct the parents may possibly predispose a preschooler to feeling guilty? 1. The caregiver's responses are too harsh 2. The individual is unable to establish companionship 3. The parents try to control the child and limit choices 4. The parents fail to establish a sense of trust in the child
1 Preschoolers often develop a feeling of guilt if the caregiver's responses are too harsh. If a young adult is not able to establish companionship and intimacy, isolation results due to rejection and disappointment. The toddler develops his or her autonomy by making choices. Controlling the child and limiting choices can predispose a child to a sense of shame and doubt. If parents fail to establish a sense of trust with an infant, it can lead to a feeling of mistrust in the infant.
Which should the nurse share with the parents of a toddler-age client regarding a predominant change that occurs to the gastrointestinal system during this stage of development? 1. Food is rejected due to texture 2. Voluntary control of elimination 3. Capacity of the stomach decreases 4. Acidity of gastric contents increases
2 The most predominant change to the gastrointestinal system during the toddler stage of development is voluntary control of elimination; this is important to share with the parents because this is the stage of development where toilet training occurs. While food is rejected due to texture, this is not due to a change in the gastrointestinal system but due to maturation of the senses. The capacity of the stomach increases allowing for 3 meals per day. While the acidity of the gastric contents does increase, this is not a predominant change the nurse would include in the teaching session because it does not affect day to day care.
A nursing instructor asks a nursing student about the physical changes found in preschoolers. Which statement made by the student indicates adequate teaching? Select all that apply. 1. Their body appearance looks bulky 2. They grow about 2.5 to 3 inches per year 3. They have difficulty in walking up and down the stairs 4. Their average weight gain is around 8 pounds per year 5. They double their birth length by around 4 years of age
2, 5 Preschoolers grow 6.2 to 7.5 cm (2.5 to 3 inches) per year, and their height doubles their birth length by around 4 years of age. These statements indicate adequate teaching. Preschoolers have elongated legs, which makes their body look slender. At this age, children can easily run up and down the stairs. The average weight gain by preschoolers is 5 pounds (2.26 kg) per year.
During a community health survey, the nurse is conducting a survey about the language development in preschoolers. What behavior is the nurse able to document in preschoolers? Select all that apply. 1. Preschoolers start to understand riddles and jokes 2. Preschoolers want to know the reason behind an event 3. Preschoolers have a vocabulary of 8,000 to 14,000 words 4. Preschoolers know that words may have arbitrary meanings 5. Preschoolers cannot distinguish between phonetically similar words
2, 3, 5 Preschoolers start to question "Why?" and "How come?" Their vocabulary increases rapidly and they can define their feelings by using 8,000 to 14,000 words. School-aged children are able to understand riddles and jokes. This is not seen in preschool children. School-aged children clearly understand that words have arbitrary meanings. This is not seen in preschoolers. Preschoolers get confused between phonetically similar sounds. They are not able to understand the difference between die and dye or wood or would. Therefore, the nurse will not document this behavior with preschoolers.
Which teaching points, supported by current evidence, should the nurse include in a teaching session to the parents of a toddler-age client related to poison prevention? Select all that apply. 1. Use of plants for teas or medicine 2. Correct administration of drugs 3. Safe storage of toxic substances 4. Strategies for effective discipline 5. Taking medications out of the child's sight
2, 3, 4, 5 Teaching points supported by evidence that the nurse should include in a teaching session to parents of a toddler-age client related to poison prevention include information related to correct administration of drug, safe storage of toxic substances, strategies for effective discipline, and the importance of taking medications out of the child's sight. The use of plants for teas or medicine should be avoided because this is known to increase the risk for poisoning.
What statements would a nurse include in a safety promotional program to educate the parents of preschoolers? Select all that apply. 1. Have your child sleep on his or her back or side 2. Teach your children physical safety rules 3. Allow your children to be friendly to strangers 4. Remove doors from unused refrigerators and freezers 5. Avoid instructing children to cross roads and walk in parking lots
2, 4 A nurse should educate parents to teach their children about basic physical safety rules such as the proper use of safety scissors, never running with an object in their mouth or hand, and never attempting to use the stove or oven unassisted. A nurse should also instruct parents to remove doors from unused refrigerators and freezers because if a child cannot freely exit from appliances, asphyxiation can occur. Having a child sleep on his or her back or side helps to avoid the risk of sudden infant death syndrome. This advice is helpful for infants rather than preschoolers. Preschoolers should be instructed not to talk to strangers to reduce the risk of injury and stranger abduction. Preschoolers should be taught how to cross roads and walk in parking lots to acquaint them to traffic rules and lower the risk of car accidents.
Which nursing actions are developmentally appropriate when caring for a hospitalized preschool-age child? Select all that apply. 1. Providing brochures regarding home care options 2. Using toys for distraction during a painful procedure 3. Knocking on the child's hospital room door prior to entering 4. Offering medical equipment to play with prior to a procedure 5. Providing clear instructions about details of a procedure that will occur near discharge
2, 4 When providing care to a preschool-age client who is hospitalized, the nurse should use toys for distraction during a painful procedure and offer medical equipment for the client to play with prior to a procedure. Brochures are not an age-appropriate teaching strategy for the preschool-age client. Knocking on the door prior to entering the room is a hospital policy and not developmentally appropriate care. Instructions for any procedure should be provided just prior to initiation when caring for a preschool-age client.
A nurse is educating the parents of a preschooler about the importance of play in the development of their child. Which statements made by a parent indicates the need for further teaching? Select all that apply. 1. Playing helps the child to socialize with others 2. Pretend play helps children learn to understand others 3. Playing is important because it helps the child to release frustration 4. We should eliminate all television, electronic games, and computer programs 5. If the child fantasizes about imaginary playmates, we should bring him or her back to reality
4, 5 Television, videos, electronic games, and computer programs support development and the learning of basic skills. There should be limited use of these items for preschoolers, but these need not be completely avoided. Imaginary playmates are a sign of health and allow the child to distinguish between reality and fantasy. The parents should know that playing helps the child to socialize with others. Pretend play allows children to learn to understand others' points of view, develop skills in solving social problems, and become more creative. Playing also serves as a medium for the child to release frustration.
A toddler who lacks toilet training is admitted to a hospital. What does the nurse need to do when collecting urine samples from the toddler? Select all that apply. 1. Squeeze urine from the diaper 2. Place a hat under the toilet seat 3. Convince the child to void in the unfamiliar receptacle 4. Attach single-use bags over the child's urethral meatus 5. Use the terms for urination that the child can understand
4, 5 The nurse should use special collection devices for infants or toddlers who are not toilet trained. A single-use bag with self-adhering material over the child's urethral meatus can be used in toddlers to collect urine. The nurse needs to use terms for urination such as "pee pee" that the child is able to understand. Urine should not be collected by squeezing urine from the diaper because the results may be inaccurate. A young child is often reluctant to void in unfamiliar receptacles. A potty chair or specimen hat placed under the toilet seat is usually effective for young children rather than toddlers. A young child is often reluctant to void in unfamiliar receptacles. They should not forced to void.
