Peds Ch 4

The nurse is providing anticipatory guidance to the parents of an 18-month-old child. Which recommendation should be the most helpful to the parents?

Describe proper behavior when the child misbehaves

The parents of a 2 year old child report to the nurse because their child is "such a picky eater." Which recommendation would be most helpful for developing healthy eating habits in this child?

Offering a variety of foods along with the foods the child likes

The parents of a 3-year-old toddler tell the nurse that their child constantly says "no" to everything and they are very frustrated. The parents ask the nurse what they should do. Which response(s) by the nurse are appropriate? Select all that apply.

"Have you tried using "time-outs" for negative behavior?" "Giving your toddler choices instead of posing 'yes' or 'no' questions may decrease the 'no' response." "This action is normal for this age. If measures to stop this behavior do not work, you should make the decision for your toddler to move on with the activity occurring."

A nurse is discussing safety measures with the parents of a toddler. What would the nurse emphasize to address the most frequent type of accident in toddlers?

"Keep all cleaning products and drugs out of the reach of your child."

During a visit to the pediatric clinic the mother of a 2-year-old tells the nurse that her husband is concerned that their son isn't potty trained yet. The mother states, "There is no way he could be potty trained. His bladder is too small." How should the nurse respond?

"The bladder of a 2-year-old is actually the size of an adult's bladder, but there are a lot of variables to when a child is potty-trained.

During play time in the community health center the nurse hears several children interacting with the caregivers. Which statement(s) are considered aligned with the communication milestones for a 3-year-od child? Select all that apply.

"Watch cartoon TV." "Why no candy?" "I cold." Rationale: Telegraphic speech is common in a 3 yr old. Nouns and verbs are present and verbalized in 3 to 4 word sentences

The parent of a toddler half-jokingly states: "I am so tired of hearing NO! I wish he would stop! What suggestions will the nurse offer to reduce toddler negativism?

-Make statements: "It is time for lunch." -Offer simple choices: "Blue shirt or red one?" -Use humor to make "no" funny: "Do cows bark?" -Avoid ending a request with "okay?" -Avoid "yes" and "no" questions

The nurse is assessing a 2 year old toddler. Which observations would alert the nurse that the child may be developmentally delayed?

-the child will not pick up a toy or touch the nose when directed by the nurse -the child's vocabulary consists of the words "ball", "dada", "mum", "drink", and "up" Rationale: the 2 year old toddler should be speaking in 2 word sentences, and should be able to follow simple commands. Imitating the clapping of hands and pushing and pulling objects is expected of a 2 year old. The child should not be able to stack blocks until the age of 3, so this observation would not be a concern at this age.

The nurse finds the diet of a 30-month-old girl to be low in calcium. What suggestion can significantly increase this toddler's calcium intake?

Give her slices of cheddar cheese as a snack. Rationale: Although a half-cup of spinach contains 120 mg of calcium, it is nonbioavailable, making spinach a poor source of calcium. Dairy products are considered the primary source of dietary calcium

Which suggestion by the nurse meant to promote good dental health in the 15 month old is inappropriate?

Brush your child's teeth with a pea-sized amount of fluoride containing tooth paste Rationale: Using fluoride tooth paste prior to age 2 years promotes development of fluorosis. The first dental visit should be made at 1 year. This check up is overdue. Continual snacking and bottle drinking deep the teeth in contact with cariogenic substances for extended periods.

The nurse find the diet of a 30 month old child to be low in calcium. What suggestion can significantly increase this toddler's calcium intake?

Give her slices of cheddar cheese as a snack. Rationale: Two and one-half ounces of cheddar cheese provides the toddler's daily requirement of 500 mg of calcium. Chocolate milk provides calcium but the sugar it contains should not be a regular part of a toddler diet. Applesauce provide fiber, not calcium. Spinach and dark greens do contain calcium, but that calcium has limited bioavailability.

The nurse is reviewing sleep and rest activities of a 16 month old child with the parents. The parent states, I have told my spouse it is unhealthy for our child to sleep with us. It's time for the child to sleep in one's own bed. What do you think? What is the nurse's best initial response?

It must be difficult for the two of you to both feel strongly about what is best for you and your child.

The nurse is teaching the parent of a 2 year old child about age appropriate toys. Which would be of most interest plus stimulating to the growth and development of this child?

giving the child bowls, pot, pans, and large spoons. Rationale: the kitchen items are usually of most interest since they give opportunity to copy observed parental actions. Also, these items can be used not only to role model but also to stack, nest, make noise, and rearrange in many configurations. They are also inexpensive. However, all the other toys are appropriate and safe for toddlers.

the nurse is recommending food items for an 18 month old child. Which ones will benefit the child's neurologic system most?

peanut butter on crackers, cheese, and whole milk

The nurse is assessing speech development in the 2 year old whose family uses both Spanish an English in the home. What finding is of concern?

the toddler speaks 15 words between the two languages Rationale: Of concern is speaking only 15 words between Spanish and English. At 20 months, the bilingual child should use 20 words. The other findings fit the norms for a bilingual child.