Ch 30 - Toddler 2018
The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. What should the nurse say in response?
"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."
Parents are asking a pediatric nurse how to deal with separation anxiety every time they try to have an adult night out. Which advice by the nurse sounds like the most appropriate way to handle this situation?
"Inform the child that you are going out but the regular babysitter will care for them and put them to bed."
A mother is concerned because her 14-month-old son, who had a big appetite when breast-feeding a few months ago, seems uninterested in eating solid food. She still breast-feeds him daily, but is thinking of weaning him soon. How should the nurse respond to this mother?
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."
In working with the toddler, which statement would be most appropriate to say to the toddler to decrease the behavior known as negativism?
"It is time for lunch. I am going to put your bib on."
The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern?
"This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech."
During a health history, the nurse explores the sleeping habits of a 3-year-old boy by interviewing his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group?
"We keep a strict bedtime ritual for our son, which includes a bath and bedtime story."
A group of caregivers of toddlers are discussing the form of discipline in which the child is placed in a "time-out" chair. Which statement made by these caregivers is most appropriate related to this form of discipline?
"When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to time out."
When assessing a 33 month old, the nurse would expect to find how many teeth?
20
A 12 month old had an initial screening for lead which was reported at 4.2 mg/dl. The nurse anticipates that the child will be screened again at what age?
24 months
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this?
A regular routine and rituals will provide stability and security.
The nurse is promoting language and cognitive development to the parents of a 3-year-old boy. Which guidance about reading with their child will be most helpful?
Ask the child questions as you read.
The mother of a toddler half-jokingly states: "I am so tired of hearing 'NO!' What suggestions will the nurse offer to reduce toddler negativism? Select all that apply.
Avoid "yes" and "no" questions. Offer simple choices: "Blue shirt or red one?" Make statements: "It is time for lunch." Avoid ending a request with "Okay?" Use humor to make "no" funny: "Do cows bark?"
A nurse is presenting a class on discipline for a group of parents of toddlers. What information would be important for the nurse to teach this group? Select all that apply.
Consistency in the rules is important so the child understands what is expected. If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. Even at this young age, children need boundaries.
The parents of a 3-year-old who had bone cancer that resulted in amputation of the lower left leg ask their health care provider about expected behaviors for their child. Which behavior is expected and acceptable during hospitalization for treatments?
Crawling may be their preferred mode of travel because they may not want to wait for help to put the prosthesis on.
The nurse is preparing the anticipatory guidance sheets that are provided to parents. When organizing the sheets, place the milestones in their proper sequence from earliest to latest.
Creep up stairs Run and jump in place Engage in parallel play Name one color Zip up their own jackets
While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their back yard a few days ago. The nurse explains that this is an instance of which of the following?
Deferred imitation
The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group?
Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior.
A toddler's "no" can best be eliminated by asking a question instead of making a statement.
False
The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development?
Her vocabulary is between 10 and 15 words.
Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital?
I will be back after you eat your dinner and SpongeBob goes off."
A mother shares with the health care provider that her 2-year-old toddler seems to have temper tantrums on a daily basis. Which would be considered good advice to give to this parent? Select all that apply.
If the child has a tantrum when asked to perform a task, consider if the task is not appropriate for this age group. If the parent gives in and gives the child a treat like candy, this is actually encouraging the child to have more tantrums so they can get more rewards. When the child is frustrated and throws a tantrum, role play for the child the proper way to show frustration.
The nurse is caring for a toddler in the pediatric unit and notes the child is responding according to expected developmental stages. Which characteristic will the nurse predict this toddler to exhibit while in the hospital?
Insists on doing a new skill and then asking for help
A nursing instructor is leading a class discussion exploring the various aspects of Erikson's theories of the developmental tasks of toddlers. The instructor determines the session is successful when the students correctly choose which task as a priority for toddlers?
Learning to act on one's own
The parents of a 2-year-old child born with short-gut syndrome feed their toddler via a feeding tube. Knowing this is a developmental time when children usually feed themselves, the parents are asking the nurses what they can do to help foster the child's independence. Which suggestion would be most appropriate at this time?
Let the child choose what clothing he or she will wear the next day.
A parent is giving the toddler a tub bath. What behavior is not recommended by heath care personnel regarding bathing?
Let the toddler take bubble baths and play in the bubbles.
The nurse is designing a nursing care plan for a toddler with lymphoma, who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan?
Monitoring the toddler for developmental delays
Once temper tantrums have started, which intervention is appropriate?
Move objects out of the way or move the child to prevent injury.
The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description?
Myelinization of the brain and spinal cord is complete at about 24 months.
A parent with a 2-year-old invites a friend with a toddler over for a play date when they notice their children are not really interacting while playing. The children are playing side-by-side when one toddler gets up and grabs a toy car out of the hands of the other toddler, which results in both toddlers crying. To prevent this from occuring again, which intervention should the parents make?
Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy.
The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce siblings to a new member of the family. Which suggestion should the nurse prioritize to help older siblings, especially toddlers, understand the change in the family dynamics?
Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing?
Playing independently and are side by side
The nurse is supervising a play group of children on the unit. The nurse expect the toddlers will most likely be involved in which activity?
Playing with the plastic vacuum cleaner and pushing it around the room
Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching?
Reasoned with the child to stop the behavior
The nurse determines that a 20-month old is in Piaget's sensorimotor stage of cognitive development. Which actions support this assessment? Select all that apply.
The child has an imaginary playmate The child has a limited concept of time. The child demonstrates egocentricity.
In discussing their 2-year-old's behavior with the nurse, which of the parents' statements suggests the child may be ready for toilet teaching?
The child hides behind her bedroom door when defecating.
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior?
The need for separation and control
A nurse, who is also a mother of a 2-year-old child, attends a party at a friend's house and notes some safety concerns that she would like to share with the other mother privately. Which observations during the party would be considered a safety concern that should be addressed privately when appropriate? Select all that apply.
The nurse/mother notes that the toddler's car seat is located in the passenger front seat. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.
The nurse is assessing speech development in the 2-year-old whose family uses both Spanish and English in the home. What finding is of concern?
The toddler speaks 15 words between the two languages.
A nurse is assessing a 2-year-old's language development. What would the nurse expect to assess?
Use of a two-word noun-verb sentence
Parents of a 2-year-old girl are having a conversation with the nurse about tantrums. Which technique would the nurse most likely suggest?
Use short "time-outs" and remain calm.
A nurse is assessing a 15 month old at a well-child visit. Which actions demonstrate that the child is achieving milestones? Select all that apply.
Uses 4 to 6 words when speaking Understands and follows simple commands Scribbles with a crayon
Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?
Uses two-word sentences or phrases
A nurse is presenting a class on toilet training to a group of parents with toddlers. Which information would the nurse include in the class? Select all that apply.
Using training pants that slide down easily and quickly Praising the child when he or she urinates or defecates Putting the child on the potty chair at regular intervals during the day
Parents share that their toddler often needs a snack in between meals. Which snack choice is nutritious enough to give the toddler energy but also may help prevent dental caries? Select all that apply.
orange slices cheese slices yogurt
The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for this age group?
Stacking blocks
When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as:
parallel play
Parents are beginning potty training their 2-year-old child and seek advice from the nurse on how to be successful in this endeavor. Which statement by the parents indicates that further teaching is needed?
"He wants to accompany me to the bathroom but I prefer to go alone."
During a well-child visit, a mother tells the nurse that she uses timeout to discipline her 2 year old. The nurse determines that the mother understands the concept of timeout when the mother states that she keeps the toddler in time out for _______ minutes.
2
During a well-child visit, the nurse observes the child saying "no" to her mother quite frequently. The mother asks the nurse, "How do I deal with her saying no all the time?" What would be appropriate for the nurse to suggest? Select all that apply.
"Limit the number of questions you ask of her." "Make a statement instead of asking a question." "Offer her two options from which to choose."
A mother of a 2-year-old girl is asking her friend when she should start potty training the child. The mother expresses concern about the high cost of diapers and training pants and would really like to have her trained as soon as possible. Which advice by the friend would be considered the best response?
"When she is uncomfortable in her wet diaper and brings a clean diaper to you, that's a good indication she is ready for potty training."
The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which safety intervention should the nurse address?
Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the backseat of the car.
What is a true statement regarding developmental milestones of the 30-month-old?
Full set of primary teeth
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.
A mother brings her 2-year-old child to the pediatrician's office, voicing concerns about her toddler's growth over the last year. According to the child's records, the toddler has gained 6 pounds (2.7 kg ) and grown 2.5 in (6.25 cm) since his last visit a year ago. How should the nurse respond to this mother's concerns?
Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about.
Which gross motor developmental milestone is least likely for a 2 year old?
Rides a tricycle
The pediatric nurse is presenting basic safety tips at a local health fair for families. The nurse should point out the majority of hospital visits for toddlers can be prevented by exercising which precaution?
Safely store all chemical substances
The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly?
Telling the child firmly that we don't scream in the office
The 18-month-old has most likely attained which gross motor skill?
The ability to walk independently.
The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this area?
The child does not point to named body parts.
The nurse is examining a 2-year-old girl for speech and language development. Which finding would suggest a delay in speech development?
The child does not use the names of familiar objects.
A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?
Total weight gain of 15 lb in the past year
The best way for a parent to handle a temper tantrum by a toddler is to calmly express disapproval and then ignore it.
True
The nurse is explaining safety precautions for toddlers to the mother of a normal 30-month-old boy. Which activity might the nurse suggest may be done without supervision?
Undressing himself
What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition?
"I give my daughter juice at breakfast and when she is thirsty during the day."
After teaching the mother of a 13-month boy old about suggestions for bathing and hygiene, the nurse determines that the teaching was successful when the mother states:
"It might be best to give him a bath in the evening."
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 the toddler years, the child attempts to become autonomous. Which statement by a 3-year-old's caregiver indicates that the child is developing autonomy?
"My child uses the potty chair and is dry all day long."
A nurse in a busy pediatric clinic is educating a group of parents with toddlers about the nutritional needs of this age group. Which concepts should be addressed in this educational presentation? Select all that apply.
Active, "busy" toddlers may need up to 1,400 cal/day. Try to limit the fat intake to less than 35% of total calories. Milk is still important to incorporate in the diet for bone health.
A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply.
Remain calm and ignore the tantrum. Do not reward the behavior by giving into the toddler's demands and buying the candy. Pick the toddler up and move her to a safe environment but do not give in to her desires.
A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply.
Remain calm and ignore the tantrum. Do not reward the behavior by giving into the toddler's demands and buying the candy. Pick the toddler up and move her to a safe environment but do not give in to her desires.
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development?
The child is unable to push a toy lawnmower.
A nurse hands a toddler a toy hammer. Instead of hitting or pounding the hammer on an object, the toddler begins shaking it. What concept related to growth and development is this toddler displaying?
assimilation
A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate?
"You'll probably notice that your daughter is uncomfortable in wet diapers."
Parents are proud of their toddler's fast-developing fine motor skills. Which skill they describe should the nurse point out as a safety risk?
Ability to turn knobs
