Chapter 30: Nursing Care of a Family with a Toddler

Parents are beginning to potty train 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."

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."

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."

After teaching the mother of a 13-month-old boy 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."

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."

During the toddler years, the child attempts to become autonomous. Which statement by a 3-year-old toddler's caregiver indicates that the toddler is developing autonomy?

"My toddler uses the potty chair and is dry all day long."

"When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out."

"When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out."

The parents of a toddler ask the nurse, "We are so frustrated. It seems like our child has temper tantrums all the time. What can we do?" Which response by the nurse is appropriate?

"Stay calm and nearby then once it is over, try to distract your child."

The nurse is interviewing a 3-year-old child who tells the nurse: "Want go potty." The parents tell the nurse that their child often speaks in this type of broken speech. How will the nurse respond regarding this concern?

"This is a normal, common speech pattern in the 3-year-old child and is called telegraphic speech."

The nurse is teaching parents how to avoid a power struggle with their 2-year-old girl. Which comment indicates that more teaching is needed?

"We will make sure she shares her toys with cousins her age."

A group of caregivers are discussing the form of discipline in which the child is placed in a "time-out" chair. Which statement made by these caregivers is appropriate related to this form of discipline?

"When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out."

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 assessing a toddler's fine motor skills. Which finding by the nurse could be a safety concern?

Ability to turn door knobs

During a well-child visit, a parent tells the nurse that they use time-out to discipline their 2-year-old child. The nurse determines that the parent understands the concept of time-out when the parent states keeping the child in time-out for how long?

2 minutes

When assessing a 33-month-old, the nurse would expect to find how many teeth?

20

The nurse is preparing to assess a 2-year-old at a well-child visit and notes the child was 22 lb (9.98 kg) and 24 in (60.96 cm) tall at 1 year old. The nurse determines the child is following a normal pattern of growth after obtaining which set of current measurements?

27 lbs (12.27 kg) and 27 in (68.58 cm) tall

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.

Allowing at least 6 weeks to prepare the child psychologically for the training 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

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.

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.

Nursing students reviewing information about discipline demonstrate a need for additional education when they identify what information as correct?

Discipline and punishment are interchangeable.

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.

The nurse is assessing 2-year-old twins. The parent states, "My twins will not play together, only alongside each other." Which action will the nurse take first?

Explain that this is normal behavior for toddlers.

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 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 group of students is reviewing material about ways parents can help to foster a child's self-esteem. The students demonstrate a need for additional studying when they identify which method as promoting self-esteem?

Limiting the choices and decisions that the child makes

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.

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 18-month-old toddler has most likely attained which gross motor skill?

The ability to walk independently.

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

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.

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.

A 12-month-old infant had an initial screening for lead, which was reported at 4.2 µg/dl (0.20 µmol/L). Which information will the nurse provide the parents as a follow-up to receiving the laboratory value?

There is no action needed. The lead level is normally rechecked at 24 months.

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.

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. Active, "busy" toddlers may need up to 1,400 cal/day.

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 and their nearly 3-year-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

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.

cheese slices yogurt orange slices

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

The nurse is designing a nursing care plan for a toddler with lymphoma who is hospitalized for treatment. What intervention is the priority for this toddler's nursing plan?

monitoring the toddler for developmental delays

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.

The parents of a toddler are asking the nurse if their child is lagging behind since the child does not have a very large vocabulary at the present time. Many times their toddler just points to an object and the parents give it to the toddler. Which concepts/statements should the nurse share with this family about language development of a toddler? Select all that apply.

Read aloud to the toddler to help build and strengthen vocabulary by pointing to pictures in the book. Since toddlers imitate what they hear, use good grammar and incorporate pronouns like "I" and "you." Reinforce language by voicing a request, "You want the apple?"

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 backyard a few days ago. The nurse explains that this is an instance of which of the following?

deferred imitation

When obtaining a toddler's history to determine appropriate anticipatory guidance, which upcoming milestone correlates with safety and poisoning concerns?

gaining motor skills

The nurse is supervising a play group of children on the unit. The nurse expects the toddlers will most likely be involved in which activity?

playing with the plastic vacuum cleaner and pushing it around the room

During a well-child visit to the health care provider, the parent reveals a family struggling with the changes from their "sweet, cuddly 16-month-old child" to that of a negative, more aggressive 2-year-old toddler. After the clinic visit, the nurse will document which priority nursing focus for this visit?

ready for enhanced family coping

A family has recently moved into the area and is bringing their 18-month-old son into the office for his first visit. The father is in dusty work clothes and explains that they are in the process of restoring the house they recently moved into, which was built in the 1920s and which had been vacant for many years. The nurse urges the father to have a blood test done on the son. Which of the following is the best rationale for this intervention?

risk for lead paint poisoning due to the age of the house

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 parent interact with their 2-year-old child. For which interaction will the nurse advise the parent that they are handling the child's negativism properly?

telling the child firmly that people do not scream in the doctor's office