Growth + Development (Toddler)
The parents of a 30-month-old toddler have brought the toddler into the emergency department because of a seizure. During the health history, the nurse learns that the toddler was frustrated and angry immediately preceding the seizure. The nurse suspects the toddler had a breath-holding spell. Which parental report suggests breath-holding? The event took place during a nap. A tantrum preceded the event. The toddler became unconscious. The toddler was lethargic afterward.
A tantrum preceded the event.
The parents of an overweight 2-year-old boy admit that their child is a bit "chubby," but argue that he is a picky eater who will eat only junk food. Which response by the nurse is best to facilitate a healthier diet? "You may have to serve a new food 10 or more times." "Serve only healthy foods. He'll eat when he's hungry." "Give him more healthy choices with less junk food available." "Calorie requirements for toddlers are less than infants."
"Give him more healthy choices with less junk food available."
The nurse is discussing sensory development with the mother of a 2-year-old boy. Which parental comment suggests the child may have a sensory problem? "He wasn't bothered by the paint smell." "I dropped a pan behind him and he cried." "He was licking the dishwashing soap." "He doesn't respond if I wave to him."
"He doesn't respond if I wave to him."
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 in the morning. Mommy loves you." "I will be back after you eat your dinner and SpongeBob goes off." "I will be back later this afternoon." "I will come back when it is time for your bath tonight."
"I will be back after you eat your dinner and SpongeBob goes off." bc toddlers have no real concept of time.
A mother is concerned because her 14-month-old son, who had a big appetite when breastfeeding a few months ago, seems uninterested in eating solid food. She still breastfeeds 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." "It is normal for toddlers to lose their appetites; try weaning him all at once so that he will be more interested in the solid food." "It is not normal for toddlers to lose their appetites; spoon feed him yourself to make sure he gets proper nutrition." "It is not normal for toddlers to lose their appetites; have him tested for a gastrointestinal condition."
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."
During play time in the community health center the nurse hears several children interacting with the caregivers. Which statement(s) are appropriate for a 3-year-od child? Select all that apply. "Watch cartoon TV." "Why no candy?" "Can we go outside, please?" "Ball." "I cold."
"Watch cartoon TV." "Why no candy?" "I cold."
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." "We will give her a choice whenever possible." "Both of us, as parents, will agree on and consistently enforce the limits we set." "Childproofing our home will make it less necessary to say 'No!'"
"We will make sure she shares her toys with cousins her age."
Which is the best way for parents to aid a toddler in achieving the developmental task? Allow the toddler to make simple decisions Urge the toddler to dress oneself completely alone Give the toddler small household chores to do Help the toddler learn to count
Allow the toddler to make simple decisions
The nurse is caring for an 18-month-old child. The nurse is aware that the child is which stage according to Erikson? Industry versus inferiority Autonomy versus shame and doubt Initiative versus guilt Trust versus mistrust
Autonomy versus shame and doubt
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 the chld's last visit a year ago. How should the nurse respond to this mother's concerns? Tell her that her child's growth is less than is expected and gather a nutritional history on the child. Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about. Ask the mother if there are other small people in her family. Tell the mother that she needs to return to the pediatrician's office in 3 months to re-weigh the child and measure his height for any changes.
Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about.
A 15-month-old toddler is brought to the pediatrician's office for a well-child checkup and the nurse is reviewing health promotion with the family. What recommendation(s) would the nurse make to the family to help ensure the child's health? Select all that apply. Keep all medications locked up and out of reach for the child. Begin dental examinations at age 1 year. Provide foods rich in calories and carbohydrates for the child. Never allow the child to ride in the car unless secured in a car seat. Turn the hot water heater temperature down to 120℉ (48.9℃).
Keep all medications locked up and out of reach for the child. Turn the hot water heater temperature down to 120℉ (48.9℃). Never allow the child to ride in the car unless secured in a car seat.
The parents of a 2-year-old boy report to the nurse that 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. Assuring the parents that food jags are normal, and they can be honored safely. Encouraging the parents to eat a variety of wholesome foods themselves. Advising the parents to minimize distractions at mealtime.
Offering a variety of foods along with the foods the child likes.
During a routine health visit with the parents of a 2-year-old child, the parents share some changes they have noticed in their child the past few months that are of concern. This family is struggling to remodel their grandparents' older home. The nurse suspects lead poisoning when they hear the parents mention which symptoms? Select all that apply. a. The child seems to sleep and nap more throughout the day than usual. b. The child is constantly pulling on the ears. c. The child vomits at least 2 to 3 times/day. d. The child cries and starts rubbing the abdomen like it "hurts" sometimes. e. The child seems to be irritable more frequently.
The child seems to be irritable more frequently. The child cries and starts rubbing the abdomen like it "hurts" sometimes. The child seems to sleep and nap more throughout the day than usual.
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 Ability to name one color Verbalization of 4 to 6 words Knowledge of full name
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 Half of speech understood by outsider Talks about a past event Asks "why" often
Uses two-word sentences or phrases
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? a. "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." b. "It doesn't hurt to start when they turn 2 as long as you don't punish them for having many accidents." c. "I started training my kids when they started to pull themselves up to a standing position." d. "You will just have to condition yourself to take her to the potty chair every hour until they get the hang of it."
a. "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 parent of a preschool-aged child reports that the child seems to believe in imaginary things. The parent voices concern that this "fantasy world" may become a problem. What response(s) by the nurse is indicated? Select all that apply. a. "Your child is engaging in what we call magical thinking." b. "Fantasy play is most often seen in lonely children in an attempt to occupy themselves." c. "This type of thought process allows your child to begin to observe the differences in the world." d. "While imagination is normal, this type of fantasy world can cause problems for your child and should be discouraged." e. "This type of imagination is not normally seen until a child is school aged."
a. "Your child is engaging in what we call magical thinking." c. "This type of thought process allows your child to begin to observe the differences in the world."
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? a. Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant. b. Plan time for the secondary caregiver to focus on the toddler while the primary caregiver focuses on the infant. c. Have a grandparent or another special adult in the child's life take the toddler on an errand or a special visit. d. Move the toddler to a new bedroom with a "grown-up-bed."
a. Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
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? a. Reasoned with the child to stop the behavior b. Tried to refocus the child's attention as tantrum behavioral cues appeared c. Made sure the child was rested and not hungry before going to the mall d. Remained relatively calm even though embarrassed
a. Reasoned with the child to stop the behavior
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. a. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. b. The safety gate/fence surrounding the pool area is secure and a little hard, even for parents, to unlatch. c. The nurse/mother notes that the toddler's car seat is located in the passenger front seat. d. The toddler was wearing a helmet while riding a tricycle. e. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.
a. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. c. The nurse/mother notes that the toddler's car seat is located in the passenger front seat. e. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.
A 2-year-old toddler holds his breath until passing out when he wants something the parent does not want him to have. The nurse would decide whether these temper tantrums are a form of seizure based on the fact that: a. seizures are not provoked; temper tantrums are. b. seizures rarely occur in toddlers. c. seizures typically occur with fever; temper tantrums do not. d. with seizures, cyanosis rarely develops.
a. seizures are not provoked; temper tantrums are.
A mother expresses surprise to the nurse that her daughter has begun masturbating. The most important initial nursing response is that: a. this is a normal and expected activity best treated matter-of-factly. b. girls as well as boys will masturbate. c. toilet teaching places much focus on the genitals. d. there may be undue stress in your child's life.
a. this is a normal and expected activity best treated matter-of-factly.
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? analytical exploration imitation logical reasoning assimilation
assimilation
During the toddler years allowing the child to make decisions is a good way to help the toddler achieve ________ and gain independence.
autonomy
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother? a. Tell both the mother and child that the child will be carefully guarded and won't be in as much danger as she might be if she were home exploring her environment. b. Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning." c. Remind them staying in the hospital now will help the child get well quicker and be home soon, but the other children should not be alone. d. Distract the child with a special blanket, stuffed animal, or other "lovey" from home while the mother quietly slips out.
b. Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning."
A mother tells the nurse that her toddler does not want to go to bed at night and keeps getting back up when she is put to bed. What recommendations would the nurse make to this mother to foster sleep in the toddler? a. Place the child in her bed, tell her goodnight, and then lock the door. b. Read the child a book in bed and take time to calm the child down before turning out the lights. c. If she does not want to go to sleep at her normal bedtime, let her stay up for a little while longer. d. Instruct the toddler to stay in bed or she will have her favorite stuffed animal taken away from her.
b. Read the child a book in bed and take time to calm the child down before
The 18-month-old toddler has most likely attained which gross motor skill? a. The ability to walk up stairs alone. b. The ability to walk independently. c. The ability to balance on one foot. d. The ability to pedal a tricycle.
b. The ability to walk independently.
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler? a. The toddler should say two words plus "ma-ma" and "da-da." b. The toddler should speak in two-word sentences ("Me go"). c. The toddler should be able to count out loud to 20. d. The toddler should say 20 nouns and 4 pronouns.
b. The toddler should speak in two-word sentences ("Me go").
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? a. "She's well past the age to begin toilet training; most children are ready by age 1, when they have developed the needed nervous system control." b. "It is best to wait a little longer, until she is 3; only then will she be socially developed enough to understand what you are asking her to do." c. "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." d. "The best time to start toilet training is as soon as the child begins walking."
c. "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? a. Aggressive behaviors such as hitting and biting are common in toddlers. b. A sense of control can be provided through offering limited choices. c. A regular routine and rituals will provide stability and security. d. Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly.
c. A regular routine and rituals will provide stability and security.
A toddler is hospitalized and the nurse wants to make the transition from home to hospital as easy as possible for him. Which action by the nurse would be most beneficial to assist the toddler in adapting to the hospital? a. Instruct the parents to allow the nurse to do everything for the child to aid in attachment. b. Tell the child what is expected of him to help with compliance. c. Follow the child's home routines as much as possible while in the hospital. d. Allow the child to dictate when and what they want to do and adhere to their requests.
c. Follow the child's home routines as much as possible while in the hospital.
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? a. Encourage the toddlers to play to allow for observation. b. Determine when this form of play was first noted. c. Document the finding in the medical records. d. Explain that this is normal behavior for toddlers.
d. Explain that this is normal behavior for toddlers.
The nurse is observing a 3-year-old boy in a day care center. Which behavior might suggest an emotional problem? is unable to share toys with others sucks his thumb periodically has persistent separation anxiety goes from calm to tantrum suddenly
has persistent separation anxiety
