PEDS- Chapter 4 - "the point review"

Parents and their 35 month old child have returned to the clinicfor a follow up appointment. Which of the finding may signal a speech delay?

Uses two word sentences or phrases * a child nearly 3 should speak three to four word sentences

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 2-year-old's thinking is not mature enough to include the concept of "sharing." She sees situations from her point of view (egocentrism). That makes sharing with another beyond what she can accept as an understandable action

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." *High juice intake can contribute to either obesity or appetite suppression. None is needed, but if juice is given limit the amount to 4 to 6 ounces daily. Water should be the choice for thirst.

The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which true statement best accomplishes this

A regular routine and rituals will provide stability and security. *Toddlers benefit most from routines and rituals that help them anticipate events and teach and reinforce expected behaviors. Knowing that a child can move from calm to temper tantrum very quickly,

The parents of a 2-year-old boy complain 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 *Toddlers require fewer calories proportionately than infants, and their appetite decreases (physiologic anorexia). Offering a variety of healthy foods along with foods the child likes will acknowledge preferences while keeping the door open to new foods. Prolonged particular food preferences (food jags) are common. It is also important that mealtime be calm, pleasant, and focused on eating. Toddlers mimic behaviors observed. It is important that parents set a good example with their mealtime behaviors and food choices

The mother of a toddler boy 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 "its time for lunch" -Avoid ending a request with "okay?" -Avoid "yes" and "no" questions -Use humor to make "no" funny: "do cows bark?" *Offer simple choices "blue shirt or red one?"

During a parenting class the nurse ask parents to place in order the steop needed for helping their toddlers master toileting. The sequence is?

-observe same-sex family members use -Have clother toddler sit on potty -place cotents of soiled diaper in potty -have toddler sit on potty with bare bottom -attain 2 weeks of acceptable bowel -use training pants during the day

A stay-at-home father wants to purchase commercial toddler meals because his 16-month-old girl recently choked on table food. Which food items will the nurse suggest not be given to this child?

-sticky foods like peanut butter alone, gummy candies, and marshmallows -Round foods such as hot dogs, whole grapes, and cherry tomatoes -Hard foods such as nuts, raw carrots, and popcorn

The nurse assessing the young toddler's head expects to find the anterior fontanel closed by _______________months.

18

Parents are proud of their toddler's fast-developing fine motor skills. Which one they describe should the nurse point out as a safety risk?

Ability to turn knobs *Turning knobs opens doors and may allow the child access to the outdoors or unsafe areas within the home. Close to follow will be the ability to unscrew lids, creating poisoning risks.

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 toothpaste *Using fluoride toothpaste prior to age 2 years promotes development of fluorosis.

A mother expresses surprise to the nurse that her toddler daughter has begun masturbating. The most important initial nursing response is:

his is a normal and expected activity best treated matter-of-factly.

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. *Two and one-half ounces of cheddar cheese provides the toddler's daily requirement of 500 mg of calcium.

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

Giving the child bowls, pot, pans, and large spoons *

The nurse is recommenting food items for an 18 month old girl. Which ones will benefit the childs neurologic system most?

Peanut butter on crackers, cheese, and whole milk *dietary fat is needed for mylinization

A mother complains her 2-year-old daughter has gradually eaten more and more poorly since her 1-year-old well-child visit. The nurse assesses the child's growth and development as normal. What concept explains the mother's concern?

Physiologic anorexia *Physiologic anorexia results when the rapid growth of infancy slows in toddlerhood and less food is required for body size.

The nurse is visiting a day care center and watches two toddlers at play. What best describes the play observed?

Playing alongside one another

Parents of a toddler describe how they handled their childs temper tantrum in a shopping mall. What action of the parents indicated need for aditional teaching?

Reasoned with the child to stop the behavior

Parents who just moved into their "dream home" are concerned because their toddler boy, who had achieved daytime bowel and bladder control, has begun wetting and defecating in his underwear. The nurse explains this is called:

Regression

The nurse is examining a 3-year-old girl during a regular visit. Which finding would disclose a developmental delay in this child?

The child demonstrates separation anxiety. *The child should be past the stage of separation anxiety by age 3 years

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. *By 24 months most children will name objects familiar to them in their daily lives. Not doing so is strong evidence that a speech delay may exist

In discussing with the nurse their 2-year-old's behavior, which of the parents' descriptors suggests the child may be ready for toilet teaching?

The child hides behind her bedroom door when defecating.

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. *Of concern is speaking only 15 words between Spanish and English. At 20 months, the bilingual child should use 20 words.

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 *Engage the child by asking him questions as he listens. This gives him a chance to contribute to the story. The child does not have to sit still. He may want to move around or even act out part of the story. Story time should happen regularly and not be just a reward. Even if the child can tell the story, he may wish to hear it read again because he enjoys the repetition and familiarity.

The nurse is discussing proper discipline with the mother of a 15-month-old boy. Which statement is most important

Never spank the child for any reason. *Toddlers younger than 18 months of age should not be spanked due to the possibility of injury