Prep U: Peds Ch. 4

By which age should the child know his/her own gender?

A:3 R:By the age of three, the child should know his or her own gender. The other age ranges are incorrect.

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?

A:Deferred imitation R: Children at this stage are able to remember an action and imitate it later (deferred imitation); they can do such things as pretend to drive a car or put a baby to sleep because they have not seen this just previously but at a past time. Toddlers engage in assimilation when they learn to change a situation (or how they perceive it) because they are not able to change their thoughts to fit the situation, such as shaking a toy hammer as if it were a rattle, because they are more familiar with rattles than hammers. All during the toddler period, children play beside children next to them, not with them. This side-by-side play (called parallel play) is not unfriendly but is a normal developmental sequence that occurs during the toddler period. Autonomy, or independence, is the primary developmental task of the toddler years, according to Erikson. Although this child's act may be a sign of autonomy, it is more specifically an act of deferred imitation

The nurse is talking to the mother of a 19-month-old girl about setting limits and supervising activities. In which of the following situations will the nurse recommend letting the child do as she pleases?

A:Exploring her body R:It is normal for toddlers to explore their genitals when they are undressed. The parent should allow this and not punish the child. Choosing food and deciding bedtimes need to be done by an adult. Likewise, safety dictates that the picnic table is not a safe play area

When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old?

A:He should speak in two-word sentences ("Me go"). R:By 2 years of age, children typically speak in two-word (noun and verb) sentences.

Once temper tantrums have started, which of the following interventions are appropriate?

A:Move objects out of the way or move the child to prevent injury. R:Appropriate interventions include moving objects out of the way or moving the child to prevent injury from occurring during the temper tantrum. The caregiver should not speak to the child and should avoid eye contact until the child has calmed down. The child's behavior should not be engaged. Do not talk excessively about the tantrum because this can negatively impact the child's self-esteem

The nurse is observing a play group of children of all ages. The toddlers in the group would most likely be doing which of the following activities?

A:Playing with the plastic vaccum cleaner pushing it around the room R: Playtime for the toddler involves imitation of the people around them such as adults, siblings, and other children. Push-pull toys allow them to use their developing gross motor skills. Preschool children have imitative play, pretending to be the mommy, the daddy, a policeman, a cowboy, or other familiar characters. The school-age child enjoys group activities and making things, such as drawings, paintings, and craft projects. The adolescent enjoys activities they can participate in with their peers

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

A:The child demonstrates separation anxiety. R:The child should be past the stage of separation anxiety by age 3 years. Imitating actions, copying a circle on paper, and responding to single requests are developmentally appropriate.

A toddler's father is concerned because his son refuses to share. What is your best response concerning this?

A:This is normal toddler behavior; sharing is learned later. R: Sharing is not usually learned until the preschool period; toddlers play parallel to each other

When leaving a child who has separation anxiety, parents should say goodbye firmly, explain that they will return, and then leave promptly.

A:True R:Prolonged goodbyes only lead to more crying. Sneaking out prevents crying and may ease the parents' guilt, but it can strengthen fear of abandonment so should be discouraged.

A toddler's mother tells you that no matter what she asks of her child, he says, "No." A suggestion you might make to help her handle this problem is for her to

A:give him secondary, not primary, choices. R: Encouraging toddlers to express their opinion aids in developing a sense of autonomy; allowing secondary choices encourages this without disrupting family life.

A mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" Which of the following would be appropriate for the nurse to suggest? Select all that apply. a)Cheese b)Pieces of apples c)Cookies d)Orange slices e)Yogurt

A: • Cheese • Pieces of apples • Orange slices • Yogurt R:Good choices for between-meal snacks include fruits such as pieces of apples or orange slices, and protein foods such as cheese or pieces of chicken. Cheese as well as yogurt provide calcium. Cookies and other high carbohydrate foods should be avoided because they promote dental caries

The parents of a 30-month-old girl have brought her into the emergency department because she had a seizure. During the health history, the nurse suspects the child had a breath-holding spell. Which of the following parental reports suggests breath-holding?

A: A tantrum preceded the event. R: The fact that there was a precipitating event of frustration and anger points to the likelihood that this is a cyanotic breath-holding spell. Breath-holding spells never occur during sleep, nor do they feature postictal confusion. Unconsciousness is not definitive because it is common to both seizures and breath-holding spells.

Parents of a 2-year-old girl are having a conversation with the nurse about tantrums. Which of the following techniques would the nurse most likely to suggest?

A: Use short "time-outs" and remain calm. R: The best response to tantrums is to remain calm and use short "time-outs." Responses need to be consistent, rather than varied. Telling the child she is bad is negative. Promising a reward for good behavior will result in rewarding bad behavior.

The way you would advise a toddler's mother to handle temper tantrums would be to

A: appear to ignore them. R: Rewarding temper tantrums can teach children that they are an effective method of interaction. Ignoring tantrums teaches that they are ineffective.

What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition?

A:"I give my daughter juice at breakfast and when she is thirsty during the day." R: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 other statements support good toddler nutrition. Whole milk is needed through age 2 years. Two cups daily is adequate. Nutritious snacks support quality intake when quantity is poor. New foods offered with old ones provide sameness along with the new.