Care of the Toddler
A toddler is prescribed amoxicillin for bilateral otitis media. The parent reports that the toddler refuses to take the oral medication. The nurse knows that more education is needed when the parent makes which statement?
"I will shake the medication well, and draw up the medication to the top of the syringe. My spouse and I will hold our toddler down and force the medication down his throat."
Blood pressure monitoring becomes part of the routine health assessment at what age?
3 years
The nurse is assessing a 2-year-old boy during a well-child visit. The nurse correctly identifies the child's current stage of Erikson's growth and development as:
autonomy versus shame and doubt
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?
"Give him more healthy choices with less junk food available."
The nurse is measuring the head circumference of a 1-year-old infant during a well-child visit. The parent asks the nurse why this assessment is being performed. Which response will the nurse provide to the parent?
"Head circumference is typically assessed until age 2 or 3 to help determine if growth is appropriate."
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."
The nurse is preparing to assess the internal ear structures of a 3-year-old. The child is resistant to the otoscope. How should the nurse respond?
"Let's see if I can find some puppies or kittens."
The nurse is obtaining a health history on a toddler and asks the parents about their health history, the health history of their other children, and of their parents' health history. The parents ask the nurse why this information is necessary. What is the best response by the nurse?
"The information can alert us to any disease process that might run in families."
During a wellness check up for a 4-year-old client, the parents state, "We just moved into a new home and our child has begun wetting and defecating in the underwear. Which response by the nurse is appropriate?
"This is a normal response to stress during childhood."
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."
The nurse is teaching the parents of a 2-year-old child how to handle the child's temper tantrums. The nurse determines that the teaching was successful if the parents make which statement?
"We will ignore our child while having the tantrum."
After teaching a group of parents about language development in toddlers, which statement by a member of the group indicates successful teaching?
"When my 3-year-old asks 'Why?' all the time, this is completely normal."
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."
A 3-year-old child is hospitalized. The parents are concerned because the child is now refusing to use the potty and is wetting the bed, even though the child has achieved toilet training. Which response by the nurse is most appropriate?
"Your child is experiencing regression as a result of stress."
The nurse is caring for a toddler who was just diagnosed with a hearing impairment. What would the nurse expect to assess in the child?
A delay or lack of clear, understandable speech pattern
The nurse had instructed the family of a toddler on home safety during a previous visit. During this current visit, what observation indicates that instruction has been effective?
All windows in the home have locked screens.
Which is the best way for parents to aid a toddler in achieving the developmental task?
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?
Autonomy versus shame and doubt
The pediatric nurse is performing a head-to-toe exam on a 2-year-old child during a well child assessment. Which method will the nurse use to accurately determine the child's heart rate?
Counting the apical rate
The parent of a 2-year-old toddler tells the nurse she needs to constantly scold the toddler for having wet pants. The parent says the toddler was potty trained at 12 months, but since starting to walk, the toddler wets the pants all the time. Which nursing diagnosis would be most applicable?
Deficient parental knowledge related to inappropriate method for toilet training
During a regular check up for a 24-month-old girl, the nurse observes that all incisors and cuspids and some first molars have erupted. This would be a good time to promote optimal oral care. Which of the following topics would be most appropriate?
Horizontal brushing technique
Once a temper tantrum has started, which intervention is appropriate?
Move objects out of the way or move the toddler to prevent injury
The nurse is observing a 3-year-old boy in a day care center. Which behavior might suggest an emotional problem?
has persistent separation anxiety
The nurse caring for a 3-year-old patient is having a very difficult time persuading the child to take an oral medication. The child yells "Yucky" every time the nurse approaches with the medication. Which of the following is the best approach to take when giving medication to a resistant toddler?
Offer the child a popsicle to numb the mouth and decrease the bad taste of the medicine.
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 occurring 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 discussing proper discipline with the parent of a 15-month-old toddler. Which teaching is most important?
Physical punishment such as spanking is discouraged.
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
The nurse is administering otic medication to a 22-month-old with a diagnosis of otitis media. Which nursing action ensures that the medication is distributed appropriately?
Pull the pinna down and back
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 is determining a toddler's language development. What is an expected finding for language development in a 2-year-old?
Speaks in two-word sentences using a noun and a verb
Which would be least effective in gaining the cooperation of a toddler during a physical examination?
Tell the child that another child the same age wasn't afraid.
The 18-month-old toddler has most likely attained which gross motor skill?
The ability to walk independently.
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.
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.
The home health nurse is visiting a 2-year-old client's home. Which finding will cause the nurse to intervene?
The family's medications are located in a kitchen drawer.
The nurse is teaching a student how to instill ear drops into a 2-year-old. What technique does the nurse demonstrate to the student?
The nurse pulls the pinna of the ear down and back.
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents that the child is displaying:
object permanence.
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler?
The toddler should speak in two-word sentences ("Me go").
The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse?
The toddler's anterior fontanel (fontanelle) is not fully closed.
A parent is concerned because the toddler refuses to share. What is the nurse's best response to the parent regarding this concern?
This is normal toddler behavior; sharing is learned later.
When participating as part of a rehabilitation team for a 3½ -year old, which of the following areas would be the most likely focus of care?
Toileting
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.
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
Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer?
artificially acquired active immunity
The nurse is caring for a toddler with special needs. Which developmental tasks related to toddlerhood might be delayed in the child with special needs?
developing language and motor skills
