Chapter 26: Growth and Development of the Toddler - ML6
Correct response: Use of a two-word noun-verb sentence Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, p. 967.
A nurse is assessing a 2-year-old's language development. What would the nurse expect to assess? Knowledge of full name Verbalization of 4 to 6 words Ability to name one color Use of a two-word noun-verb sentence
Correct response: Explain that children can take their first steps as late as 18 months of age. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TABLE 26.3 Language Development in Toddlers, p. 961.
A 13-month-old child is brought to the clinic for a well-child visit. The child's parent expresses concern that the child has not started to walk yet. What is the best action should the nurse take? Explain that children can take their first steps as late as 18 months of age. Explain that the child could start walking any day. Ask the parent if the child has been ill recently. Refer the child to a developmental specialist for evaluation.
Correct response: Total weight gain of 15 lb in the past year Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PHYSICAL GROWTH, p. 956. Explanation: A child gains only about 5 to 6 lb (2.5 kg) and 5 in (12 cm) a year during the toddler period, much less than the rate of growth during the infant year. Because the weight gain of the boy in this scenario is so much greater than normal, the nurse should be concerned that the boy is overweight or obese. All of the other findings listed are normal for a 2-year-old.
A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse? Increase in height of 5 inches in the past year Forward curve of the spine at the sacral area Total weight gain of 15 lb in the past year Prominent abdomen
Correct response: "Keep all cleaning products and drugs out of the reach of your child." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, BOX 26.2 Most Dangerous Potential Poisons, p. 970.
A nurse is discussing safety measures with the parents of a toddler. What would the nurse emphasize to address the most frequent type of accident in toddlers? "Turn the handles of your pots away from the edge of the stove when cooking." "Make sure to have your child securely fastened in a car seat." "Keep all cleaning products and drugs out of the reach of your child." "Have your child wear a helmet when beginning to ride a tricycle."
Correct response: 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. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 969.
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 toddler was wearing a helmet while riding a tricycle. The safety gate/fence surrounding the pool area is secure and a little hard, even for parents, to unlatch. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. The nurse/mother notes that the toddler's car seat is located in the passenger front seat. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.
Correct response: Learning to act on one's own Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PSYCHOSOCIAL DEVELOPMENT, p. 957. Erikson's psychosocial developmental task for toddlers is to achieve autonomy (independence) while overcoming doubt and shame. Erikson's psychosocial developmental task for infants is to develop a sense of trust. Learning to speak and to understand and respond to discipline are not developmental tasks according to Erikson.
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 speak Learning to act on one's own Learning to trust Learning to understand and respond to discipline
Correct response: Round foods such as hot dogs, whole grapes, and cherry tomatoes Hard foods such as nuts, raw carrots, and popcorn Sticky foods like peanut butter alone, gummy candies, and marshmallows Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TEACHING GUIDELINES 26.2 Avoiding Choking, p. 972.
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? Select all that apply. Vegetables such as corn, green beans, and peas Hard foods such as nuts, raw carrots, and popcorn Round foods such as hot dogs, whole grapes, and cherry tomatoes Fruits such as peaches, pears, and kiwi Sticky foods like peanut butter alone, gummy candies, and marshmallows
Correct response: food jag Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 973.
A toddler's mother reports that her child will only eat peanut butter and jelly sandwiches for several days in a row. The child will then refuse to eat them for several weeks. Which term would the nurse use to document this behavior? physiologic anorexia food jag egocentrism echolalia
Correct response: Tantrums are a common occurrence for a toddler of this age. Maintaining a consistent daily routine can help to reduce tantrums. Ignoring the behavior is often helpful in reducing the duration of the tantrum. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.
During a wellness care visit, the parents of a 2-year-old toddler report that they are struggling to deal with their toddler's daily and increasing number of tantrums. What information should be provided to the parents? Select all that apply. Ignoring the behavior is often helpful in reducing the duration of the tantrum. Tantrums are a common occurrence for a toddler of this age. Maintaining a consistent daily routine can help to reduce tantrums. Tantrums at this age can signal the development of an aggression disorder in a toddler. Tapping the toddler on the hands and voicing displeasure in the toddler's actions can successfully interrupt the behavior.
Correct response: Move objects out of the way or move the toddler to prevent injury. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.
Once a temper tantrum has started, which intervention is appropriate? Move objects out of the way or move the toddler to prevent injury. Engage the toddler's behavior. Speak to the toddler during the tantrum. Have a long talk with the toddler regarding the tantrum.
Correct response: Ignore the toddler's behavior. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.
Parents discuss with the nurse their 2-year-old toddler's temper tantrums. Which technique would the nurse suggest? Ignore the toddler's behavior. Use short "time-outs" and remain calm. Inform of punishment if the toddler continues. Promise a reward if the toddler behaves.
Correct response: Talk to him that night about the details of the dreams. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 974.
Parents of 3-year-old boy ask the nurse for suggestions on how to deal with their son's nightmares. Which suggestion would be least effective? Try having him sleep with a night-light on in his room. Talk to him that night about the details of the dreams. Try reassuring him that it was a dream and not real. Search the room to show him that there aren't any monsters.
Correct response: Saying no is your son's way of trying to exert his independence and is expected. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.
The father of a toddler reports his son says "no" every time he attempts to correct him. What is the best advice the nurse can offer to the parent? This is a normal part of toddlerhood. Saying no is your son's way of trying to exert his independence and is expected. You may need to lessen the amount of correction being given to the child as he seems to be responding to feeling "overly restricted." Continue to correct him because he needs discipline.
Correct response: The family's medications are located in a kitchen drawer. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 969.
The home health nurse is visiting a 2-year-old client's home. Which finding will cause the nurse to intervene? The toddler goes to the bathroom alone to urinate. All of the windows in the home are locked. The toddler in not allowed in the kitchen while food is being prepared. The family's medications are located in a kitchen drawer.
Correct response: "Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 977.
The mother of a 15-month-old son is returning to work and wants to place her son in the day care close to work; however, they will only accept potty-trained children. Which response from the nurse will best address this situation in answering the mother's questions of how best to potty train her son? "Each time you change his diaper, tell your son how important and fun it is to use the potty chair." "Get your son a potty chair and have him sit on it for a few minutes each day." "Encourage your son to watch his older siblings use the toilet." "Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained."
Correct response: Pounding bench Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978. The 3-year-old child should have a tricycle, large sturdy toys such as big blocks, active toys like a pounding bench, and musical toys that encourage rhythmic movement. The preschooler also likes show-and-tell, guessing games (because his or her memory is improving), and big-pieced jigsaw puzzles. For the 4-year-old, construction toys, jigsaw puzzles, memory games, and fantasy play are favorites.
The mother of a 3-year-old is considering the following purchases as a birthday present. Which toy would the nurse suggest as the most age appropriate choice? Memory games Pounding bench Bicycle with training wheels 100-piece jigsaw puzzles
Correct response: autonomy versus shame and doubt Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PSYCHOSOCIAL DEVELOPMENT, pp. 957-958.
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 trust versus mistrust industry versus inferiority initiative versus guilt
Correct response: The toddler speaks 15 words between the two languages. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, COMMUNICATION AND LANGUAGE DEVELOPMENT, p. 961.
The nurse is assessing speech development in the 2-year-old toddler whose family uses two languages in the home. What finding is of concern? The toddler speaks 15 words between the two languages. The parents understand the child much of the time. The child mixes words from the two languages within a sentence. Some words the toddler speaks are a blend of the two languages.
Correct response: Physical punishment such as spanking is discouraged. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, BOX 26.5 Negative Impact of Physical Punishment, p. 976.
The nurse is discussing proper discipline with the parent of a 15-month-old toddler. Which teaching is most important? Only use praise after the child has corrected a wrong behavior. Rules and limits should be simple and few. Physical punishment such as spanking is discouraged. Toddlers are unable to follow instructions easily.
Correct response: has persistent separation anxiety Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, EMOTIONAL AND SOCIAL DEVELOPMENT, pp. 962-963.
The nurse is observing a 3-year-old boy in a day care center. Which behavior might suggest an emotional problem? sucks his thumb periodically has persistent separation anxiety goes from calm to tantrum suddenly is unable to share toys with others
Correct response: Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, EMOTIONAL AND SOCIAL DEVELOPMENT, pp. 961-962. The secondary caregiver can occasionally take over the care of the new baby while the mother or other primary caregiver devotes herself to the toddler. The primary caregiver might also plan special times with the toddler when the new infant is sleeping and the caregiver has no interruptions. This approach helps the toddler feel special. Moving the older child to a larger bed lets the toddler take pride in being "grown up" now, but it should be done some time before the new baby appears. While acknowledging that time with another adult can be a special time, the main concern is for the toddler to understand they are not being replaced by the newest member of the family.
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. Move the toddler to a new bedroom with a "grown-up-bed." Have a grandparent or another special adult in the child's life take the toddler on an errand or a special visit. Plan time for the secondary caregiver to focus on the toddler while the primary caregiver focuses on the infant.
Correct response: Creep up stairs Run and jump in place Engage in parallel play Name one color Zip up their own jackets Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 966. A 15-month-old can creep upstairs. An 18-month-old can run and jump in place. A 24-month-old engages in parallel play; a 30-month-old can name one color. Zipping their jackets occurs around their third birthday.
The nurse is preparing the anticipatory guidance sheets that are provided to parents. When organizing the sheets, place the milestones in the ir proper sequence from earliest to latest. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Run and jump in place 2Engage in parallel play 3Zip up their own jackets 4Name one color 5Creep up stairs
Correct response: Share that the heads of children at this age are large in proportion to the rest of their body. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PHYSICAL GROWTH, p. 956.
The nurse is providing education to a teen mother about her 20-month-old daughter's growth. The teen says her daughter seems to have such a big head. What information should the nurse include in the response? Share that the heads of children at this age are large in proportion to the rest of their body. Some children have large heads but that does not signal a problem. Explain that the child looks normal. Teach the mother that this larger head than body appearance will be this way until the child is about 6 years old.
Correct response: A regular routine and rituals will provide stability and security. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 962.
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. A regular routine and rituals will provide stability and security. Aggressive behaviors such as hitting and biting are common in toddlers. A sense of control can be provided through offering limited choices.
Correct response: "It must be difficult for the two of you to both feel strongly about what is best for you and your child." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 974.
The nurse is reviewing sleep and rest activities of a 16-month-old child with the parents. The father states, "I have told my wife it is unhealthy for our child to sleep with us. It's time for him to sleep in his own bed. What do you think?" What is the nurse's best initial response? "It must be difficult for the two of you to both feel strongly about what is best for you and your child." "Have you thought about just trying to let your child sleep in his own bed to see how it goes?" "I will note this in your child's chart for the doctor to see." "Co-sleeping is viewed acceptable by some professionals, but as interfering with the child's independence by others."
Correct response: Playing with the plastic vacuum cleaner and pushing it around the room Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, BOX 26.1 Appropriate Toys for Toddlers, p. 967.
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? Watching a movie with other children their age Playing with the plastic vacuum cleaner and pushing it around the room Pretending to be mommies and daddies in the play house Painting pictures in the art corner of the room
Correct response: "We will ignore our child while having the tantrum." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, pp. 976-978.
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 attempt to reason with our child to limit tantrums." "We will offer our child a treat to stop having the tantrum." "We will place our child in time-out for 5 minutes after the tantrum." "We will ignore our child while having the tantrum."
Correct response: Offering a variety of foods along with the foods the child likes. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TEACHING GUIDELINES 26.3 Meeting Nutritional Needs of the Picky Eater, p. 973. 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. All options encourage the development of healthy eating habits, but at this time, variety plus preferred foods will be most helpful.
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. Advising the parents to minimize distractions at mealtime. Encouraging the parents to eat a variety of wholesome foods themselves. Assuring the parents that food jags are normal, and they can be honored safely.
Correct response: Appear to ignore the toddler Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.
What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums? Distract the toddler with a toy when the toddler begins holding the breath Appear to ignore the toddler Mimic the toddler's behavior by also holding the breath Promise the toddler a special activity if the toddler will stop
Correct response: Include the child in activities that interest the adult. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 966.
Which action is appropriate to enhance a toddler's self-esteem? Utilize negative criticism as well as positive reinforcement. Include the child in activities that interest the adult. Avoid applauding for unsuccessful attempts. Utilize belittling techniques as opposed to time-outs.
Correct response: Rides a tricycle Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, MOTOR SKILL DEVELOPMENT, p. 959.
Which gross motor developmental milestone is least likely for a 2-year-old? Jumps in place Rides a tricycle Climbing stairs with assistance Stands on one foot with help
Correct response: Allow the toddler to make simple decisions Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TABLE 26.1 Developmental Theories - ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 979.
Which is the best way for parents to aid a toddler in achieving the developmental task? Help the toddler learn to count Allow the toddler to make simple decisions Urge the toddler to dress oneself completely alone Give the toddler small household chores to do
Correct response: "Watch cartoon TV." "Why no candy?" "I cold." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, COMMUNICATION AND LANGUAGE DEVELOPMENT, p. 960.
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. "Ball." "Why no candy?" "Can we go outside, please?" "I cold." "Watch cartoon TV."
Correct response: Stacking blocks Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TABLE 26.2 Motor Skill Development, p. 960.
The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for this age group? Using crayons to color in a coloring book Putting shapes into appropriate holes Painting by number Stacking blocks
Correct response: "When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 976. A method for a child who is not cooperating or who is out of control is to send the child to a "time-out" chair. This should be a place where the child can be alone but observed without other distractions. The duration of the isolation should be limited—1 minute per year of age is usually adequate. Caregivers should warn the child in advance of this possibility, but only one warning per event is necessary.
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." "We use the time-out chair when our child gets tired but does not want to take a nap." "Our time-out chair is in the master bedroom so my child cannot see anyone else in the family." "My child is 3 years old now and I put my child in time-out for 5 to 10 minutes when misbehaving."
Correct response: "It is normal for children to engage in play alongside other children at this age." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, COGNITIVE DEVELOPMENT, p. 957.
The mother of an 18-month-old girl voices concerns about her child's social skills. She reports that the child does not play well with others and seems to ignore other children who are playing at the same time. What response by the nurse is indicated? "It is normal for children to engage in play alongside other children at this age." "Perhaps you should consider a preschool to promote more socialization opportunities." "Has your child displayed any aggressive tendencies toward other children?" "Does your child have opportunities to socialize much with other children?"
Correct response: The child speaks in one-word sentences. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TABLE 26.3 Language Development in Toddlers, p. 961.
The nurse is assessing a healthy 2-year-old client. Which assessment finding most concerns the nurse? The child can stand on his tiptoes. The child speaks in one-word sentences. The child has difficulty with stairs. The child is pointing to named body parts.
Correct response: undress himself Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TABLE 26.2 Motor Skill Development, p. 960.
The nurse is observing a 36-month-old boy during a well-child visit. Which motor skill has he most recently acquired? kick a ball pull a toy while walking push a toy lawnmower undress himself
Correct response: "Give him more healthy choices with less junk food available." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 973.
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? "Calorie requirements for toddlers are less than infants." "You may have to serve a new food 10 or more times." "Give him more healthy choices with less junk food available." "Serve only healthy foods. He'll eat when he's hungry."
Correct response: "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." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TEACHING GUIDELINES 26.4 Providing Toddlers With Guidance, p. 977. A toddler's "no" can best be eliminated by limiting the number of questions asked of the child. In addition, using statements instead of asking questions and keeping the child to a choice between two options are effective. Using timeout is a discipline measure and would be inappropriate to counteract a toddler's negativism. Offering a choice rather than a bribe such as ice cream is more effective and longer lasting for modifying the child's behavior.
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. "Offer her two options from which to choose." "Offer her something she would like, such as ice cream, to distract her." "Limit the number of questions you ask of her." "Make a statement instead of asking a question." "Use time-out every other time she tells you no."
Correct response: "My toddler uses the potty chair and is dry all day long." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 977.
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 has temper tantrums when we go to the store." "Every night my toddler follows the same routine at bedtime." "When my toddler falls down, they always wants me to pick them up." "My toddler uses the potty chair and is dry all day long."
Correct response: Explain that this is normal behavior for toddlers. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 966-967.
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? Document the finding in the medical records. Explain that this is normal behavior for toddlers. Encourage the toddlers to play to allow for observation. Determine when this form of play was first noted.
Correct response: Stands alone Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 968 ,977. Explanation: At 15 months, toddlers have mastered standing and walking alone. The child has yet to develop the ability to feed herself with a spoon, point to her nose and mouth, or run to her mother.
The nurse is assessing the development of a 15-month-old girl during a well-child visit. Which skill would the nurse expect to see? Stands alone Runs to her mother Points to her nose and mouth Feeds herself with a spoon
Correct response: Autonomy versus shame and doubt Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PSYCHOSOCIAL DEVELOPMENT, p. 957.
The nurse is caring for an 18-month-old child. The nurse is aware that the child is which stage according to Erikson? Trust versus mistrust Autonomy versus shame and doubt Industry versus inferiority Initiative versus guilt
Correct response: give the toddler secondary, not primary, choices Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.
A parent tells the nurse that no matter what is asked of the toddler, the toddler says, "No." What suggestion might the nurse make to help the parent handle this situation? give the toddler secondary, not primary, choices ask no further questions of the toddler tell the toddler never to say "No" again pretend the parent does not hear the toddler's response
Correct response: "The bladder of a 2-year-old is actually the size of an adult's bladder, but there are a lot of variables to when a child is potty-trained." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 977.
During a visit to the pediatric clinic the mother of a 2-year-old tells the nurse that her husband is concerned that their son isn't potty trained yet. The mother states, "There is no way he could be potty trained. His bladder is too small." How should the nurse respond? "The bladder of a 2-year-old is actually the size of an adult's bladder, but there are a lot of variables to when a child is potty-trained." "You should talk to the physician about your son not being potty-trained in case there are issues preventing him from being able to control his urine flow." "Your husband is correct, at the age of 2 your son should have a good amount of urine control." "Two years old is rather early for a boy to be potty-trained."
Correct response: The child does not use the names of familiar objects. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, COMMUNICATION AND LANGUAGE DEVELOPMENT, p. 961. 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. Repeating words heard or phrases out of context (echolalia) is normal and a way to practice words and incorporate them in the vocabulary. At 2 years, most children understand much more than they can clearly repeat. Using two-word sentences is a developmental expectation at this age.
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 puts together sentences of two words. The child repeats what the parents say out of context and at random moments. The child does not use the names of familiar objects. The child does not speak clearly but shows understanding of what is said.
Correct response: Full set of primary teeth Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 975.
What is a true statement regarding the developmental milestones of the 30-month-old child? Full set of primary teeth Triples birth weight Anterior fontanel (fontanelle) closes Head circumference equals chest circumference
Correct response: The toddler should speak in two-word sentences ("Me go"). Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, COMMUNICATION AND LANGUAGE DEVELOPMENT, p. 960.
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 be able to count out loud to 20. The toddler should say two words plus "ma-ma" and "da-da." The toddler should say 20 nouns and 4 pronouns. The toddler should speak in two-word sentences ("Me go").
Correct response: seizures are not provoked; temper tantrums are. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.
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: seizures rarely occur in toddlers. seizures are not provoked; temper tantrums are. with seizures, cyanosis rarely develops. seizures typically occur with fever; temper tantrums do not.
Correct response: large piece puzzle Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, BOX 26.1 Appropriate Toys for Toddlers, p. 967. Explanation: An appropriate toy for a 3-year-old child is a large piece puzzle. Board games are more appropriate for preschool and school-aged children; fabric books and squeaky toys are more appropriate for older infants and younger toddlers (10 to 18 month of age).
A 3-year-old child is hospitalized with a diagnosis of sickle cell anemia. The child's condition has improved, and the child is much more active and eager to play. Which toy should the nurse offer the child? large piece puzzle squeaky toy board games fabric books
Correct response: "Your child is experiencing regression as a result of stress." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 979.
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? "Once discharged, your child will quickly learn to use the toilet again." "Do not worry. This is a normal response to being in the hospital." "Your child is experiencing regression as a result of stress." "Why do you believe your child is refusing to use the potty?"
Correct response: "At this age, the digestive tract is not completely mature and children may pass undigested food." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PHYSIOLOGIC CHANGES, p. 957.
A 3-year-old child is seen at the clinic for a checkup. When collecting information, the child's parent reports concern about the child's stools because sometimes the child passes what appears to be undigested food. What response by the nurse is appropriate? "Why are you concerned about this?" "Your child may be eating foods that are too harsh or difficult to digest." "At this age, the digestive tract is not completely mature and children may pass undigested food." "Do you notice other symptoms, such as pain or straining, when this happens?"
Correct response: Limiting the choices and decisions that the child makes Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 971
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? Showing respect and support to the child Acting as a coach rather than a cheerleader Limiting the choices and decisions that the child makes Using positive reinforcement while limiting criticism
Correct response: this is a normal and expected activity best treated matter-of-factly. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978. Masturbation is a normal event to be done in private. Calling attention to the behavior may increase the frequency. Both girls and boys masturbate, and toilet teaching calls attention to the genital area. These two statements are accurate information but not the best first response. Excessive or public masturbation points to stress.
A mother expresses surprise to the nurse that her daughter has begun masturbating. The most important initial nursing response is that: toilet teaching places much focus on the genitals. this is a normal and expected activity best treated matter-of-factly. girls as well as boys will masturbate. there may be undue stress in your child's life.
Correct response: "It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, THE NURSE'S ROLE IN TODDLER GROWTH AND DEVELOPMENT, p. 965.
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 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 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."
Correct response: Pieces of apples Orange slices Cheese Yogurt Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, BOX 26.4 Key Nutrients Provided by Fruits and Vegetables, p. 972. Good choices for between-meal snacks include fruits (e.g., pieces of apples or orange slices) and high-protein foods (e.g., 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.
A mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" What foods would be appropriate for the nurse to suggest? Select all that apply. Yogurt Cheese Pieces of apples Orange slices Cookies
Correct response: 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 Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 977. For effective toilet training, parents should allow 1 to 2 weeks to psychologically prepare the child for training, using training pants that slide down easily and quickly, praising the child when he or she urinates or defecates, limiting the time spent on the potty chair to no longer than 10 minutes (or less if the child is resistant), and putting the child on the potty chair at regular intervals during the day.
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. Putting the child on the potty chair at regular intervals during the day Using training pants that slide down easily and quickly Allowing at least 6 weeks to prepare the child psychologically for the training Praising the child when he or she urinates or defecates Keeping the child on the potty chair for as long as necessary
Correct response: This is normal toddler behavior; sharing is learned later. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 966-967.
A parent is concerned because the toddler refuses to share. What is the nurse's best response to the parent regarding this concern? The toddler is probably reacting to some family crisis. Play time with other toddlers should be cut back until your toddler learns to share. This is normal toddler behavior; sharing is learned later. Behavior modification techniques can change the toddler's behavior.
Correct response: 3-year-old preschool-aged child who goes up stairs on hands and knees Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 968
A pediatric nurse is providing care to several children. The nurse is reviewing the assessment findings for each of the children. Which finding requires the nurse to intervene? 9-month-old infant who can pull self up to a standing position 24-month-old toddler who engages in parallel play 14-month-old toddler who walks with a parent's assistance 3-year-old preschool-aged child who goes up stairs on hands and knees
Correct response: "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 977.
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? "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." "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." "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." "The best time to start toilet training is as soon as the child begins walking."
Correct response: Give her slices of cheddar cheese as a snack. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 971. Two and one-half ounces of cheddar cheese provides the toddler's daily requirement of 500 mg of calcium. Chocolate milk provides calcium but the sugar it contains should not be a regular part of a toddler diet. Applesauce provides fiber, not calcium. Spinach and dark greens do contain calcium, but that calcium has limited bioavailability.
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. Use unsweetened applesauce as a dessert. Offer chocolate milk to increase milk intake. Include dark greens and spinach in her meals.
Correct response: "A 2-year-old child's behavior can be greatly altered if rituals are not maintained." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 974.
The parent of a 2-year-old client states it is the child's naptime. The child is refusing to take a nap and cries, "I have to put my babies to sleep first!" The parent states, "I am so sorry, I do not know what is wrong. My child does not act this way at home. My child has 2 baby dolls we rock to sleep each day at home before nap." Which response by the nurse is most appropriate? "You need to have someone bring the baby dolls to the hospital." "I am sure your child is just acting out since your child is in the hospital and not at home." "Your child's behavior indicates discipline occurring at home is not consistent." "A 2-year-old child's behavior can be greatly altered if rituals are not maintained."
Correct response: Deficient parental knowledge related to inappropriate method for toilet training Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 977.
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? Total urinary incontinence related to delayed toilet training Deficient parental knowledge related to inappropriate method for toilet training Excess fluid volume related to inability to control urination Ineffective coping related to lack of self-control of 2-year-old toddler
Correct response: "This is a normal happening for a toddler of this age." "As your toddler begins to learn that you will return the toddler will become less upset." "Establishing a routine for saying goodbye to your toddler will be helpful." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, EMOTIONAL AND SOCIAL DEVELOPMENT, pp. 962-963.
The parent of a 20-month-old toddler reports the toddler has been becoming distraught when the parent leaves. The parent asks the nurse for advice about what is going on and how to best manage it. What information can be provided? Select all that apply. "This is actually a regression for your toddler because separation anxiety normally occurs in infancy." "Your care providers may be frightening to your toddler." "This is a normal happening for a toddler of this age." "As your toddler begins to learn that you will return the toddler will become less upset." "Establishing a routine for saying goodbye to your toddler will be helpful."
Correct response: "This is called parallel play and is normal for this age group." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 966. Typical play of the toddler period is beside, not with, another toddler (parallel play). No further assessment is needed, nor does this indicate an autism spectrum disorder. The nurse should respond to the parent and not simply tell the parent to talk to the primary health care provider as this does not address the parent's concern.
The parent of a toddler notices the child plays nicely next to another toddler but does not play with that child. The parent expresses concern about this behavior to the nurse during an examination. Which response by the nurse is appropriate? "Be sure to inform the primary health care provider of your concern." "This is called parallel play and is normal for this age group." "This behavior needs to be further assessed to ensure appropriate development." "I believe your toddler is exhibiting signs of an autism spectrum disorder."
Correct response: frequently babbles to herself when playing Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler, TABLE 26.3 Language Development in Toddlers, p. 960.
The parents of a 2-year-old girl are concerned with her behavior. For which behavior would the nurse share their concern? plays by herself even when other children are present likes to change toys frequently frequently babbles to herself when playing refuses to share toys with her sister
Correct response: "Stay calm and nearby then once it is over, try to distract your child." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 26: Growth and Development of the Toddler.
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? "It is important to show the child who is in control." "Try reasoning with your child when the tantrum starts." "When your child gets like this, it is best to give into what the child wants." "Stay calm and nearby then once it is over, try to distract your child."
