Passpoint Toddler

Parents ask the nurse for advice about handling their 2-year-old's negativism. What is the best recommendation?

Set realistic limits for the child, and then be sure to stick to them.

Which statement by a caregiver of a toddler with nephrotic syndrome indicates that the nurse's discharge teaching was effective?

"I have been checking the urine for protein so I will be able to do it at home."

The nurse teaches the parents of a 2-year-old child how to instill antibiotic eardrops. Which statement about the direction to pull on the earlobe indicates that the child's parent has understood the teaching?

"I should pull the earlobe down and backward."

A nurse is helping a pregnant caregiver devise a plan to help her 2-year-old child adjust to the birth of her second child. Which statement by the client indicates more instruction is needed?

"I'll tell my child that the new baby can be a playmate when the baby arrives."

A toddler is in the hospital. The parents tell the nurse they are concerned about the seriousness of the child's illness. Which response to the parents is most appropriate?

"It must be difficult for you when your child is ill and hospitalized. Tell me your concerns."

A preschool-age child with a history of being abused has blood drawn. The child lies very still and makes no sound during the procedure. Which comment by the nurse would be most appropriate?

"It's okay to cry when something hurts."

Two toddlers are arguing over a toy in the playroom. What should the nurse should say to the children?

"Let me see if I can get both of you a similar toy."

Which statements would indicate that the parents of a child being treated with antibiotics for an ear infection understand the reason for a follow-up visit after the child completes the course of therapy?

"We need to make sure that her ear infection has completely cleared."

Which amount of daily milk intake should the nurse include in the plan of care for a 15-month-old?

2 to 3 cups (500 to 750 mL)

A nurse on the pediatric floor is caring for a toddler refusing to take liquid acetaminophen for fever. What would be the best option?

Allow the parent to hold the child and give the medication.

Which action should the nurse take when suspecting that a child has been abused by the parent?

Ensure that any and all findings are reported to the proper authorities.

The nurse develops the preoperative teaching plan for a 14-month-old child with an undescended testis who is scheduled to have surgery. Which method is most appropriate?

Explain to the parents how the defect will be corrected.

What advice should a nurse give to the caregivers of a 2-year-old client who frequently throws temper tantrums?

Ignore the behavior when it happens.

A 21-month-old child admitted with the diagnosis of croup now has a respiratory rate of 48 breaths/min, a heart rate of 120 bpm, and a temperature of 100.8°F (38.2°C) rectally. The nurse is having difficulty calming the child. What should the nurse do next?

Notify the health care provider (HCP) immediately.

The nurse assesses a toddler for pain. Which method would be the most appropriate?

Observe the child for restlessness.

A toddler is hospitalized with multiple injuries. Although the parent states that the child fell down the stairs, the child's history and physical findings suggest abuse as the cause of the injuries. What is the nurse's first responsibility in caring for this child?

Report the incident to the proper authorities.

A toddler with croup is given a racemic epinephrine treatment because of increasing respiratory distress. Which finding indicates that the treatment has been effective?

Retractions are less severe.

A toddler hospitalized with nephrotic syndrome has marked dependent edema and hypoalbuminemia. The child's urine is frothy. When assessing the child's vital signs, the nurse should report which finding to the health care provider?

body temperature of 102.8° F (39.3° C)

The nurse caring for a 3-year-old with otitis media notes that the client has an allergy to amoxicillin that causes wheezing. Which prescription should the nurse question?

cephalexin

A nurse observes two 2-year-old children playing. The nurse documents what form of play as normal for this age group?

digging side-by-side in a sandbox

The nurse advises a mother with a 2-year-old child to avoid encouraging excessive milk consumption by the toddler because excess milk consumption can lead to which problem?

iron deficiency

After teaching the parents about the urethral catheter placed after surgical repair of their child's hypospadias, the nurse determines that the teaching was successful when the parent states that the catheter in their child's penis accomplishes which goal?

keeps the new urethra from closing

A toddler is diagnosed with a dislocated right shoulder and a simple fracture of the right humerus. Which behavior suggests that the client's injuries stem from abuse?

not crying when moved

A nurse is caring for an infant with dehydration and weight loss. The infant's parent states that the infant doesn't like to eat and the parent hates to make the infant eat. The nurse should

request that a dietitian talk with the parent about infants and nutrition.

A client with bacterial meningitis is admitted to the inpatient unit. Which infection control measure should the nurse be prepared to use?

respiratory isolation

A client is being treated for left lower lobe pneumonia. In what position should the nurse position the toddler to maximize oxygenation?

right lateral

Which family should the nurse determine as most in need of follow-up?

single parent with a toddler who has third-degree burns over 20% of the body

A nurse is caring for a young client with tetralogy of Fallot (TOF). The client is upset and crying. The nurse observes that the client is dyspneic and cyanotic. Which position would help relieve the client's dyspnea and cyanosis?

squatting

Parents of a 2-year-old child with chronic otitis media are concerned that the disorder has affected their child's hearing. Which behavior suggests that the child has a hearing impairment?

using gestures to express desires

A 24-month-old child has been diagnosed with pneumococcal pneumonia. The healthcare provider has prescribed penicillin G, 300,000 units IM daily. What site should the nurse use to administer this injection?

ventrogluteal muscle

A nurse is caring for a pediatric client wearing diapers. The nurse must calculate the urine output for the client. The dry diaper weighs 35 g. The wet diaper weighs 250 g. How much urine output has the client had? Record your answer using a whole number.

215

An 18-month-old with a congenital heart defect is to receive digoxin twice a day. Which instruction should the nurse give the parents?

Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.

A parent calls the nurse to report that their toddler has just been burned on the arm. What should the nurse advise the parent to do first?

Run cool water over the burned area, and then wrap it in a clean cloth.

The telehealth nurse obtains a history from a parent of a toddler. Which finding should alert the nurse to suspect that the child has had a febrile seizure?

The seizure occurred when the child had a respiratory infection.

The parent of a toddler hospitalized for episodes of diarrhea reports that when the toddler cannot have things the way they want, they throw their legs and arms around, scream, and cry. The parent says, "I don't know what to do!" After the nurse teaches the parent about ways to manage this behavior, which statement by the parent indicates that the nurse's teaching was successful?

"Next time my child screams and throws their legs, I'll ignore the behavior."

When caring for a toddler with epiglottitis, the nurse should first:

place a tracheotomy tray at the bedside.

The parent of a toddler who has just been admitted with severe dehydration secondary to gastroenteritis says that they cannot stay with their child because they have to take care of their other children at home. Which of the responses by the nurse would be most appropriate?

"I understand, but feel free to visit or call anytime to see how your child is doing."

A young client develops a fever and rash and is diagnosed with rubella. The client's mother has just given birth to another child. Which statement by the mother best indicates that she understands the implications of rubella?

"I'll call my neighbor who's 2 months pregnant and tell her not to have contact with my children."

A nurse is giving discharge instructions to a parent of a 13-month-old infant who weighs 18 lb (8.2 kg). Which statement by the parent demonstrates understanding of car seat safety?

"My infant may ride in a front-facing car seat when weighing 30 lb (13.6 kg)."

A boy, age 2, is diagnosed with hemophilia. The nurse explains to the father how the gene for hemophilia is transmitted. Which statement by the father indicates an understanding of gene transmission?

"Our newborn daughter may be a carrier of the trait."

A nurse in a clinic finds the mother of a 15-month-old child in tears. The mother states that her child doesn't love her, because the child says "no" to everything. Which response is appropriate?

"Saying 'no' is part of toddler development and is normal at this age."

A parent voices concern to the nurse that a 2-year-old toddler never seems to want to play with other children at the park. What would be the nurse's best response?

"That is considered normal at this age."

The parents of a child with rheumatic fever express concern that their other children will develop the disease. Which response from the nurse is best?

"This disease is not contagious."

The parent of a child hospitalized with tetralogy of Fallot tells the nurse that the child's 3-year-old sibling has become quiet and shy and demonstrates more than a usual amount of genital curiosity since this child's hospitalization. What should the nurse tell the parent?

"This may be how your child expresses feeling a need for attention."

When teaching caregiver of a client with congenital heart disease, the nurse should explain all medical treatments and emphasize which instruction?

"Try to maintain your child's usual lifestyle to promote normal development."

The health care provider prescribes an eye patch for a child with strabismus. Which statement by the child's parent would indicate the need for additional teaching about this treatment?

"You see, their problem eye is patched."

The nurse is attempting to reduce the risk for impaired skin integrity related to immobility in a toddler. Which actions does the nurse include in the plan of care? Select all that apply.

-change position frequently -clean skin only when soiled -promote good nutrition

A parent brings their 2-year-old child to the clinic because of their concerns about the child's nutritional status. For the last week, the child has refused to eat anything except animal crackers and peanut butter and jelly sandwiches. Which measure would be most appropriate for the nurse to suggest?

Do not worry about this behavior because food fads usually last only a short time.

As two toddlers play side by side, their parents note that they are not sharing their toys with each other and one cries when a toy is taken by the other child. The nurse hears the parents telling their children to share. Which is the nurse's best response?

Do nothing as this is normal behavior for a toddler.

A client is admitted to the hospital for an asthma exacerbation. The nursing history reveals this client was exposed to varicella (chickenpox) 1 week ago. When, if at all, would this client require isolation?

Immediate isolation in a private room is required .

The mother of a toddler asks the nurse what she should do with her toddler when he has a temper tantrum. Which suggestion would be most appropriate?

Leave the toddler alone during the tantrum as long as he is safe.

A public health nurse is teaching a group of parents at a community health center about feeding and nutrition for toddlers. Which information is most important for the nurse to include in the teaching?

Toddlers often eat one food for many days in a row.

A parent tells the nurse that the primary discipline method used in the home is corporal punishment. What should the nurse tell the parent about corporal punishment?

Use can result in children becoming accustomed to spanking.

A 14-month-old child has a severe diaper rash. Which recommendation should the nurse provide to the parents?

Wash the buttocks using mild soap.

The nurse observes a parent instilling ear drops prescribed twice a day for a 2-year-old. The nurse decides that the teaching about positioning the pinna for instillation of the drops is effective when the parent pulls the toddler's pinna in which direction?

down and backward

A young child who has been sexually abused has difficulty putting feelings into words. Which approach should the nurse employ with the child?

engaging in play therapy

While examining a 2-year-old client, the nurse sees that the anterior fontanel is open. The nurse should

notify the physician.

The nurse is planning care for a toddler with a seizure disorder. Which item in the care plan should the nurse revise?

padded tongue blade at the bedside

The nurse conducts a developmental screening of a 15-month-old child with cerebral palsy. Which milestones would the nurse expect a typically developing toddler of this age to have achieved?

putting a block in a cup

A child with osteomyelitis is to receive nafcillin IV every 6 hours. Before administering the drug, the nurse calculates the appropriate dosage. The recommended dosage is 50 to 100 mg/kg daily; the child weighs 22 lb (10 kg). Which dosage is acceptable?

250 mg every 6 hours

When teaching a caregiver of a 17-month-old about toilet training, which instruction would initially be most appropriate?

Be sure the toddler is ready before starting to toilet train.

A toddler is receiving an infusion of total parenteral nutrition via a Broviac catheter. As the child plays, the I.V. tubing becomes disconnected from the catheter. What should the nurse do first?

Clamp the catheter.

The nurse is reviewing the laboratory data for a young client in acute kidney failure and notes an elevated serum potassium level. What is the priority assessment action for the nurse based on the laboratory data?

Institute telemetry monitoring.

The toddler with nephrotic syndrome exhibits generalized edema. Which measure should the nurse institute for this child with impaired skin integrity related to edema?

Separate opposing skin surfaces with a soft cloth.

At 0300 the parent of a 3-year-old child calls the telehealth nurse and reports the child has a temperature of 101°F (38°C), a runny nose, and a barky cough that "gets going and will not stop." The parent states that they just gave the child acetaminophen. What should the nurse recommend next?

Sit with the child in a steamy, warm bathroom.

A charge nurse is making shift assignments when a staff nurse requests to not be assigned to a particular child because of the quantity of time the child requires. The charge nurse knows that the child and family have bonded with the staff nurse. What should the charge nurse do next?

Talk with the staff nurse about the assignment and the concerns voiced.

A registered nurse (RN) has been paired with a licensed practical nurse (LPN) for the shift. Whose care should the RN delegate to the LPN?

a 2-year-old child who nearly drowned 2 days earlier

Which behavior in a 20-month-old would lead the nurse to suspect that the child is being abused?

absence of crying during the examination

Twelve hours after cardiac surgery, the nurse assesses a 3-year-old who weighs 33 lb (15 kg). The nurse should notify the surgeon about which clinical finding?

alterations in levels of consciousness

A nurse is assessing a child who recently received an antibiotic for an ear infection. The parent states that the child seems to have a harder time hearing than before and that the child reported ringing in the ears. The nurse suspects the child is taking an antibiotic from which class?

aminoglycosides

When assessing speech development, the nurse should refer which child for further re-evaluation?

an 18-month-old who only says "no"

A toddler with hemophilia is hospitalized with multiple injuries after falling off a sliding board. X-rays reveal no bone fractures. When caring for the child, what is the nurse's highest priority?

assessing the child's level of consciousness (LOC) frequently

The nurse caring for a 2-year-old client offers the child the choice to hold the syringe and squirt the medication in the mouth or have the nurse give the medication. According to Erikson, what does this help the child achieve?

autonomy

The nurse develops the plan of care for a toddler with an acetaminophen overdose. Which intervention should the nurse expect to include as part of the initial treatment?

gastric lavage

A nurse is caring for a toddler with Down syndrome. To help the toddler cope with painful procedures, the nurse can

hold and rock the child and give the child a security object.

A toddler is admitted to the facility for treatment of a severe respiratory infection. The child's recent history includes fatty stools and failure to gain weight steadily. The physician diagnoses cystic fibrosis. By the time of the child's discharge, the child's parents must be able to perform which task independently?

performing postural drainage

The inability of an 18-month-old child to perform what activity would cause the nurse to be concerned?

playing with pull toys

A nurse is caring for a group of pediatric clients. The nurse understands that which age group would most likely identify their pain as punishment for past behavior?

preschool or toddler (age 2-5 years)

A toddler has a temperature above 101°F (38.3°C). The healthcare provider orders acetaminophen, 120 mg suppository, to be administered rectally every 4 to 6 hours. The nurse should question an order to administer the medication rectally if the child has a diagnosis of

thrombocytopenia

A parent calls the pediatric clinic to express concern over the child's eating habits. The parent says the child eats very little and consumes only a single type of food for weeks on end. The nurse knows that this behavior is characteristic of:

toddlers

A nurse is caring for a client who has just been immunized. When teaching the client's caregivers about potential adverse effects, the nurse should instruct the caregivers to immediately report

generalized urticaria.

A toddler diagnosed with nephrotic syndrome has a fluid volume excess related to fluid accumulation in the tissues. Which measure should the nurse anticipate including in the child's plan of care?

Weigh the child before breakfast.

During a well-baby visit, a toddler's parent states that the parent keeps all medications out of the toddler's reach in the kitchen cabinet. Which is an appropriate response by the nurse?

"Medications should be kept in a locked location."

A nurse is caring for a child with intussusception. Which of the following is an expected client outcome related to the nursing diagnosis Acute pain related to cramping, which might be made for this child?

The child exhibits no manifestations of discomfort.

For a client with a Wilms' tumor, which preoperative nursing intervention takes highest priority?

avoiding abdominal palpation

When reviewing the history of a 3-year-old child with Down syndrome, which behavior(s) should the nurse interpret as a delay in early development? Select all that apply.

-lack of use of expressive language -poor response to verbal commands -onset of walking at age 20 months

A toddler is admitted to the emergency department with a suspected seizure disorder. When informing the parents about necessary diagnostic procedures, which statement is most appropriate for the nurse?

"The best way to diagnose seizures is through a computed tomography (CT) scan."