Peds Chapter 22
The nurse is providing care to a toddler-aged patient who weighs 10 kg. What is the minimum number of kilocalories this child should receive each day? Record your answer as a whole number. ____________________
700 Feedback: The minimum number of kilocalories per day for a toddler-aged patient is 70 kcal/kg/day. For a toddler who is 10 kg, this means a minimum of 700 kcal per day.
The nurse is providing care to a toddler-aged patient who weighs 10 kg. What is the maximum number of kilocalories this child should receive each day? Record your answer as a whole number. ____________________
900 Feedback: The maximum number of kilocalories per day for a toddler-aged patient is 90 kcal/kg/day. For a toddler who is 10 kg, this means a maximum of 900 kcal per day.
The parent of a toddler states, "My child wants to do everything by herself." Which term should the nurse use to describe this behavior in the medical record? 1) Autonomy 2) Egocentric 3) Negativism 4) Temperament
1 1 Autonomy is defined as being self-governing. A toddler-aged child is exhibiting autonomy by wanting to do everything by herself. 2 Egocentric, or not being able to process the views of others, is a common trait during the toddler stage of development. However, this is not the best term to use to describe this situation in the medical record. 3 Negativism, or the tendency to be negative with attitude, is a common trait for the toddler that is manifested by the word no. 4 Temperament is the mental, physical, and emotional traits of the child. This is not the best term to use to describe this situation in the medical record.
Which nursing action is appropriate when assisting with the assessment of a toddler-aged patient who is diagnosed with a communicable disease? 1) Asking the parents if the child has been exposed to anyone who has been sick 2) Determining if the child has received the human papillomavirus (HPV) vaccine 3) Establishing if the mother was exposed to any sexually transmitted infections (STIs) during pregnancy 4) Monitoring for any musculoskeletal abnormalities
1 1 It is important to determine if the toddler-aged patient who presents with symptoms of an infectious disease process has been exposed to anyone who has recently been ill. 2 The Centers for Disease Control and Prevention (CDC) does not recommend that the toddler-aged patient be immunized with HPV; therefore, this is not an appropriate action by the nurse. 3 Although exposure to STIs during pregnancy can expose the newborn to infectious diseases, this topic is not applicable when assessing the toddler-aged patient with an infectious disease. 4 The nurse should closely assess the child's skin and respiratory systems, but not the musculoskeletal system.
Which is a priority teaching point regarding nutrition for the toddler-aged child? 1) Limiting milk consumption 2) Offering water with each meal 3) Offering the child finger foods only 4) Emphasizing the need for two snacks per day
1 1 Milk consumption should be limited to no more than 24 to 32 ounces per day. Milk consumption greatly reduces the toddler's consumption of other sources of vitamins and proteins. 2 Although offering water with meals is appropriate, this is not the priority teaching point. 3 Although offering finger foods enhances autonomy, the toddler-aged child should be offered the same foods that other members of the family are eating during mealtimes. 4 The toddler should consume three meals per day with three snacks per day in order to take in adequate calories without drops in blood glucose.
Which should the nurse recommend to the parents of a toddler who is exhibiting tantrums? 1) Ignoring the child's behavior 2) Locking the child in the bedroom 3) Swatting the child on the backside 4) Giving in to the demands of the child
1 1 The nurse should recommend that the parents ignore the toddler's behavior during a tantrum; however, safety should also be ensured. 2 Locking the child in the bedroom without supervision is a safety risk. 3 Swatting the child on the backside is not a recommended response to a child who is exhibiting a tantrum. 4 Giving in to the demands of the child will encourage the behavior to continue.
Which push-pull toys should the nurse recommend for play when providing education to the parents of a toddler-aged patient? (Select all that apply.) 1) Child grocery carts 2) Large trucks or cars 3) Soft foam balls 4) Soft mats 5) Safety noodles
1,2 1. This is correct. A child grocery cart is an appropriate push-pull toy for the nurse to recommend to the parents of a toddler-aged patient. 2. This is correct. A large truck or car is an appropriate push-pull toy for the nurse to recommend to the parents of a toddler-aged patient. 3. This is incorrect. Although a soft foam ball is an appropriate toy for a toddler, it is used for throwing and catching and not for pushing and pulling. 4. This is incorrect. Although a soft mat is an appropriate toy for a toddler, it is used for rocking and rolling and not for pushing and pulling. 5. This is incorrect. Although safety noodles are appropriate for swimming, this is not an example of a pushing-and-pulling toy.
Which should the nurse identify as most important to social development during the toddler stage of development? 1) Peers 2) Siblings 3) Religious figures 4) Day-care providers
2 1 Peers become important for socialization during school age and adolescence. 2 Family members, including siblings, are most important to socialization during the toddler stage of development. 3 Religious figures may be important to moral development, not social development. 4 Day-care providers or teachers become important to socialization during the preschool and school-age years.
The parents of a toddler have not sought the recommended dental care for their child. Which type of abuse should the nurse identify in this situation? 1) Physical abuse 2) Physical neglect 3) Emotional abuse 4) Emotional neglect
2 1 Physical abuse is the act of hitting a child to produce harm. 2 Physical neglect occurs when a child's medical needs, such as dental visits, are not provided. 3 Emotional abuse includes constant belittling. 4 Emotional neglect occurs when a child's emotional needs are not attended to appropriately.
Which statements should the nurse include when discussing the use of child safety seats for the parents of a toddler-aged patient? (Select all that apply.) 1) "Your child should be placed in a safety seat that is rear facing." 2) "If your child must be placed in the front seat, it is important to adjust the seat so it is as far from the dashboard as possible and to disengage the airbag system." 3) "Your child can be secured using the seat belt provided within the vehicle without an additional car seat." 4) "It is appropriate to hold your child in your lap for short distances if there isn't room for a safety seat within the vehicle." 5) "It is appropriate to place your child in the back seat with the use of an appropriate child safety seat."
2,5 1. This is incorrect. The toddler-aged child does not need to be rear facing when placed in a child safety seat. 2. This is correct. If the child must be placed in the front seat, it is important to ensure the seat is as far as possible from the dashboard and that the airbag system is disengaged. 3. This is incorrect. The toddler-aged child should be placed in a child safety seat, and the seat should be secured using the seat belt provided. It is not appropriate for the child to be secured with a seat belt alone. 4. This is incorrect. The child should never be held on the lap, even for short distances. 5. This is correct. The best place for the child in the car is in the back seat with the use of an appropriate child safety seat.
Which point should the nurse include in a teaching session for the parents of a toddler-aged patient who live in a home with stairs? 1) Allowing the child to walk up and down the steps to enhance autonomy 2) Ensuring that the child is instructed not to use the steps without assistance 3) Placing a gate so the child is unable to access the steps without supervision 4) Suggesting that the family consider moving to a home that does not have steps
3 1 Allowing the toddler-aged patient who is still learning to walk independently to walk up and down the steps is not safe. 2 Teaching the child not to use the steps without assistance is not an age-appropriate teaching point because the child may not understand and follow verbal rules. 3 Placing a gate so the child is unable to access the steps without assistance is an appropriate teaching point for the parents of a toddler-aged child in a home with stairs. 4 Suggesting that the family move because of this safety issue is not an appropriate suggestion.
Which parental statement regarding the sleep needs of a toddler indicates the need for additional education from the nurse? 1) "My child should sleep a total of 14 hours per day." 2) "My child will need only one afternoon nap versus two naps per day." 3) "I should not put my child down for a nap too late in the afternoon." 4) "I should expect my child to sleep 14 hours each night in addition to an afternoon nap."
4 1 A toddler-aged child should sleep a total of 14 hours in a 24-hour period. 2 A toddler-aged child needs only one afternoon nap versus two naps per day. 3 Late afternoon naps should be avoided because they interfere with the toddler's ability to sleep at night. 4 The total amount of sleep the toddler should get in a 24-hour period is 14 hours; this includes the afternoon nap, which is expected.
The nurse is providing care to a toddler-aged client whose laboratory data indicate anemia. Which question should the nurse include in the health history of this patient? 1) "Does your child eat green leafy vegetables?" 2) "Does your child have a history of bleeding?" 3) "How much milk does your child drink each day?" 4) "Does your child eat the same types of foods as the rest of the family?"
3 1 Although green leafy vegetables are a source of iron, this is not the question the nurse should include in the health history for a toddler-aged child. 2 This question is more appropriate if the toddler-aged child is suspected of having a clotting disorder versus anemia. 3 Many toddler-aged children develop iron-deficiency anemia because of overconsumption of milk; therefore, this question is most appropriate to include in the health history for this child. 4 Although it is important to determine if the toddler-aged child eats the same types of foods as the rest of the family to determine developmental milestones, this question is not appropriate to determine the source of anemia.
The parent of a toddler states, "My child is constantly saying 'no.'" When documenting this in the medical record, which term should the nurse use? 1) Autonomy 2) Egocentric 3) Negativism 4) Temperament
3 1 Autonomy is defined as being self-governing. This is not the best term to use to describe this situation in the medical record. 2 Egocentric, or not being able to process the views of others, is a common trait during the toddler stage of development. However, this is not the best term to use to describe this situation in the medical record. 3 Negativism, or the tendency to be negative with attitude, is a common trait for the toddler that is manifested by the word no. 4 Temperament is the mental, physical, and emotional traits of the child. This is not the best term to use to describe this situation in the medical record.
The home-care nurse is conducting a home visit for the family of a toddler-aged patient. Which finding necessitates education related to safety? 1) Drugs kept in a medicine cabinet in the bathroom 2) Knives stored on the counter out of reach 3) A bucket of water used for mopping in the hallway 4) Cleaning supplies stored in a locked cabinet under the sink
3 1 Drugs kept in a medicine cabinet that is out of reach of the toddler-aged child are not a safety concern necessitating education. 2 Knives kept on the counter that are out of reach of the toddler-aged child are not a safety concern necessitating education. 3 A bucket of water used for mopping, kept out in the open, is a drowning risk for the toddler-aged child. The nurse should educate the family regarding this issue. 4 Cleaning supplies that are stored in a locked cabinet under the sink are not a safety concern necessitating education.
Which risk is increased for a child during the toddler stage of development because of exploration and curiosity? 1) SIDS 2) Suffocation injuries 3) Accidental poisoning 4) Motor vehicle accidents
3 1 SIDS, or sudden infant death syndrome, occurs during infancy and not the toddler stage of development. 2 Suffocation injuries are more likely to occur in infancy than during the toddler stage of development. 3 Accidental poisoning is a risk for injury during the toddler stage of development because of exploration. 4 Motor vehicle accidents are the leading cause of death among adolescents, not toddlers.
Which form of discipline should the nurse encourage when providing care to the family of a toddler-aged child? 1) Saying "no" 2) Ignoring the behavior 3) Implementing "time-outs" 4) Implementing corporal punishment
3 1 Saying "no" is an appropriate form of discipline for the infant. 2 Ignoring the behavior is encouraged during tantrums; however, this is not a form of discipline. 3 Implementing time-outs is an effective form of discipline during the toddler stage of development. 4 Corporal punishment should never be encouraged as a form of discipline.
Which activity should the nurse recommend to the parents of a toddler-aged child to challenge object permanence? 1) Jumping rope 2) Stacking blocks 3) Playing hide-and-go-seek 4) Reading books about colors
3 1 The toddler-aged child does not have the coordination for jumping rope. Also, this activity does not challenge object permanence. 2 Stacking blocks is an age-appropriate activity for the toddler for mastery of fine motor skills but does not challenge object permanence. 3 Playing hide-and-go-seek is an activity that challenges the toddler's object permanence. 4 Reading books about colors is not an activity that challenges object permanence for the toddler-aged child.
Which goal should the nurse include in the plan of care for a toddler-aged client who is diagnosed with seasonal flu? 1) "The child will verbalize the need to have a bowel movement." 2) "The child will ask for fever reducers when hyperthermia occurs." 3) "The child will sneeze and cough into a tissue provided by the caregiver." 4) "The child will use hand sanitizer prior to touching other children in the day-care environment."
3 1 Verbalization of bowel movements is not an age-appropriate intervention because many toddlers are not toilet-trained. 2 It is unrealistic to expect a toddler-aged patient to ask for a fever reducer with hyperthermia. 3 It is appropriate to ask the toddler-aged patient to sneeze or cough into a tissue provided by the caregiver. 4 Although the toddler-aged child can be provided hand sanitizer for use, it is unrealistic to expect a child in this stage of development to implement hand hygiene practices independently.
Which data collected during the health history process cause the nurse to assess for autism? 1) Using pronouns incorrectly 2) Sleeping less than 14 hours per day 3) Using two-word sentences at 20 months of age 4) Lacking interest in games such as hide-and-go-seek
4 1 Pronoun use begins during the toddler stage of development; however, it is not uncommon for a toddler to use pronouns incorrectly, and this does not necessitate further assessment for autism. 2 A toddler who sleeps less than 14 hours per day is not manifesting a behavior indicative of autism. 3 The toddler is expected to use two-word sentences by 20 months of age. 4 Poor social and play skills may indicate autism. These data necessitate further examination for autism.