prep-u - chapter 26: growth and development of the toddler

What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums?

Appear to ignore the toddler

Parents and their nearly 3-year-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?

Uses two-word sentences or phrases

The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for this age group?

Stacking blocks

A parent is concerned because the toddler refuses to share. What is the nurse's best response to the parent regarding this concern?

This is normal toddler behavior; sharing is learned later.

The nurse is providing anticipatory guidance to the parents of an 18-month-old child. Which recommendation should be the most helpful to the parents?

Describe proper behavior when the child misbehaves.

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?

Talk to him that night about the details of the dreams.

The nurse is caring for a 17-month-old child admitted to the acute care facility. The child is fretful and becomes calmer when given a tattered blanket from home. What inference can be made about the child's behavior in response to receiving the blanket?

The ability of the child to soothe herself is a positive sign of development.

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

The child demonstrates separation anxiety.

A mother reports her 2-year-old daughter has gradually eaten more and more poorly since her 1-year-old well-child visit. The nurse assesses the child's growth and development as normal. What concept explains the mother's concern?

physiologic anorexia

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

The nurse is assessing the language development of a 3-year-old girl. Which finding would suggest a problem?

speaks in 2- to 3-word sentences

A mother expresses surprise to the nurse that her daughter has begun masturbating. The most important initial nursing response is that:

this is a normal and expected activity best treated matter-of-factly.

The nurse is observing a 36-month-old boy during a well-child visit. Which motor skill has he most recently acquired?

undress himself

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

The toddler should speak in two-word sentences ("Me go").

A parent of a 2-year-old child asks the nurse, "What would be a good between-meal snack?" What food(s) is appropriate for the nurse to suggest? Select all that apply.

-cheese -yogurt -orange slices -apple slices

The nurse is caring for an 18-month-old child. The nurse is aware that the child is which stage according to Erikson?

Autonomy versus shame and doubt

The nurse is discussing sensory development with the mother of a 2-year-old boy. Which parental comment suggests the child may have a sensory problem?

"He doesn't respond if I wave to him."

A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate?

"You'll probably notice that your daughter is uncomfortable in wet diapers."

The parent of a 2-year-old toddler tells the nurse she needs to constantly scold the toddler for having wet pants. The parent says the toddler was potty trained at 12 months, but since starting to walk, the toddler wets the pants all the time. Which nursing diagnosis would be most applicable?

Deficient parental knowledge related to inappropriate method for toilet training

What is a true statement regarding the developmental milestones of the 30-month-old child?

Full set of primary teeth

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?

"Keep all cleaning products and drugs out of the reach of your child."

The nurse is teaching the parents of a 2-year-old child how to handle the child's temper tantrums. The nurse determines that the teaching was successful if the parents make which statement?

"We will ignore our child while having the tantrum."

The nurse is caring for an 18-month-old child who has had surgery. The medical record indicates the child weighs 23 pounds (10.45 kg). When monitoring his urinary output the nurse is aware that normal hourly output should be what value?

10 ml/hr

Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching?

Reasoned with the child to stop the behavior

A nurse is assessing a 2-year-old's language development. What would the nurse expect to assess?

Use of a two-word noun-verb sentence

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."

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 uses the potty chair and is dry all day long."

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?

"Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained."

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."

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?

"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

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.

-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

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?

3-year-old preschool-aged child who goes up stairs on hands and knees

The parents of a 30-month-old toddler have brought the toddler into the emergency department because of a seizure. During the health history, the nurse learns that the toddler was frustrated and angry immediately preceding the seizure. The nurse suspects the toddler had a breath-holding spell. Which parental report suggests breath-holding?

A tantrum preceded the event.

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.

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?

Explain that this is normal behavior for toddlers.

The caregivers of a 2-year-old are concerned the child is not learning how to share and play well with other children. While acknowledging their concern and devotion, the nurse should point out which activity would be best for this child's developmental level?

Mowing the lawn with a toy lawnmower

Which gross motor developmental milestone is least likely for a 2-year-old?

Rides a tricycle

The nurse is examining a 2-year-old girl for speech and language development. Which finding would suggest a delay in speech development?

The child does not use the names of familiar objects.

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."

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?

"At this age, the digestive tract is not completely mature and children may pass undigested food."

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."

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."

The parents of a 3-year-old boy have asked the nurse for advice about a preschool for their child. Which suggestion is most important for the nurse to make?

"The staff should be trained in early childhood development."

A 3-year-old child is hospitalized. The parents are concerned because the child is now refusing to use the potty and is wetting the bed even though the child has achieved toilet training. Which response by the nurse is most appropriate?

"Your child is experiencing regression as a result of stress."

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.

-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.

Which is the best way for parents to aid a toddler in achieving the developmental task?

Allow the toddler to make simple decisions

The nurse 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.

Which action is appropriate to enhance a toddler's self-esteem?

Include the child in activities that interest the adult.

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 act on one's own

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?

Limiting the choices and decisions that the child makes

The nurse is educating a parent regarding child safety for the 14-month-old toddler. What would the nurse include in the educational plan?

Maintain supervision when the child is near stoves, ovens, irons and other hot items the child could reach.

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.

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.

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?

Saying no is your son's way of trying to exert his independence and is expected.

The home health nurse is visiting a 2-year-old client's home. Which finding will cause the nurse to intervene?

The family's medications are located in a kitchen drawer.

A toddler's parent reports that their child will only eat peanut butter and jelly sandwiches for several days in a row. The child will then refuse to eat these sandwiches for several weeks. How should the nurse best document this behavior?

food jag

The nurse is observing a 3-year-old boy in a day care center. Which behavior might suggest an emotional problem?

has persistent separation anxiety

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

The nurse is assigned to care for a 15-month-old toddler. When developing a care plan addressing the nutritional needs of the toddler, which client goal(s) demonstrate the nurse's understanding of these needs? Select all that apply.

-"The child will drink amounts suggested by the pediatrician of milk and other fluids on a daily basis." -"The child will stop drinking from a bottle while in bed within the next 2 weeks." -"The child will learn to drink from a cup within the next month."

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.

-"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."

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 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."

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.

-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

The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this?

A regular routine and rituals will provide stability and security.