341 Ch 4
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 toddler is probably reacting to some family crisis. Play time with other toddlers should be cut back until your toddler learns to share. Behavior modification techniques can change the toddler's behavior.
This is normal toddler behavior; sharing is learned later.
The toddler grows about how many inches (centimeters) in height per year? 5 in (12.5 cm) 7 in (17.5 cm) 3 in (7.5 cm) 1 in (2.5 cm)
3 in (7.5 cm)
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? "Your child's behavior indicates discipline occurring at home is not consistent." "I am sure your child is just acting out since your child is in the hospital and not at home." "A 2-year-old child's behavior can be greatly altered if rituals are not maintained." "You need to have someone bring the baby dolls to the hospital."
"A 2-year-old child's behavior can be greatly altered if rituals are not maintained."
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." "Serve only healthy foods. He'll eat when he's hungry." "Give him more healthy choices with less junk food available."
"Give him more healthy choices with less junk food available."
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." "I dropped a pan behind him and he cried." "He wasn't bothered by the paint smell." "He was licking the dishwashing soap."
"He doesn't respond if I wave to him."
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? "Has your child displayed any aggressive tendencies toward other children?" "Does your child have opportunities to socialize much with other children?" "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."
"It is normal for children to engage in play alongside other children at this age."
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 drink milk from a bottle for the next 2 months." "The child will be weaned from breastfeeding within the next month." "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."
"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."
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? "Check to make sure your child can attend with the sniffles." "The staff should be trained in early childhood development." "Make sure that you can easily get an appointment to visit." "Look for a preschool that is clean and has a loving staff."
"The staff should be trained in early childhood development."
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." "This is actually a regression for your toddler because separation anxiety normally occurs in infancy." "Establishing a routine for saying goodbye to your toddler will be helpful." "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."
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? "Do not worry. This is a normal response to being in the hospital." "Why do you believe your child is refusing to use the potty?" "Once discharged, your child will quickly learn to use the toilet again." "Your child is experiencing regression as a result of stress."
"Your child is experiencing regression as a result of stress."
While observing a 13-month-old and her parents in the playroom of the hospital unit, the nurse notes that the toddler is using her index finger to point towards a toy. What should the nurse say to the parents? "Has your daughter started turning book pages on her own yet." "I notice your daughter is using her index finger to point. This is something we should tell the doctor." "Your daughter is demonstrating fine motor skills appropriate to her age by pointing with her index finger." "How long has your daughter used her index finger to point to objects?"
"Your daughter is demonstrating fine motor skills appropriate to her age by pointing with her index finger."
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? 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 9-month-old infant who can pull self up to a standing position 24-month-old toddler who engages in parallel play
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? The event took place during a nap. The toddler became unconscious. A tantrum preceded the event. The toddler was lethargic afterward.
A tantrum preceded the event.
The nurse is assessing a toddler's fine motor skills. Which finding will concern the nurse? Ability to hold a crayon to write Able to use a spoon to self-feed Put shapes into matching openings Ability to turn door knobs
Ability to turn door knobs
Which is the best way for parents to aid a toddler in achieving the developmental task? Allow the toddler to make simple decisions Help the toddler learn to count Give the toddler small household chores to do Urge the toddler to dress oneself completely alone
Allow the toddler to make simple decisions
The nurse is promoting language and cognitive development to the parents of a 3-year-old boy. Which guidance about reading with their child will be most helpful? Ask the child questions as you read. Read a different book if he knows the story. Keep story time a reward for being good. Have the child sit still during the story.
Ask the child questions as you read.
The nurse is assessing a 2-year-old boy during a well child visit. The nurse correctly identifies the child's current stage of Erickson's growth and development as: Industry versus inferiority Initiative versus guilt Autonomy versus shame and doubt Trust versus mistrust
Autonomy versus shame and doubt
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? Ineffective coping related to lack of self-control of 2-year-old toddler Total urinary incontinence related to delayed toilet training Excess fluid volume related to inability to control urination Deficient parental knowledge related to inappropriate method for toilet training
Deficient parental knowledge related to inappropriate method for toilet training
The nurse is playing a game with a toddler in the hospital room. What is the most important benefit of this nurse-client interaction? Developing a trusting relationship with the nurse Occupying the toddler's time while the parents are meeting with the physician Utilizing clinical time when the unit is not busy Distracting the toddler from expending too much energy with active playing
Developing a trusting relationship with the nurse
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother? Remind them staying in the hospital now will help the child get well quicker and be home soon, but the other children should not be alone. Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning." Tell both the mother and child that the child will be carefully guarded and won't be in as much danger as she might be if she were home exploring her environment. Distract the child with a special blanket, stuffed animal, or other "lovey" from home while the mother quietly slips out.
Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning."
The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development? She asks many questions. She talks incessantly. She uses complete 3- to 4-word sentences. Her vocabulary is between 10 and 15 words.
Her vocabulary is between 10 and 15 words.
The nurse is talking to the parent of a 19-month-old toddler about setting limits and supervising activities. In which situation will the nurse recommend letting the toddler do as he or she pleases? Deciding one's bedtime schedule Choosing one's own foods Playing on the picnic table Exploring one's body
Exploring one's body
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. Utilize a front-facing car seat with appropriate harness straps until at least the age of 24 months. If the child reaches to touch a firearm, gently slap the child's hand and firmly state 'No.' Assure there are no empty buckets in the home/play area that could result in accidental drowning.
Maintain supervision when the child is near stoves, ovens, irons and other hot items the child could reach.
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing? Playing apart from others without being part of a group Playing in an organized group with each other Playing independently and are side by side Playing together in an activity without organization
Playing independently and are side by side
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? Pretending to be mommies and daddies in the play house Playing with the plastic vacuum cleaner and pushing it around the room Watching a movie with other children their age Painting pictures in the art corner of the room
Playing with the plastic vacuum cleaner and pushing it around the room
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? Remained relatively calm even though embarrassed Made sure the child was rested and not hungry before going to the mall Tried to refocus the child's attention as tantrum behavioral cues appeared Reasoned with the child to stop the behavior
Reasoned with the child to stop the behavior
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? Explain that the child looks normal. Share that the heads of children at this age are large in proportion to the rest of their body. Teach the mother that this larger head than body appearance will be this way until the child is about 6 years old. Some children have large heads but that does not signal a problem.
Share that the heads of children at this age are large in proportion to the rest of their body.
The nurse is assessing the language development of a 3-year-old girl. Which finding would suggest a problem? Tells the nurse she saw Na-Na today Tells the nurse her name Speaks in 2- to 3-word sentences Makes simple conversation
Speaks in 2- to 3-word sentences
The 18-month-old toddler has most likely attained which gross motor skill? The ability to walk up stairs alone. The ability to walk independently. The ability to pedal a tricycle. The ability to balance on one foot.
The ability to walk independently.
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 copies a circle on a piece of paper. The child demonstrates separation anxiety. The child follows directions when made one at a time. The child imitates the nurse in use of a stethoscope.
The child demonstrates separation anxiety.
In discussing their 2-year-old's behavior with the nurse, which of the parents' statements suggests the child may be ready for toilet teaching? The child frequently repeats words parents just said. The toddler walks with a wide, swaying gait. The child hides behind her bedroom door when defecating. The child often removes her shoes and socks.
The child hides behind her bedroom door when defecating.
The nurse is assessing a healthy 2-year-old client. Which assessment finding most concerns the nurse? The child is pointing to named body parts The child can stand on tiptoe The child speaks in one-word sentences The child has difficulty with stairs
The child speaks in one-word sentences
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 speak in two-word sentences ("Me go"). The toddler should say 20 nouns and 4 pronouns.
The toddler should speak in two-word sentences ("Me go").
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? Talks about a past event Half of speech understood by outsider Uses two-word sentences or phrases Asks "why" often
Uses two-word sentences or phrases
The parents of a toddler are asking the nurse if their child is lagging behind since the child does not have a very large vocabulary at the present time. Many times their toddler just points to an object and the parents give it to the toddler. Which concepts/statements should the nurse share with this family about language development of a toddler? Select all that apply. When the child points to an object, wait and make the child name the object before giving it to him or her. Since toddlers imitate what they hear, use good grammar and incorporate pronouns like "I" and "you." Read aloud to the toddler to help build and strengthen vocabulary by pointing to pictures in the book. If the child asks, "Why?" be sure to give him or her a full explanation since the child is showing initiative. Reinforce language by voicing a request, "You want the apple?"
When the child points to an object, wait and make the child name the object before giving it to him or her. Since toddlers imitate what they hear, use good grammar and incorporate pronouns like "I" and "you." Read aloud to the toddler to help build and strengthen vocabulary by pointing to pictures in the book. If the child asks, "Why?" be sure to give him or her a full explanation since the child is showing initiative. Reinforce language by voicing a request, "You want the apple?"
During a wellness check up for a 4-year-old client, the parents state, "We just moved into a new home and our child has begun wetting and defecating in the underwear. Which response by the nurse is appropriate? "This is a normal response to stress during childhood." "I will let the primary health care provider know of your concern." "Has your child reported any pain with urination or bowel movements?" "Have you noticed an increase in urinary frequency?"
"This is a normal response to stress during childhood."
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? A sense of control can be provided through offering limited choices. Aggressive behaviors such as hitting and biting are common in toddlers. 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.
A regular routine and rituals will provide stability and security.
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 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." "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 starting him with just a tablespoonful of food on his plate."
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."
The home health nurse is visiting a 2-year-old client's home. Which finding will cause the nurse to intervene? The toddler in not allowed in the kitchen while food is being prepared The toddler goes to the bathroom alone to urinate All of the windows in the home are locked The family's medications are located in a kitchen drawer
The family's medications are located in a kitchen drawer
