Ch. 11 Health Promotion of the Toddler & Family
The parent of a 3-year-old child tells the nurse, "I offer food as a reward for appropriate behavior. I'm very pleased, because it works very well." The nurse informs the parent that the child may be at risk for which condition? 1 Obesity 2 Early childhood caries 3 Iron-deficiency anemia 4 Rickets
1 If food is offered as reward, the child may overeat for nonnutritive reasons. Therefore the child may be at risk for obesity. Caries is caused by frequent nocturnal breastfeeding or coating pacifiers in honey. Iron-deficiency anemia may occur if the child does not consume enough iron-enriched foods. Rickets is caused by vitamin D deficiency.
The nurse is caring for a toddler receiving an iron supplement. What factors does the nurse recognize as causes of increased iron absorption? Select all that apply. 1 Tea 2 Calcium 3 Infection 4 Malabsorption disorders 5 Food cooked in cast-iron vessels
2, 5 Factors that increase iron absorption include calcium and food cooked in cast-iron vessels. Infection, malabsorption disorders, and tannins found in tea and coffee can all decrease iron absorption.
Which type of play is characteristic of toddlers? 1 Tactile 2 Solitary 3 Parallel 4 Cooperative
3 Children progress from solitary play during infancy to parallel play during toddlerhood. Tactile play is exploratory play in which the toddler uses water toys, finger paints, or other manipulative objects to play. Cooperative play is not characteristic of a toddler's play.
What are some characteristics of physical development in a 30-month-old child? Select all that apply. (p. 362) 1 Genital fondling is noted. 2 The anterior fontanel is open. 3 The birth weight has doubled. 4 Sphincter control has been achieved. 5 Primary dentition is complete.
4, 5 (I put 1, 3, 4) Sphincter control in preparation for bowel and bladder control is usually achieved by 30 months of age. Primary dentition is usually completed by 30 months of age. The anterior fontanel closes between 12 and 18 months of age. Birth weight should have doubled at 5 to 6 months of age and quadrupled by 2½ years of age. Genital fondling is not a characteristic of physical development in this age group; this is part of the development of gender identity.
For a toddler with sleep problems, what should the nurse suggest that the parents do? 1 Vary the bedtime ritual. 2 Explain away their fears. 3 Use a transitional object at bedtime. 4 Restrict stimulating activities throughout the day.
3 Transitional objects may help ease the toddler's anxiety and facilitate sleep. A consistent set of bedtime rituals will facilitate a toddler's sleep. Toddlers should engage in stimulating physical activity during the day to help them sleep at night. Toddlers do not understand verbal explanations, so parents cannot explain away their fears.
What does the nurse suspect is causing malnourishment and dental caries in a child? 1 The parents refraining from giving the toddler fruit-flavored drinks 2 The parents giving a cup of fruit to the toddler on a daily basis 3 The parents feeding lean meats and low-fat cheeses to the toddler 4 The parents giving 10 ounces of fruit juice per day to the toddler
4 Six ounces of fruit juice per day is sufficient for a toddler. Excessive consumption of fruit juice can result in diarrhea, overnutrition or undernutrition, and dental caries. Fruit-flavored drinks do not prevent diarrhea, overnutrition or undernutrition, or dental caries. Therefore, avoiding giving fruit-flavored drinks does not cause these complications. One cup of fruit per day is sufficient for a toddler and does not cause diarrhea, overnutrition or undernutrition, or dental caries. Giving lean meats and low-fat cheeses does not cause diarrhea, overnutrition or undernutrition, or dental caries; rather, it helps prevent obesity.
The nurse is teaching parents about developmental milestones of a child. Arrange different milestones in order of their occurrence in a child from birth to 3 years. (p. 361-2) 1. Creeps upstairs 2. Engages in parallel play 3. Jumps with both feet 4. Builds a tower of four cubes 5. Participates in solitary play
5, 1, 4, 2, 3 (I put 1, 5, 4, 2, 3) A nurse should be aware of all the developmental milestones of a child from birth. An infant participates in solitary play (see Chapter 9). A child creeps upstairs by the age of 15 months, builds a tower of four cubes by 18 months, engages in parallel play by 24 months, and jumps with both feet by the age of 30 months.
What gross motor skill is developmentally appropriate for a toddler who is 18 months of age? (p. 361) 1 Creeps up stairs 2 Jumps in place with both feet 3 Stands on one foot momentarily 4 Kicks ball forward without overbalancing
2 Discrepancy: PPT says jump in place w both feet @ 30 months At 18 months of age toddlers are expected to jump in place with both feet. Creeping up stairs occurs at 15 months of age. At 30 months of age most toddlers can stand on one foot momentarily. Kicking the ball forward without overbalancing is developmentally appropriate at 24 months of age.
The nurse is teaching the parents of a 2½-year-old child about appropriate feeding practices. Which actions by the parent can place the child at risk? 1 Feeding the child while the child is in active play 2 Calling the child from active play 15 minutes prior to eating 3 Refraining from giving the child hot dogs, fruit gel snacks, and popcorn 4 Replacing one of the child's meals with frequent nutritional snacks
1 Feeding the child while he or she is in active play can increase the risk of choking. Therefore, the parent should not feed the child while he or she in active play. Having the child come inside 15 minutes before eating allows an adequate amount of time for the child to settle down. Foods such as hot dogs, fruit gel snacks, and popcorn increase the risk of choking. Therefore, the parent should not give these foods to the child. Frequent nutritional snacks may be sufficient to replace a meal.
The parent of a toddler, concerned that the child is not getting enough calories, tells the nurse, "She'll only eat crackers, cheese, and turkey." How can the nurse characterize the typical toddler's eating behavior? 1 Ritualism 2 Regression 3 Negativism 4 Abnormal behavior
1 Ritualism is common in toddlers, who often go on food jags during which they insist on having the same foods, same dish, same cup, or same spoon. In regression there is a retreat from one's current pattern of function to a past level of behavior; it has nothing to do with a toddler's food patterns. Negativism is the toddler's answer of no to every request; it is not associated with only eating certain foods. Only eating crackers, cheese, and turkey is not abnormal behavior for a toddler.
A parent of an 8-month-old infant asks the nurse if the baby's pacifier can be coated with honey, because it is good for the immune health. What should the nurse tell the parent? 1 Honey should not be given to infants less than 12 months of age. 2 Honey is a good source of vitamin A. 3 Honey prevents the incidence of childhood caries. 4 Honey improves the child's ability to suck.
1 The parent should be informed that honey is to be avoided in infants less than 12 months of age because it can lead to botulism. Honey is not a good source of vitamin A. Evidence shows that it can lead to early childhood cavities. There is no evidence that it improves the ability of a child to suck.
What is one of the major tasks of toddlerhood? 1 Toilet training 2 Establishing an identity 3 Developing the ability to conserve objects 4 Engaging in imaginative and dramatic play
1 Toilet training is one of the major tasks of toddlerhood. Establishing an identity is a task of adolescence. Toddlers have an inability to conserve objects, so the ability to conserve objects is not a major task of toddlerhood. Imaginative and dramatic play is a task of preschoolers rather than of toddlers.
What should the nurse expect a 24-month-old toddler to be able to do? (p. 355) 1 Walk alone by using a wide stance for extra balance 2 Ambulate independently up and down a set of stairs 3 Jump using both feet and stand on one foot for second 4 Walk on tiptoes and climbs stairs with alternate footing
1 Usually by the age of 12 to 13 months, toddlers are able to walk alone by using a wide stance for extra balance. Therefore, a 24-month-old toddler should be able to walk alone using a wide stance for extra balance. Walking up and down the stairs is a normal finding for a toddler at 26 months of age. A 30-month-old toddler with normal development can jump using both feet and stand on one foot for a second. Walking on tiptoes and climbing stairs with alternate footing are normal findings for a toddler at 3 years, or 36 months, of age. Therefore a 24-month-old toddler would not be able to do these activities.
A toddler is given pasta, but refuses the dish because it does not taste good to the child. The nurse then gives the child a banana to eat, but the child refuses to try it, because he doesn't think it will taste good. What is the nurse's next step? 1 Give the banana to the child later. 2 Inform the pediatrician about the child's behavior. 3 Force the child to eat the banana now to avoid hunger. 4 Tell the child that a banana is different from pasta.
1 (I guessed 4) A toddler may refuse to eat something when a previous food did not taste good. This type of reasoning is called transductive reasoning. In such situations the nurse should accept the response and offer the refused food at a later time. It is not necessary to inform the pediatrician at this stage. The nurse should never force-feed a child. Telling a toddler that a banana is different from pasta will not necessarily be helpful, because this sort of reasoning may not be understood by the child.
The parent of a 2½-year-old child tells the nurse that the child does not sleep well. Which questions does the nurse include in the assessment to identify sleeping problems? Select all that apply. 1 "Tell me about the child's daily routine." 2 "How long does the child stay at a daycare facility?" 3 "What is the child's favorite bedtime object?" 4 "What does the child eat before bedtime?" 5 "How long does the child watch television during the day?"
1, 2, 3, 4 (I put 1, 2, 3, 4, 5) Unsure why 5 is not an answer. Sleep problems in toddlers are seen because of fears, stressors, or awareness of separation. Therefore the nurse asks about those specific areas of the child's life. Asking about daily routines helps the nurse to understand what stressors are affecting the child. The awareness of separation can be assessed by asking how long the child is away from home. Children use transitional objects such as an animal or a blanket to ease their insecurity. Asking about the child's favorite bedtime object helps to understand whether the child is coping with stress effectively. A heavy meal before bedtime interferes with sleep. Therefore it is important to assess what the child eats before bedtime. Long hours of watching TV are related to obesity; keeping television out of a child's room provides quiet time before sleep.
The nurse is assessing the fine motor skills in a 24-month-old toddler. Which action by the toddler indicates delayed development? Select all that apply. 1 The toddler is unable to release an object at will. 2 The toddler is unable to build a block tower. 3 The toddler is unable to draw circles on paper. 4 The toddler loses balance while throwing a ball. 5 The toddler cannot drop objects into a narrow-necked bottle.
1, 2, 4, 5 (I put 1, 3, 5) At 15 months the child can grasp and release an object at will. The toddler is able to build a block tower at the age of 24 months. The toddler can throw a ball without losing balance at 18 months. The toddler can drop objects into a narrow-necked bottle at the age of 15 months. The child is able to draw circles on paper from the age of 36 months.
A toddler is not gaining optimal weight and height for his or her age. The laboratory reports reveal very low levels of vitamin B12 and vitamin D. What should the parents be told in order to correct these low levels? Select all that apply. (p. 367) 1 Feed poached organ meat to the child. 2 Do not overcook vegetables. 3 Give multivitamin and mineral supplement. 4 Regularly expose child to sunlight for 10 min/day. 5 Give a combination of fruits, vegetables, and nuts.
1, 3, 4 Parents should be advised about the foods and supplements that can provide vitamin B12 and vitamin D to the child. Vitamin B12 is present only in foods of animal origin, such as organ meat, chicken, milk, and red meat. Supplements of vitamin B12 and vitamin D can also be advised. Sunlight is the major source for vitamin D, and the parents should be advised to regularly expose the child to sunlight for 5 to 15 min/day. Giving a combination of vegetables, fruits, and nuts cannot correct the low levels of vitamin B12 and vitamin D.
The nurse teaches the parent measures to be followed when administering iron supplements to a 3-year-old child. During a follow-up visit, the nurse finds that the child still has anemia, even after following the complete treatment regimen. Which action by the parent is likely responsible for this condition? Select all that apply. (p. 367) 1 Administering iron supplements with milk 2 Administering iron supplements with meat 3 Administering iron supplements with orange juice 4 Administering iron supplements with an oral antacid 5 Administering iron supplements with sweet potato
1, 4, 5 (I put 1, 2, 4) Milk decreases the absorption of iron in the body. Therefore, the parent should not administer iron supplements to the child along with milk. A high pH decreases iron absorption. Antacids have a high pH, so they should not be administered along with iron supplements. Sweet potatoes contain oxalates. These oxalates form insoluble complexes with the iron and reduce its absorption in the body. Meat, fish, and poultry enhance the absorption of iron and enhance its therapeutic action. Vitamin C enhances iron absorption. Orange juice is rich in vitamin C, so it enhances iron absorption in the body.
A parent of an 18-month-old child informs the nurse that the child does not eat properly and is very fussy. Sometimes the child does not eat anything; on other days the child eats a lot. What is the most appropriate response of the nurse? 1 "Is the child taking any medications for any sort of health problems?" 2 "This is a normal phenomenon at this age. Your child is fine." 3 "The child may need some blood tests, because there is a problem with the gastrointestinal (GI) system." 4 "The child needs to be admitted into the hospital immediately for treatment."
2 Most toddlers at 18 months of age have decreased nutritional needs manifested as decreased appetite. This phenomenon is called physiologic anorexia. During this stage they become fussy eaters with strong taste preferences, and they may eat nothing one day and large amounts the next day. Therefore the parent should be informed that this is normal, and the child is fine. This phenomenon is not caused by medications. The parent should be reassured that the child has no health issues and does not require any treatment at a hospital.
Which toddler behavior indicates negativism? 1 Possessing the ability to withstand delayed gratification 2 Throwing a temper tantrum when unable to open the door 3 Showing the ability to interact with others in a less egocentric manner 4 Possessing the ability to tolerate separation anxiety
2 Negativism is the tendency for toddlers to give persistent negative responses to requests by saying words such as "no" or "me do." This may be their sole vocabulary. Temper tantrums and anger also indicate negativism in the child. The ability to withstand delayed gratification and to interact with others in a less egocentric manner indicates psychosocial development, not negativism, in the toddler. An ability to tolerate separation anxiety when separated from the parents indicates psychosocial development, not negativism.
What term describes the phenomenon at work when a toddler separates from the mother and begins to make sense of experiences in the environment but is then drawn back to the mother for assistance in verbally articulating the meaning of these experiences? 1 Gender identity 2 Rapprochement 3 Transitional objects 4 Mental symbolization
2 Rapprochement is defined as the phenomenon of a toddler's separation from the mother and beginning to make sense of experiences in the environment, followed by a drawing back to the mother for assistance in verbally articulating the meaning of these experiences. Gender identity is defined as a sense of maleness or femaleness. Transitional objects, such as a favorite blanket or toy, provide security for children, especially when they are separated from their parents, dealing with a new stress, or just fatigued. Mental symbolization is associated with prelogical reasoning, in which painful experiences take on new significance because memory is associated with the specific event.
While speaking to the parents of a child, the nurse finds that the child has not shown any interest in food the last few days. The nurse learns that the toddler likes vegetarian food, and his or her favorite plate is a plastic one. The parents serve food on a ceramic plate. What advice should the nurse give the parents? 1 Serve the child's favorite food in a ceramic bowl instead. 2 Serve the child's favorite food on the favorite plate. 3 Plastic plates are contraindicated for toddlers. 4 Serve mixed foods such as stews, as most children like them.
2 Toddlers show ritualism in eating food. Therefore the child may be less likely to reject foods if they are served on his or her favorite plate. This will enhance the child's interest in eating the food, and the child will gain optimal weight. Because toddlers have unpredictable table manners, plastic dishes and cups are safer and more economical in case the child throws the dish. Many children of this age do not like mixed foods such as stews and casseroles and the parents may want to consider simple dishes with easily-identified ingredients instead.
The parent of a 20-month-old toddler tells the nurse, "I don't understand my child's eating habits. Sometimes my child eats a lot and the next day nothing at all. Sometimes my child may push away the plate and reject a favorite food for no reason." What does the nurse understand from the child's behavior? 1 The child is displaying symptoms of anorexia. 2 The child is influenced by the psychologic components of food. 3 The child becomes unpredictable after 20 months of age. 4 The parent is consistent about mealtimes with the child.
2 (I put 1) At the age of 18 months, toddlers show signs of decreased appetite by being fussy eaters or having strong taste preferences. These children are influenced by the psychologic components of the food instead of taste. They are more interested in the pleasure of eating or the social aspect of mealtime. This phenomenon is called physiologic anorexia. The child may become unpredictable during mealtimes, but it does not mean that the child generally becomes unpredictable after 20 months. A consistent mealtime contributes to the child's need for ritualism and helps to reduce undesirable behavior at mealtimes.
A 2-year-old child resists going to bed and has the habit of banging his or her head against the wall and crying when a parent tries to place the child in the bed. What advice should the nurse to the parent? (p. 364) 1 During temper tantrums ignore the behavior of the child. 2 Praise the child after the temper tantrum for any positive, appropriate behavior. 3 Never be lenient with the child; otherwise tantrums will become a habit. 4 Do not tell stories to children who throw tantrums before bedtime.
2 (I put 1) Temper tantrums are common in children. But if the child is banging his or her head against the wall, the parent should not ignore the behavior because the child could be injured. After the tantrum ends the parent should reinforce any positive behavior of the child by praising or by giving a reward. The child should not be punished during or after tantrums. Telling stories to the child at bedtime can also be useful.
Parents of a toddler are worried because their child touches the genitalia in public. What should the nurse advise? (p. 358) 1 Do not allow the child to play with genitalia in public or private places. 2 Teach that genital stimulation in private is acceptable but not in public. 3 Take the toddler to a psychologist or psychiatrist for a health checkup. 4 Ignore it, because it is a normal phenomenon in psychosocial development.
2 (I put 1) Activities of a toddler should be dealt with carefully because reactions of parents influence the attitudes of children and can affect their psychosocial development. It is a normal phenomenon for toddlers to stimulate their genital organs, but they should be taught that such activities are not accepted in public places and should be done in private. At this stage parents need not consult a psychologist or psychiatrist for a health checkup of the toddler. However it is also inappropriate to ignore such behavior.
What information should the nurse give to parents of toddlers about the regular use of fluoridated water or beverages that contain fluoride? (p. 369) 1 All fluoridated water is toxic to children. 2 These drinks can cause stains or pits in the teeth. 3 Regular use of fluoridated water is recommended for toddlers. 4 It is not necessary to check the fluoride level in your water supply.
2 (I put 3) Parents should be cautioned that regular use of fluoridated water or beverages such as bottled water containing fluoride can result in staining or pitting of the child's teeth. Fluoridated water is not toxic to children. Regular use of fluoridated water is not recommended for toddlers. The American Academy of Pediatric Dentistry recommends that children between 6 months and 3 years of age have 0.25 mg in those with a water supply less than 0.3 parts per million.
The nurse assesses a toddler and finds that the child is in a growth spurt. What should the nurse tell the family regarding feeding the child to meet his or her nutritional needs? Select all that apply. 1 Plan a nutritionally balanced day. 2 Plan a nutritionally balanced week. 3 Serve food in various physical forms. 4 The toddler shouldn't smell a new food. 5 Feed the child when it is actively playing.
2, 3 (I put 1, 2, 3) Toddlers try to control their environment as they grow. Parents should be advised to plan for a nutritionally balanced week. By serving food in different forms and shapes, "food jags" can be prevented. New food should be introduced in a stepwise pattern, such as having the child smell, touch, taste, and then eat the new food. Feeding the toddler when he or she is actively playing can cause choking and is not recommended.
The nurse is teaching a parent about ways to ensure proper oral hygiene for a 2-year-old child. Which statements made by the parent indicate effective learning? Select all that apply. 1 "I should stand facing my child while brushing her teeth." 2 "I should tell my child to 'roar like a lion' to brush the back teeth." 3 "I should sit on the floor with my child's head resting between my thighs while brushing." 4 "I should use a rice-size amount of toothpaste to brush my child's teeth." 5 "I should rinse my child's mouth thoroughly after using fluoridated gels."
2, 3, 4 (I put 1, 2, 5) Roaring like a lion exposes the back teeth, making it easier to brush the back teeth of the child. Sitting on the floor with the child's head resting between the thighs ensures easy access to the child's teeth. Using large amounts of toothpaste can irritate child's oral mucosa. Therefore, the parent should use only a rice-size amount of toothpaste. The parent should stand behind the child to ensure visibility in the mirror. After brushing, the parent should avoid rinsing the child's mouth thoroughly to enhance the effectiveness of fluoridated gels.
The nurse is assessing gross motor skills in a 24-month-old child. Which action does the nurse ask the toddler to perform? (p. 361) 1 To walk alone without support 2 To jump with both feet 3 To walk up and down the stairs 4 To stand on one foot
3 (I put 1) A 24-month-old child is able to walk up and down stairs. Therefore the nurse assesses this action to determine whether the child shows normal gross motor skill development. The child is able to walk alone with a wide stance at 13 months. The toddler can jump with both feet at 30 months of age. The child can stand on one foot by 2.5 years of age.
A parent has a 2-year old in the clinic for a well-child checkup. Which statement by the parent suggests the need for additional information about injury prevention in early childhood? 1 "We keep all of the medicines out of reach." 2 "We have a fence around the swimming pool." 3 "We've put gates at the top and bottom of our stairs." 4 "Our 2-year-old toddler takes a bath with his sister while we cook dinner."
4 Allowing a 2-year-old toddler to take a bath unsupervised suggests that the parent needs additional information about injury prevention in early childhood. Keeping all medicines out of reach or locked, placing gates at the top and bottom of the stairs, and having a fence around the swimming pool are all ways to prevent injury and therefore do not warrant additional teaching about injury prevention.
When is voluntary control of the anal and urethral sphincters typically achieved? 1 Between 8 and 12 months 2 Between 10 and 12 months 3 Between 18 and 20 months 4 Between 18 and 24 months
4 Between 18 and 24 months of age most toddlers have achieved voluntary control of the anal and urethral sphincters. Most toddlers have not achieved this control between the ages of 8 to 12 months, 10 to 12 months, or 18 to 20 months.
While caring for a 3-year-old child, the nurse finds that the toddler hits the parent and laughs. What is the appropriate reaction to the toddler in this situation? 1 Tell the child to stop hitting, because hitting hurts others. 2 Tolerate the child's behavior until the hitting stops. 3 Leave the child's room immediately when the hitting occurs. 4 Tell the child to stop hitting, because people are not supposed to hit others.
4 It is appropriate to tell a 3-year-old child to stop hitting while emphasizing that hitting others is unacceptable. Telling the child to stop hitting and that hitting can hurt others is ineffective because, as the aggressor, hitting makes the toddler happy. The nurse should not tell the parent to tolerate the hitting, because this may send the message that hitting is acceptable behavior. Leaving the child alone may cause emotional distress for the child.
What instructions should the nurse not include when teaching parents about injury prevention at the toddler's well-child visit? 1 Remove unsecured and scatter rugs. 2 Supervise the child while playing outside. 3 Never leave the child unsupervised in a bathtub. 4 Child should wear a seatbelt when sitting in the front passenger seat.
4 The nurse should teach parents about injury prevention at the toddler's well-child visit. Such information includes the need to remove all unsecured or scatter rugs to prevent injury; to supervise when the child plays outside; and to never leave the child unsupervised in a bathtub. The nurse should teach the parents that the safest place in the car for a toddler is in an appropriate car seat in the back, not the front, seat of the vehicle.
What should the nurse recommend that parents do to minimize toddler temper tantrums? 1 Giving the child a flat, large slice of cheese 2 Giving the child a small, thick cookie rather than a large, flat one 3 Giving the same foods to the child every day instead of new foods 4 Giving medication in a large cup if the child refuses to take medicine in a small cup
4 Toddlers do not understand the concept of conservation in which mass can change in shape and size. Therefore, the amount of medication appears smaller in a large cup than it does in a small cup. Therefore, the parent can give the child medication in large cup if the child refuses to take the medicine from the small cup. The parent should give the child thicker, smaller slices of cheese rather than flat, large pieces of cheese. The parent should also give the child a large, flat cookie, rather than a small, thick one to ensure comfort. A child should be exposed to different foods on a regular basis to be able to process the complex sensory information needed to eat different flavors and textures.
The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy? 1 Helping the toddler complete tasks 2 Helping the toddler learn the difference between right and wrong 3 Providing opportunities for the toddler to play with other children 4 Encouraging the toddler to do things for himself or herself when capable
4 Toddlers have an increased ability to control their bodies, themselves, and the environment. Autonomy develops when children complete tasks of which they are capable. To successfully achieve autonomy, the toddler needs to have a sense of accomplishment. This does not occur if parents complete tasks. Children at this age engage in parallel play. This will not foster autonomy. The concept of right and wrong is too advanced for toddlers and will not contribute to autonomy.
The nurse finds that a toddler shows transductive reasoning of preoperational thoughts. Which statement made by the toddler supports the nurse's finding? 1 "I can bring my dead grandfather back with my super power." 2 "I can fly in the air like a bird with the help of my super hero." 3 "I don't eat that because it's green, and I don't like green food." 4 "I don't like this food, because the last time I ate something new, it wasn't good."
4 Transductive reasoning indicates the reasoning from the particular to the particular. One example of transductive reasoning of preoperational thoughts is when toddlers refuse to eat a food because something previously eaten did not taste good. The statements "I can bring my dead grandfather back with my super power," and "I can fly in the air like a bird with the help of my super hero" indicate magical thinking of preoperational thoughts. The statement "I don't eat that food because it's green, and I don't like green food" indicates centration of preoperational thoughts.
During a home visit to a toddler, the nurse finds that the home has a balcony with rails, and the opening between the rails is 3 inches. There is a carbon monoxide detector in the home. Cough syrup has been placed in a childproof container on a high level shelf. The house has an old refrigerator in a storage room, and its doors have been removed. Which finding in the home should be addressed by the nurse? (p. 371-2) 1 Openings of the railings in balcony 2 Presence of carbon monoxide detector 3 Placing of old refrigerator with doors removed 4 Placing of cough syrup in a container at high level
4 (I put 1) It is important for a nurse to give appropriate instructions to the parents to prevent any accidental injuries to toddlers at home. Toddlers are often able to remove childproof containers and can access high-level, tight-security areas. They try to explore things by tasting them and therefore can ingest cough syrup, which could lead to poisoning. Parents should be advised to lock such containers or medicines in a cabinet where the child is unlikely to see it. Most toddlers cannot pass through an opening of 4 inches or less. It is important to have a carbon monoxide detector in homes where the heating system is old. Parents should be advised to remove the doors of old appliances such as refrigerators or ovens before storing them or discarding them to prevent accidental trapping of their toddlers.
