chapter 26 growth and development of the toddler
What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition?
"I give my daughter juice at breakfast and when she is thirsty during the day."
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."
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."
In working with the toddler, which statement would be most appropriate to say to the toddler to decrease the behavior known as negativism?
"It is time for lunch. I am going to put your bib on."
After teaching the mother of a 13-month boy old about suggestions for bathing and hygiene, the nurse determines that the teaching was successful when the mother states:
"It might be best to give him a bath in the evening."
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."
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."
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."
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."
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.
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."
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 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
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
A nurse observes a child engaged in parallel play in a nursery. What is an example of parallel play?
A boy sitting beside a girl in the floor, each playing independently with a separate set of blocks
The nurse is assessing a toddler's fine motor skills. Which finding will concern the nurse?
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
What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums?
Appear to ignore the toddler
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 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
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 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.
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.
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
The nurse is discussing proper discipline with the parent of a 15-month-old toddler. Which teaching is most important?
Physical punishment such as spanking is discouraged.
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.
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 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 speaks in one-word sentences
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.
The nurse is explaining safety precautions for toddlers to the mother of a normal 30-month-old boy. Which activity might the nurse suggest may be done without supervision?
Undressing himself
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 assessing a 2-year-old boy during a well-child visit. The nurse correctly identifies the child's current stage of Erikson's growth and development as
autonomy versus shame and doubt
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?
exploring one's body
The parents of a 2-year-old girl are concerned with her behavior. For which behavior would the nurse share their concern?
frequently babbles to herself when playing
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
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?
"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."
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."
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."
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?
"Your daughter is demonstrating fine motor skills appropriate to her age by pointing with her index finger."
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 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 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?
Share that the heads of children at this age are large in proportion to the rest of their body.
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.
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 assessing the language development of a 3-year-old girl. Which finding would suggest a problem?
speaks in 2- to 3-word sentences
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents that the child is displaying:
object permanence.
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.
