Pediatric Ch. 11

What gross motor skill is developmentally appropriate for a toddler who is 18 months of age?

Jumps in place with both feet

Parents of a toddler are worried because the child behaves abnormally after the birth of a baby sister. The toddler now likes to drink milk from the feeding bottle rather than from a favorite cup and demands to be given the same toys as the baby sister. What is the best approach in handling this behavior?

Ignore this behavior and praise appropriate behavior.

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?

Tell the child to stop hitting, because people are not supposed to hit others.

The nurse finds that a toddler shows transductive reasoning of preoperational thoughts. Which statement made by the toddler supports the nurse's finding?

"I don't like this food, because the last time I ate something new, it wasn't good."

The parent of a 12-year-old child asks the nurse whether meat and hot dogs can be included in the child's diet. How does the nurse respond?

"Slice the meat into small pieces before serving."

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.

Administering iron supplements with milk Administering iron supplements with an oral antacid Administering iron supplements with sweet potato

While assessing a toddler's eyes, the nurse finds the presence of persistent strabismus. The nurse instructs the parents to immediately consult an ophthalmologist for the toddler. Which condition does the nurse seek to prevent by this instruction?

Amblyopia

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.

Feed poached organ meat to the child. Give multivitamin and mineral supplement Regularly expose child to sunlight for 10 min/day.

A toddler is not gaining optimal weight and height for his or her age. The laboratory reports reveal very low levels of vitamin B 12 and vitamin D. What should the parents be told in order to correct these low levels? Select all that apply.

Feed poached organ meat to the child. Give multivitamin and mineral supplement. Regularly expose child to sunlight for 10 min/day.

A mother tells the nurse that her toddler always says no to her requests. How does Erikson describe this toddler's behavior?

Negativism

Which information about bottle-mouth caries should be given to parents?

O Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome.

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?

Obesity

Which type of play is characteristic of toddlers?

Parallel

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?

Praise the child after the temper tantrum for any positive, appropriate behavior.

A mother sits while her toddler is playing with other toddlers. After a few minutes her toddler comes to her to be held. After the mother holds her child, the child returns to playing with other toddlers. What is this task of development called?

Rapprochement

The parents of an 18-month-old child tell the nurse that they have prolonged bottle feeding to decrease the child's crying. What does the nurse conclude from this behavior?

The child is at risk for early childhood caries.

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?

The child is influenced by the psychologic components of food.

The parent of a preschooler tells the nurse, "After the birth of my second baby, my preschooler has been using baby talk and has been aggressive with other kids." What does the nurse conclude about the preschooler?

The child is using displacement.

During an assessment of an 18-month-old child, the nurse finds that the child can say four to six words and can build a tower of four cubes.. The child also throws temper tantrums occasionally. Which statement describes the child's development?

The child may have delayed language development.

What does the nurse suspect is causing malnourishment and dental caries in a child?

The parents giving 10 ounces of fruit juice per day to the toddler

Which toddler behavior indicates negativism?

Throwing a temper tantrum when unable to open the door

The nurse is teaching the parents of a 22-year-old child about appropriate feeding practices. Which actions by the parent can place the child at risk?

VO Feeding the child while the child is in active play

What should the nurse expect a 24-month-old toddler to be able to do?

Walk alone by using a wide stance for extra balance

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.

"I should tell my child to 'roar like a lion' to brush the back teeth." "I should sit on the floor with my child's head resting between my thighs while brushing." "I should use a rice-size amount of toothpaste to brush my child's teeth."

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?

"Our 2-year-old toddler takes a bath with his sister while we cook dinner."

A parent of a toddler asks the nurse, "Why do toddlers throw tantrums?" What is the most appropriate answer to this question?

"Tantrums result from a toddler's strong drive for mastery and autonomy."

For which child would fluoride supplementation be recommended?

A child 6 months or older whose drinking water is deficient in fluoride

The nurse provides a parent with nutritional counseling to ensure proper bone development in a 2-year-old child. During follow-up visits, the nurse observes poor bone growth in the child. Which actions made by the parent may be responsible for this situation?

Allowing the child minimal exposure to sunlight

A toddler is brought to the emergency room following an accidental swallowing of a foreign body. The child undergoes treatment and is well now. What instructions does the nurse give the parents during discharge? Select all that apply.

Avoid contact with small plastic balls. Cut fruits in small pieces and give to the child. Slice hot dogs lengthwise into short pieces for the child to eat.

When is voluntary control of the anal and urethral sphincters typically achieved?

Between 18 and 24 months

What suggestions can the nurse make to help prevent dental caries in a family's toddler? Select all that apply.

Eliminating the bedtime bottle Never putting juice in the bottle Substituting a bottle of water for milk or juice

The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy?

Encouraging the toddler to do things for himself or herself when capable

Which characterizes the development of 2-year-old child?

Engaging in parallel play

A 2-year-old child has recently started having temper tantrums, holding her breath and occasionally fainting. What is the most appropriate action by the nurse?

Explaining to the parent that this is not harmful

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?

Give the banana to the child later.

What should the nurse recommend to the parents to help toddler cope with the birth of a new sibling?

Give the toddler a doll with which he or she can imitate the parents.

What should the nurse teach parents to prevent dental caries in a 2-year- old child?

Giving the child aged cheese, such as cheddar

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?

Placing of cough syrup in container high level

What are some characterists of physical development in a 30-month-old child? Select all that apply.

Sphincter control has been achieved Primary dentition is complete

Which statement is most characteristic of the motor skills of a 24- month-old child?

The toddler's activities begin to produce purposeful results.

What gross motor developmental milestone should the nurse expect to see achieved by children who are 12 to 13 months of age?

Walking alone, using a wide stance

A parent of an 18-month-old toddler 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?

Honey should not be given to infants.

Around 18 months of age most toddlers manifest a decreased nutritional need and a diminished appetite. This condition is known as what?

Physiologic anorexia

When explaining the proper restraint of toddlers in motor vehicles to a group of parents, what should the nurse include?

Placing the car seat in the back seat of the car, facing forward

The parent of a 22-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.

"Tell me about the child's daily routine." "How long does the child stay at a daycare facility?" "What is the child's favorite bedtime object?" "What does the child eat before bedtime?"

The parent of a 2 1/2-year-old child tells the nurse that the child does not sleep well. Which question does the nurse include in the assessment to identify sleeping problems? Select all that apply.

"Tell me about the child's daily routine." "How long does the child stay at a daycare facility?" "What is the child's favorite bedtime object?" "What does the child eat before bedtime?"

What should the nurse recommend that parents do to minimize toddler temper tantrums?

Giving medication a large cup if the child refuses to take medicine in a small cup

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?

"This is a normal phenomenon at this age. Your child is fine.".

A parent brings a 2-year-old toddler to the clinic for a well-child visit. Which statement by the parent indicates to the nurse that the parent needs more instruction regarding accident prevention?

"We make sure we fasten the front seat belt tightly."

The parent of a 2-year-old child tells the nurse, "My child mostly drinks milk and fruit juice and consumes very little solid food." The nurse further assesses the child for which condition?

Iron deficiency

The nurse is teaching the parent of a 2-year-old how to care for the child's teeth. Which instruction should be included?

Brush the toddler's teeth wth plain water if the child does not like toothpaste.

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.

Calcium Food cooked in cast-iron vessels

The nurse is caring for a toddler receiving an iron supplement. What factors does the nurse recognize as causes of increased iron absorption? Select that apply.

Calcium Food cooked in cast-iron vessels

A toddler is admitted to the hospital for chemotherapy. The parent gives a toy to the child to play with whenever the parent is away from the child. The child likes the toy and when someone tries to take the toy away, the child starts throwing tantrums. What statement by the nurse is appropriate regarding the child's behavior?

Give the toy to the child to minimize loneliness.

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.

Plan a nutritionally balanced week. Serve food in various physical forms.

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 verbally articulating the meaning of these experiences?

Rapprochement

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?

Ritualism

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?

Serve the child's favorite food on the favorite plate

What are some characteristics of physical development in a 30-month-old child? Select all that apply.

Sphincter control has been achieved. Primary dentition is complete.

The nurse should teach parents of toddlers how to prevent poisoning by instructing them to do what?

Store poisonous substances in locked cabinet

Parents of a toddler are worried because their child touches the genitalia in public. What should the nurse advise?

Teach that genital stimulation in private is acceptable but not in public.

The mother of a toddler tells the nurse that her son has started kicking, screaming at the top of his lungs, and holding his breath until he faints when the two are grocery shopping. What does the nurse recognize as the cause of temper tantrums in toddlers?

The child's desire for independence

The parents of a toddler want to know when they can start toilet training their child. Which behavior of the toddler may indicate a readiness for toilet training? Select all that apply.

The toddler is able to recognize the urge to defecate or urinate. The toddler is able to verbally communicate when wet or soiled. The toddler is able to remove the clothes without any help. The toddler expresses willingness to please the parents.

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.

The toddler is unable to release an object at will. The toddler is unable to build a block tower. The toddler loses balance while throwing a ball. The toddler cannot drop objerts into a narrow-necked bottle.

What information should the nurse give to parents of toddlers about the regular use of fluoridated water or beverages that contain fluoride?

These drinks can cause stains or pits in the teeth.

Which statement characterizes the eating behavior of toddlers?

They become fussy eaters.

The nurse is assessing gross motor skills in a 24-mont-old child. Which action does the nurse ask the toddler to perform?

To walk up and down the stairs

The nurse is assessing gross motor skills in a 24-month-old child. Which action does the nurse ask the toddler to perform?

To walk up and down the stairs

For a toddler with sleep problems, what should the nurse suggest that the parents do?

Use a transitional object at bedtime.