Pediatric Test 2 Sherpaths for Toddler Growth/Development

Which report by a parent would indicate normal social development of the 2-year-old patient? "He doesn't care at all when I leave him." "He only talks to himself, and not to me." "I never really know what he is saying to me." "He will play next to another child and watch the child, but won't interact with the child."

"He will play next to another child and watch the child, but won't interact with the child." Playing beside other children, or parallel play, indicates normal social development of the toddler.

The nurse is evaluating the teaching provided to the parents of a three-year-old. Which statements made by the parents about motor vehicle safety recommendations would indicate to the nurse that teaching has been effective? Select all that apply. "Our child should be positioned in a rear-facing car seat." "Our child should be positioned in a forward-facing car seat." "Our child should be fastened into the car seat with a five-point harness." "Our child's car seat should be secured in the passenger side, front-seat position." "Sometimes I forget my purse in the house. I leave the child in the car when I quickly run into the house. This is OK."

"Our child should be positioned in a forward-facing car seat." Use of a forward-facing car seat is an appropriate motor vehicle safety recommendation for a three-year-old toddler. "Our child should be fastened into the car seat with a five-point harness." Use of a car seat with a five-point harness is an appropriate motor vehicle safety recommendation for a three-year-old, as it will safely secure the child in the car seat.

The nurse is working with parents who have reported that their toddler has had several temper tantrums. Which statements by the nurse suggest appropriate strategies for responding to a temper tantrum? "Tell the child to stop acting childish." "Tell the child he has no reason to act that way." "Let the temper tantrum run its course. The child just needs to wear himself out." "Tell the child that temper tantrums are not okay and put the child in his room until he calms down."

"Tell the child that temper tantrums are not okay and put the child in his room until he calms down." Isolating a child communicates to the child that the behavior is not acceptable. Also, explaining that temper tantrums are not tolerated provides the child with appropriate guidance and discipline. As a result, the child may be less likely to resort to temper tantrums.

The nurse is evaluating the teaching provided to parents about fall prevention for toddlers. Which statement(s) by the parents indicate that the teaching was effective? Select all that apply. "We need to install screen guards in our windows." "We should let our child freely explore and learn from experience." "We should remove any furniture that can be easily moved or tilted." "We should make sure our child doesn't climb on any breakable furniture." "We should check on our children periodically, so they learn how to maintain safety independently."

"We need to install screen guards in our windows." This is an important safety precaution. Toddlers can easily fall from windows, and screen guards are an important way to prevent these accidents. "We should remove any furniture that can be easily moved or tilted." This is necessary to protect toddlers, especially as they grow more curious and begin to meet their motor development milestones. Toddlers often pull on furniture to stand, and furniture may topple and fall on them.

Which head circumference measurement would be expected for a two-year-old whose head circumference was 18 inches at the 12-month checkup? 18 inches 17 inches 19.5 inches 21.5 inches

19.5 inches Head circumference increases approximately 1.5 inches from 12 months to 24 months.

A toddler who weighs 22 lbs at 1 year of age would be expected to weigh approximately ??? lbs by the third birthday.

32 The average weight gain is 5 lbs (2.26 kg) per year. Therefore, a toddler weighing 22 pounds at 1 year of age would be expected to weigh approximately 32 pounds (22 + 5 + 5) by the third birthday.

A toddler who was 33 inches in height on his or her second birthday would be expected to measure approximately ???? inches in height on his or her third birthday.

36 The average toddler grows approximately 3 in. (7.62 cm) each year. The toddler would therefore be expected to be 36 inches (33 + 3) on his or her third birthday.

Which would be the expected adult height for a toddler who is 34 inches tall at the 30-month checkup? __

68 Children attain half their adult height between ages 2 and 3 years. A child who was 34 inches tall at the 30-month checkup would be expected to be approximately 68 inches tall as an adult.

What anticipatory guidance can the nurse give parents of a toddler to support the toddler's need for increasing autonomy? Take the food away if the toddler spills it. Continue feeding the toddler during mealtime. Give the toddler finger foods to decrease messes. Allow the toddler to practice feeding with a spoon.

Allow the toddler to practice feeding with a spoon. Allowing the toddler to practice feeding with a spoon will help increase autonomy at mealtimes.

Identify the gross motor capability of the toddler. Select all that apply. Riding a bicycle Ascending the stairs Jumping over objects Hop on one foot Throwing a ball overhand

Ascending the stairs Learning to climb is a gross motor milestone of the toddler. Throwing a ball overhand Throwing a ball overhand is a gross motor skill capability of the toddler.

In order for toilet training to be successful, a toddler should demonstrate which signs of toilet training readiness? Select all that apply. Child can undress without assistance. Child removes a soiled diaper without assistance. Child sits through a movie without wetting a diaper. Child can self-feed using a fork and spoon at all meals. Child brings a diaper to the mother for a change when asked.

Child can undress without assistance. The child's ability to remove his or her own pants is a sign of readiness for toilet training. Child removes a soiled diaper without assistance. Dislike of wet or soiled diapers is a sign of readiness for toilet training. Child sits through a movie without wetting a diaper. Having dry periods of at least two hours is a sign of readiness for toilet training.

A three-year-old girl is brought to the emergency department with a third-degree burn on her hand. The mother is extremely distressed and says to the nurse: "My daughter is so active and curious—it is hard to predict her behavior." Why is it important for the nurse to discuss developmental milestones when advising this parent about safety measures? Select all that apply. Developmental milestones do not need to be discussed, since they are not related to this child's third-degree burn. Discuss the importance of keeping the child close at all times and preventing exploration and wandering to prevent injury. Discussing developmental milestones will help the mother prepare for the type of behavior the child will exhibit now and in the future. Discussing motor milestones, including increased motor capacity, explains why the child will be reaching and moving quickly, making the child more prone to accidents. Discussing cognitive milestones, including increased curiosity and the desire to explore without understanding the consequences of actions, will help the parent understand the need for child-proofing the home and close supervision of the child at this age.

Discussing developmental milestones will help the mother prepare for the type of behavior the child will exhibit now and in the future. Preparing for the future by providing anticipatory (ie, anticipatory guidance) is an important reason for the nurse to discuss developmental milestones when advising this mom. This can help to prevent injury in the future anticipate behavior associated with. Discussing motor milestones, including increased motor capacity, explains why the child will be reaching and moving quickly, making the child more prone to accidents. Motor milestones are important for the nurse to discuss when advising this mother about safety measures. This will help the mother consider ways to make the child's environment safe (eg, keeping poisonous substances out of reach, restricting access to climbing hazards). Discussing cognitive milestones, including increased curiosity and the desire to explore without understanding the consequences of actions, will help the parent understand the need for child-proofing the home and close supervision of the child at this age. Cognitive milestones are important for the nurse to discuss when advising a parent about safety measures. At this age, children do not have the capacity to anticipate consequences so they should be watched closely, and appropriate measures should be taken to make her environment as safe as possible.

Which cognitive advancements are expected between 19 and 24 months? Domestic mimicry Ability to relate to time of day Abstract thinking to solve problems Imitating an action only while another person is performing it

Domestic mimicry Domestic mimicry (imitating a parent of the same sex) and deferred imitation (imitating an action hours after the toddler watched the original action) are expected cognitive advancements of the toddler.

Identify fine motor capabilities for the toddler. Select all that apply. Drawing a circle Stacking blocks or toys Drinking from a sippy cup Using a spoon without difficulty Drawing a person with several body parts

Drawing a circle Drawing loops and lines (scribbling) is a fine motor skill capability of the toddler. Stacking blocks or toys Building a tower of blocks is a fine motor skill capability of the toddler. Drinking from a sippy cup By 12-18 months, the toddler should have mastered the use of a sippy cup and can use an adult cup without much spilling.

The parents of a two-and-half-year-old-patient are frustrated by their child's preference for only chicken nuggets. The nurse suggests which action(s) to help their child appreciate new tastes and encourage the consumption of a variety of foods? Select all that apply. Eat a wide variety of foods as a family. Make the child eat everything on the plate. Create routine by serving the same foods daily. Talk with the child about the foods they like most. Serve only the foods the child will agree to eat.

Eat a wide variety of foods as a family. Eating a wide variety of foods as a family will expose the child to a variety of different foods with different tastes and textures and will encourage the consumption of well-rounded diet. Talk with the child about the foods they like most. Parents should talk about different foods they enjoy eating to encourage a sense of curiosity and willingness to try a variety of foods. Parents should avoid discussing food aversions with their child.

Which one of the following developmental characteristics explains why a toddler frequently uses the words me, I, and mine? Animism Ritualism Negativism Egocentrism

Egocentrism Egocentrism is when a toddler views everything in relation to self and is unable to consider another's point of view, and it explains why the predominant words in the toddler's language are me, I, and mine.

The parents of a three-year-old toddler report that the child refuses to eat dinner and will only eat once or twice a day. Which responses by the nurse are most appropriate? Select all that apply. Gather the child's weekly food history. Ask parents if child has a snack before dinner. Advise parents to offer smaller portions at mealtime. Encourage parents to offer only the child's favorite foods. Advise parents to make child sit at the table until all food has been consumed.

Gather the child's weekly food history. Nutritional consumption in children tends to balance out over a week. Advise parents to offer smaller portions at mealtime. Toddlers typically consume only two to three tablespoons at one sitting. Offering smaller portions may prevent the child from becoming overwhelmed by the food presented.

The nurse is providing discharge teaching to the mother of a two-day-old newborn. The mother expresses concern about how her three-year-old toddler will react to the new baby. The nurse explains that the toddler may experience which common reaction(s) to a new baby? Suspiciousness Intense joy and excitement Depression and withdrawn behavior Jealousy and feelings of resentment

Jealousy and feelings of resentment A three-year-old will likely experience jealousy of a new baby because of the parents' redirected focus on the baby and fear that the baby will replace him or her as the object of the parents' affection. The nurse should suggest that the parents involve the toddler in caring for the baby in age-appropriate ways and schedule quality time with the toddler.

Which characteristics are typical of the toddler's physical appearance? Select all that apply. Leaner Knees curved inward Flattened plantar arch Inward curve of the spine Mature abdominal muscles

Leaner Loss of adipose (fat) tissue as the toddler becomes more active is typical of a toddler's appearance. Flattened plantar arch Toddler's feet seem flat because of a plantar fat pad that disappears around 2 years of age. This is typical of a toddler's appearance. Inward curve of the spine An exaggerated lumbar curve is typical of a toddler's appearance.

What important parental guidance advisory needs should caregivers be reminded of when discussing motor development in the toddler? Encourage the toddler to walk because he or she will fall down when running. Keep the toddler in a crib until 3 years of age, even if he or she tries to climb out. As motor development increases, allow the toddler to use a toothbrush unsupervised. Motor development in this age group is far ahead of development of judgment and perception.

Motor development in this age group is far ahead of development of judgment and perception. This difference in timing of the development of different skills increases the risk for injury.

The parents of a toddler are worried that the child is not eating at meal times. Which suggestions should the nurse make to promote healthy eating for the child? Offer three meals and two snacks per day. Offer the child a routine menu of nutritious food each day. Offer a treat, such as a cupcake, with meals to encourage a healthy appetite. Serve a large breakfast with a high protein content to increase the child's metabolism.

Offer three meals and two snacks per day. This will help the child build a regular appetite. Setting meal times will train the toddler to eat at regular times, and limited snacks will help ensure an appetite at those times.

The nurse is preparing a community program to decrease the incidence of water-related accidents and deaths. The nurse should plan to implement teaching about water-safety issues in which ways? Select all that apply. Prepare handouts with parent education about home water safety precautions. Promote education about life jacket use on boats among summer camp populations. Organize community outreach sessions and material on swimming classes for children and water safety programs. Perform inspections at community pools and condo associations to check for pool safety issues. Provide pamphlets with information on preventing drowning deaths to community pool locations.

Prepare handouts with parent education about home water safety precautions. Handouts are a good way to provide water safety recommendations. The nurse can inform parents of simple in-home water safety precautions, including guidelines such as installing toilet lid locks and never allowing a child to bathe unattended. Promote education about life jacket use on boats among summer camp populations. The nurse can target certain populations, such as summer camps and other communities where children are at a higher risk for water-related accidents, to provide educational materials to address this risk. Organize community outreach sessions and material on swimming classes for children and water safety programs. The nurse can plan outreach education about swimming and water safety classes. The nurse can recommend certain organizations, such as the American Red Cross and the YMCA, for assistance. Provide pamphlets with information on preventing drowning deaths to community pool locations. Providing education to those using community pools will work to decrease the rates water-related injury.

Which physical changes are normally seen as an infant transitions into a toddler? Select all that apply. Cherub appearance Protruding abdomen Increased adipose tissue Excessive curve of the back Wide gap between knees when standing erect

Protruding abdomen A potbellied abdomen due to immature abdominal muscles is a normal physical change as an infant transitions into a toddler. Excessive curve of the back An exaggerated lumbar curve is a normal physical change as an infant transitions into a toddler. Wide gap between knees when standing erect A gap between the knees is the result of short, bowed legs, which are a normal physical change as an infant transitions into a toddler.

The parents of a toddler ask the nurse how to ensure their child eats a well-rounded diet. Which mealtime practices does the nurse suggest to help encourage the toddler to try a variety of new foods? Select all that apply. Spoon-feed the child. Provide whole milk daily. Offer large servings of tasty foods. Provide small portions every two to three hours. Offer varieties of a single type of food.

Provide whole milk daily. Offering 12 to 16 oz per day of whole milk provides toddlers with needed calcium, fat, and other nutrients. This approach can contribute to the consumption of a well-rounded diet. Provide small portions every two to three hours. Providing small portions is a practice that encourages toddlers to try new foods without pressure. This can contribute to the consumption of a well-rounded diet.

When caring for a toddler in the hospital, which nursing intervention is most developmentally appropriate? Not allowing the child to have a pacifier while in the hospital. Allowing the child to decide if the nurse can perform a procedure. Asking the parents to leave the room when performing an assessment. Scheduling evening medications to follow the toddler's bedtime routine.

Scheduling evening medications to follow the toddler's bedtime routine. The toddler may experience distress when a routine is not followed. The nurse can provide care in the hospital that helps support routines, if possible.

The nurse makes which recommendation(s) to the parents of a three-year-old who throws a tantrum every night at bedtime? Select all that apply. Set appropriate limits. Establish a regular bedtime routine. Set a behavior expectation plan. Allow the tantrums as a sign of autonomy. Identify the triggers for the tantrums.

Set appropriate limits. Appropriate limit-setting will help the toddler better understand the boundaries with regard to his or her behavior. Establish a regular bedtime routine. A regular bedtime routine will be predictable and thereby make the transition from waking to sleeping time smoother. Set a behavior expectation plan. Having a behavior expectation plan in place will help the parents respond in a consistent manner to the tantrums. It shows what behaviors the parents will not tolerate and the expected consequences. Identify the triggers for the tantrums. It is important for the parents to identify specific triggers for the toddler's tantrums (eg., sleepiness) so that they can be addressed. Prevention is the best intervention.

Which toy is appropriate to encourage cognitive development in the toddler? Card game Board game Stacking cups One-hundred-piece puzzle

Stacking cups Stacking cups would encourage cognitive development. Cups are also safe and durable. This would be an appropriate toy.

The nurse is teaching the mother of a toddler about safety precautions necessary to prevent accidents and injuries. The nurse determines that the teaching has been effective when the mother identifies which situation(s) as requiring close supervision? Select all that apply. Taking a nap Taking a bath Taking medicine Climbing a tree Helping to cook in the kitchen

Taking a bath Infants, toddlers, and young children should be watched closely throughout their baths to prevent drowning. It takes only seconds to drown in only one inch of water. Taking medicine Taking medicine is a situation that warrants close supervision. Children should be given medicine by a parent or another responsible adult. In addition, parents should be sure all medications and poisonous items are kept securely in a locked medicine box or cabinet. Climbing a tree Toddlers should be watched closely when they are climbing. Toddlers are curious and as their gross motor skills increase, they are often eager to climb, making them prone to falls. Providing effective supervision is an excellent way to let children grow and explore yet keep them safe. Helping to cook in the kitchen Helping prepare food is a situation that warrants close supervision. Toddlers and small children should not be left alone in the kitchen or around hot water to prevent thermal injuries such as scalds and burns.

Which role does the nurse play in toilet training? Select all that apply. Explaining Piaget's and Freud's stages of development Teaching parents the importance of physical readiness Providing the parents with one-on-one toilet training coaching Making home visits to ensure the child is reaching appropriate milestones Teaching the parents about developmental signs of toilet training readiness

Teaching parents the importance of physical readiness There are physical and psychological signs of readiness that the nurse can explain to the parents, such as voluntary control of the bladder and bowel and recognition of the need to void. This will help the parents determine when their child is ready and will decrease frustration. Teaching the parents about developmental signs of toilet training readiness The nurse can inform the parents of physical and psychological signs of readiness, such as the child showing interest in the toilet or the child disliking a wet or soiled diaper.

The parent of a two-and-a-half-year-old with 19 teeth reports that they do not have fluoridated city water at home and do not have access to a dentist for preventative care. Which actions should the nurse take? Select all that apply. Tell the parents to apply a topical fluoride varnish daily. Tell the parents to apply a topical fluoride varnish every six months. Recommend that the parents give the child an oral supplement of 0.5 mg of fluoride daily. Recommend that the parents give the child an oral supplement of 0.25 mg of fluoride daily. Recommend that the parents give the child and oral supplement of 0.5 mg of fluoride every six months.

Tell the parents to apply a topical fluoride varnish every six months. The application of fluoride varnish should be every three to six months during early childhood if the child does not have access to a dentist. Recommend that the parents give the child an oral supplement of 0.25 mg of fluoride daily. A supplement containing 0.25 mg of fluoride is recommended for children without access to fluoridated water.

The parent of a toddler reports that the two-year-old sometimes screams and hits himself in the head with a toy when it is close to bedtime. How would the nurse describe this behavior? Acting out Temper tantrum Tourette's syndrome Developmental disability

Temper tantrum This child is having a temper tantrum, which is a common behavior pattern seen in toddlers. Children of this age lack the verbal ability to express themselves well or to reason with parents and often resort to tantrums and aggressive outbursts.

How does the ability for a 24-month-old to build a two-block tower demonstrate a toddler's fine motor development? The ability to stack one block on top of another demonstrates an improvement in the toddler's balance. The ability to stack one block on top of another demonstrates an improvement in the toddler's autonomy. The ability to stack one block on top of another demonstrates an improvement in the toddler's visual acuity. The ability to stack one block on top of another demonstrates an improvement in a toddler's hand-eye coordination.

The ability to stack one block on top of another demonstrates an improvement in a toddler's hand-eye coordination. An improvement in a toddler's hand-eye coordination is typical at this stage and stacking blocks demonstrates development of fine motor skills.

The pediatric nurse is teaching a new nurse how to recognize signs that a toddler is ready for toilet training. The nurse includes which indicators as signs of readiness for toilet training? Select all that apply. The child shows an interest in toilets and putty chairs. The child is able to pull up and remove his or her pants. The child is eager to please the parents with a dry diaper. The child notices his or her own wet diaper and may try to remove it. When placed on the toilet, the child will sit for a short time.

The child shows an interest in toilets and putty chairs. It is a sign of readiness when the toddler shows an interest in the toilet and how it works. This shows that the child may be ready to learn about the process and practice of using the toilet or potty chair. The child is able to pull up and remove his or her pants. This demonstrates physical maturation and is one sign of readiness for toilet training. The child is eager to please the parents with a dry diaper. This scenario reflects readiness for toilet training, since the child is showing signs of psychological maturation as well as the physical ability to hold their urine for a while. The child notices his or her own wet diaper and may try to remove it. This reflects readiness for toilet training because the child understands the difference between being wet and dry and shows a preference for being clean and dry.

Which behaviors are expected in the toddler? Select all that apply. Throwing tantrums Crying when the toddler's parent leaves for work Developing a sense that bad behavior is punished Insisting on same book being read every morning Feeling guilty when they steal a toy from another child

Throwing tantrums Negativism, or saying "no" to requests, is an expected behavior in toddlers and is a way that they can test their independence and boundaries. In extreme cases, it can lead to screaming, kicking, hitting, biting, or breath-holding. Crying when the toddler's parent leaves for work Crying when a parent leaves, or separation anxiety, is an expected behavior in the toddler. Developing a sense that bad behavior is punished Controlling behavior to avoid punishment is an expected behavior in the toddler. Insisting on same book being read every morning Reading the same book, or ritualism, is an expected behavior in the toddler.

Which safety recommendation for burn prevention is the most important to provide to the parents of an active three-year-old? Keep the household water lukewarm. Monitor the barbecue grill closely while cooking. Use a fireplace screen when you have a fire in the fireplace. Turn pot handles toward the center of the stovetop when you are cooking.

Turn pot handles toward the center of the stovetop when you are cooking. Turning pot handles inward toward the center of the stovetop will reduce the likelihood of a toddler reaching up to grab a heated pot and injuring himself or herself. This is a common source of injury. This recommendation is the most important because it most directly prevents burns and scalding in toddlers.