Deck 8: Toddlers and Preschoolers

Question 1

The nurse finishes a series of parenting classes on the topic of tantrums and discipline. Which comment by an attending parent causes the nurse concern?

A)"We have learned to ignore her and she stops."
B)"I will give snack and a nap if he is that grumpy."
C)"He plays and then suddenly screams for no reason."
D)"She is learning that a tantrum means a time-out alone."

Answer 1

"He plays and then suddenly screams for no reason."

Question 2

The nurse in a pediatric clinic is assessing the motor development of a 3-year-old patient. The nurse reviews the toddler's last assessment results prior to determining changes. Which new development does the nurse expect to find during assessment?

A)Climbs on furniture unassisted
B)Rides a bicycle with training wheels
C)Independently builds a tower of seven blocks
D)Climbs stairs while holding the railing

Answer 2

Independently builds a tower of seven blocks

Question 3

Identify one or more choices that best complete the statement or answer the question.
The community pediatric nurses are making home visits to families who have children either above or below the normal ranges in weight and/or height. One nurse visits a home with three qualifying children under the age of 5 years who are all below the standards for their ages. Which interventions will the nurse introduce to the caretakers? Select all that apply.

A)Prepare food for a toddler to eat seven times a day.
B)Serve generous portions and insist on a clean plate.
C)Encourage grazing throughout the day.
D)Physically feed the children to assure better intake.
E)Serve a variety of foods to provide varied nutrients.

Answer 3

Prepare food for a toddler to eat seven times a day.
Encourage grazing throughout the day.

Question 4

The nurse is providing care for a preschooler who is 5 years of age. The patient is hospitalized for treatment of a broken femur from a fall. Which behavior by the caregiver is of most concern to the nurse?

A)Requests updates on and changes in the patient
B)Frequently asks questions and expresses concerns
C)Remains adamant about staying at the bedside
D)Insists in reviewing all changes in the plan of care

Question 5

During a routine pediatric visit the nurse evaluates the cognitive skills of a toddler. The nurse draws a circle on paper and places the crayon in the toddler's right hand. The toddler shifts the crayon to the left hand and draws a circle. Which advice does the nurse provide to the parent?

A)Respect the toddler's preference of one hand over another.
B)Watch the toddler's tendency to alternately use both hands.
C)Reassure the parent that hand preference is not established until age 5 years.
D)Gently insist drawing instruments be placed in the right hand.

Question 6

Identify one or more choices that best complete the statement or answer the question.
A parent tells the nurse a toddler is exhibiting signs of being ready to potty train. Which action by the parent will draw the nurse's approval? Select all that apply.

A)"I am initially teaching my son to urinate sitting down."
B)"He has to sit on the potty 10 minutes each hour."
C)"We are still using diapers in order to avoid messes."
D)"Accidents result in the loss of a favorite toy for the day."
E)"We are using treats, stickers, and new underwear as incentives."

Question 7

The nurse works in the pediatric unit of a hospital and is currently providing care for a 1-year-old patient. Which action by the nurse is most important for maintaining the safety of this patient?

A)Question about the presence of smoke and carbon monoxide detectors in the home.
B)Check the temperatures of water, food, and drinks in order to prevent burns.
C)Provide caregiver education on basic home, outdoor play, and car safety measures.
D)Regularly check equipment in the crib environment for potential safety hazards.

Question 8

The nurse in a pediatric clinic is performing a routine assessment on a preschool child. The nurse plans to evaluate some of the child's growth and development by interacting directly with the child. Which level of language does the nurse expect if the child is 4 years of age?

A)Sate full name and address without prompting
B)Appropriately converse using two to three sentences
C)Answer questions consistently with a "yes" or "no"
D)Speak clearly enough to be understood

Question 9

The nurse is gathering assessment information from the parent of a 5-year-old child. The parent states, "I am very frustrated. She insists on doing things alone even if it is a struggle to do it right, and gets angry if I redo the task." Which information will the nurse share with the parent to promote greater understanding?

A)Assure the parent that the child will become more compliant as she matures.
B)Suggest how the parent can critique the child's actions without hurting feelings.
C)Encourage the parent to set aside time each week to teach the child the correct way to do things.
D)Explain the child's interest in new things, the need to be independent, and pride in her abilities.

Question 10

A parent has brought a toddler to a new pediatric clinic for a routine visit. The nurse will obtain a health history from the parent. Which information is most important for the nurse to gather?

A)Chief complaint
B)Family medical history
C)Toddler medical history
D)Social history

Question 11

Identify one or more choices that best complete the statement or answer the question.
The nurse is caring for a 1-year-old patient after surgery for an intracranial shunt replacement. The nurse selects the FLACC scale for assessment because of the toddler's inability to participate in pain evaluation. The nurse will recognize which assessment finding as an indication of some level of pain? Select all that apply.

A)Constantly frowns, clenched jaw, quivering chin
B)Squirms, shifting back and forth, tense
C)Cries steadily and loudly, sometimes screams or sobs
D)Legs are positioned normally and appear relaxed
E)Answers to name, sucks thumb, and holds toy

Question 12

The nurse is providing care for a 5-year-old patient whose tonsils were removed this morning. The nurse identifies the patient is in pain but not willing to speak. The nurse uses the Wong-Baker FACES scale for pain evaluation. Which indicator does the nurse expect the patient to use to describe the level of pain?

A)The frowning face out of a series of faces
B)A number between 7 and 10 from a scale of 0 to 10
C)An intense red color on a range from pink to deep red
D)The word that identifies the degree of pain (i.e., ouch, hurts bad)

Question 13

Identify one or more choices that best complete the statement or answer the question.
The parent of a toddler at age 2 years and a preschooler at age 4 years is sharing a concern about sibling rivalry. The parent states, "It is so upsetting to see them fighting with each other. I am afraid one of them will hurt the other." Which interventions will the parent and nurse design together in a plan for management? Select all that apply.

A)Set rules defining acceptable behavior.
B)Separate them to opposite sides of the room.
C)Teach children to be kind to each other.
D)Recognize the toddler has increased risk for injury.
E)Assist with appropriate expression of feelings.

Question 14

A 4-year-old patient is on a regular regimen of medications for a chronic condition. The parent expresses frustration because of the difficulty in administering the medications. Which advice will the nurse provide to the parent for managing the process?

A)Ask if the child wants pills or a liquid form of medicine.
B)Inquire if the child prefers the medication at a certain time.
C)Make sure the medicine is sweet and refer to it as candy.
D)Put the medication in juice or milk as preferred by the child.

Question 15

The nurse is involved in a clinic screening for the kindergarten readiness of preschoolers. Primarily the children being screened are between the ages of 4 and 5 years. Which child does the nurse recognize as being ready to attend school?

A)The 4-year-old who points correctly to three different colors and voices reluctance to start school.
B)The 5-year-old who is unhappy about being told there is a 5-minute wait and then refuses to count.
C)The 4-year-old who counts to 10, recalls part of a story, and asks questions about the screening.
D)The 5-year-old who insists a parent stay with him, counts to 10, knows five colors, and recalls a story.

Question 16

The nurse is asking a parent of a toddler at age 18 months if there are any particular parenting challenges at this time. Which advice will the nurse offer if the parent shares issues with separation anxiety?

A)The parent needs to just leave quickly and ignore the toddler's protests.
B)The parent needs to keep reassuring the toddler that the parent will return.
C)The toddler is to be left only with family members until the fear subsides.
D)The parent needs to plan leaving times to coincide with the toddler's naps.

Question 17

The nurse is evaluating the motor development of a preschooler at age 5 years. Which assessment finding is essential in order for the child to be considered ready for preschool?

A)Dress independently
B)Use the toilet without assistance
C)Draw stick figures with two or more body parts
D)Throw overhand and catch a bounced ball

Question 18

The nurse is evaluating the language skills of a 2-year-old patient. Which assessment finding causes the nurse to suspect a developmental delay?

A)States, "Want mommy!"
B)Points to objects named by the nurse
C)Converses using two short sentences
D)Repeats sounds but not words said by the nurse

Question 19

Identify one or more choices that best complete the statement or answer the question.
A community center is offering classes taught by pediatric nurses on summer safety for toddlers and preschoolers. Which topics will the nurses include in the teaching plan? Select all that apply.

A)Safety near swimming areas
B)Dangers of toys being left in a pool
C)Safety related to flotation devices
D)Bicycle safety for riders or passengers
E)Safety during trampoline play

Question 20

The nurse in a pediatric office is performing physical assessments on multiple patients. Which patient will the nurse specifically report to the physician because of physical assessment findings?

A)The 4-year-old patient with a blood pressure of 110/75 mm Hg, pulse of 98 beats/minute.
B)The 3-year-old patient with a history of prematurely closed fontanels who has a headache.
C)The 2-year-old patient with asthma who exhibits abdominal breathing at 26 breaths per minute.
D)The 3-year-old patient with a soiled diaper, at the 70th percentile of weight and height.