Deck 9: Growth and Development of the Toddler

Question 1

The period of toddlerhood is from 12 months to:

A) 15 months
B) 18 months
C) 24 months
D) 36 months

Answer 1

36 months

Question 2

During the toddler stage, a child will gain approximately how many pounds per year?

A) 1
B) 3
C) 5
D) 7

Answer 2

5

Question 3

Growth rate slows for toddlers due to which of the following causes?

A) decline in appetite and erratic eating habits
B) hormonal changes, especially a decline in growth hormone
C) increased activity levels burning more calories
D) sleep problems resulting in less sleep per night

Answer 3

decline in appetite and erratic eating habits

Question 4

Most toddlers can climb stairs by how many months?

A) 10
B) 12
C) 15
D) 18

Question 5

Until myelination of the spinal cord is completed, the child will:

A) have some difficulty in walking
B) have difficulty kicking a ball forward without losing balance
C) experience transitory paresthesia of the legs
D) have diminished feeling from the waist down

Question 6

All of a child's deciduous teeth usually erupt by how many months of age?

A) 15
B) 18
C) 24
D) 30

Question 7

The nurse is assessing a toddler of 18 months to see what skills the child has for dressing himself. The nurse expects to find that a toddler of this age can do which of the following tasks?

A) put on his shoes
B) tie his own shoelaces
C) remove his own shoes
D) tie others' shoelaces

Question 8

Caregivers ask the nurse at what age their 1-year-old will be able to ride a tricycle. The most accurate response by the nurse would be which of the following?

A) 13 months
B) 16 months
C) 18 months
D) 24 months

Question 9

The usual eating patterns of toddlers are to:

A) eat a lot in the morning and taper off by night
B) vary widely in amount eaten and in foods liked and disliked from day to day
C) eat consistently the same amount and type of food day by day
D) eat only one preferred food at every meal day after day

Question 10

Which of the following best describes the term physiologic anorexia?

A) period of decreased appetite as a result of decreased caloric need
B) refusing to eat in order to get secondary gains from behavior
C) not eating, which brings a variety of changes in body function
D) changes in appetite due to fluctuating eating habits

Question 11

Which of the following foods would be best for the toddler?

A) bacon, fried egg, toast and butter, and whole milk
B) sliced white turkey breast, green beans, and skim milk
C) fried chicken leg, potatoes and gravy, and ice cream
D) hot dog, French fries, and pudding

Question 12

Toddlers achieve bladder and bowel control during this stage and can typically retain urine up to how many hours before they have to void?

A) 1
B) 2
C) 4
D) 6

Question 13

To avoid overlooking food allergies in the toddler, the nurse would advise the caregivers to add new foods:

A) one at a time
B) no more than once a week
C) on the weekends
D) during the evening meal only

Question 14

The most common reasons toddlers in this country have a potbelly appearance is because of underdeveloped abdominal muscles or:

A) eating too much at any one given meal
B) overconsumption of fatty foods
C) drinking too many sugary drinks
D) poor nutrition intake or constipation

Question 15

According to Freud, toddlers are in which stage of development?

A) oral
B) phallic
C) anal
D) cerebral

Question 16

The nurse is working with the caregivers of a toddler. In teaching the caregivers about growth and development, the nurse provides information about the fact that depth perception is developing during the toddler years. Since their child is just entering the toddler stage, the caregivers will realize that developing depth perception will affect their child in which of the following ways?

A) cause the child to have an increased fear of heights and of falling out of bed at night
B) bring about an unusual sense of dizziness at times
C) cause the child difficulty in learning to swim and in swimming
D) put the toddler at risk for frequent falls when learning to walk, run, and climb stairs

Question 17

The breath sounds of a toddler are especially easily heard through the stethoscope. Which of the following reasons explains this?

A) The heart makes less competitive noise as it beats.
B) The body is lengthening and adipose tissues are decreasing.
C) The alveoli are more elastic in young children.
D) Children are easily frightened and they breathe more heavily. Children are easily frightened and they breathe more heavily.

Question 18

If a toddler seizes or loses consciousness, the tongue may obstruct the airway. This obstruction by the tongue is even more likely at this age because:

A) the tongue is large in proportion to the size of the mouth
B) children do not have as great a muscle control as adults
C) younger children gag more easily than older children and adults
D) the airway is smaller in the toddler than in the adult

Question 19

The nurse is working with the caregivers of a 32-month-old child. They are very concerned that their child and one of the child's playmates were discovered undressed. On questioning the children, it was clear that these children had been comparing and inspecting their bodies. The nurse would advise the caregivers that because of their child's stage of development and age, their best response would be:

A) timely and logical consequences for unacceptable behavior
B) punishment severe enough to prevent recurrence of behavior
C) constant one-on-one supervision during all waking hours
D) matter-of-fact manner by caregivers in responding

Question 20

Caregivers share with the nurse a concern that their 34-month-old child may be masturbating. The nurse would do some teaching with the caregivers to help them understand which of the following ideas?

A) Manipulation of the genitalia and masturbation are a natural, private behavior of toddlerhood.
B) Masturbation needs to be stopped before the child enters public or private school.
C) Their child may be overly interested in sex, and this may be a sign of sexual abuse.
D) Other caregivers will not let their children play with a child who masturbates.

Question 21

The caregivers ask the nurse how to deal with questions of sexuality. Which of the following suggestions would the nurse most likely stress?

A) Give as detailed an explanation as you can about the subject.
B) Before explaining anything, find out what the child really wants to know.
C) Tell the child before he or she finds out from the television or movies.
D) Talk to your child with one of his or her friends present.

Question 22

Which of the following behaviors by caregivers most helps a child internalize a specific gender?

A) telling boys that big boys don't cry
B) buying and encouraging wearing the clothing and accessories of the gender
C) continual rewards for responding in a manner consistent with a specific gender
D) asking a daughter to do the dishes and a son to mow the lawn

Question 23

At what age do toddlers spend time engaging in symbolic play and domestic mimicry?

A) 12 months
B) 15 months
C) 18 months
D) 24 months

Question 24

At which of the following months of age are toddlers able to acknowledge different points of view?

A) 12
B) 18
C) 24
D) 36

Question 25

Which of the following tasks is one of the three major psychosocial tasks of toddlerhood?

A) gaining self-control
B) learning to play well with others
C) sharing with others
D) finding an identity

Question 26

The nurse is doing some teaching with a toddler, explaining that the child is to take medicine to help him get well and that it is taken once a day until the total amount prescribed is finished (7 days). The mother and the nurse agree that this medicine will be given in the early morning each day. Which of the following statements by the nurse will the toddler understand best?

A) "Your mommy will give you the medicine between 8:00 and 9:00 AM each morning until it is gone."
B) "You will be taking your medicine every morning after breakfast until it is gone."
C) "For a week you will be taking your medicine in the early morning."
D) "Your mommy will give you your medicine every day by 9:00 AM until it is gone."

Question 27

The nurse is giving the caregivers general advice on how to talk to their toddler when the child is intrusive and needs redirection. The nurse would advise the caregivers to:

A) speak as firmly and as loudly as necessary to let the child know that he or she has done something to displease you
B) send the child to time-out to think about how he or she needs to interact nicely with others without interrupting
C) let the child know that he or she can have an appointment to talk with the caregiver later and give the child a time
D) get at eye level with the toddler and touch him or her gently on the shoulder to get his or her attention before speaking

Question 28

The nurse is preparing to give a 34-month-old toddler who has a persistent cough some cough syrup. Which of the following statements by the nurse would best help the toddler understand why he or she is being given this medicine?

A) "This will help you not to cough your head off."
B) "This medicine will help you feel better and will help your cough go away."
C) "If you take this, you won't have to have a stick in the arm."
D) "The doctor wants you to take this medicine whenever you have a bad cough."

Question 29

The nurse is working with a family who describes a great deal of frustration because their child is overturning every bucket in the house, including mop buckets with dirty water and paint buckets when they paint, as well as the sand pail in the sandbox. Which of the following statements by the nurse would be best in this situation?

A) "Toddlers do think of every bucket as the same. So if you can turn over one, you can turn them all over."
B) "Perhaps you could explain this to your child a number of times, and this will increase the chances he will understand."
C) "If you pour a bucket of water on the child when he empties your bucket, this will most likely cause him to stop and think."
D) "Print the child's name on the sand bucket and your name on the other buckets to indicate that only the sand bucket is the child's bucket."

Question 30

Early stages of faith as a foundation for other faith development may occur as early as:

A) 9 months
B) 1 year
C) 15 months
D) 2 years

Question 31

A mother tells the nurse that she is frustrated by her toddler saying "no" to everything she says. Which of the following statements by the nurse would be true and most helpful to the mother?

A) "Reform every question so the child will have to say 'yes' to get what she wants."
B) "This is an expression of your child's search for autonomy, and it will usually stop by about 30 months of age."
C) "Walk away from your child when she tells you 'no,' and pay attention when she says 'yes,' so you can modify this behavior."
D) "Start telling the child 'no' whenever she asks you for something so she will get the idea that negativity is not rewarding."

Question 32

The nurse is teaching the caregivers how to handle a 2-year-old's negativism. Which of the following communications to the child by the caregivers would indicate they had understood the nurse's teaching?

A) "Do you want lunch now?"
B) "Do you want peanut butter or bologna for lunch?"
C) "If you don't stop for lunch now, you will have to go in time-out."
D) "If you don't hurry up and eat, we won't have time to go to the store."

Question 33

Caregivers complain to the nurse that their 2-year-old child insists on having his own way and is very stubborn about wanting things done at the same time in the same way every day. The best response by the nurse is which of the following responses?

A) "Usually stubbornness can be corrected with behavior modification."
B) "You will need to teach your child that the caregiver is the one in charge."
C) "Routines provide a sense of security and control over the environment."
D) "Coming up with a way to change this presents a challenge to caregivers."

Question 34

A caregiver is upset that her 34-month-old girl has begun to wet the bed and suck her thumb after being admitted to the hospital. This caregiver asks the nurse to explain why this is happening. The nurse's best response is which of the following?

A) "This behavior is a defense mechanism when normal routines are changed."
B) "Your daughter probably does not like the primary nurse who has been assigned."
C) "Your toddler is angry, and this is her way of letting us know that she is unhappy."
D) "Bed-wetting and thumb sucking are just a way of getting even with you for abandoning her."

Question 35

Which of the following is the best initial approach when a child has shown signs of regression?

A) Have the child sit in time-out and think about what he or she is doing and about his or her feelings.
B) Ignore the regression, and compliment the child on positive attributes and behaviors.
C) Ask the child why he or she is behaving like a little baby.
D) Distract the child with new foods and new activities.

Question 36

Which of the following descriptions best represents one of the three essential components of successful and effective discipline, as identified by the American Academy of Pediatrics?

A) negative reinforcement for negative behaviors
B) punishment that is neither too harsh nor too soft for the rule infraction
C) supportive and loving relationship(s) between caregiver(s) and child
D) knowledge by the child that the caregivers are in charge and in control

Question 37

When may the nurse legally use corporal punishment with a child?

A) when the child has done something that is dangerous
B) if the caregivers give verbal permission and rules for punishment
C) if the agency the nurse works for has a protocol for corporal punishment
D) when the child receiving corporal punishment is the nurse's own child

Question 38

A couple is expecting their new baby any day, and they are concerned their 2-year-old will have problems accepting a new sister or brother. Which of the following statements by the caregivers would indicate they have acted on the teaching provided by the nurse about helping the toddler to deal with the birth of his sibling?

A) "We started toilet training this week and hopefully will have our 2-year-old trained by the time the baby is born."
B) "We told the 2-year-old that he will have not only a brother or sister but a new playmate soon."
C) "The grandparents have been having our 2-year-old sleep over at least once a week for the past month."
D) "The 2-year-old was moved out of the nursery this week. We wanted to wait longer but the baby is due any day."

Question 39

A mother takes a small wrapped gift to the hospital with her. The people who will come to visit her are the husband, the mother, the mother-in-law, the mother's firstborn who is 2 years old, friends, and the health care practitioner. This gift is most likely for which of the following people and for which of the following purposes?

A) the husband, to let him know his role as a father is greatly appreciated
B) the mother-in-law, to let her know she is very important as the mother of the father
C) the toddler, to let her know that the mother loves her and she is just as important to her as the new baby
D) for the health care practitioner who got the mother safely through pregnancy and delivery with a healthy newborn

Question 40

The caregivers of a toddler are very concerned about the temper tantrums their child has. This child falls on the floor in public, kicks and screams, and holds his breath. The nurse would offer which of the following pieces of advice:

A) "Don't move the child out of public attention."
B) "Call EMS (emergency medical services) if the child is holding his breath."
C) "Make sure someone knows CPR (cardiopulmonary resuscitation)."
D) "The child may faint but it is nothing serious."

Question 41

The caregivers are tired of their child's temper tantrums and share this information with the nurse. The nurse tells the caregivers that these temper tantrums will disappear:

A) by the age of 4
B) when the caregivers discipline the child properly
C) when the child is able to reason
D) after the child is toilet trained

Question 42

Toilet-training success depends on which of the following factors?

A) rewards that the caregivers come up with for compliance
B) the readiness of both the child and the caregiver
C) how stubborn the child is compared to the caregiver
D) what playmates are doing in terms of toileting

Question 43

In addition to the development of sphincter muscle control, what other physical development must be complete prior to beginning bowel and bladder training in order for training to be successful?

A) full-size bladder
B) muscle development of the bladder
C) myelinization of the spinal cord
D) full development of the abdominal muscles

Question 44

The nurse is doing some teaching with caregivers who are trying to toilet train their 26-month-old child. When teaching toilet-training methods, which of the following behaviors would the nurse most likely recommend to the caregivers?

A) Have the child go without diapers and clean up any feces or urine on the floor themselves.
B) Use time-out and withdrawal of privileges for not using the toilet.
C) Remind the child as frequently as every 15 minutes about the availability of the toilet.
D) Use a calm, relaxed approach, praise for success, and no punishment at all.

Question 45

The caregivers of a toddler are concerned that their child does not play nicely with other children. The caregivers describe the child as frequently taking toys away from others and not being willing to share toys. The nurse working with these caregivers would explain that:

A) toddlers most often play alongside other children and not with them, and this behavior is typical at this age
B) caregivers need to teach children how to play nicely by role-modeling this behavior for the child
C) this child may need an older playmate who can teach him or her about proper play
D) some children are more aggressive than others, and this aggression needs to be punished

Question 46

Which of the following best describes the term parallel play?

A) playing the same thing the entire time of play
B) lining toys up in a linear fashion, one after another
C) playing alongside, but not with, other children
D) mimicking what other children are playing

Question 47

A father asks the nurse why his toddler engages in fantasy and make-believe in play. The best answer by the nurse is:

A) "Some children use fantasy to escape their stressful world, so the more stressful their life is, the more they fantasize."
B) "Fantasy helps the toddler cope with caregiver expectations and helps the child conceptualize how he or she wishes the world to be."
C) "Your child probably does not have enough playmates to keep busy in reality-based play."
D) "Some children are just more imaginative and creative than others, and these children engage in fantasy play."

Question 48

Caregivers ask the nurse how they need to deal with their toddler who is a picky eater and eats very little at mealtime. In addition to telling the caregivers that this is not unusual behavior for a toddler, which of the following statements by the nurse would be most helpful?

A) "Serve 1 tablespoon per year of age of each of the major food groups, and make the child sit at the table until this is consumed."
B) "Serve more vegetable and fruit juice as well as protein shakes, allowing the child to drink when unwilling to eat."
C) "Offer smaller amounts of food to encourage the toddler to ask for more, and serve frequent nutritious snacks throughout the day."
D) "Serve new foods frequently, as children like variety and the child may be tired of the same old foods at every meal."

Question 49

The nurse is doing some teaching about oral hygiene with a group of caregivers of toddlers. The nurse would most likely include which of the following statements in this teaching?

A) Caretakers need to physically assume some responsibility for effective teeth cleaning.
B) Children often do not like the taste of toothpaste, so allow them to use just water if they prefer.
C) Provide the child with a firm toothbrush with pointed bristles and floss.
D) Children do not need to see a dentist until they are around 5 years of age.

Question 50

A father asks the nurse how many hours of sleep a 2-year-old requires each day. The best response by the nurse would be:

A) "Eight to ten hours and a nap is usually adequate by the time a child is 2."
B) "Most 2-year-olds need 12 to 14 hours of sleep every day, with a nap as well."
C) "A 2-year-old needs at least 15 hours and two naps per day."
D) "It depends on the child, with some only needing 4 to 6 hours and others needing 9 to 10."

Question 51

Grandparents who are expecting a toddler to visit most need to do which of the following things in preparation for the visit?

A) Buy whole milk and soft foods.
B) Lock up all medications and toxic substances.
C) Check out reading material for toddlers from the library.
D) Rest up for the visit.

Question 52

A pediatric nurse is monitoring the urinary output of a toddler. The toddler weighs 15 pounds. The nurse is aware that the toddler's urinary output should equal or exceed ____________________ milliliters (mL) per hour.

Question 53

A 3-year-old child presents to the pediatric clinic for a routine examination. The nurse is attempting to perform an assessment. The nurse is aware that the child's attention span is approximately ____________________ minutes.

Question 54

Which of the following communication strategies should be implemented when interacting with a toddler? Select all that apply.

A) refrain from relating time to familiar occurrences, such as after eating lunch
B) position oneself at the child's eye level before speaking
C) use rewards such as food for acknowledging good behavior
D) avoid using literal terms