Question 1

When assessing the oral cavity of a 2.5-year-old toddler, which finding is expected?

Accepted Answer

All 20 deciduous teeth are generally present by 2.5 to 3.0 years of age.

Question 2

The nurse is preparing a community educational program for the parents of toddlers. Which topics should the nurse include that address the 2020 National Health Goals for safety? (Select all that apply.)

Accepted Answer

The 2020 National Health Goals for toddlers focus on safety. The nurse can help the nation achieve these goals by educating parents about the importance of using car seats and childproofing the home against poisoning and lead poisoning. The National Health Goals do not address pets in the home. Foot stools for toilet training are not a safety concern.

Question 3

The parents of a toddler want to assist the child achieve the developmental task of autonomy. Which approach should the nurse suggest to the parents?

Accepted Answer

To develop a sense of autonomy is to develop a sense of independence. A healthy level of autonomy is achieved when parents are able to balance independence with consistently sound rules for safety. Allowing the child to make simple decisions helps the child achieve autonomy in a safe setting. Teaching how to count will not help develop autonomy in the child. Providing the child with chores will not develop autonomy. The child is not developmentally prepared to be able to put on clothes independently.

Question 4

A mother is concerned that her 2-year-old child is having seizures when he holds his breath until he passes out when he wants something his mother does not want him to have. What should the nurse respond to this mother's concern?

Accepted Answer

Some children hold their breath as part of a temper tantrum until they become cyanotic. Breath holding occurs when a child is provoked; the child develops a distended chest, often has air-filled cheeks, and shows increasing distress as the body registers oxygen want. A seizure cannot be provoked. Seizures can occur in all ages. Cyanosis can occur with seizures. Seizures can occur in those with neurologic problems and not just with a fever.

Question 5

The nurse had instructed the family of a toddler on home safety during a previous visit. During this current visit, what observation indicates that instruction has been effective?

Accepted Answer

To prevent falls, the parents should keep the house windows closed or keep secure screens in place. Prescribed medication should be stored in a locked cabinet and not left out on a table because this could cause accidental poisoning. House plants should not be within reach of the toddler because this could cause an accidental poisoning or injury if the plant is pulled on top of the child. Nuts could cause accidental choking and should not be within the child's reach.

Question 6

The parents of a toddler plan to begin toilet training. Which instruction should the nurse provide to the parents at this time?

Accepted Answer

Training should begin with defecation training because this is an easier concept for the child to grasp. There is no time limit regarding the amount of time it takes to toilet train a toddler. Even though theoretically a child can begin toilet training once able to walk, the child needs to reach specific milestones before being able to successfully toilet train. Children are more likely to remain dry during the day than during the night.

Question 7

The nurse is determining a toddler's language development. What is an expected finding for language development in a 2-year-old?

Accepted Answer

A 2-year-old child should be speaking in simple two-word sentences using a noun and a verb. Any 2-year-old child who does not talk in two-word, noun-verb simple sentences needs a careful assessment to determine the cause because this is beyond a point of normal development. Counting is not an expectation for a 2-year-old child. The child will not be able to speak 20 nouns and 4 pronouns.

Question 8

The nurse observes a toddler riding a tricycle and decides that the parents need additional safety education. What did the nurse observe?

Accepted Answer

Toddlers need to wear a helmet as soon as they begin riding a tricycle. Parents are not as conscientious about using helmets as they are for bicycle riding so this is an area where health teaching is necessary. Wearing a helmet would be expected, and the nurse would not need to provide additional safety education for the parents. Long pants and tennis shoes do not pose a safety issue.

Question 9

The mother of a toddler is frustrated because no matter what she asks of the child, the response is "no." What can the nurse suggest to the mother to assist with this problem?

Accepted Answer

A toddler needs experience in making choices, and to provide the opportunity to do this, a parent could give a secondary choice. Pretending not to hear the child, asking no further questions, and telling the child to never say "no" again will not help with the toddler's obstinacy.

Question 10

The mother of a toddler is frustrated because the toddler insists on brushing his own teeth and being left alone in the bathtub. What advice should the nurse provide to the mother about these expectations?

Accepted Answer

Toddlers need a toothbrush they recognize as their own. Toward the end of the toddler period, they can begin to do the brushing themselves under supervision; although, almost all children need some supervision until about age 8 years. It is not unusual for a toddler to have opinions and want to do things themselves. The mother needs to permit the child to perform autonomous acts with supervision. The child is too young to be permitted in the bathtub alone. This is a safety hazard.

Question 11

The mother of a toddler is concerned because the child has taken the wheels off of a toy truck and placed them in a sandbox as stepping stones to walk. What should the nurse explain about this child's behavior?

Accepted Answer

At the end of the toddler period, children enter a second major period of cognitive development termed preoperational thought and begin to use a process termed assimilation. This is when the child learns to change a situation and is what causes toddlers to use toys in the "wrong" way such as taking the wheels off of a truck and using them as stepping stones. The child has changed the toy's use to fit his or her thoughts or used assimilation. This behavior does not mean that the child does not like toy trucks. The number of toys does not need to be limited. This behavior is not abnormal but expected.

Question 12

The mother of a toddler observes the child play next to another child but not with the child. What should the nurse explain to the mother about this type of play behavior?

Accepted Answer

All during the toddler period, children play beside children next to them, not with them. This side-by-side play called parallel play is not unfriendly but is a normal developmental sequence that occurs during the toddler period. This is not peer, adjacent, or premature play. This behavior is not abnormal, does not need to be stopped, and is not seen in school-age children.

Question 13

The nurse is preparing to assess a toddler during a routine health maintenance visit. Which assessment will the nurse perform to determine the child's growth milestone?

Accepted Answer

Growth milestones are assessed at every health maintenance visit and are determined by measuring height and weight. Blood pressure does not assess a growth milestone. A urine specimen would be done at specific times. A hemoglobin level would be determined during specific times. Urine specimens and hemoglobin levels do not measure growth milestones.

Question 14

A mother brings a 15-month-old child to the clinic for a routine health maintenance visit. Which immunization should the nurse prepare to administer to this child?

Accepted Answer

The measles-mumps-rubella (MMR) vaccine is administered at either the 12-month or 15-month visit. Rinne test is not an immunization but rather a test for hearing. The oral polio vaccination is not listed as an immunization needed for toddlers. Hepatitis A vaccination is given at either the 12-month or 18-month visit.

Question 15

The mother of a 2-year-old child tells the nurse that she is constantly scolding the child for having wet pants. The child was toilet trained at 12 months, but since walking, the child wets all of the time. Which nursing diagnosis should the nurse use guide instruction for the mother?

Accepted Answer

The mother is having difficulty understanding the principles of toilet training. The diagnosis of deficient parental knowledge about toilet training is the most appropriate for the nurse to use to guide instruction for the mother. The child is not experiencing total urinary incontinence. The child does not have an excess in fluid volume. The mother is not demonstrating ineffective coping.

Question 16

The parents of a toddler are worried that the child is not eating enough because food is always left on the child's plate. What should the nurse encourage the parents to do?

Accepted Answer

Because the actual amount of food eaten daily varies, the parents should be instructed to place a small amount of food on a plate and allow their child to eat it and ask for more rather than serve a large portion the child cannot finish. Cleaning a plate gives a child a feeling of independent functioning, whereas leaving food uneaten suggests parents expected something more. Allowing self-feeding is a major way to both strengthen independence in a toddler and improve the amount of food consumed. Most toddlers insist on feeding themselves and generally will resist eating if a parent insists on feeding them. An individual child may react to repeated attempts at being fed by refusing to eat at all. The child does not need discipline.

Quiz 30: Nursing Care of a Family With a Toddler