Question 1

Which should the nurse expect for a toddler's language development at age 18 months?

Accepted Answer

During the second year of life,level of comprehension and understanding of speech increases and is far greater than the child's vocabulary.This is also true for bilingual children,who are able to achieve this linguistic milestone in both languages.The 18-month-old child has a vocabulary of 10 or more words.At this age,the child does not use one-word sentences or phrases.The child has a limited vocabulary of single words that are comprehensible.

Question 2

Which comments indicate that the mother of a toddler needs further teaching about dental care?

Accepted Answer

Children should first see the dentist 6 months after the first primary tooth erupts and no later than age 30 months.Toddlers need fluoride supplements when they use a water supply that is not fluorinated.Toddlers also require supervision with dental care.The parent should finish brushing areas not reached by the child.A small nylon bristle brush works best for cleaning toddlers' teeth.

Question 3

What is the primary purpose of a transitional object?

Accepted Answer

Decreasing anxiety,particularly separation anxiety,is the function of a transitional object; it provides comfort to the toddler in stressful situations and helps make the transition from dependence to autonomy.A decrease in parental guilt (distress)is an indirect benefit of a transitional object.A transitional object may be part of a bedtime ritual,but it may not keep the child quiet at bedtime.A transitional object does not significantly affect negativity and tantrums,but it can comfort a child after tantrums.

Question 4

Kimberly's parents have been using a rearward-facing,convertible car seat since she was born.The parents should be taught that most car seats can be safely switched to the forward-facing position when the child reaches which age?

Accepted Answer

It is now recommended that all infants and toddlers ride in rear-facing car safety seats until they reach the age of 2 years or the height or weight recommended by the car seat manufacturer.Children 2 years old and older who have outgrown the rear-facing height or weight limit for their car safety seat should use a forward-facing car safety seat with a harness up to the maximum height or weight recommended by the manufacturer.One year is too young to switch to a forward-facing position.

Question 5

The parent of 16-month-old Chris asks,"What is the best way to keep Chris from getting into our medicines at home?" The nurse should advise that:

Accepted Answer

The major reason for poisoning in the home is improper storage.Toddlers can climb,unlatch cabinets,and obtain access to high-security places.For medications,only a locked cabinet is safe.Toddlers can climb by using furniture.High places are not a deterrent to an exploring toddler.Toddlers are not able to generalize as dangerous all of the different forms of medications that may be available in the home.Teaching them not to touch medicines is not feasible.Many parents require medications for chronic illnesses.They must be taught safe storage for their home and when they visit other homes.

Question 6

Which are characteristic of the physical development of a 30-month-old child (select all that apply)?

Accepted Answer

Usually by age 30 months,the primary dentition of 20 teeth is completed,and the child has sphincter control in preparation for bowel and bladder control.A doubling of birth weight,opening of the anterior fontanel,and doubling of length are not characteristic of the physical development of a 30-month-old child.

Question 7

The mother of a 14-month-old child is concerned because the child's appetite has decreased.The best response for the nurse to make to the mother is:

Accepted Answer

Toddlers need small,frequent meals.Nutritious selection throughout the day,rather than quantity,is more important with this age-group.Physiologically,growth slows and appetite decreases during the toddler period.Milk consumption should not exceed 16 to 24 oz daily.Juice should be limited to 4 to 6 oz per day.Increasing the amount of milk will only further decrease solid food intake.Supplemental vitamins are important for all children,but they do not increase appetite.

Question 8

The most fatal type of burn in the toddler age-group is:

Accepted Answer

Flame burns from matches and lighters represent one of the most fatal types of burns in the toddler age-group.Scald burns from water,hot object burns from cigarettes or irons,and electric burns from outlets are all significant causes of burn injury.The child should be protected from these causes by reducing the temperature of the hot water in the home,keeping objects such as cigarettes and irons away from children,and placing protective guards over electrical outlets when not in use.

Question 9

Motor vehicle injuries are a significant threat to young children.Knowing this,the nurse plans a teaching session with a toddler's parents on car safety.Which will she teach (select all that apply)?

Accepted Answer

Toddlers younger than 2 years should be secured in a rear-facing,upright,approved car safety seat.After the age of 2 years,a forward-facing car seat can be used.Harness straps should be adjusted to provide a snug fit.The car safety seat should be placed in the middle of the rear seat.Children younger than 13 years should not ride in a front passenger seat that is equipped with an air bag.

Question 10

What is helpful to tell a mother who is concerned about preventing sleep problems in her 2-year-old child?

Accepted Answer

The preschooler has a great imagination.Sounds and shadows can have a negative effect on sleeping behavior.Night-lights provide the child with the ability to visualize the environment and decrease the fear felt in a dark room.A dark,quiet room may be scary to a preschooler.High-carbohydrate snacks increase energy and do not promote relaxation.Most 2-year-olds take one nap each day.Many give up the habit by age 3.Insufficient rest during the day can lead to irritability and difficulty sleeping at night.

Question 11

Steven,16 months old,falls down a few stairs.He gets up and "scolds" the stairs as if they caused him to fall.This is an example of which of the following?

Accepted Answer

Animism is the attribution of lifelike qualities to inanimate objects.By scolding the stairs,the toddler is attributing human characteristics to them.Ritualism is the need to maintain sameness and reliability.It provides a sense of comfort to the toddler.Irreversibility is the inability to reverse or undo actions initiated physically.Steven is acting in an age-appropriate manner.

Question 12

Which should the nurse teach to parents of toddlers about accidental poison prevention (select all that apply)?

Accepted Answer

To prevent accidental poisoning,parents should be taught to promptly discard empty poison containers,to know the number of the nearest poison control center,and to caution the child against eating nonedible items,such as plants.Parents should place all potentially toxic agents,including cosmetics,personal care items,cleaning products,pesticides,and medications,in a locked cabinet,not in the garage.Parents should be taught to never remove labels from containers of toxic substances.

Question 13

Which toy is the most developmentally appropriate for an 18- to 24-month-old child?

Accepted Answer

Push-pull toys encourage large muscle activity and are appropriate for toddlers.Nesting blocks are more appropriate for a 12- to 15-month-old child.A bicycle with training wheels is appropriate for a preschool or young school-age child.A computer can be appropriate as early as the preschool years.

Question 14

A nurse is planning care for a hospitalized toddler in the preoperational thinking stage.Which characteristics should the nurse expect in this stage (select all that apply)?

Accepted Answer

The characteristics of preoperational thinking that occur for the toddler include egocentrism (views everything in relation to self),animism (believes that inert objects are alive),and magical thinking (believes that thinking something causes that event).Concrete thinking is seen in school-age children and ability to reason is seen with adolescents.

Question 15

Which play item should the nurse bring from the playroom to a hospitalized toddler in isolation?

Accepted Answer

Large plastic blocks are appropriate for a toddler in isolation.Play objects for toddlers must still be chosen with an awareness of danger from small parts.Large,sturdy toys without sharp edges or removable parts are safest.Small plastic toys such as Legos can cause choking or can be aspirated.Balloons can cause significant harm if swallowed or aspirated.Coloring book and crayons would be too advanced for a toddler.

Question 16

The nurse recommends to parents that peanuts are not a good snack food for toddlers.The nurse's rationale for this action is that:

Accepted Answer

Foreign-body aspiration is common during the second year of life.Although they chew well,children at this age may have difficulty with large pieces of food such as meat and whole hot dogs and with hard foods such as nuts or dried beans.Peanuts have many beneficial nutrients but should be avoided because of the risk of aspiration in this age-group.The sodium level may be a concern,but the risk of aspiration is more important.Many foods pass through the gastrointestinal tract incompletely digested.This is not necessarily detrimental to the child.

Question 17

The leading cause of death during the toddler period is:

Accepted Answer

Injuries are the single most common cause of death in children ages 1 through 4 years.It is the period of highest death rate from injuries of any childhood age-group except adolescence.Infectious and childhood diseases are less common cause of deaths in this age-group.Congenital disorders are the second leading cause of death in this age-group.

Question 18

The nurse is assessing parental knowledge of temper tantrums.Which are true statements regarding temper tantrums (select all that apply)?

Accepted Answer

Temper tantrums are a common response to anger and frustration in toddlers.They occur more often when toddlers are tired,hungry,bored,or excessively stimulated.A nap prior to fatigue or a snack if mealtime is delayed will be helpful in alleviated the times when tantrums are most likely to occur.Tantrums may include screaming,kicking,throwing things,biting themselves,or banging their head.Effective management of tantrums includes safely isolating and ignoring the child.The child should learn that nothing is gained by having a temper tantrum.Giving in to the child's demands only increases the behavior.

Question 19

Parents need further teaching about the use of car safety seats if they make which statement?

Accepted Answer

Parents need to be taught to always use the restraint even for short trips.Further teaching is needed if they make this statement.Parents have understood the teaching if they encourage the child to help attach buckles,straps,and shields but always double-check fastenings; do not start the car until everyone is properly restrained; and anchor the car safety seat securely to the car's anchoring system and apply the harness snugly to the child.

Question 20

A nurse places some x-ray contrast the toddler is to drink in a small cup instead of a large cup.Which concept of a toddler's preoperational thinking is the nurse using?

Accepted Answer

The nurse is using the toddler's inability to conserve.This is when the toddler is unable to understand the idea that a mass can be changed in size,shape,volume,or length without losing or adding to the original mass.Instead,toddlers judge what they see by the immediate perceptual clues given to them.A small glass means less amount of contrast.Magical thinking is believing that thoughts are all-powerful and can cause events.Centration is focusing on one aspect rather than considering all possible alternatives.Irreversibility is the inability to undo or reverse the actions initiated,such as being unable to stop doing an action when told.

Quiz 32: The Toddler and Family