Question 1

A nurse is preparing to perform a physical assessment on a toddler. Which action is most appropriate for the nurse to take?

Accepted Answer

Intrusive procedures can be distressing for toddlers, so it is best to leave them until the end of the assessment to minimize anxiety and ensure cooperation.

Question 2

During a clinic visit, the parents of a 15-month-old ask what disease and injury prevention topics would be appropriate to discuss at this age. Which response by the nurse is the most appropriate?

Accepted Answer

Teaching simple handwashing is a good topic to discuss at this age as it helps prevent the spread of germs and infections. The other options are not appropriate for a 15-month-old as they are either too advanced or not developmentally appropriate.

Question 3

The nurse is asked to teach injury prevention measures to a classroom of 4-year-old preschoolers. Which teaching points are most appropriate at this age? Select all that apply.

Accepted Answer

A,B,D,E

Question 4

The nurse is planning care for a preschool-age child and family. In order to assess the family, what should the nurse plan to do during each health supervision visit? Select all that apply.

Accepted Answer

These are all important aspects of assessing a family during a health supervision visit.

Question 5

At a routine healthcare visit, a nurse measures a toddler and plots the height and weight on the growth charts. The nurse documents that the toddler is above the 95th percentile for weight and is at the 5th percentile for height. How should the nurse interpret these data?

Accepted Answer

The fact that the toddler is above the 95th percentile for weight but at the 5th percentile for height indicates a potential disproportion in growth. This warrants further evaluation to ensure that there are no underlying health issues causing this discrepancy.

Question 6

The nurse is evaluating the car seat of a 3-year-old who weighs 42 pounds. Which recommendation should the nurse make about the car seat to the parents?

Accepted Answer

A car seat with a harness approved for higher weights and heights is the best option for a 3-year-old who weighs 42 pounds. A belt-positioning booster seat is typically recommended for children between 40-80 pounds and may not provide enough support for a child at the higher end of that range. A convertible, rear-facing seat is typically used for infants and younger toddlers and may not be appropriate for a 3-year-old. A regular seat with a lap and shoulder strap is not recommended for children under 4 feet and 9 inches tall or under the age of 8 years old.

Question 7

A parent questions how her toddler plays with other toddlers. Which response by the nurse displays the best description of the differences in play between the toddler and the preschool-age child?

Accepted Answer

Toddlers generally engage in parallel play, meaning they play side by side but not necessarily together or cooperatively. Preschool-age children, on the other hand, are more likely to engage in cooperative play where they actively play with each other and have a shared goal or activity. Option B is not entirely accurate as both age groups tend to engage in imaginative play and roleplaying, but preschool-age children may have a better understanding of the roles they are playing. Option C is incorrect because it is actually the opposite – toddlers tend to play alone or alongside others without truly interacting, while preschool-age children play interactive games and engage in conversation during play. Option D is also incorrect as there are clear differences in the way toddlers and preschool-age children play.

Question 8

A 27-month-old toddler who is in the pediatric office for a well-child visit begins to cry the moment he is placed on the examination table. The parent attempts to comfort the toddler; however, nothing is effective. Which of these actions by the nurse takes priority?

Accepted Answer

Allowing the toddler to sit on the parent's lap and beginning the assessment is the best option as it provides a sense of security and comfort to the toddler. This can help him calm down and make the examination easier to conduct. Option A is not a suitable choice as it can frighten the toddler and potentially harm the child. Option C is also not an appropriate option as it does not address the child's discomfort and may increase his distress. Option D is not necessary as the parent can usually provide the necessary physical support during the examination.

Question 9

A nurse observes the parent/child interaction during the 4-year-old well-child checkup and notes that the parent speaks harshly to the child and uses negative remarks when speaking with the nurse. Which statement by the nurse would be most beneficial?

Accepted Answer

This answer both addresses the negative interaction and offers a solution. It also provides privacy for the conversation to occur without the child present. Option A does offer privacy for the child, but it does not address the larger issue at hand. Option B does offer a solution but can be perceived as judgmental and hurtful to the parent. Option D does not address the parent's behavior and can potentially exacerbate the situation.

Question 10

Which of these measures used by a nurse will help relieve parental anxiety related to the changing appetite in the toddler who is gaining weight along the 50th percentile?

Accepted Answer

Discussing the growth of the toddler as compared to the growth chart will help relieve parental anxiety as it will provide them with a clear picture of their toddler's weight gain as compared to the norm. This will help reassure the parents that their child is growing at a healthy rate and ease their anxiety. Option B may aggravate parental anxiety as it may give a feeling that the child is not gaining enough weight. Option C and D may not be directly related to the concern of changing appetite and weight gain in the toddler.

Question 11

A mother of an 18-month old asks the nurse whether she can begin to introduce low-fat milk like the rest of the family drinks. The nurse answers the mother based on the knowledge that low-fat milk can safely be introduced at what age?

Accepted Answer

The American Academy of Pediatrics recommends introducing low-fat milk at 2 years of age in order to ensure adequate intake of fat and calories for brain development during the first 2 years of life.

Question 12

The nurse is creating a teaching care plan for the toddler and family. Which nursing diagnoses are normally used at each healthcare visit for this age group? Select all that apply.

Accepted Answer

A) Toddlers experience rapid growth and development, so there may be knowledge deficits related to growth patterns that need to be addressed at each healthcare visit.
B) Toddlers are still learning gross and fine motor skills, which can put them at risk for injury. This diagnosis should be assessed at each healthcare visit.
C) Toddlers are often in childcare environments and are exposed to infectious diseases, so the risk for exposure should be assessed at each healthcare visit.
D) Toys that encourage development are critical to promoting growth and development in toddlers, so assessing for knowledge deficits related to this topic at each healthcare visit can be beneficial. E is not a common nursing diagnosis for this age group.

Question 13

Which of these developmental milestones should the nurse expect to find in children who are between 2 and 3 years old? Select all that apply.

Accepted Answer

According to developmental milestones, children between 2 and 3 years old should be able to scribble and draw on paper, kick a ball, and go up and down stairs. While some children may be able to feed themselves always at this age, not all will have achieved this milestone. Overhand throwing typically does not develop until later in childhood.

Question 14

The nurse is performing a well-child exam on a child who turned 4 years old 3 months ago. What can the nurse ask the child to do to assess appropriate milestones for this age?

Accepted Answer

The answer of The nurse is performing a well-child exam...

Question 15

Which of these aspects of developmental health supervision should be included in each healthcare visit of young children? Select all that apply.

Accepted Answer

Assessment of physical, cognitive, and social-emotional development should be included in every healthcare visit to monitor the child's growth and development. Education should also be provided to the parents or caregivers regarding the child's nutrition, safety, and developmental milestones to promote optimal health. Intervention should also be provided if there are any concerns or delays in the child's development. Discipline and toilet training may be discussed during specific visits but are not necessary aspects of every healthcare visit.

Question 16

Which health promotion activities can the nurse recommend to the parents of a preschool-age child in order to enhance the child's self-concept? Select all that apply.

Accepted Answer

Praising the child for staying dry at night (B) reinforces positive behavior and boosts self-esteem. Setting aside time for the child each day (D) shows the child they are valued and important, enhancing self-concept. Discussing appropriate activities with the daycare provider (E) ensures the child is engaged in activities that promote self-esteem and development.

Question 17

Which assessment question would get the most accurate response when a nurse is assessing learning and reading skills in the early childhood years?

Accepted Answer

Keeping books readily available is the best assessment question for assessing learning and reading skills in the early childhood years as it directly addresses the availability of reading material which can impact a child's literacy development. The other options are not as directly related to reading and learning skills.

Question 18

A nurse who is the manager of an ambulatory pediatric healthcare center is planning protocols for the routine healthcare visits of the children. Children at this care center have a high incidence of obesity. At which age should the nurses at this clinic calculate the body mass index (BMI) for all pediatric clients?

Accepted Answer

The American Academy of Pediatrics recommends that healthcare providers calculate and plot BMI for all children starting at age 2 (24 months) as part of their routine health assessments. This helps in early identification of obesity and overweight issues, allowing for timely interventions.

Question 19

The nurse is assessing the toddler for early childhood caries. The nurse will teach the family which factors contribute to this condition? Select all that apply.

Accepted Answer

Early childhood caries are primarily caused by inadequate dental care, poor diet (high in sugars), and inadequate brushing, which lead to the buildup of plaque and bacteria on teeth.

Question 20

Parents of a preschool-age child report that they find it necessary to spank the child at least once a day. Which response should the nurse make to the parents?

Accepted Answer

Instead of condoning or condemning the parents' choice to spank, the nurse should provide guidance and education on positive discipline strategies. Suggesting alternate forms of discipline can help the parents develop a less punitive approach to managing their child's behavior.

Quiz 8: Health Promotion and Maintenance for the Toddler and Preschooler