Question 1

Although a 14-month-old girl received a shock from an electrical outlet recently,her parents find her about to place a paper clip in another outlet.The best interpretation of this behavior is that:

Accepted Answer

During the tertiary circular reactions stage,children have only a rudimentary sense of the classification of objects.The appearance of an object denotes its function for these children.The slot of an outlet is for putting things into.Her cognitive development is appropriate for her age and represents typical behavior for a toddler.Only some awareness exists of a causal relation between events.

Question 2

Developmentally,most children at age 12 months:

Accepted Answer

By age 12 months,most children are eating the same food that is prepared for the rest of the family.Using a spoon usually is not mastered until age 18 months.The parents should be engaged in weaning a child from a bottle if that is the source of liquid.Toddlers should be encouraged to drink from a cup at the first birthday and weaned totally by 14 months.The child should be weaned from a milk/formula-based diet to a balanced diet that includes iron-rich sources of food.

Question 3

The most effective way to clean a toddler's teeth is for the:

Accepted Answer

For young children,the most effective cleaning of teeth is done by the parents.Different positions can be used if the child's back is to the adult.The adult should use one hand to stabilize the chin and the other to brush the child's teeth.The child can participate in brushing,but for a thorough cleaning adult intervention is necessary.

Question 4

A parent asks the nurse about how to respond to negativism in toddlers.The most appropriate recommendation is to:

Accepted Answer

The nurse should suggest to the parent that questions should be phrased with realistic choices rather than "yes" or "no" answers.This provides a sense of control for the toddler and reduces the opportunity for negativism.Negativism is not an indication of stubbornness or insolence and should not be punished.The negativism is not a function of attention; the child is testing limits to gain an understanding of the world.The toddler is too young to be asked to not always say "no."

Question 5

A father tells the nurse that his daughter wants the same plate and cup used at every meal,even if they go to a restaurant.The nurse should explain that this is:

Accepted Answer

The child is exhibiting the ritualism that is characteristic at this age.Ritualism is the need to maintain sameness and reliability.It provides a sense of comfort to the toddler.It will dictate certain principles in feeding practices,including rejecting a favorite food because it is served in a different container.This does not indicate a child who has unreasonable expectations or a need to exert control,but rather normal development.Toddlers use ritualistic behaviors to maintain necessary structure in their lives.This is not regression,which is a retreat from a present pattern of functioning.

Question 6

Which factor is most important in predisposing toddlers to frequent infections such as otitis media,tonsillitis,and upper respiratory tract infections?

Accepted Answer

Toddlers continue to have the short,straight internal ear canal of infants.The lymphoid tissue of the tonsils and adenoids continues to be relatively large.These two anatomic conditions combine to predispose the toddler to frequent infections.The abdominal respirations and lowered pulse and respiratory rate of toddlers do not affect their susceptibility to infection.The defense mechanisms are more efficient compared with those of infancy.

Question 7

Which characteristic best describes the gross motor skills of a 24-month-old child?

Accepted Answer

The 24-month-old child can go up and down stairs alone with two feet on each step.Skipping and the ability to broad jump are skills acquired at age 3.Tricycle riding is achieved at age 4.

Question 8

Which statement about toilet training is correct?

Accepted Answer

Voluntary control of the anal and urethral sphincters is achieved sometime after the child is walking.The child must be able to recognize the urge to let go and to hold on.The child must want to please the parent by holding on rather than pleasing self by letting go.Bowel training precedes bladder training.Watching older siblings provides role modeling and facilitates imitation for the toddler.The child should be introduced to the potty chair or toilet in a nonthreatening manner.

Question 9

In the clinic waiting room,a nurse observes a parent showing an 18-month-old child how to make a tower out of blocks.In this situation the nurse should recognize that:

Accepted Answer

This is a good parent-child interaction.The 18-month-old is capable of building a tower of 3 or 4 blocks.The ability to build towers of blocks usually begins at age 15 months.With ongoing development,the child is able to build taller towers.At this age,children imitate others around them and no longer throw blocks.

Question 10

The parents of a newborn say that their toddler "hates the baby ...he suggested that we put him in the trash can so the trash truck could take him away." The nurse's best reply is:

Accepted Answer

The arrival of a new infant represents a crisis for even the best-prepared toddler.Toddlers have their entire schedule and routines disrupted because of the new family member.The nurse should work with parents on ways to involve the toddler in the newborn's care and help focus attention on the toddler.The toddler does not hate the infant.This is an expected response to the changes in routines and attention that affect the toddler.This is a normal response.The toddler can be provided with a doll to tend to its needs when the parent is performing similar care for the newborn.

Question 11

Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child.The best interpretation of this behavior is that:

Accepted Answer

Play develops from the solitary play of infancy to the parallel play of toddlers.The toddler plays alongside other children,not with them.This typical behavior of the toddler is not intentionally aggressive.Shared play is not within their cognitive development.
Toddlers do not conceptualize shared play.Because the toddler cannot view the situation from the perspective of the other child,it is okay to take the toy.Therefore,no right or wrong is associated with taking a toy.

Question 12

The psychosocial developmental tasks of toddlerhood include:

Accepted Answer

If the need for basic trust has been satisfied,toddlers can give up dependence for control,independence,and autonomy.One of the tasks that the toddler is concerned with is the ability to withstand delayed gratification.Development of a conscience occurs during the preschool years.The recognition of sex differences occurs during the preschool years.The ability to get along with age mates develops during the preschool and school-age years.

Question 13

Parents tell the nurse that their toddler daughter eats little at mealtimes,only sits at the table with the family briefly,and wants snacks "all the time." The nurse should recommend that the parents:

Accepted Answer

Most toddlers exhibit a physiologic anorexia in response to the decreased nutritional requirement associated with the slower growth rate.Parents should assist the child to develop healthy eating habits.The toddler is often unable to sit through a meal.Frequent nutritious snacks are a good way to ensure proper nutrition.To help with developing healthy eating habits,food should not be used as positive or negative reinforcement for behavior.The child may develop habits of overeating or eat nonnutritious foods in response.

Question 14

A parent of an 18-month-old boy tells the nurse that he says "no" to everything and has rapid mood swings.If he is scolded,he shows anger and then immediately wants to be held.The nurse's best interpretation of this behavior is that:

Accepted Answer

Toddlers use distinct behaviors in the quest for autonomy.They express their will with continued negativity and the use of the word "no." Children at this age also have rapid mood swings.The nurse should reassure the parents that their child is engaged in expected behavior for an 18-month-old.

Question 15

The nurse is discussing with a parent group the importance of fluoride for healthy teeth.The nurse should recommend that the parents:

Accepted Answer

The decision about fluoride supplementation cannot be made until it is known whether the water supply contains fluoride and the amount.It is difficult to teach this age-group to spit out the mouthwash.Swallowing fluoridated mouthwashes can contribute to fluorosis.Fluoridated toothpaste is still indicated,but very small amounts are used.Fluoride supplementation is not recommended until after age 6 months.

Question 16

A toddler's parent asks the nurse for suggestions on dealing with temper tantrums.The most appropriate recommendation is to:

Accepted Answer

The parent should be told that the best way to deal with temper tantrums is to ignore the behaviors,provided that the actions are not dangerous to the child.Tantrums are common during this age-group as the child becomes more independent and increasingly complex tasks overwhelm him or her.The parents and caregivers need to have consistent and developmentally appropriate expectations.Punishment and explanations will not be beneficial.

Question 17

The nurse is planning care for a 17-month-old child.According to Piaget,in what stage would the nurse expect the child to be?

Accepted Answer

The 17-month-old is in the fifth stage of the sensorimotor phase: tertiary circular reactions.The child uses active experimentation to achieve previously unattainable goals.Trust is Erikson's first stage.Preoperations is the stage of cognitive development,usually present in older toddlers and preschoolers.Secondary circular reactions last from about ages 4 to 8 months.

Question 18

The parents of a 2-year-old tell the nurse that they are concerned because the toddler has started to use "baby talk" since the arrival of their new baby.The nurse should recommend that the parents:

Accepted Answer

The baby talk is a sign of regression in the toddler.It should be ignored,while praising the child for developmentally appropriate behaviors.Regression is children's way of saying that they are expressing stress.The parents should not introduce new expectations and should allow the child to master the developmental tasks without criticism.

Question 19

What describes a toddler's cognitive development at age 20 months?

Accepted Answer

At this age the child is in the final sensorimotor stage.Children will now search for an object in several potential places,even though they saw only the original hiding place.Children have a more developed sense of objective permanence.They will search for objects even if they have not seen them hidden.Putting an object in a container but being unable to take it out indicates tertiary circular reactions.An embryonic sense of time exists; although toddlers may behave appropriately to time-oriented phrases,their sense of timing is exaggerated.

Question 20

An appropriate recommendation in preventing tooth decay in young children is to:

Accepted Answer

Sweets should be consumed with meals so the teeth can be cleaned afterward.This decreases the amount of time that the sugar is in contact with the teeth.Raisins,honey,and molasses are highly cariogenic and should be avoided.

Quiz 32: The Toddler and Family