Chapter 17: The Toddler My Nursing Test Banks

Chapter 17: The Toddler

Elsevier items and derived items 2007 by Saunders, an imprint of Elsevier Inc.

MULTIPLE CHOICE

1. Which of these behaviors reported by a parent of an 18-month-old toddler would the nurse report to the pediatrician as a cause for concern?

a.

The child has temper tantrums.

b.

The child feeds himself sloppily.

c.

The child walks by holding onto furniture.

d.

The child speaks in short sentences.

ANS: C

By 18 months, a toddler should have been walking alone for several months. The toddler who walks holding onto furniture should be evaluated by a developmental specialist.

DIF: Cognitive Level: Analysis REF: Text Reference: 400, Table 17-1

OBJ: Objective: 2 TOP: Topic: Development

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

2. The nurse assessing growth and development of a 2-year-old child would expect to find:

a.

That the child jumps with both feet

b.

That 20 deciduous teeth have erupted

c.

That the child can hop on one foot

d.

A vocabulary of 900 words

ANS: A

The 2-year-old can jump with both feet. The remaining achievements occur after 2 years of age.

DIF: Cognitive Level: Analysis REF: Text Reference: 400, Table 17-1

OBJ: Objective: 2 TOP: Topic: Physical Development

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

3. A parent remarks, My 18-month-old daughter carries her blanket around everywhere. Is this normal? The nurse who has an understanding of toddler development might explain that:

a.

She carries her blanket because she is ritualistic.

b.

Carrying her favorite blanket is self-consoling behavior.

c.

This behavior can be discouraged by offering new toys to the child.

d.

This could be indicative of emotional distress.

ANS: B

Favorite possessions and repetitive rituals are self-consoling behaviors for the toddler.

DIF: Cognitive Level: Application REF: Text Reference: 403

OBJ: Objective: 6 TOP: Topic: Guidance and Discipline

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

4. The nurse observed three toddlers playing side by side with dolls. Closer observation revealed that the children were not interacting with one another. This type of play would be characterized as:

a.

Solitary

b.

Parallel

c.

Associative

d.

Cooperative

ANS: B

Toddlers engage in parallel play. Children play next to, but not with, each other.

DIF: Cognitive Level: Analysis REF: Text Reference: 411

OBJ: Objective: 9 TOP: Topic: Play

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

5. The nurse planning anticipatory guidance for parents of a toddler would include which of the following instructions?

a.

Adhere to a rigid schedule because the toddler is ritualistic.

b.

Limit setting should include praise.

c.

Shoes should fit snugly at the toe and arch.

d.

Dress the toddler in pants with a zipper so he or she can learn to zip and unzip clothes.

ANS: B

Limit-setting should include praise as well as disapproval for undesired behavior.

DIF: Cognitive Level: Application REF: Text Reference: 403

OBJ: Objective: 2 TOP: Topic: Daily Care

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

6. The best advice the nurse can offer a parent who is concerned because her 2-year-old is very active and does not eat much is:

a.

Insist that the child eat one food on the plate.

b.

Help the child to wind down with a quiet activity before mealtime.

c.

Maintain a consistent eating schedule for the family.

d.

Serve the meal with a variety of interesting plates, cups, and utensils.

ANS: B

Quiet time before meals provides an opportunity for the active toddler to wind down.

DIF: Cognitive Level: Application REF: Text Reference: 406

OBJ: Objective: 11 TOP: Topic: Nutrition Counseling

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. How would the nurse advise a parent who states, I never know how much food to feed my child?

a.

Serving sizes should not exceed 1 teaspoon of each type of food.

b.

Food quantities must be carefully measured to avoid overfeeding.

c.

Use 1 tablespoon of each food for each year of age as a guideline.

d.

A toddler should eat three balanced meals. Snacks are not necessary.

ANS: C

A tablespoon of each type of food for each year of age is a good guideline to follow when determining serving sizes.

DIF: Cognitive Level: Application REF: Text Reference: 406

OBJ: Objective: 11 TOP: Topic: Nutrition Counseling

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

8. The nurse discussing toilet training with parents would identify which of the following as an indicator of readiness? The child is:

a.

Willing to sit on the potty for 15 to 20 minutes

b.

Dry in the daytime for 4-hour periods

c.

Able to communicate that he or she is wet

d.

Curious about bathroom activities

ANS: C

Children are ready for toilet training when they can communicate in some fashion that they are wet or need to urinate or defecate.

DIF: Cognitive Level: Comprehension REF: Text Reference: 405

OBJ: Objective: 7 TOP: Topic: Toilet Independence

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. The nurse selects the most appropriate toy for a normal 2-year-old child, which is:

a.

A bicycle with training wheels

b.

A dump truck

c.

Wind-up toys

d.

Legos

ANS: B

The 2-year-old enjoys playing with objects that can be pushed or pulled.

DIF: Cognitive Level: Application REF: Text Reference: 410

OBJ: Objective: 9 TOP: Topic: Toys and Play

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

10. To encourage a toddler to practice independence, the nurse would recommend that the childs mother:

a.

Offer a variety of items to choose from to stimulate his mind.

b.

Allow the child to determine his own daily routine.

c.

Offer him a choice between two items.

d.

Set the routine herself, but discuss with her toddler how he or she would have done it differently.

ANS: C

The toddler can be allowed to make choices as the situation warrants, but the number of choices should be limited because too many confuse the toddler.

DIF: Cognitive Level: Application REF: Text Reference: 399

OBJ: Objective: 3 TOP: Topic: General Characteristics

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

11. On a home visit, the nurse notes each of the following. The observation that requires teaching intervention to protect the 15-month-old child who lives there is:

a.

The fireplace has a screen.

b.

The dining room table has a tablecloth on it.

c.

There are paintings on the wall.

d.

The kitchen floor is clean but not shiny.

ANS: B

A tablecloth presents a safety hazard because the curious toddler will reach up and pull on it. The toddler could be injured if items on the table are moved when the tablecloth is pulled.

DIF: Cognitive Level: Analysis REF: Text Reference: 409, Table 17-6

OBJ: Objective: 8 TOP: Topic: Injury Prevention

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

12. The nurse considers the appropriate snack for a 2-year-old child would be:

a.

Hot dog sections

b.

Grapes

c.

Popcorn

d.

Applesauce

ANS: D

Applesauce is a healthy and safe snack food for the toddler. The toddler risks choking on such foods as grapes, hot dogs, and popcorn.

DIF: Cognitive Level: Analysis REF: Text Reference: 407

OBJ: Objective: 8 TOP: Topic: Injury Prevention

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

13. The nurse assessing vital signs on a 2-year-old would be concerned about the finding of:

a.

Temperature 98.8 F

b.

Pulse 100 beats/min

c.

Respirations 36 breaths/min

d.

Blood pressure 90/60 mm Hg

ANS: C

In the toddler period, the respiratory rate decreases to 25 breaths per minute.

DIF: Cognitive Level: Analysis REF: Text Reference: 400

OBJ: Objective: 2 TOP: Topic: Physical Development

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. When assessing language development in a 2-year-old, an expected finding would be:

a.

A 900-word vocabulary

b.

Use of two-word sentences

c.

Use of pronouns and prepositions

d.

100% of speech is understandable

ANS: B

The 2-year-old should be using two-word sentences.

DIF: Cognitive Level: Analysis REF: Text Reference: 403

OBJ: Objective: 5 TOP: Topic: Speech Development

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

15. The nurse has explained the use of time-outs to the parent of a 3-year-old. The nurse determines the parent understands the information when she states an appropriate period for a time-out is:

a.

3 minutes

b.

6 minutes

c.

10 minutes

d.

15 minutes

ANS: A

Timing for time out is usually based on 1 minute per year of age.

DIF: Cognitive Level: Application REF: Text Reference: 403

OBJ: Objective: 10 TOP: Topic: Guidance and Discipline

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

16. The parent of a toddler tells the nurse, My daughters appetite has decreased. Thank goodness she loves to drink milk. The most appropriate response for the nurse to make is:

a.

Has your daughter been sick recently?

b.

How much milk does she drink in a day?

c.

Has she become a fussy eater, too?

d.

Have you tried offering her finger foods?

ANS: B

Milk should be limited to 24 ounces a day. Too few solid foods can lead to dietary deficiencies of iron.

DIF: Cognitive Level: Analysis REF: Text Reference: 406

OBJ: Objective: 11 TOP: Topic: Nutrition Counseling

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

17. The nurse suggests that bladder training should start when the toddler can stay dry for _____ hours.

a.

1

b.

2

c.

3

d.

4

ANS: B

If the toddler is mature enough to retain urine for 2 hours, bladder training can be effective.

DIF: Cognitive Level: Application REF: Text Reference: 406

OBJ: Objective: 2 TOP: Topic: Bladder Training

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

18. The nurse explains to frustrated parents that a toddler will test their own power with:

a.

Negativism

b.

Dawdling

c.

Tantrums

d.

Food fads

ANS: A

By refusing to eat, dress, sleep, or anything else by saying NO, the toddler tests his own power to control. Because toddlers are also egocentric, they come to believe that their negativism is absolute. This is especially true if the adults give into it

DIF: Cognitive Level: Comprehension REF: Text Reference: 399

OBJ: Objective: 2 TOP: Topic: Negativism

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

MULTIPLE RESPONSE

1. The nurse points out physiological changes that occur in the toddler, which serve as a protection against disease, such as:

Select all that apply.

a.

Toughening of the skin

b.

Increased capillary response for thermoregulation

c.

Stabilization of body temperature

d.

Elevation in white blood cell count

e.

Enlarged adenoids and tonsils

ANS: A, B, C, E

With the exception of an increased WBC count, which is always pathological, the other options are all maturing changes that equip the toddler better to fight disease.

DIF: Cognitive Level: Application REF: Text Reference: 400

OBJ: Objective: 2 TOP: Topic: Physiological Changes

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

COMPLETION

1. The nurse assessing a 2-year-old is satisfied to see that the present weight of the child has ____________________ the birthweight.

ANS: tripled

DIF: Cognitive Level: Comprehension REF: Text Reference: 399

OBJ: Objective: 2 TOP: Topic: Tripled Birthweight

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

NOT: Rationale: The birth weight has usually tripled by the time the child is 2 years of age.

2. The nurse explains that with the completion of myelination, the toddler will have the neuromuscular maturity to attain ____________________ or ____________________ control.

ANS: bowel, bladder

DIF: Cognitive Level: Application REF: Text Reference: 400

OBJ: Objective: 2 TOP: Topic: Myelination

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

NOT: Rationale: With the mature myelin, the toddler is able to translate neural impulses and respond in a significant manner. With myelination, the toddler can now translate the feeling of a full bladder or bowel and respond by defecating or urinating at willhopefully in the bathroom.

3. The nurse recognizes that when the toddler claims everything in the environment as mine, it is an example of the toddler trait of ____________________.

ANS: egocentrism

DIF: Cognitive Level: Application REF: Text Reference: 400, Table 17-1

OBJ: Objective: 2 TOP: Topic: Egocentrism

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

NOT: Rationale: Toddlers are egocentric in that they perceive their world only as it applies to themMY mommy, MY dog, MY car, MY house, My street. As they mature and have more experience with the world, they come to a more realistic viewpoint.

4. When the previously potty-trained 3-year-old wets the bed after admission to the hospital, the nurse assesses this event is caused by a ____________________ related to the new environment.

ANS: regression

DIF: Cognitive Level: Analysis REF: Text Reference: 406

OBJ: Objective: 2 TOP: Topic: Toddler Regression

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

NOT: Rationale: Regression occurs when a situation causes the person to go back to a less mature manner of coping. Faced with the new situation (hospital admission), the toddler reverts to an earlier coping mechanism in which potty training has no part. The same regression frequently appears when a new baby is introduced to the family circle, or when a traumatic event such as a death or divorce affects the family

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