How would the nurse advise a parent who states, “i never know how much food to feed my child”?

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Leifer: Introduction to Maternity & Pediatric Nursing, 6th Edition Chapter 17: The Toddler Test Bank MULTIPLE CHOICE 1. Which behavior reported by a parent of an 18-month-old toddler would the nurse report to the pediatrician as a cause for concern? a. Has temper tantrums b. Feeds self sloppily c. Walks by holding onto furniture d. 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: OBJ: KEY: MSC:

Cognitive Level: Analysis REF: p. 407, Table 17-1 2 TOP: Delayed Walking Nursing Process Step: Implementation 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 that: a. the child jumps with both feet. b. 20 deciduous teeth have erupted. c. the child can hop on one foot. d. the child has 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: p. 407, Table 17-1 OBJ: 2 TOP: Jumping 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 Copyright © 2011 by Saunders, an imprint of Elsevier Inc.

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Favorite possessions and repetitive rituals are self-consoling behaviors for the toddler. DIF: Cognitive Level: Application REF: p. 406 OBJ: 6 TOP: Self Consoling 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: p. 418 OBJ: 11 TOP: 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 instruction? 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: p. 410 OBJ: 2 TOP: Limit Setting KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 6. The best advice the nurse can offer a parent concerned because her 2-year-old is very active and does not eat much is to: a. insist that the child eat one food on the plate. b. help the child 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.

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DIF: Cognitive Level: Application REF: p. 413 OBJ: 11 TOP: Quiet Time 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: p. 413 OBJ: 9 TOP: Food Portions 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: p. 412 OBJ: 8 TOP: Toilet Independence KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 9. a. b. c. d.

The nurse selects the most appropriate toy for a normal 2-year-old child, which is a: bicycle with training wheels. dump truck. wind-up toy. building block set.

ANS: B The 2-year-old enjoys playing with objects that can be pushed or pulled. DIF: Cognitive Level: Application REF: p. 418 OBJ: 11 TOP: Toys and Play KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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10. To encourage a toddler to practice independence, the nurse would recommend that the child’s 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: p. 406 OBJ: 2 TOP: Offering Choices KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 11. On a home visit, the nurse notes that the parents require teaching intervention to protect the 15-month-old child who lives there because: 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: OBJ: KEY: MSC:

Cognitive Level: Analysis REF: p. 415, Health Promotion box 10 TOP: Injury Prevention Nursing Process Step: Assessment NCLEX: Safe, Effective Care Environment: Safety and Infection Control

12. The nurse considers the appropriate snack for a 2-year-old child to 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 is at risk for choking on foods such as grapes, hot dogs, and popcorn. DIF: OBJ: KEY: MSC:

Cognitive Level: Analysis REF: p. 415, Health Promotion box 10 TOP: Injury Prevention Nursing Process Step: Planning NCLEX: Health Promotion and Maintenance: Growth and Development

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.

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13. The nurse assessing vital signs on a 2-year-old would be concerned about the finding of: a. temperature of 37.1 C (98.8 F). b. pulse at 100 beats/min. c. respirations of 36 breaths/min. d. blood pressure of 90/60 mm Hg. ANS: C In the toddler period, the respiratory rate decreases to 25 breaths/min. DIF: Cognitive Level: Analysis REF: p. 408 OBJ: 2 TOP: Vital Signs 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: OBJ: KEY: MSC:

Cognitive Level: Analysis REF: p. 409, Table 17-2 3 TOP: Speech Development Nursing Process Step: Assessment 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 _____ minutes. a. 3 b. 6 c. 10 d. 15 ANS: A Timing for time-out is usually based on 1 minute per year of age. DIF: Cognitive Level: Application REF: p. 410 OBJ: 2 TOP: 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 daughter’s appetite has decreased. Thank goodness she loves to drink milk.” The most appropriate response for the nurse to make is:

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Test Bank a. b. c. d.

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“Has your daughter been sick recently?” “How much milk does she drink in a day?” “Has she become a fussy eater, too?” “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 TOP: Nutrition Counseling MSC: NCLEX: Physiological Integrity

REF: p. 413 OBJ: 9 KEY: Nursing Process Step: Assessment

17. The nurse suggests that bladder training should start when the toddler can stay dry for _____ hour(s). 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: p. 412 OBJ: 2 TOP: Bladder Training KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 18. The nurse explains to frustrated parents that toddlers 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: p. 406 OBJ: 2 TOP: Negativism KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 19. The nurse assessing a 3-year-old knows that the expected weight gain for this age child is ______ times the birth weight. a. 2 b. 2.5

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c. 3 d. 4 ANS: D The expected weight of a 2 1/2-year-old toddler is 4 times the birth weight. DIF: Cognitive Level: Comprehension REF: p. 407 OBJ: 2 TOP: Weight Prediction KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 20. The nurse reminds the parents that when speaking to a toddler, the adult should: a. be at eye level with the child. b. hold by the shoulders to keep child’s attention. c. seat the child to focus on conversation. d. speak in a firm strong voice. ANS: A Being at eye level is helpful to hold the child’s attention and is especially important when the child is frightened. DIF: Cognitive Level: Comprehension REF: p. 410 OBJ: 2 TOP: Conversing with Toddler KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 21. Day care for the toddler differs from that of the preschooler due to the fact that toddlers: a. have a shorter attention span. b. need more group play. c. are less prone to environmental dangers. d. require less outdoor space. ANS: A Toddlers have a shorter attention span than preschoolers and are prone to investigate other opportunities in the environment that may put them in harm’s way. Toddlers are more interested in parallel play. DIF: Cognitive Level: Application REF: p. 414 OBJ: 2 TOP: Day Care KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance: Growth and Development MULTIPLE RESPONSE 22. When selecting a potty chair the parents are encouraged to select one that has which characteristic(s)? Select all that apply. a. Small enough for the child’s feet to touch floor b. Sturdy and stable c. Supportive of child’s back and arms

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d. Made of plastic or fiberglass e. Capable of being taken apart easily ANS: A, B, C Potty chairs should be small and sturdy and supportive for the child’s back and arms. The composition is not important as long as it is stable. DIF: Cognitive Level: Comprehension REF: p. 412 OBJ: 2 TOP: Potty Chairs KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 23. The nurse suggests offering which food(s) to support the toddler’s desire to self-feed? Select all that apply. a. Pureed foods b. Finger foods c. Foods served cold d. Foods in colorful dishes e. Foods that are varied and colorful ANS: B, D, E Finger foods that are varied and colorful and served in colorful dishes at a moderate temperature are all attractive. Foods can be chopped into small pieces, but not pureed. DIF: Cognitive Level: Comprehension REF: p. 413 OBJ: 9 TOP: Self-Feeding KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 24. The nurse points out that which physiological change(s) in the toddler serves as protection against disease? 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 white blood cell (WBC) count, which is always pathological, the other options are all maturing changes that equip the toddler to better fight disease. DIF: TOP: KEY: MSC:

Cognitive Level: Application REF: p. 407 OBJ: 2 Physiological Changes Nursing Process Step: Implementation NCLEX: Health Promotion and Maintenance: Growth and Development

COMPLETION

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25. The nurse assessing a 2-year-old is satisfied to see that the present weight of the child has _____________ the birth weight. ANS: tripled The birth weight has usually tripled by the time the child is 2 years of age. DIF: Cognitive Level: Comprehension REF: p. 406 OBJ: 2 TOP: Tripled Birth Weight KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 26. The nurse explains that with the completion of myelination, the toddler will have the neuromuscular maturity to attain _______________ or _______________ control. ANS: bowel, bladder bladder, bowel 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 will—hopefully in the bathroom. DIF: Cognitive Level: Application REF: p. 407 OBJ: 2 TOP: Myelination KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 27. 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 Toddlers are egocentric in that they perceive their world only as it applies to them, such as MY 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. DIF: Cognitive Level: Application REF: p. 418, Table 17-1 OBJ: 2 TOP: Egocentrism KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 28. 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(n) ____________________ related to the new environment. ANS: regression

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Regression occurs when a situation causes the person to go back to a less mature manner of coping. Faced with the new situation, in this case a 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 infant is introduced to the family circle, or when a traumatic event such as a death or divorce affects the family DIF: Cognitive Level: Analysis REF: p. 413 OBJ: 2 TOP: Toddler Regression KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

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

What will the nurse advise a parent to do when introducing solid foods?

What advice should the nurse provide the parent of a toddler regarding how do you handle temper tantrums?

Which behavior reported by a parent of an 18 month old toddler would the nurse report to the pediatrician as a cause for concern quizlet?