CHAPTER 30 PREP U

Once a temper tantrum has started, which intervention is appropriate?

  Move objects out of the way or move the toddler to prevent injury.

  

The nurse is explaining safety precautions for toddlers to the mother of a normal 30-
month-old boy. Which activity might the nurse suggest may be done without
supervision?

  Undressing himself

When observing a group of toddlers playing in a child care setting, it is noted that the
toddlers are all playing with buckets and shovels but are not playing with each other.
This type of play is referred to as:
Parents of a toddler describe how they handled their child's temper tantrum in a
shopping mall. What action of the parents indicates need for additional teaching?

  Reasoned with the child to stop the behavior

The nurse is assessing a toddler's fine motor skills. Which finding will concern the
nurse?

  Ability to turn door knobs

The nurse is recommending food items for an 18-month-old girl. Which ones will benefit
the child's neurologic system most?

  Peanut butter on crackers, cheese, and whole milk

The nurse is observing a 24-month-old boy in a day care center. Which finding suggests
delayed motor development?

  The child is unable to push a toy lawnmower.

  

The nurse observing toddlers in a day care center notes that they may be happy and
pleasant one moment and overreact to limit setting the next minute by throwing a
tantrum. What is the focus of the toddler's developmental task that is driving this
behavior?

  The need for separation and control

During a health history, the nurse explores the sleeping habits of a 3-year-old boy by
interviewing his parents. Which statement from the parents reflects a recommended
guideline for promoting healthy sleep in this age group?

  "We keep a strict bedtime ritual for our son, which includes a bath and bedtime
story."

The father of a 2-year-old girl tells the nurse that he and his wife would like to begin
toilet training their daughter soon. He asks when the right time is to begin this process.
What should the nurse say in response?

  "When she starts tugging on a wet or dirty diaper, she is letting you know she's
ready."

A parent with a 2-year-old invites a friend with a toddler over for a play date when they
notice their children are not really interacting while playing. The children are playing
side-by-side when one toddler gets up and grabs a toy car out of the hands of the other
toddler, which results in both toddlers crying. To prevent this from occurring again,
which intervention should the parents make?

  Parents should ensure that toys in front of each child are "similar" to prevent
fighting over one toy.

A mother of a 2-year-old girl is asking her friend when she should start potty training the
child. The mother expresses concern about the high cost of diapers and training pants
and would really like to have her trained as soon as possible. Which advice by the friend
would be considered the best response?

  "When she is uncomfortable in her wet diaper and brings a clean diaper to you,
that's a good indication she is ready for potty training."

  

The parents of a 2-year-old child born with short-gut syndrome feed their toddler via a
feeding tube. Knowing this is a developmental time when children usually feed
themselves, the parents are asking the nurses what they can do to help foster the
child's independence. Which suggestion would be most appropriate at this time?

  Let the child choose what clothing he or she will wear the next day.

A single mother with three young children is reluctant to leave her crying and upset 16-
month-old daughter overnight in the hospital but needs to go home to care for the other
children. Which suggestion from the nurse will best address the fears and concerns of
both the child and mother?
   Encourage the mother to give the child a personal item of the mother's to hold
on to until she returns and to tell the child a specific time she will return, such as
The nurse is presenting an in-service training to a group of pediatric nurses on
the topic of play. The nurse determines the session is successful when the group
correctly chooses which example as best displaying toddlers playing?

  Playing independently and are side by side

The nurse is supervising a play group of children on the unit. The nurse expects the
toddlers will most likely be involved in which activity?

  Playing with the plastic vacuum cleaner and pushing it around the room

  

The parent of a 2-year-old client states it is the child's naptime. The child is refusing to
take a nap and cries, "I have to put my babies to sleep first!" The parent states, "I am so
sorry, I do not know what is wrong. My child does not act this way at home. My child has
2 baby dolls we rock to sleep each day at home before nap." Which response by the
nurse is most appropriate?

  "A 2-year-old child's behavior can be greatly altered if rituals are not
maintained."

During a wellness check up for a 4-year-old client, the parents state, "We just moved
into a new home and our child has begun wetting and defecating in the underwear.
Which response by the nurse is appropriate?

  "This is a normal response to stress during childhood."

  

The nurse is assessing 2-year-old twins. The parent states, "My twins will not play
together, only alongside each other." Which action will the nurse take first?

  Explain that this is normal behavior for toddlers.

  

The parents of a toddler are asking the nurse if their child is lagging behind since the
child does not have a very large vocabulary at the present time. Many times their
toddler just points to an object and the parents give it to the toddler. Which
concepts/statements should the nurse share with this family about language
development of a toddler? Select all that apply.

  Reinforce language by voicing a request, "You want the apple?"

  Read aloud to the toddler to help build and strengthen vocabulary by pointing to
pictures in the book.
   Since toddlers imitate what they hear, use good grammar and incorporate
pronouns like "I" and "you."

A group of students is reviewing material about ways parents can help to foster a child's
self-esteem. The students demonstrate a need for additional studying when they identify
which method as promoting self-esteem?

  Limiting the choices and decisions that the child makes

  

In discussing their 2-year-old's behavior with the nurse, which of the parents' statements
suggests the child may be ready for toilet teaching?

  The child hides behind her bedroom door when defecating.

  

Parents of a toddler describe how they handled their child's temper tantrum in a
shopping mall. What action of the parents indicates need for additional teaching?

  Reasoned with the child to stop the behavior

The nurse is assessing a toddler's fine motor skills. Which finding will concern the
nurse?

  Ability to turn door knobs

  

The nurse is promoting language and cognitive development to the parents of a 3-year-
old boy. Which guidance about reading with their child will be most helpful?

  Ask the child questions as you read.

  

The nurse is observing a 24-month-old boy in a day care center. Which finding suggests
delayed motor development?

  The child is unable to push a toy lawnmower.

  

The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The
parents tell the nurse that their daughter often speaks in this type of broken speech.
What would be the nurse's appropriate response to this concern?
   "This is a normal, common speech pattern in the 3-year-old and is called telegraphic
speech."

  

The nurse observing toddlers in a day care center notes that they may be happy and
pleasant one moment and overreact to limit setting the next minute by throwing a
tantrum. What is the focus of the toddler's developmental task that is driving this
behavior?

  The need for separation and control

  

The 18-month-old toddler has most likely attained which gross motor skill?

  The ability to walk independently.

  

While awaiting an appointment at the doctor's office for his 20-month-old daughter, a
young father is astonished to see his daughter assume a proper stance and swing a toy
golf club in the play area of the waiting room. A nurse also observes the behavior, and
the father recalls that his daughter saw him practicing his golf swing in their back yard a
few days ago. The nurse explains that this is an instance of which of the following?

  Deferred imitation

  

The father of a 2-year-old girl tells the nurse that he and his wife would like to begin
toilet training their daughter soon. He asks when the right time is to begin this process.
What should the nurse say in response?

  "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

  

A parent with a 2-year-old invites a friend with a toddler over for a play date when they
notice their children are not really interacting while playing. The children are playing
side-by-side when one toddler gets up and grabs a toy car out of the hands of the other
toddler, which results in both toddlers crying. To prevent this from occurring again,
which intervention should the parents make?

  Parents should ensure that toys in front of each child are "similar" to prevent fighting
over one toy.

  
The parents of a toddler express some frustration because they are having a hard time
getting their child to take a nap, even though the child is acting tired and cranky. Which
suggestion for the parents to try is most appropriate when working with toddlers?

  "It's naptime, do you want to sleep with your stuffed bear or with your sock monkey?"

  

A mother of a 2-year-old girl is asking her friend when she should start potty training the
child. The mother expresses concern about the high cost of diapers and training pants
and would really like to have her trained as soon as possible. Which advice by the friend
would be considered the best response?

  "When she is uncomfortable in her wet diaper and brings a clean diaper to you, that's a
good indication she is ready for potty training."

  

Parents are asking a pediatric nurse how to deal with separation anxiety every time they
try to have an adult night out. Which advice by the nurse sounds like
the most appropriate way to handle this situation?

  "Inform the child that you are going out but the regular babysitter will care for them and
put them to bed."

  

The parents of a 2-year-old child born with short-gut syndrome feed their toddler via a
feeding tube. Knowing this is a developmental time when children usually feed
themselves, the parents are asking the nurses what they can do to help foster the
child's independence. Which suggestion would be most appropriate at this time?
A grandmother who is the primary caregiver of a 2-year-old is expressing concern about
how to best handle the temper tantrums that can occur two or three times a day, often in
public places. She explains she spanked her own children for this but she is worried this
is not the best way to handle the situation. Which response from the nurse
will best address this concern?

  "Remain calm, pick the child up, and move to a quiet and neutral place until she gains
self-control; don't give in to her demands."

A single mother with three young children is reluctant to leave her crying and upset 16-
month-old daughter overnight in the hospital but needs to go home to care for the other
children. Which suggestion from the nurse will best address the fears and concerns of
both the child and mother?

  Encourage the mother to give the child a personal item of the mother's to hold on to until
she returns and to tell the child a specific time she will return, such as "when breakfast
comes in the morning."
During a wellness check up for a 4-year-old client, the parents state, "We just moved
into a new home and our child has begun wetting and defecating in the underwear.
Which response by the nurse is appropriate?

  "This is a normal response to stress during childhood."

A 15-month-old toddler is brought to the pediatrician’s office for a well-child checkup

and the nurse is reviewing health promotion with the family. What recommendation(s)
would the nurse make to the family to help ensure the child’s health? Select all that
apply.

  Keep all medications locked up and out of reach for the child.
  Turn the hot water heater temperature down to 120℉ (48.9℃).
  Never allow the child to ride in the car unless secured in a car seat.