Chapter 11: Health Promotion of the Toddler and Family Flashcards
The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy?
a. Help the toddler complete tasks
b. Provide opportunities for the toddler to play with other children
c. Help the child to learn the difference between right and wrong
d. Encourage the toddler to do things for himself or herself when he or she is capable of doing them
d. Encourage the toddler to do things for himself or herself when he or she is capable of doing them
Toddlers have an increased ability to control their bodies, themselves, and the environment. Autonomy develops when children complete tasks of which they are capable. To successfully achieve autonomy, the toddler needs to have a sense of accomplishment. This does not occur if parents complete tasks. Children at this age engage in parallel play. This will not foster autonomy. This concept is too advanced for toddlers and will not contribute to autonomy.
The nurse is teaching the parent of a 2-year-old child how to care for the child’s teeth. Which instruction should be included?
a. Flossing is not recommended at this age
b. Toddlers are old enough to brush their teeth effectively
c. The parents should brush the toddler’s teeth with plain water if he or she does not like toothpaste
d. The toddler’s toothbrush should be small and have a hard, rounded, nylon bristles
c. The parents should brush the toddler’s teeth with plain water if he or she does not like toothpaste
Some toddlers do not like the flavor of toothpaste, so water can be used for teeth brushing at this age. Flossing should be done after brushing to establish it as part of dental care for the toddler. Two-year-olds cannot effectively brush their own teeth; parental assistance is necessary. Soft multi tufted bristled toothbrushes are recommended to avoid damaging a toddler’s teeth or gums.
In teaching prospective parents about the emergence of gender identify, the nurse should instruct them that this concept emerges at about:
a. 12 months of age
b. 24 months of age
c. At birth
d. At 3 years of age
b. 24 months of age
The concept of gender identity begins at about 2 years of age (24 months), at which children are able to label their own as well as other genders. It is not inherent at birth or by 1 year of age.
A hospitalized toddler clings to a worn, tattered blanket. The toddler screams when anyone tries to take it away. Which is the best explanation for the toddler’s attachment to the blanket?
a. The blanket encourages immature behavior
b. The blanket is an important transition object
c. The developmental task of individualization-separation has not been mastered
d. The child and mother have inadequate bonding
b. The blanket is an important transition object
The blanket is an important transitional object that provides security when the child is separated from parents. Transitional objects are important to help toddlers separate, and attachment to them does not indicate immature behavior. Transitional objects are helpful when a toddler experiences increased stress such as hospitalization. The attachment to the blanket does not reflect inadequate bonding with the mother.
A parent is concerned because her 18-month-old daughter who was previously a “good eater” by her accounts is now being very picky during meal times. Meal time patterns of intake vary from one day to the next with eating large amounts then hardly eating at all. Based on this information, the nurse would suspect that the toddler:
a. Probably has an ear infection so the parent should not be concerned
b. Refer the parent to the pediatrician for a diagnostic work up
c. Tell the mother that this type of behavior is associated with regression
d. May be exhibiting physiological anorexia which is a common finding during this time period
d. May be exhibiting physiological anorexia which is a common finding during this time period
These findings are indicative of physiological anorexia as during this time period, many toddlers demonstrate variation in food intake, strong food preferences and picky eating behaviors. There is no correlation with ear infections causing this type of eating behavior. A diagnostic work up is not warranted and this behavior does not demonstrate regression.
Which characterizes the development of a 2-year-old client?
a. Engages in parallel play
b. Fully dresses self with supervision
c. Has a vocabulary of at least 500 words
d. Has attained one third of his or her adult height
a. Engages in parallel play
Two-year-olds play alongside each other, otherwise known as parallel play. Toddlers need help with dressing because this is a task they are just beginning to learn; learning this extends into the preschool years. A toddler commonly has a vocabulary of 300 words. A toddler has attained one half of his or her adult height.
One of the major tasks of toddlerhood is toilet training. In teaching the parents about a child’s readiness for toilet training, it is important for the nurse to emphasize that:
a. Nighttime bladder control develops first, so parents should focus on that in the initial teaching with their toddler
b. Bowel control is accomplished before bladder control, so the parent should focus on bowel training first
c. The toddler must have the gross motor skill to climb up to the adult toilet before training is begun
d. The universal age for toilet training to begin is 2 years, and the universal age for completion is 4 years
b. Bowel control is accomplished before bladder control, so the parent should focus on bowel training first
Bowel training is usually accomplished before bladder training because of its greater regularity and predictability. The sensation to defecate is stronger than that of urination. The completion of bowel training will give the toddler a sense of accomplishment that can be carried onto bladder training. Nighttime bladder control normally takes several months to years after daytime training; therefore, this should not be the initial focus of toilet training with a toddler. There is no universal right age to begin toilet training or an absolute deadline to complete training. One of the nurse’s most important responsibilities is to help parents identify the readiness signs in their child.
The nurse notices that a toddler is more cooperative taking medication from a small cup than from a large cup. This is an example of which characteristic of preoperational thought?
a. Egocentrism
b. Irreversibility
c. Inability to conserve
d. Transductive reasoning
c. Inability to conserve
The smaller cup makes it look like less medicine to the child at this stage of cognitive development. The inability to see situations from other perspectives, besides their own, does not facilitate medication administration. The inability to reverse or undo actions physically initiated does not facilitate medication administration. Focusing on particulars does not explain the cooperation with the smaller medication cup.
Which food activities would be considered to be normal adaptations for toddlers? Select all that apply.
a. They often pick up many types of foods, preferring snacking rather than eating just at mealtimes
b. Appetite and food choices exhibit a consistent pattern
c. Toddlers often exhibit “picky” eating behaviors which is considered to be a normal abnormal
d. Children tend to eat more when they are growing
e. Foods should not be given to children during playtime
a. They often pick up many types of foods, preferring snacking rather than eating just at mealtimes
c. Toddlers often exhibit “picky” eating behaviors which is considered to be a normal abnormal
e. Foods should not be given to children during playtime
Toddlers exhibit grazing or nibbling behaviors and sometimes prefer to snack throughout the day. Toddlers often exhibit “picky” preferential behaviors in their food choices. Foods should not be given to children during playtime as a safety measure to prevent possible choking or aspiration. Appetite and food choices are inconsistent during this time frame. Toddlers will eat more during growth spurt periods.
A toddler is exploring the environment but returns to his mother within a few minutes of exploration. This finding would be noted as an example of:
a. Separation anxiety
b. Separation
c. Rapprochement
d. Individuation
c. Rapprochement
Rapprochement occurs when the child returns to the mother for reassurance following exploration of the environment. Separation anxiety is when the child experiences anxiety based on separation from the parent or significant figure. Separation refers to the emergence of the child as a separate figure from the mother or parent. Individuation refers to the emergence of the child by expressing their own individual characteristic.
Which statement characterizes toddler’s eating behaviors?
a. They have increased appetites
b. They have few food preferences
c. Their table manners are predictable
d. They become fussy eaters
d. They become fussy eaters
Toddlers have physiologic anorexia, which contributes to picky, fussy eating. This usually begins at about 18 months of age. They have a decrease in appetite known as physiologic anorexia at this age. They have strong taste preferences at this age. Use of finger foods contributes to the unpredictable table manners of toddlers.
When explaining the proper restraint of toddlers in motor vehicles to a group of parents, the nurse should include:
a. Wearing safety belts snugly over the toddler’s abdomen
b. Placing the car seat in the front passenger seat if there is an airbag
c. Using lab and shoulder belts when child is over 3 years of age
d. Placing the child in the back seat of the car facing forward
d. Placing the child in the back seat of the car facing forward
Car seats are required for toddlers to prevent injury in case of a motor vehicle accident. The car seat should be placed in the back seat, forward facing. Safety belts can cause injuries if they are placed over a toddler’s abdomen. Car seats should be in the rear of the car because airbags can injure the toddler. Three-year-olds should be restrained in car seats.
The nurse should teach parents of toddlers how to prevent poisoning by instructing them to
a. Consistently use safety cues
b. Store poisonous substances in a locked cabinet
d. Keep ipecac in the home
e. Sore poisonous substances out of reach
b. Store poisonous substances in a locked cabinet
This is an appropriate action to prevent the curious toddler from getting into poisonous substances and products. Not all poisonous substances have safety caps, and safety caps are not always foolproof. Ipecac does not prevent poisoning and is not recommended as a treatment for poisoning. Toddlers can climb and are curious; therefore, storing substances out of reach only does not eliminate the potential for poisoning.
For a toddler with sleep problems, the nurse should suggest that the parents
a. Use a transitional object at bedtime
b. Vary the bedtime ritual
c. Restrict stimulating activities throughout the day
d. Explain away their fears
a. Use a transitional object at bedtime
Transitional objects may help ease the toddler’s anxiety and facilitate sleep. A consistent set of bedtime rituals will facilitate a toddler’s sleep. Toddlers should have stimulating physical activity during the daytime in order for them to sleep at night. Toddlers do not understand verbal explanations, so parents cannot explain away their fears.
Characteristics of physical development of a 30-month-old child are: (Select all that apply).
a. Anterior fontanel is open
b. Birth weight as doubled
c. Genital fondling is noted
d. Sphincter control is achieved
e. Primary dentition is complete
d. Sphincter control is achieved
e. Primary dentition is complete
Sphincter control in preparation for bowel and bladder control is usually achieved by 30 months of age. Primary dentition is usually completed by 30 months of age. Anterior fontanel closes between 12 and 18 months of age. Birth weight should double at 5-6 months of age and quadruple by 2½ years of age. Genital fondling is not a characteristic of physical development of this age group. This is part of the development of gender identity.
