chapter 36: Toddler and family Flashcards
- Which is most important in predisposing toddlers to frequent infections such as otitis media, tonsillitis, and upper respiratory tract infections?
a. Respirations are abdominal.
b. Pulse and respiratory rates are slower than those in infancy.
c. Defence mechanisms are less efficient than those during infancy.
d. Short, straight internal ear/throat structures and large tonsil/adenoid lymph tissue
ANS: D
Toddlers still have the short, straight internal ear canal of infants, and the lymphoid tissue of the tonsils and adenoids continues to be relatively large. These two anatomical 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 toddler’s defence mechanisms are more efficient compared to those of infancy.
- Which is a psychosocial developmental task of toddlerhood?
a. Development of a conscience
b. Recognition of sex differences
c. Ability to get along with age-mates
d. Ability to delay gratification
ANS: D
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 the temptation of an immediate reward to wait for a later, better one, known as delayed gratification. Development of a conscience and recognition of sex differences occur during the preschool years. The ability to get along with age-mates develops during the preschool and school-age years.
- 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. What is the best interpretation of this behaviour?
a. This is normal behaviour for his age.
b. This is unusual behaviour for his age.
c. He is not effectively coping with stress.
d. He is showing he needs more attention.
ANS: A
Toddlers use distinct behaviours in their quest for autonomy. They express their will with continuous negativity and 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 typical behaviour for an 18-month-old.
- According to Piaget, which stage is a 17-month-old child expected to be in?
a. Trust
b. Preoperations
c. Secondary circular reactions
d. Tertiary circular reactions
ANS: D
The 17-month-old is in the fifth stage of the sensorimotor phase: tertiary circular reactions (13 to 18 months). 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.
- What best describes a toddler’s cognitive development at age 20 months?
a. Searches for an object only if he or she sees it being hidden
b. Realizes that “out of sight” is not out of reach
c. Puts objects into a container but cannot take them out
d. Understands the passage of time, such as “just a minute” and “in an hour”
ANS: B
At this age the child is in the final sensorimotor stage. Children 19 to 24 months of age will now search for an object in several potential places, even though they saw only the original hiding place. They 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 as well as being able to take it out indicates tertiary circular reactions. An embryonic sense of time exists, but although the children may behave appropriately to time-oriented phrases, their sense of timing is exaggerated.
- Although a 14-month-old girl received a shock from an electrical outlet recently, her parents found her about to place a paper clip in another outlet. What is the best interpretation of this behaviour?
a. Her cognitive development is delayed.
b. This is typical behaviour because toddlers are not very developed.
c. This is typical behaviour because of her inability to transfer knowledge to new situations.
d. This is not typical behaviour because toddlers should know better than to repeat an act that caused pain.
ANS: C
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 behaviour for a toddler. Only some awareness exists of a causal relation between events.
- Two toddlers are playing in a sandbox, when one child suddenly grabs a toy from the other. What is the best interpretation of this behaviour?
a. This is typical behaviour because toddlers are aggressive.
b. This is typical behaviour because toddlers are egocentric.
c. Toddlers should know that sharing toys is expected of them.
d. Toddlers should have the cognitive ability to know right from wrong.
ANS: B
Play develops from the solitary play of infancy to the parallel play of toddlers. The toddler plays alongside other children, not with them. This is typical behaviour for the toddler and is not intentionally aggressive. Shared play is not within their cognitive development. Because the toddler cannot view the situation from the perspective of the other child, it is okay to take the toy, and no sense of right or wrong is associated with the act.
- Which is correct about toilet training?
a. Bladder training is usually accomplished before bowel training.
b. Wanting to please the parent helps motivate the child to use the toilet.
c. Watching older siblings use the toilet confuses the child.
d. Children must be forced to sit on the toilet when first learning.
ANS: B
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 hold on. The child must want to please the parent by holding on rather than pleasing him- or herself by letting go. Bowel training precedes bladder training. Watching older siblings provides role modelling and facilitates imitation for the toddler. The child should be introduced to the potty chair or toilet in a nonthreatening manner.
- Which characteristic best describes the gross motor skills of a 24-month-old child?
a. The child skips.
b. The child rides a tricycle.
c. The child broad jumps.
d. The child walks up and down stairs.
ANS: D
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.
- In the clinic waiting room, a nurse observes a parent showing an 18-month-old child how to make a tower out of blocks. What should the nurse recognize in this situation?
a. Blocks at this age are used primarily for throwing.
b. Toddlers are too young to imitate the behaviour of others.
c. Toddlers are capable of building a tower of blocks.
d. Toddlers are too young to build a tower of blocks.
ANS: C
This is a good parent–child interaction. The 18-month-old is capable of building a tower of three or four 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.
- A toddler’s parent asks the nurse for suggestions on dealing with temper tantrums. Which is the most appropriate recommendation?
a. Punish the child.
b. Leave the child alone until the tantrum is over.
c. Ignore the behaviour, provided that it is not injurious.
d. Explain to the child that this is wrong.
ANS: C
The parent should be told that the best way to deal with temper tantrums is to ignore the behaviour, provided that they are not dangerous to the child. Tantrums are common in this age group as the child becomes more independent and increasingly complex tasks overwhelm him or her. Parents and caregivers need to have consistent and developmentally appropriate expectations. Punishments and explanations will not be beneficial. The presence of the parent is necessary both for safety and to provide a feeling of control and security to the child when the tantrum is over.
- A parent asks the nurse about how to deal with negativism in toddlers. What is the most appropriate recommendation? a. Punish the child.
b. Provide more attention.
c. Ask the child to not always say “no.”
d. Reduce the opportunities for a “no” answer.
ANS: D
The nurse should suggest to the parent that questions should be phrased to present realistic choices instead of requiring 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.”
- The parents of a 2-year-old tell the nurse that they are concerned because she has started to use “baby talk” since the arrival of their new baby. What should the nurse recommend to the parents?
a. Ignore the “baby talk.”
b. Explain to the toddler that “baby talk” is for babies.
c. Tell the toddler frequently, “You are a big kid now.”
d. Encourage the toddler to practise more advanced patterns of speech.
ANS: A
The baby talk is a sign of regression in the toddler. It should be ignored, while praising the child for developmentally appropriate behaviours. Regression is a child’s way of expressing stress. The parents should not introduce new expectations and instead allow the child to master developmental tasks without criticism.
- Parents tell the nurse that their toddler daughter eats a little at mealtime, only sits at the table with the family briefly, and wants snacks “all the time.” What should the nurse recommend to the parents?
a. Give her planned, frequent, and nutritious snacks.
b. Offer rewards for eating at mealtimes.
c. Avoid snacks so she is hungry at mealtimes.
d. Explain to her in a firm manner what is expected of her.
ANS: A
Most toddlers exhibit a physiological anorexia in response to the decreased nutritional requirements associated with their slower growth rate. Parents should assist the child in developing healthy eating habits. Toddlers are often unable to sit through a meal, so frequent, nutritious snacks are a good way to ensure they are getting proper nutrition. To help with developing healthy eating habits, food should not be used as positive or negative reinforcement for behaviour. The child may develop habits of overeating or eat non-nutritious foods in response
- 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. Which is the basis for the nurse’s response?
a. It is a sign that the child is spoiled.
b. It is a way for her to exert unhealthy control.
c. It shows regression, which is common at this age.
d. It demonstrates ritualism, which is common at this age.
ANS: D
The child is exhibiting the ritualism that is characteristic of this age. Ritualism comes from the need to maintain sameness and reliability that provides a sense of comfort to the toddler. It will dictate certain principles in feeding practices, including rejecting a favourite food because it is served in a different container. This does not indicate a child who has unreasonable expectations, but rather normal development. Toddlers use ritualistic behaviours to maintain necessary structure in their lives. This is also not regression, which is a retreat from a present pattern of functioning.