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A parent asks the nurse about negativism in toddlers. What is the most appropriate recommendation?
- A. Punish the child.
- B. Provide more attention.
- C. Ask child not to always say no.
- D. Reduce the opportunities for a no answer.
Correct Answer: D
Rationale: The nurse should suggest to the parent that questions should be phrased with realistic choices rather than 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 comply with requests not to say no.
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Which is an appropriate recommendation in preventing tooth decay in young children?
- A. Substitute raisins for candy.
- B. Substitute sugarless gum for regular gum.
- C. Use honey or molasses instead of refined sugar.
- D. When sweets are to be eaten, select a time not during meals.
Correct Answer: B
Rationale: Regular gum has high sugar content. When the child chews gum, the sugar is in prolonged contact with the teeth. Sugarless gum is less cariogenic than regular gum. Raisins, honey, and molasses are highly cariogenic and should be avoided. Sweets should be consumed with meals so that the teeth can be cleaned afterward. This decreases the amount of time that the sugar is in contact with the teeth.
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. The nurse should explain that this is what?
- A. A sign the child is spoiled
- B. An attempt to exert unhealthy control
- C. Regression, which is common at this age
- D. Ritualism, an expected behavior at this age
Correct Answer: D
Rationale: The child is exhibiting the ritualism, which is characteristic at this age. Ritualism is the need to maintain sameness and reliability. It provides a sense of structure and comfort to the toddler. It will dictate certain principles in feeding practices, including rejecting a favorite food because it is served in a different container. This does not indicate the child has unreasonable expectations but rather is part of normal development. Ritualism is not regression, which is a retreat from a present pattern of functioning.
Which characteristic best describes the gross motor skills of a 24-month-old child?
- A. Skips
- B. Broad jumps
- C. Rides tricycle
- D. Walks up and down stairs
Correct Answer: D
Rationale: A 24-month-old child can go up and down stairs alone with two feet on each step. Skipping and broad jumping are skills acquired at age 3 years. Tricycle riding is achieved at age 4 years.
A 17-month-old child should be expected to be in which stage, according to Piaget?
- A. Preoperations
- B. Concrete operations
- C. Tertiary circular reactions
- D. Secondary circular reactions
Correct Answer: C
Rationale: A 17-month-old is in the fifth stage of the sensorimotor phase, tertiary circular reactions. The child uses active experimentation to achieve previously unattainable goals. Preoperations is the stage of cognitive development usually present in older toddlers and preschoolers. Concrete operations is the cognitive stage associated with school-age children. The secondary circular reaction stage lasts from about ages 4 to 8 months.
The nurse is discussing with a parent group the importance of fluoride for healthy teeth. What should the nurse recommend?
- A. Determine whether the water supply is fluoridated.
- B. Use fluoridated mouth rinses in children older than 1 year.
- C. Give fluoride supplements to infants beginning at age 2 months.
- D. Brush teeth with fluoridated toothpaste unless the fluoride content of water supply is adequate.
Correct Answer: A
Rationale: The decision about fluoride supplementation cannot be made until it is known whether the water supply contains fluoride and the amount. It is difficult to teach toddlers to spit out mouthwash. Swallowing fluoridated mouthwashes can contribute to fluorosis. Fluoride supplementation is not recommended until after age 6 months and then only if the water is not fluoridated. Fluoridated toothpaste is still indicated if the fluoride content of the water supply is adequate, but very small amounts are used.