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Parents tell the nurse that their toddler eats little at mealtime, only sits at the table with the family briefly, and wants snacks all the time. What should the nurse recommend?
- A. Give her 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.
Correct Answer: A
Rationale: Most toddlers exhibit a physiologic anorexia in response to the decreased nutritional requirements associated with the slower growth rate. Parents should assist the child in developing healthy eating habits. Toddlers are often unable to sit through a meal. Frequent nutritious snacks are a good way to ensure proper nutrition. To help with developing healthy eating habits, food should be not be used as positive or negative reinforcement for behavior. The child may develop habits of overeating or eat non-nutritious foods in response. A toddler is not able to understand explanations of what is expected of her and comply with the expectations.
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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.
What factor is most important in predisposing toddlers to frequent infections?
- A. Respirations are abdominal.
- B. Pulse and respiratory rates in toddlers are slower than those in infants.
- C. Defense mechanisms are less efficient than those during infancy.
- D. Toddlers have short, straight internal ear canals and large lymph tissue.
Correct Answer: D
Rationale: Toddlers continue to have the short, straight internal ear canals of infants. The lymphoid tissue of the tonsils and adenoids continues to be relatively large. These two anatomic conditions combine to predispose toddlers to frequent infections. The abdominal respirations and lowered pulse and respiratory rate of toddlers do not affect their susceptibility to infection. The defense mechanisms are more efficient compared with those of infancy.
A toddlers parent asks the nurse for suggestions on dealing with temper tantrums. What is the most appropriate recommendation?
- A. Punish the child.
- B. Explain to child that this is wrong.
- C. Leave the child alone until the tantrum is over.
- D. Remain close by the child but without eye contact.
Correct Answer: D
Rationale: The best way to deal with temper tantrums is to ignore the behaviors, provided that the actions are not dangerous to the child. Tantrums are common during this age group as the child becomes more independent and overwhelmed by increasingly complex tasks. The parents and caregivers need to have consistent and developmentally appropriate expectations. Punishment 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.
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.
The developmental task with which the child of 15 to 30 months is likely to be struggling is a sense of which?
- A. Trust
- B. Initiative
- C. Intimacy
- D. Autonomy
Correct Answer: D
Rationale: Autonomy versus shame and doubt is the developmental task of toddlers. Trust versus mistrust is the developmental stage of infancy. Initiative versus guilt is the developmental stage of early childhood. Intimacy and solidarity versus isolation is the developmental stage of early adulthood.