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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.
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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.
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.
The parents of a newborn say that their toddler hates the baby. He suggested that we put him in the trash can so the trash truck could take him away. What is the nurses best reply?
- A. Lets see if we can figure out why he hates the new baby.
- B. Thats a strong statement to come from such a small boy.
- C. Lets refer him to counseling to work this hatred out. Its not a normal response.
- D. That is a normal response to the birth of a sibling. Lets look at ways to deal with this.
Correct Answer: D
Rationale: The arrival of a new infant represents a crisis for even the best prepared toddler. Toddlers have their entire schedules and routines disrupted because of the new family member. The nurse should work with the parents on ways to involve the toddler in the newborns care and to help focus attention on the toddler. The toddler does not hate the infant. This is an expected, normal response to the changes in routines and attention that affect the toddler. The toddler can be provided with a doll to imitate parents behaviors. The child can care for the dolls needs at the same time the parent is performing similar care for the newborn.
Which statement 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.
Correct Answer: B
Rationale: 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 to 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 modeling and facilitates imitation for the toddler. The child should be introduced to the potty chair or toilet in a nonthreatening manner.
What developmental characteristic does not occur until a child reaches age 2 1/2 years?
- A. Birth weight has doubled.
- B. Anterior fontanel is still open.
- C. Primary dentition is complete.
- D. Binocularity may be established.
Correct Answer: C
Rationale: Usually by age 30 months, the primary dentition of 20 teeth is complete. Birth weight doubles at approximately ages 5 to 6 months. The anterior fontanel closes at ages 12 to 18 months. Binocularity is established by age 15 months.