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.
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Parents 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 nurses best interpretation of this behavior?
- A. This is normal behavior for his age.
- B. This is unusual behavior for his age.
- C. He is not effectively coping with stress.
- D. He is showing he needs more attention.
Correct Answer: A
Rationale: Toddlers use distinct behaviors in the quest for autonomy. They express their will with continued 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 expected behavior for an 18-month-old.
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.
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.
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 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.
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