What is a characteristic of a toddlers language development at age 18 months?
- A. Vocabulary of 25 words
- B. Use of holophrases
- C. Increasing level of understanding
- D. Approximately one third of speech understandable
Correct Answer: C
Rationale: During the second year of life, the understanding and understanding of speech increase to a level far greater than the childs vocabulary. This is also true for bilingual children, who are able to achieve this linguistic milestone in both languages. An 18-month-old child has a vocabulary of approximately 10 words. At this age, the child does not use the one-word sentences that are characteristic of 1-year-old children. The child has a very limited vocabulary of single words that are comprehensible.
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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.
The parents of a 2-year-old child tell the nurse they are concerned because the toddler has started to use baby talk since the arrival of their new baby. What should the nurse recommend?
- A. Ignore the baby talk.
- B. Tell the toddler frequently, You are a big kid now.
- C. Explain to the toddler that baby talk is for babies.
- D. Encourage the toddler to practice more advanced patterns of speech.
Correct Answer: A
Rationale: Baby talk is a sign of regression in the toddler. Often toddlers attempt to cope with a stressful situation by reverting to patterns of behavior that were successful in earlier stages of development. It should be ignored while the parents praise the child for developmentally appropriate behaviors. Regression is childrens way of expressing stress. The parents should not introduce new expectations and allow the child to master the developmental tasks without criticism.
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.
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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