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What is the leading cause of death during the toddler period?
- A. Injuries
- B. Infectious diseases
- C. Childhood diseases
- D. Congenital disorders
Correct Answer: A
Rationale: Injuries are the most common cause of death in children ages 1 through 4 years. It is the highest rate of death from injuries of any childhood age group except adolescence. Congenital disorders are the second leading cause of death in this age group. Infectious and childhood diseases are less common causes of death in this age group.
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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.
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 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.
Although a 14-month-old girl received a shock from an electrical outlet recently, her parent finds her about to place a paper clip in another outlet. Which is the best interpretation of this behavior?
- A. Her cognitive development is delayed.
- B. This is typical behavior because toddlers are not very developed.
- C. This is typical behavior because of toddlers inability to transfer remembering to new situations.
- D. This is not typical behavior because toddlers should know better than to repeat an act that caused pain.
Correct Answer: C
Rationale: During the tertiary circular reactions stage, children have only a rudimentary sense of the classification of objects. The appearance of an object denotes its function for these children. The slot of an outlet is for putting things into. This is typical behavior for a toddler, who is only somewhat aware of a causal relation between events. Her cognitive development is appropriate for her age.
A toddler, age 16 months, falls down a few stairs. He gets up and scolds the stairs as if they caused him to fall. What is this an example of?
- A. Animism
- B. Ritualism
- C. Irreversibility
- D. Delayed cognitive development
Correct Answer: A
Rationale: Animism is the attribution of lifelike qualities to inanimate objects. By scolding the stairs, the toddler is attributing human characteristics to them. Ritualism is the need to maintain sameness and reliability. It provides a sense of comfort to toddlers. Irreversibility is the inability to reverse or undo actions initiated physically. The toddler is acting in an age-appropriate manner.