Deck 11: Health Promotion and Maintenance of the Toddler and Preschooler

Question 1

A 27-month-old toddler who is in the pediatric office for a well-child visit begins to cry the moment he is placed on the examination table. The parent attempts to comfort the toddler, but nothing is effective. Which would be the most appropriate action for the nurse to take?

A)Instruct the father to hold the toddler down tightly to complete the examination.
B)Allow the toddler to sit on the parent's lap and begin the assessment.
C)Ask another nurse in the office to hold the toddler, since the parent is not able to control the toddler's behavior.
D)Allow the toddler to stand on the floor until the crying stops.

Answer 1

Allow the toddler to sit on the parent's lap and begin the assessment.

Question 2

A nurse who is the manager of an ambulatory pediatric health care center is planning protocols for the routine health care visits of the children. Children within the catchment area of this care center have a high incidence of obesity. The most important assessment data in monitoring the two-year-old child with obesity is:

A)Weight alone.
B)The child's percentile score of height and weight and weight on the growth chart.
C)Changes in the child's percentile on the growth chart from birth to the present.
D)The child's body mass index.

Answer 2

The child's body mass index.

Question 3

The mother of a toddler asks the nurse: "Now that my child has outgrown his infant car seat, what should I do when we are in the car?" Which is the best response by the nurse?

A)"Place him in a booster chair on the seat beside you so you can watch him."
B)"Be sure to select a car seat according to his weight and height, and make sure it contains shoulder harnesses."
C)"Your child should remain in the rear-facing car seat until he reaches 40 pounds."
D)"The child can now be buckled safely into the regular car seat belts."

Answer 3

"Be sure to select a car seat according to his weight and height, and make sure it contains shoulder harnesses."

Question 4

The home health nurse is observing the home environment for safety issues to discuss with the mother. Which observation creates a risk of injury for the toddler?

A)The mother fills the mop bucket and places it on the floor.She then leaves the room to obtain the mop.
B)When cooking, the mother only uses the back burners of the stove.
C)The mother straps her child into the high chair.
D)The mother has child-proof latches only on the cabinets containing household chemicals, medications, and poisons.

Question 5

Parents of a preschool-age child report that they find it necessary to spank the child at least once a day. Which response should the nurse make to the parents?

A)"Spanking is one form of discipline; however, you want to be certain that you do not leave any marks on the child."
B)"Let's talk about other forms of discipline that have a more positive effect on the child."
C)"I think you are not parenting your child properly, so let's talk about ways to improve your parenting skills."
D)"Can you try only spanking the child every other day for one week and see how that affects the child's behavior?"

Question 6

The nurse is teaching a group of mothers of toddlers and preschoolers about oral care and the prevention of caries. Which statements should the nurse include in the presentation? Standard Text: Select all that apply.

A)"The tendency toward dental caries is inherited."
B)"Fruit juice is an excellent source of vitamin C, so allow your child to drink as much fruit juice a day as desired."
C)"If your child is under two, you should use toothpaste without fluoride."
D)"Three-year-old children are mature enough to be able to brush their teeth independently."
E)"The child should see a dentist by one year of age."

Question 7

Which of these developmental milestones should the nurse expect to find in children who are between two and three years old? Standard Text: Select all that apply.

A)Always feeds self
B)Throws ball overhand
C)Kicks a ball
D)Goes up and down stairs
E)Scribbles and draws on paper

Question 8

At a routine health care visit, a nurse measures a toddler and plots the height and weight on the growth charts. The nurse documents that the toddler is above the 95th percentile for weight and is at the 5th percentile for height. How should the nurse interpret these data?

A)The toddler is proportionate for age.
B)The height and weight are disproportionate, and the toddler needs further evaluation.
C)The toddler needs to eat more at each feeding.
D)The family most likely is short.

Question 9

The nurse is explaining the primary purpose of performing health maintenance activities at each pediatric visit. The best explanation touches on:

A)Planning appropriate disciplinary measures for control of behavior.
B)Reviewing developmental milestones with the parents.
C)Prevention of disease and injury.
D)Teaching growth and development to the parents.

Question 10

The pediatric clinic is scheduled to be remodeled. The charge nurse has been asked to design the new well-child waiting area. In planning the area, the nurse will want to include: Standard Text: Select all that apply.

A)Subdued colors to help calm the children.
B)A separate area where parents can sit and not be disturbed by the children's noise.
C)Avoiding carpet and draperies which cannot be readily cleaned.
D)Coloring books, crayons, and story books that are stored on a low shelf for easy child access.
E)All wall decorations securely fastened to the walls.

Question 11

A parent questions how her toddler will interact with other toddlers. The nurse's best description of the differences in play between the toddler and the preschooler is:

A)Toddlers play "side by side," while preschoolers play cooperatively.
B)Toddlers play cooperatively, while preschoolers play interactive games.
C)Toddlers play house and imitate adult roles, while preschoolers become the "mom or dad" while playing house.
D)There are no differences between toddlers and preschoolers because both play cooperatively.

Question 12

The mother of an 18-month-old expresses concern that her toddler is having temper tantrums when things don't go her way. What advice should the nurse offer the mother? Standard Text: Select all that apply.

A)"This is common in the toddler and represents a loss of self-control."
B)"Remove the child from the area where the tantrum occurs."
C)"Provide a distraction for the child without giving in to the child's desire."
D)"Remain calm while handling the child and do not raise your voice to the child."
E)"If the tantrum continues for more than a few minutes, the mother should tap the child lightly on the behind to remind the child the consequences of misbehavior."

Question 13

A nurse is preparing to perform a physical assessment on a toddler. Which of these actions should the nurse take?

A)Explain each part of the examination to the child before performing it.
B)Ask the mother to tell the child not to be afraid.
C)Perform the assessment from head to toe.
D)Leave intrusive procedures, such as ear and eye examinations, until the end.

Question 14

The nurse recommends to the mothers of toddlers and preschoolers that they limit television to two hours a day. The nurse also discusses promoting physical activities that are related to kinesthesia. Which activities would the nurse suggest? Standard Text: Select all that apply.

A)Walking on a balance beam
B)Reading
C)Playing a memory game
D)Skipping
E)Giving up a pacifier

Question 15

During a well-child visit, the nurse questions the mother about a toddler's food habits. The mother expresses concern that her child, who used to be a good eater and would eat all types of vegetables, now refuses all but three types of vegetables. Which is the appropriate response for the nurse to make to the mother?

A)"This is a serious concern, and we need to address this with the physician."
B)"Toddlers often go on food jags.Just continue to offer all types of vegetables without making it an issue."
C)"Don't make an issue over it.Just stop offering those favorite vegetables and the child will start eating other vegetables."
D)"Have you thought about adding a multivitamin to the child's daily routine?"