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NURSING 325 HCAL EXAM 3 TODDLER REVIEWER Exam Questions And Answers 100%Correct/Verified Assured Success Latest Update 2023/2024 GRADED A+
Typology: Exams
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A nurse is teaching parents of a toddler about language development. Which statement best identifies the characteristics of language development in a toddler? a. Language development skills slow during the toddler period. b. The toddler understands more than he or she can express. c. Most of the toddlers speech is not easily understood. d. The toddlers vocabulary contains approximately 600 words. ANS: B The toddlers ability to understand language (receptive language) exceeds the childs ability to speak it (expressive language). Although language development varies in relationship to physical activity, language skills are rapidly accelerating by 15 to 24 months of age. By 2 years of age, 60% to 70% of the toddlers speech is understandable. The toddlers vocabulary contains approximately 300 or more words. Parents of a toddler ask the nurse when they should start toilet training. Which statement best addresses their concerns a. When the child is 18 months of age b. When the child exhibits signs of physical and psychological readiness
c. When the child has been walking for 9 months d. When the child is able to sit on the potty for 10 to 15 minutes ANS: B Neurological development is completed at approximately 18 months of age. Parents need to know that both physical and psychological readiness are necessary for toilet training to be successful. The child needs to demonstrate signs of bowel or bladder control before attempting toilet training. Waiting until 24 to 30 months of age makes the task easier; toddlers are less negative, more willing to control their sphincters, and want to please their parents. One of the physical signs of readiness for toilet training is that the child has been walking for 1 year. The ability to sit on the potty 10 to 15 minutes may demonstrate parental control rather than being a sign of developmental readiness for toilet training. Which statement by a mother of a toddler indicates a correct understanding of the use of discipline? a. I always include explanations and morals when I am disciplining my toddler. I always try to be consistent when disciplining the children, and I correct my ch b. time they are misbehaving. c. I believe that discipline should be done by only one family member. d. My rule of thumb is no more than one spanking a
day. ANS: B Consistent and immediate discipline for toddlers is the most effective approach. Unless disciplined immediately, the toddler will have difficulty connecting the discipline with the behavior. The toddlers cognitive level of development precludes the use of explanations and morals as a part of discipline. Discipline for the toddler should be immediate; therefore, the family member caring for the child should provide discipline to the toddler when it is necessary. Discipline is required for unacceptable behavior, and the one-spanking-a-day rule contradicts the concept of a consistent response to inappropriate behavior. Additionally, spanking is an inappropriate method of disciplining a child. Which comment indicates that the mother of a toddler needs further teaching about dental care? a. We use well water so I give my toddler fluoride supplements. b. My toddler brushes his teeth with my help. c. My child will not need a dental checkup until his permanent teeth come in. d. I use a small nylon bristle brush for my toddlers teeth. ANS: C Children should first see the dentist 6 months after the first primary tooth erupts and no later than age 30 months. Toddlers need fluoride supplements when they use a water supply that is not fluorinated. Toddlers need supervision with dental
care. The parent should finish brushing areas not reached by the child. A small nylon bristle brush works best for cleaning toddlers teeth. Which assessment finding in a preschooler would suggest the need for further investigation? a. The child is able to dress independently. b. The child rides a tricycle. c. The child has an imaginary friend. d. The child has a 2-pound weight gain in 12 months. ANS: D Preschool children gain an average of 5 pounds a year. A gain of only 2 pounds is less than half of the expected weight gain and should be investigated. A preschool child should be able to dress independently and be able to ride a tricycle. Imaginary friends are common for preschoolers. Which is the most appropriate action for the nurse to take when telling a preschool child about an upcoming procedure? a. Explain all the information in detail to the child. b. Speak loudly and clearly to the child. c. Inform the parents of the procedure and ask them to tell the child.
d. Use symbolic play to explain the procedure. ANS: D Symbolic play is important for emotional development because it allows the child to work through distressing feelings and can be therapeutic. It is inappropriate to give a preschooler all the information in detail. The child needs to understand what is going to happen to him without explicit details of the procedure. Speaking in clear sentences with simple words is important, but the conversation should be conducted at a nonthreatening normal sound level. The nurse has the most knowledge and best ability for explaining the procedure to the child; however, the parents can be an important resource when explaining the procedure. A nurse has admitted a child to the hospital with a diagnosis of rule out peptic ulcer disease. Which test will the nurse expect to be ordered to confirm the diagnosis of a peptic ulcer? a. A 24-hour dietary history b. A positive Hematest result on a stool sample c. A fiberoptic upper endoscopy d. An abdominal ultrasound ANS: C Endoscopy provides direct visualization of the stomach lining and confirms the diagnosis of peptic ulcer. Dietary history may yield information
suggestive of a peptic ulcer, but the diagnosis is confirmed through endoscopy. Blood in the stool indicates a gastrointestinal abnormality, but it does not conclusively confirm a diagnosis of peptic ulcer. An abdominal ultrasound is used to rule out other gastrointestinal alterations such as gallstones, tumor, or mechanical obstruction. What should the nurse teach a school-age child and his parents about the management of ulcer disease? a. Eat a bland, low-fiber diet in small frequent meals. b. Eat three balanced meals a day with no snacking between meals. c. The child needs to eat alone to avoid stress. d. Do not give antacids 1 hour before or after antiulcer medications. ANS: D Antacids can interfere with antiulcer medication if given less than 1 hour before or after antiulcer medications. A bland diet is not indicated for ulcer disease. The diet should be a regular diet that is low in caffeine, and the child should eat a meal or snack every 2 to 3 hours. Eating alone is not indicated. Which interventions should a nurse implement when caring for a child with hepatitis? Select all that apply.
a. Provide a well-balanced low-fat diet. b. Schedule play time in the playroom with other children. c. Teach parents not to administer any over-the-counter medications. d. Arrange for home schooling as the child will not be able to return to school. e. Instruct parents on the importance of good hand washing. ANS: A, C, E The child with hepatitis should be placed on a well-balanced low-fat diet. Parents should be taught to not give over-the-counter medications because of impaired liver function. Hand hygiene is the most important preventive measure for the spread of hepatitis. The child will be in contact isolation in the hospital so play time with other hospitalized children is not scheduled. The child will be on contact isolation for at least 1 week after the onset of jaundice, but after that period, will be allowed to return to school. What is the primary purpose of a transitional object? a. It helps the parents deal with the guilt they feel when they leave the child. b. It keeps the child quiet at bedtime. c. It is effective in decreasing anxiety in the toddler. d. It decreases negativism and tantrums in the
toddler. ANS: C Decreasing anxiety, particularly separation anxiety, is the function of a transitional object; it provides comfort to the toddler in stressful situations and helps make the transition from dependence to autonomy. A decrease in parental guilt (distress) is an indirect benefit of a transitional object. A transitional object may be part of a bedtime ritual, but it may not keep the child quiet at bedtime. A transitional object does not significantly affect negativity and tantrums, but it can comfort a child after tantrums. In caring for a 4-year-old child with a diagnosis of suspected child abuse, which is the best nursing intervention? a. Avoid touching the child. b. Provide the child with play situations that allow for disclosure. c. Discourage the child from remembering the incident. d. Deny the suspected perpetrator visiting rights to the child. ANS: B Play allows the child to disclose what happened to him or her without having to talk about the incident. Symbolic play is important for emotional development and it allows the child to work through distressing feelings. All children need to be touched. What is important is to tell the child in
simple, clear terms what you are doing and why you are doing it. Nurses have the opportunity to teach children the normal, healthy boundaries of their bodies and what constitutes inappropriate behavior. If the child chooses to remember what happened, it is inappropriate to discourage it. It is important to listen to the child in a nonjudgmental way, allowing the child to discuss what happened, to make statements, or to ask questions. It is not the nurses role or responsibility to restrict visitors unless child safety is an issue. The child may be negatively affected if a caregiver, who may be the abuser, does not visit. Which is helpful to tell a mother who is concerned about preventing sleep problems in her preschool child? a. Have the child always sleep in a quiet, darkened room. b. Provide high-carbohydrate snacks before bedtime. c. Communicate with the childs daytime caretaker to encourage a longer nap. d. Use a nightlight in the childs room. ANS: D The preschooler has a great imagination. Sounds and shadows can have a negative effect on sleeping behavior. Nightlights provide the child with the ability to visualize the environment and decrease the fear felt in a dark room. A dark, quiet room may be scary to a preschooler. High- carbohydrate snacks increase energy and do not promote relaxation.
Taking a longer nap during the day will not cause the child to sleep longer at night. A child who has slept for a long time at the babysitters may not be ready to sleep again.
b. Discipline should involve some physical restriction. c. The method of discipline should be consistent with the discipline methods of th d. Discipline should include positive reinforcement of desired behaviors. ANS: D Effective discipline strategies should involve a comprehensive approach that includes consideration of the parentchild relationship, reinforcement of desired behaviors, and consequences for negative behaviors. Discipline does not need to be agreed on by the child. Both parents should be in agreement so the discipline is consistently applied. Discipline does not necessarily need to include physical restriction and does not need to be consistent with that of the childs peers. DIF: Cognitive Level: Comprehension Parents of a preschool child ask the nurse, What can we do to prepare our child for kindergarten? In response, the nurse should include which critical factor in preparing a child for kindergarten entry? a. The childs ability to sit still b. The childs sense of learned helplessness c. The parents interactions and responsiveness to the child d. Attending a preschool
program ANS: C Interactions between the parent and child are an important factor in the development of academic competence. Parent encouragement and support maximize a childs potential. The childs ability to sit still is important to learning; however, parental responsiveness and involvement are more important factors. Learned helplessness is the result of a child feeling that he or she has no effect on the environment and his or her actions do not matter. Parents who are actively involved in a supportive learning environment will demonstrate a more positive approach to learning. Preschool and day care programs can supplement the developmental opportunities provided by parents at home, but they are not critical in preparing a child for entering kindergarten. Which play patterns does a 3-year-old child typically display? Select all that apply. a. Imaginary play b. Parallel play c. Cooperative play d. Structured play ANS: A, B, C Children between the ages of 3 and 5 years enjoy parallel and associative play. Children learn to share and cooperate as they play in small groups.
Play is often imitative, dramatic, and creative. Imaginary friends are common near the age of 3 years. Structured play is typical of school-age children. A nurse is planning care for a hospitalized toddler in the preoperational thinking stage. Which characteristics should the nurse expect in this stage? Select all that apply. a. Concrete thinking b. Egocentrism c. Animism d. Magical thought e. Ability to reason ANS: B, C, D The characteristics of preoperational thinking that occur for the toddler include egocentrism (views everything in relation to self), animism (believes that inert objects are alive), and magical thought (believes that thinking something causes that event). Concrete thinking is seen in school age children and ability to reason is seen with adolescents. Place in order the gross motor developmental milestones a nurse expects
to assess in a toddler. Begin with the earliest gross motor milestone expected and progress to the last gross motor milestone attained. Use the following format for your answers: A, B, C, D a. Throws a ball overhand b. Walks c Kicks a ball d. Runs ANS: B, D, A, C The toddler walks between 12 months and 15 months of age. The next gross motor milestone seen in the toddler is running. The toddler runs soon after learning how to walk, but may fall down. By the end of 24 months the toddler can throw a ball overhand. The toddler does not kick a ball until after 24 months of age.
A nurse has completed a teaching session for parents on school-age childrens expected developmental milestones. The parents need further teaching if they indicate which behavior is expected in a school-age child? a. Experiments with profanity and dirty jokes b. Laughs at silly jokes and enjoys using words c. Understands the concept of conservation d. Engages in fantasy and magical thinking ANS: D The preschool child engages in fantasy and magical thinking. The school-age child moves away from this type of thinking and becomes more skeptical and logical. Belief in Santa Claus or the Easter Bunny ends in this period of development. The school-age child goes through a period in which profanity and dirty jokes are explored. This behavior is not unusual for the school-age child. The school-age child has a sense of humor. His increased language mastery and increased logic allow for appreciation of plays on words, jokes, and incongruities. The school-age child understands conservation or that properties of objects do not change when their order, form, or appearance does. The ability to mentally understand that 1 + 3 = 4 and 4 1 = 3 occurs in which stage of cognitive development?
a. Concrete operations stage b. Formal operations stage c. Intuitive thought stage d. Preoperations stage ANS: A By 7 to 8 years of age, the child is able to retrace a process (reversibility) and has the skills necessary for solving mathematical problems. This stage is called concrete operations. The formal operations stage deals with abstract reasoning and does not occur until adolescence. Thinking in the intuitive stage is based on immediate perceptions. A child in this stage often solves problems by random guessing. In preoperational thinking, the child is usually able to add 1 + 3 = 4 but is unable to retrace the process. Which activity is most appropriate for developing fine motor skills in the school-age child? a. Drawing b. Singing c. Soccer d. Swimming
Activities such as drawing, building models, and playing a musical instrument increase the school-age childs fine motor skills. Singing is an appropriate activity for the school-age child, but it does not increase fine motor skills. The school-age child needs to participate in group activities to increase both gross motor skills and social skills but group activities do not increase fine motor skills. Swimming is an activity that also increases gross motor skills. A school nurse is teaching a health class for fifth grade children. The nurse plans to include which statement to best describe growth in the early school- age period? a. Boys grow faster than girls do until around age 10. b. Puberty occurs earlier in boys than in girls. c. Puberty occurs at the same age for all races and ethnicities. d. It is a period of rapid physical growth. ANS: A During the school-age developmental period, boys are approximately 1 inch taller and 2 pounds heavier than girls. Puberty occurs 1.5 to 2 years later in boys, which is developmentally later than puberty in girls (not unusual in 9- or 10-year-old girls). Puberty occurs approximately 1 year earlier in African- American girls than white girls. Physical growth is slow and
steady during the school-age years. Identify the statement that is the most accurate about moral development in the 9-year-old school-age child. a. Right and wrong are based on physical consequences of behavior. b. The child obeys parents because of fear of punishment. c. The school-age child conforms to rules to please others. d. Parents are the determiners of right and wrong for the school-age child. ANS: C The 7- to 12-year-old child bases right and wrong on a good-boy or good-girl orientation in which the child conforms to rules to please others and avoid disapproval. Children 4 to 7 years of age base right and wrong on consequences; consequences are the most important consideration for the child between 4 and 7 years of age. Parents determine right and wrong for the child younger than 4 years of age. Which parental behavior is the most important in fostering moral development? a. Telling the child what is right and wrong
b. Vigilantly monitoring the child and her peers c. Weekly family meetings to discuss behavior d. Living as the parents say they believe ANS: D Parents living what they believe give nonambivalent messages and foster the childs moral development and reasoning. Telling the child what is right and wrong is not effective unless the child has experienced what he or she hears. Parents need to live according to the values they are teaching to their children. Vigilant monitoring of the child and his or her peers is an inappropriate action for the parent to initiate. It does not foster moral development and reasoning in the child. Weekly family meetings to discuss behaviors may or may not be helpful in the development of moral reasoning. A nurse is assessing an older school-age child recently admitted to the hospital. Which assessment indicates the child is in an appropriate stage of cognitive development? a. Addition and subtraction ability b. Ability to classify c. Vocabulary d. Play
activity ANS: B The ability to classify things from simple to complex and to identify differences and similarities are cognitive skills of the older school-age child; this demonstrates use of classification and logical thought processes. Subtraction and addition are appropriate cognitive activities for the young school-age child. Vocabulary is not as valid an assessment of cognitive ability as is the childs ability to classify. Play activity is not as valid an assessment of cognitive function as is the ability to classify. Which is an appropriate disciplinary intervention for the school-age child? a. Time-out periods b. A consequence that is consistent with the inappropriate behavior c. Physical punishment d. Lengthy dialog about inappropriate behavior ANS: B A consequence that is related to the inappropriate behavior is the recommended discipline. Time-out periods are more appropriate for younger children. Physical intervention is an inappropriate form of discipline. It does not connect the discipline with the childs inappropriate behavior. Lengthy discussions typically are not helpful.
Which demonstrates the school-age childs developing logic in the stage of concrete operations? Select all that apply. a. Ability to recognize that 1 pound of feathers is equal to 1 pound of metal b. Ability to recognize that he can be a son, brother, or nephew at the same time c. Understands the principles of adding, subtracting, and reversibility d. Thinking characterized by egocentrism, animism, and centration ANS: A, B, C The school-age child understands that the properties of objects do not change when their order, form, or appearance does. Conservation occurs in the concrete operations stage. Comprehension of class inclusion occurs as the school-age childs logic increases. The child begins to understand that a person can be in more than one class at the same time. This is characteristic of concrete thinking and logical reasoning. The school-age child is able to understand principles of adding, subtracting, and the process of reversibility, which occurs in the stage of concrete operations. Egocentrism, animism, and centration occur in the intuitive thought stage, not the concrete operations stage of development. Which strategies can a nurse teach to parents of a child experiencing uncomplicated school refusal? Select all that apply. a. The child should be allowed to stay home until the anxiety about going to
scho b. Parents should be empathetic yet firm in their insistence that the child attends c. A modified school attendance may be necessary. d. Parents need to pick the child up at school whenever the child wants to come h e. Parents need to communicate with the teachers about the situation. ANS: B, C, E In uncomplicated cases of school refusal, the parent needs to return the child to school as soon as possible. If symptoms are severe, a limited period of part-time or modified school attendance may be necessary. For example, part of the day may be spent in the counselors or school nurses office, with assignments obtained from the teacher. Parents should be empathetic yet firm and consistent in their insistence that the child attend school. Parents should not pick the child up at school once the child is there. The principal and teacher should be told about the situation so that they can cooperate with the treatment plan. A nurse is planning a class for school-age children on obesity. Which percentile does the BMI need to exceed for a child to be assessed as obese? ANS: 95
95th
When intake of food exceeds expenditure, the excess is stored as fat. Obesity is an excessive accumulation of fat in the body and is assessed in children as a BMI that exceeds the 95th percentile for age.
Hepatitis A is the most common form of acute hepatitis in most parts of the world. It is characterized by a rapid acute onset. The incubation period is approximately 3 weeks for hepatitis A. The principal mode of transmission for hepatitis A is the fecal-oral route. Hepatitis A does not have a carrier stat The best chance of survival for a child with cirrhosis is: a.Liver transplantation. b.Treatment with corticosteroids. c.Treatment with immune globulin. d.Provision of nutritional support. ANS: A The only successful treatment for end-stage liver disease and liver failure may be liver transplantation, which has improved the prognosis for many children with cirrhosis. Liver transplantation has revolutionized the approach to cirrhosis. Liver failure and cirrhosis are indications for transplantation. Liver transplantation reflects the failure of other medical and surgical measures to prevent or treat cirrhosis. The earliest clinical manifestation of biliary atresia is: a.Jaundice. b.Vomiting. c.Hepatomegaly.