peds toddler Exam Fall 2022 {Answered/Rationales}

peds toddler Exam Fall 2022 {Answered/Rationales} A parent asks the nurse what to do when the toddler has temper tantrums. What play materials should the nurse suggest that the child be offered as another means of expressing anger? 1 Ball and bat 2 Wad of clay 3 Punching bag 4 Pegs and pounding board 4 A pounding board with pegs to hammer into holes is a safe toy for toddlers because it is fairly large, easy to manipulate, and sturdy. It also provides an acceptable way for anger to be expressed. The child's motor and hand-eye coordination are too immature for the child to use a ball and bat. A wad of clay is not as effective for releasing anger as a pounding board. A punching bag is appropriate for an older child with more mature motor coordination to compensate for a moving object. Which statement would the nurse state is true for toddlers? 1 The incidence of poisoning is very common in toddlers. 2 An 18-month-old child uses approximately up to 300 words. 3 The average toddler gains 2 to 3 pounds (0.9 to 1.4 kg) each year. 4 Toddlers prefer to engage in parallel play rather than in solitary play. 1 Poisonings occur frequently because children of around 2 years of age place objects or substances in their mouths to learn about them. The 18-month-old child uses approximately 10 words. A toddler gains approximately 5 to 7 pounds (2.3 to 3.2 kg) each year. The toddler begins to engage in parallel play during toddlerhood but also engages in solitary play. Which of these diseases would the nurse explain is most common in toddlers? 1 Influenza 2 Lung cancer 3 Hypertension 4 Angina pectoris 1 Toddlers are very prone to developing upper respiratory tract infections; hence, influenza is seen most frequently among toddlers. Lung cancer is seen commonly in younger or middle-aged adults from smoking. Hypertension is commonly seen in middle age due to an unhealthy diet, lack of exercise, and stress. Angina is common in young and middle-aged adults. A nurse teaches the mother of a 2-year-old child who has celiac disease which foods to avoid. Which foods identified by the mother indicate that she understands the teaching? 1 Bacon and eggs 2 Macaroni and cheese 3 Tuna salad and rice cakes 4 Chicken leg and corn on the cob 2 Children with celiac disease cannot digest the gliadin component of gluten. Foods containing grains such as wheat, rye, oats, and barley should be avoided; macaroni is contraindicated because it is a wheat product. Bacon and eggs, tuna and rice cakes, and chicken and corn are gluten-free foods. Which pain scale should a nurse use to measure the intensity of pain in toddlers? 1 FACES scale 2 Visual analogue scale 3 Numerical rating scale 4 Verbal descriptor scale 1 The nurse should use a FACES scale to measure the intensity of pain in children. The scale consists of six cartoon faces ranging from a smiling face ("no hurt") to increasingly less happy faces and finally to a sad, tearful face ("hurts worst"). The visual analogue scale, numerical rating scale, and verbal descriptor scale can be used in young children and adults. Which Korotkoff sound represents the diastolic blood pressure in toddlers? 1 First 2 Third 3 Fourth 4 Fifth 3 The fourth Korotkoff sound is muffled and low. This sound is the diastolic pressure in toddlers. The first Korotkoff sound is sharp and represents systolic blood pressure. The third Korotkoff sound is crispier and includes intense tapping. The fifth Korotkoff sound marks the disappearance of sound. In adolescents and adults the fifth sound corresponds with the diastolic pressure. A 3-year-old child has been observed in the clinic waiting room taking toys from others, tearing pages out of books, and striking the mother. The nurse takes time when interviewing the mother to ask about television habits because of what reason? 1 Viewing violent programs is positively correlated with the development of aggression. 2 The nurse is interested in how much time the mother spends in interactions with the child. 3 Watching Sesame Street and other children's shows results in slow cognitive development. 4 There is a direct connection between the number of hours of television viewed and toddler aggression. 1 Watching violent programs is positively correlated with the development of aggression. Television viewing time does not necessarily have anything to do with interaction time with the mother. Children's shows have not been shown to slow cognitive development. There are no statistics stating specifically that the number of hours of television watched correlates directly with an intensification of aggression. What does the nurse explain happens during the transition from infanthood to toddlerhood? 1 Reduced activity levels 2 Increased need for fats 3 Increased food choices 4 Reduced need for sleep 4 As the infant enters the toddler stage, the need for sleep declines and the activity level increases. Toddlers need less fat and more proteins. Children establish lifetime eating habits during toddlerhood, and there is increased emphasis on food choices. A toddler on the pediatric unit is required to have temporary dietary restrictions after colorectal surgery. What is the best way for the nurse to promote adherence to the restrictions? 1 By limiting restrictions to nonessential foods 2 By handling dietary changes in a matter-of-fact way 3 By having the dietitian explain the restrictions to the parents 4 By arranging to have an adult other than a parent stay at mealtime 2 Toddlers are ritualistic and do not tolerate change well; any change in diet should be done matter of factly. Because of their characteristic struggle for autonomy, toddlers should not be forced to eat. Limited restrictions on nonessential foods are not always possible. Although the parents should consult with the dietitian, this will not affect the toddler's response to the dietary restrictions. The toddler is still dependent on the parents and therefore will respond better to them than to a stranger What is an important nursing intervention in the care of a hospitalized toddler with cystic fibrosis? 1 Discouraging coughing 2 Performing postural drainage 3 Encouraging active exercise 4 Providing small, frequent feedings 2 Because the mucus glands secrete thick mucoid secretions that accumulate, reducing ciliary action and mucus flow, the nurse should perform postural drainage, which promotes the removal of mucopurulent secretions by means of gravity. Coughing should be encouraged; it helps bring up secretions from the respiratory tract. Although the nurse should encourage activities that are appropriate for the child's physical capacity, the child's energy should be conserved during acute phases of illness. Providing small, frequent feedings is not necessary; the child with cystic fibrosis may eat regular meals at the usual times. A 13-month-old child is admitted with a tentative diagnosis of bacterial meningitis, and the practitioner schedules a lumbar puncture. What is the most important action the nurse should take in preparation for the lumbar puncture? 1 Asking the parents what they were told about the test 2 Using a doll to demonstrate the procedure to the child 3 Obtaining a pacifier for the child to suck on during the procedure 4 Telling the parents that they may stay with their child during the test 1 Informed consent is required. The procedure should be explained to the parents by the practitioner, and the nurse should confirm the parents' comprehension and have them sign the consent form. The child is too young to comprehend a demonstration of the