Chapter 36: The Toddler and Family
MULTIPLE CHOICE
1. Which is most important in predisposing toddlers to frequent infections such as otitis media,
tonsillitis, and upper respiratory tract infections?
a. Respirations are abdominal.
b. Pulse and respiratory rates are slower than
those in infancy.
c. Defence mechanisms are less efficient than
those during infancy.
d. Short, straight internal ear/throat
structures and large tonsil/adenoid
lymph tissue
ANS: D
Toddlers still have the short, straight internal ear canal of infants, and the lymphoid tissue of
the tonsils and adenoids continues to be relatively large. These two anatomical conditions
combine to predispose the toddler to frequent infections. The abdominal respirations and
lowered pulse and respiratory rate of toddlers do not affect their susceptibility to infection. The
toddler’s defence mechanisms are more efficient compared to those of infancy.
DIF: Cognitive Level: Analysis REF: p. 1045
OBJ: Nursing Process: Assessment
2. Which is a psychosocial developmental task of toddlerhood?
a. Development of a conscience
b. Recognition of sex differences
c. Ability to get along with age - mates
d. Ability to delay gratification
ANS: D
If the need for basic trust has been satisfied, toddlers can give up dependence for control,
independence, and autonomy. One of the tasks that the toddler is concerned with is the ability
to withstand the temptation of an immediate reward to wait for a later, better one, known as
delayed gratification. Development of a conscience and recognition of sex differences occur
during the preschool years. The ability to get along with age-mates develops during the
preschool and school-age years.
, DIF: Cognitive Level: Comprehension REF: p. 1046
OBJ: Nursing Process: Assessment
3. A parent of an 18-month-old boy tells the nurse that he says “no” to everything and has rapid
mood swings. If he is scolded, he shows anger and then immediately wants to be held. What is
the best interpretation of this behaviour?
a. This is normal behaviour for his age.
b. This is unusual behaviour for his age.
c. He is not effectively coping with stress.
d. He is showing he needs more
attention.
ANS: A
Toddlers use distinct behaviours in their quest for autonomy. They express their will with
continuous negativity and use of the word “no.” Children at this age also have rapid mood
swings. The nurse should reassure the parents that their child is engaged in typical behaviour
for an 18-month-old.
DIF: Cognitive Level: Comprehension REF: p. 1046 OBJ: Nursing
Process: Assessment
4. According to Piaget, which stage is a 17-month-old child expected to be in?
a. Trust
b. Preoperations
c. Secondary circular reactions
d. Tertiary circular reactions
ANS: D
The 17-month-old is in the fifth stage of the sensorimotor phase: tertiary circular reactions (13
to 18 months). The child uses active experimentation to achieve previously unattainable goals.
Trust is Erikson’s first stage. Preoperations is the stage of cognitive development usually
present in older toddlers and preschoolers. Secondary circular reactions last from about ages 4
to 8 months.
DIF: Cognitive Level: Comprehension REF: p. 1048 OBJ: Nursing
Process: Assessment
5. What best describes a toddler’s cognitive development at age 20 months?
MULTIPLE CHOICE
1. Which is most important in predisposing toddlers to frequent infections such as otitis media,
tonsillitis, and upper respiratory tract infections?
a. Respirations are abdominal.
b. Pulse and respiratory rates are slower than
those in infancy.
c. Defence mechanisms are less efficient than
those during infancy.
d. Short, straight internal ear/throat
structures and large tonsil/adenoid
lymph tissue
ANS: D
Toddlers still have the short, straight internal ear canal of infants, and the lymphoid tissue of
the tonsils and adenoids continues to be relatively large. These two anatomical conditions
combine to predispose the toddler to frequent infections. The abdominal respirations and
lowered pulse and respiratory rate of toddlers do not affect their susceptibility to infection. The
toddler’s defence mechanisms are more efficient compared to those of infancy.
DIF: Cognitive Level: Analysis REF: p. 1045
OBJ: Nursing Process: Assessment
2. Which is a psychosocial developmental task of toddlerhood?
a. Development of a conscience
b. Recognition of sex differences
c. Ability to get along with age - mates
d. Ability to delay gratification
ANS: D
If the need for basic trust has been satisfied, toddlers can give up dependence for control,
independence, and autonomy. One of the tasks that the toddler is concerned with is the ability
to withstand the temptation of an immediate reward to wait for a later, better one, known as
delayed gratification. Development of a conscience and recognition of sex differences occur
during the preschool years. The ability to get along with age-mates develops during the
preschool and school-age years.
, DIF: Cognitive Level: Comprehension REF: p. 1046
OBJ: Nursing Process: Assessment
3. A parent of an 18-month-old boy tells the nurse that he says “no” to everything and has rapid
mood swings. If he is scolded, he shows anger and then immediately wants to be held. What is
the best interpretation of this behaviour?
a. This is normal behaviour for his age.
b. This is unusual behaviour for his age.
c. He is not effectively coping with stress.
d. He is showing he needs more
attention.
ANS: A
Toddlers use distinct behaviours in their quest for autonomy. They express their will with
continuous negativity and use of the word “no.” Children at this age also have rapid mood
swings. The nurse should reassure the parents that their child is engaged in typical behaviour
for an 18-month-old.
DIF: Cognitive Level: Comprehension REF: p. 1046 OBJ: Nursing
Process: Assessment
4. According to Piaget, which stage is a 17-month-old child expected to be in?
a. Trust
b. Preoperations
c. Secondary circular reactions
d. Tertiary circular reactions
ANS: D
The 17-month-old is in the fifth stage of the sensorimotor phase: tertiary circular reactions (13
to 18 months). The child uses active experimentation to achieve previously unattainable goals.
Trust is Erikson’s first stage. Preoperations is the stage of cognitive development usually
present in older toddlers and preschoolers. Secondary circular reactions last from about ages 4
to 8 months.
DIF: Cognitive Level: Comprehension REF: p. 1048 OBJ: Nursing
Process: Assessment
5. What best describes a toddler’s cognitive development at age 20 months?
