Wong’s Essentials Of Pediatric Nursing, 10th Edition By Marilyn – Test Bank

Chapter 11: Health Promotion of the Toddler and Family
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition

MULTIPLE CHOICE

1. Which factor is most important in predisposing toddlers to frequent infections?
a. Respirations are abdominal.
b. Pulse and respiratory rates are slower than those in infancy.
c. Defense mechanisms are less efficient than those during infancy.
d. Toddlers have a short, straight internal ear canal and large lymph tissue.

ANS: D
Toddlers continue to have the short, straight internal ear canal of infants. The lymphoid tissue of the tonsils and adenoids continues to be relatively large. These two anatomic 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 defense mechanisms are more efficient compared with those of infancy.

DIF: Cognitive Level: Analyze REF: p. 355
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity

2. The psychosocial developmental tasks of toddlerhood include which characteristic?
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, then toddlers can give up dependence for control, independence, and autonomy. One of the tasks that the toddler is concerned with is the ability to delay gratification. Development of a conscience occurs during the preschool years. The recognition of sex differences occurs during the preschool years. The ability to get along with age-mates develops during the preschool and school-age years.

DIF: Cognitive Level: Understand REF: p. 355
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

3. The child of 15 to 30 months is likely to be struggling with which developmental task?
a. Trust
b. Initiative
c. Autonomy
d. Intimacy

ANS: C
Autonomy vs shame and doubt is the developmental task of toddlers. Trust vs mistrust is the developmental stage of infancy. Initiative vs guilt is the developmental stage of early childhood. Intimacy and solidarity vs isolation is the developmental stage of early adulthood.

DIF: Cognitive Level: Remember REF: p. 355
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

4. 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. The nurse’s best interpretation of this behavior is included in which statement?
a. This is normal behavior for his age.
b. This is unusual behavior for his age.
c. He is not effectively coping with stress.
d. He is showing he needs more attention.

ANS: A
Toddlers use distinct behaviors in the quest for autonomy. They express their will with continued negativity and the 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 expected behavior for an 18-month-old. Having a rapid mood swing is an expected behavior for a toddler.

DIF: Cognitive Level: Understand REF: p. 358
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance

5. A nurse is planning care for a 17-month-old child. According to Piaget, which stage should the nurse expect the child to be in cognitively?
a. Trust
b. Preoperational
c. Secondary circular reaction
d. Tertiary circular reaction

ANS: D
The 17-month-old child is in the fifth stage of the sensorimotor phase, tertiary circular reactions. The child uses active experimentation to achieve previously unattainable goals. Trust is Erikson’s first stage. Preoperational 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: Remember REF: p. 356
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance

6. Which is descriptive of a toddler’s cognitive development at age 20 months?
a. Searches for an object only if he or she sees it being hidden
b. Realizes that “out of sight” is not out of reach
c. Puts objects into a container but cannot take them out
d. Understands the passage of time, such as “just a minute” and “in an hour”

ANS: B
At this age, the child is in the final sensorimotor stage. Children will now search for an object in several potential places, even though they saw only the original hiding place. Children have a more developed sense of objective permanence. They will search for objects even if they have not seen them hidden. When a child puts objects into a container but cannot take them out, this is indicative of tertiary circular reactions. An embryonic sense of time exists, although the children may behave appropriately to time-oriented phrases; their sense of timing is exaggerated.

DIF: Cognitive Level: Understand REF: p. 356
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

7. Although a 14-month-old girl received a shock from an electric 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 the inability to transfer knowledge to new situations.
d. This is not typical behavior because toddlers should know better than to repeat an act that caused pain.

ANS: C
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. Her cognitive development is appropriate for her age. Trying to put things into an outlet is typical behavior for a toddler. Only some awareness exists of a causal relation between events.

DIF: Cognitive Level: Understand REF: p. 356
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

8. Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. Which is the best interpretation of this behavior?
a. This is typical behavior because toddlers are aggressive.
b. This is typical behavior because toddlers are egocentric.
c. Toddlers should know that sharing toys is expected of them.
d. Toddlers should have the cognitive ability to know right from wrong.

ANS: B
Play develops from the solitary play of infancy to the parallel play of toddlers. The toddler plays alongside other children, not with them. This typical behavior of the toddler is not intentionally aggressive. Shared play is not within their cognitive development. Toddlers do not conceptualize shared play. Because the toddler cannot view the situation from the perspective of the other child, it is okay to take the toy. Therefore, no right or wrong is associated with taking a toy.

DIF: Cognitive Level: Analyze REF: p. 355
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

9. Steven, 16 months old, falls down a few stairs. He gets up and “scolds” the stairs as if they caused him to fall. This is an example of which of the following?
a. Animism
b. Ritualism
c. Irreversibility
d. Delayed cognitive development

ANS: A
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 the sameness and reliability. It provides a sense of comfort to the toddler. Irreversibility is the inability to reverse or undo actions initiated physically. Steven is acting in an age-appropriate manner.

DIF: Cognitive Level: Understand REF: p. 357
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

10. Which should the nurse expect for a toddler’s language development at age 18 months?
a. Vocabulary of 25 words
b. Increasing level of comprehension
c. Use of holophrases
d. Approximately one third of speech understandable

ANS: B
During the second year of life, level of comprehension and understanding of speech increases and is far greater than the child’s vocabulary. This is also true for bilingual children, who are able to achieve this linguistic milestone in both languages. The 18-month-old child has a vocabulary of 10 or more words. At this age, the child does not use the one-word sentences that are characteristic of the 1-year-old child. The child has a limited vocabulary of single words that are comprehensible.

DIF: Cognitive Level: Understand REF: p. 359
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance