RN Toddler EAQ EXAM 2022

RN Toddler EAQ EXAM 2022A 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? Ball and bat Wad of clay Punching bag Pegs and pounding board A nurse is evaluating a 3-year-old child's developmental progress. The inability to perform which task indicates to the nurse that there is a developmental delay? Copying a square Hopping on one foot Catching a ball reliably Using a spoon effectively A 13-month-old toddler has a respiratory tract infection with a low-grade fever. When teaching the parents, which intervention should the nurse emphasize? Encouraging high-calorie snacks to prevent weight loss Keeping the toddler wrapped in blankets to prevent shivering Giving small amounts of clear liquids frequently to prevent dehydration Using cool-water baths to prevent the toddler's fever from increasing further How should a nurse respond to parents who are concerned about separation anxiety in their 15- month-old toddler? "This is an expected developmental reaction." "You may be spending too much time with your child." "It might be helpful to leave your child with someone once in a while." "Toddlers who have separation anxiety may have difficulty when they start school." A 15-month-old child is hospitalized after ingesting toilet bowl cleaner. The mother confides that she feels guilty about leaving the cleaner where her child could get it. What is the best response by the nurse? "Anyone could make a mistake. Don't dwell on it." "Let's not worry about the past. Your child is going to get better." "It was an accident, but you should consider special locks on your closets." "That was careless of you. Please make sure that you poison-proof your house." A 2-year-old toddler has hearing loss caused by recurrent otitis media. What treatment does the nurse anticipate that the practitioner will recommend? Ear drops MyringotomyMastoidectomy Steroid therapy A 2-year-old toddler requires close supervision to protect against potential accidents. The nurse teaches a class for parents about the learning style of toddlers. How do toddlers learn selfprotection? Through trial-and-error strategies By imitating playmates and siblings By obeying orders from mother and father By playing with age-appropriate toys and puzzles he parents of a 2-year-old child are watching the nurse administer the Denver II Developmental Screening Test to their child. They ask, "Why did you make our child draw on paper? We don't let our child draw at home." What is the best response by the nurse? "I should have asked you about drawing first." "These drawings help us determine your child’s intelligence." "It lets us test the child’s ability to perform tasks requiring the hands." "I don't understand why drawing is forbidden in your home." While obtaining the health history of a 15-month-old toddler, the child of a migrant worker, a nurse learns that the infant recently had a fever, runny nose, cough, and white spots in the mouth lasting 3 days. A rash started on the face and spread to the whole body. What communicable disease does the nurse suspect the infant suffered from? Rubella Rubeola Pertussis Varicella A nurse is assessing a 15-month-old girl at the well-child clinic. The nurse determines that further education about toddler development is necessary when the mother says what? "She's always trying to get out of her car seat." "She cries when I leave her at the daycare center." "She gets into everything and scatters toys everywhere." "She has a temper tantrum every time I put her on the potty chair." A nurse encourages parents to have their toddler's eyes tested especially for monocular strabismus. What should the nurse explain may occur if the condition is not corrected early? Dyslexia will develop. Peripheral vision will disappear. Vision in both eyes will be diminished. Amblyopia will progress in the weak eye. A nurse explains to the mother of a 1-year-old with a history of frequent ear infections that the primary cause of otitis media in young children is what?Sinusitis Recurrent tonsillitis An inflamed mastoid process An obstructed eustachian tube A 2-year-old child who has been restricted to bed rest because of a diagnosis of meningitis is now allowed out of bed. The nurse suggests going to the playroom. The child responds by shaking the head vigorously from side to side, screaming, "No! Won't!" However, the child is trying to climb out of the crib at the same time. In light of these behaviors, what is the most likely conclusion by the nurse? The child is trying to assert independence. The child is eager to resume regular play activities. The child is unsure of the difference between yes and no. The child is confused as a result of increased intracranial pressure. The parent of a 2-year-old calls a nurse who is a neighbor and reports that the child just ate several multivitamins with iron. What should the nurse say to the parent? "Give your child orange juice." "Call the Poison Control Center." "Iron-fortified multivitamins are safe for your child." "Administer an emetic—syrup of ipecac, if you have it." A nurse is observing hospitalized toddlers in the playroom. What does the nurse identify as their most important need? Stimulating play Therapeutic play Contact with their parents Gentle discipline from the nurse A nurse in the daycare center is teaching several aides about the play behavior of 2-year-old toddlers. What is this type of play called? Group Parallel Dramatic Cooperative A nurse in the pediatric clinic is examining a toddler with suspected enterobiasis (pinworm infestation). For which first sign of an infestation should the nurse assess the child? Anal itching Scaly skin patches Maculopapular rash Bald spot on the headA child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the best initial action by the nurse? Trying to open the jaw Placing the child on the floor Calling out for assistance from staff Placing a pillow under the child's head Which age range does the nurse know is classified as the toddler years? 12 to 18 months 12 to 24 months 12 to 36 months 12 to 48 months What step should the nurse undertake during the administration of eardrops in children ages 1 to 3 years? Pulling the auricle down and backward Placing the cotton ball in the innermost part of the canal Keeping the toddler in the side-lying position for 10 to 15 minutes Holding the dropper 3 cm above the child’s ear canal to instill the drops A nurse bases the plan of care for a 15-month-old toddler with celiac disease on the pathophysiology of the disorder, which is characterized by what? Inability to metabolize gluten Absence of the enzyme phenylalanine Excessive amount of salt in the sweat glands Increase in the viscosity of mucous secretions A parent asks a nurse for suggestions because a 2-year-old child wants to take a bath alone. What is the most appropriate suggestion that the nurse should provide? "Allow the child to wash herself with supervision." "Distract the child with other activities." "Instruct the child on how to take a bath alone." "Punish the child for insisting on taking a bath alone." At what age does the anterior fontanel of the skull close? 12 to 18 months 20 to 24 months 26 to 30 months 32 to 36 months After a 4-year-old child undergoes craniotomy the nurse performs a neurologic assessment that includes level of consciousness, pupillary activity, and reflex activity. What else should the nurse include in this assessment?Blood pressure Motor function Rectal temperature Head circumference According to the student nurse, in which stage of Erikson’s theory does the child initiate self-care activities? Initiative versus guilt Integrity versus despair Autonomy versus sense of shame and doubt Generativity versus self-absorption and stagnation How many words should the nurse expect the 3-year-old child to acquire each day? 2 to 3 5 to 6 8 to 10 11 to 13 An unconscious toddler requires intermittent nasogastric feedings. When should the nurse check placement of the tube? Once a day Before each feeding At every shift change During the night shift Which age should the nurse anticipate that a toddler-age client will begin to develop awareness of ownership? 15 months 18 months 24 months 30 months nurse is educating parents about the changes to expect when their child enters toddlerhood. Which information does the nurse include? The toddler’s body appears slender. The toddler has a protruded abdomen. The toddler’s feet are severely everted. The toddler has inconspicuous cervical curves. Which statement is true about the diet plan for toddlers? Refrain from serving finger foods. Toddlers need 4 to 6 cups of milk per day.Low-fat or skimmed milk should be given until the child is 2 years old. Milk should be supplemented with solid food items like vegetables and fruits. Which gross motor skill should the nurse anticipate when assessing a 15-month-old toddler-age client during a scheduled health maintenance visit? Using a cup well Creeping up stairs Scribbling spontaneously Building a tower of two blocks Which fine motor skill should the nurse anticipate when assessing a 15-month-old client during a health maintenance visit? Kneeling without support Standing without support Creeping up stairs without assistance Holding cubes in one hand without assistance 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? Limit restrictions to nonessential foods Handle dietary changes in a matter-of-fact way Have the dietitian explain the restrictions to the parents Arrange to have an adult other than a parent stay at mealtime 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? Asking the parents what they were told about the test Using a doll to demonstrate the procedure to the child Obtaining a pacifier for the child to suck on during the procedure Telling the parents that they may stay with their child during the test What does a nurse identify as the priority short-term goal for a toddler with dehydration caused by diarrhea? Improvement of fluid balance Continuation of an antidiarrheal diet Preservation of perianal skin integrity Retention of weight appropriate for height The nurse is preparing to conduct a scheduled health maintenance visit for a 15-month-old toddler-age client. Which information should the nurse include in the teaching session with the toddler’s parents related to socialization and cognition?Engages in parallel play Imitation of parental activities An elevated fear of strangers Tolerates long periods of parental separation A 3-year-old is placed in a bilateral hip spica cast for the treatment of developmental dysplasia of the hip. The nurse should teach the parents to monitor their child and report to the practitioner the occurrence of what? Warm toes Leg numbness Skin desquamation Generalized discomfort How are toddlers different from children of other age groups? Toddlers grow more rapidly than infants do. Toddlers need more calories than infants do. Toddlers have fewer febrile seizures than preschoolers do. Toddlers sleep more during the daytime than preschoolers do. Which topic should the nurse include in a teaching session for the parents of a 13-month-old toddler-age client? Gradual weaning from the bottle Signs of toilet training readiness Peer companionship during play Development of nighttime fears Which toddler-age client has reached a height in which it is no longer safe to sleep in a crib? 26 inches 28 inches 33 inches 36 inches What is the maximum recommended dose of an intramuscular injection in a toddler? 0.5 mL 1 mL 1.5 mL 2 mL A 3-year-old boy in respiratory distress is treated in the emergency department. A diagnosis of acute spasmodic laryngitis (spasmodic croup) is made. At the time of discharge, the mother asks how to handle another attack at home. What should the nurse recommend? Placing him near a cool-mist humidifierBringing him to the emergency department Giving him an over-the-counter cough syrup Offering him warm tea sweetened with honey A nurse in the emergency department notes large welts and scars on the back of a toddler who has been admitted for an asthma attack. What additional information must be included in the nurse's assessment? History of an injury Signs of child abuse Presence of food allergies Recent recovery from chickenpox Which description provided by the parent of a toddler-age client would suggest to the nurse that the child is experiencing sleep terrors? Sweating profusely Calling out after the dream Awakening during the second half of the night Being aware that others are in the room after awakening A parent of a 20-month-old toddler who has experienced an episode of diarrhea calls the pediatric clinic for advice. What instructions should the nurse give the parent, according to evidence-based practice for this situation? Limit the child's activities, withhold oral feedings, and call the clinic in 4 hours. Wrap the child snugly, offer sugar water, and bring the child to the clinic immediately. Allow the child to continue activities, withhold oral feedings for 24 hours, and call the clinic tomorrow. Continue the child's feedings as usual, observe the frequency of stools, and bring the child to the clinic tomorrow if the diarrhea continues. After a prolonged period in a regional hospital far from home to which the parents were unable to travel, an 18-month-old toddler becomes depressed, withdrawn, and apathetic. Eventually the toddler begins playing with toys and relating to others, even strangers. When the parents visit, the child ignores them. The parents tell the nurse that their child has forgotten them. How does the nurse explain the child’s behavior? The nurse suggests that they may be right and that their child will have to get to know them again. The behavior indicates approval of the staff and the child's understanding that they will not inflict bodily harm. The behavior reflects acceptance of the hospitalization and that the experience will enhance their child's maturation. This signifies typical behavior in toddlers who are separated from their parents for prolonged periods and that their child will need special attention from them.What does the nurse educate the mother of a toddler to do in order to promote safety? "Throw plastic grocery bags away." "Fill the crib with large, stuffed toys." "Put pacifiers around the neck of the toddler." "Place the toddler to sleep on his or her back." A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate? One who cannot stand on one foot One who builds a tower of seven blocks One who exhibits echolalia when speaking One who colors outside the lines of a picture What step should the nurse follow when taking a toddler’s blood pressure? Use an ultrasonic stethoscope. Choose a cuff labeled "toddler". Use a pediatric stethoscope bell to hear Korotkoff sounds. Place the stethoscope firmly on the antecubital fossa for good auscultation. What does the nurse explain happens during the transition from infanthood to toddlerhood? Reduced activity levels Increased need for fats Increased food choices Reduced need for sleep What is the priority nursing responsibility in the care of a young toddler after a circumcision? Limiting oral fluids Monitoring intravenous fluid intake Applying ice packs to the genital area Watching for bleeding around the penis A nurse is obtaining a health history from the mother of a 15-month-old toddler with celiac disease. The nurse expects the mother to indicate what about her toddler? Has bulky, foul, frothy stools Drinks large amounts of fluid Is irritable throughout the day Voids strong, concentrated urine While in the hospital's playroom a toddler suddenly has a nosebleed that leaves blood on the play table. What is the nurse's first response in this situation? Taking the child back to the room for care Providing nursing care to stop the nosebleedCalling the housekeeping department to clean the room Securing a prescription for the blood to be tested for pathogens What does the nurse state is the cause of frequent upper respiratory tract infections in toddlers? Stress Unhealthy diet Lack of exercise Immature immune system A toddler is admitted to the emergency department with a diagnosis of acute spasmodic laryngitis. After the spasms subside, the child is ready to be discharged. What should the nurse teach the parents to do at home to help prevent another croup episode? Perform postural drainage. Discourage before-bedtime snacks. Use a cool mist vaporizer in the child's room. Demonstrate to the child how to expel air after inspiration. Which statement by the nurse is true about health promotion in infants and toddlers? Allow a toddler to sleep on his side. Place pillows in the crib of an infant. Remove grocery plastic bags from the home. Keep pacifiers on a ribbon around a toddler’s neck. Which food should the nurse recommend for a toddler-age client who is at risk for developing rickets? Yogurt Carrots Fruit juice Dried fruit What is the cause of milk anemia in toddlers? Drinking skim milk Drinking whole milk Increased milk intake Increased intake of fruits Which characteristic related to achieving autonomy does the nurse anticipate when providing care to a toddler-age client? Ritualism Positivity Magical thinking Object permanenceAn 18-month-old toddler who stepped on a rusty nail is brought to the emergency department a week later. The nurse determines that the family lives in a rural area and that the toddler has never received health care. The child shows signs of generalized tetanus, including neck and jaw stiffness and facial muscle spasms. What does the nurse conclude is the cause of these clinical findings? Bacterial infection of the upper respiratory tissues progressing to sepsis and death Neuropathy caused by an allergic reaction to the presence of the invading organism Localized edema of the upper trunk and neck tissues resulting in obstruction of the airway Painful muscle rigidity caused by exposure of the nervous system to the exotoxin of the causative organism What is true about the effect of grief and loss in toddlers? They show resilience after a loss. They express a sense of change in sleeping. They understand the concepts of permanence. They get disrupted in developing an autonomous sense of self. What is an important nursing intervention in the care of a hospitalized toddler with cystic fibrosis? Discouraging coughing Performing postural drainage Encouraging active exercise Providing small, frequent feedings Which Korotkoff sound represents the diastolic blood pressure in toddlers? First Third Fourth Fifth What would the nurse state is true about a toddler’s sleep? Total sleep averages 12 hours a day. In the awake period, a toddler exhibits sleepwalking. A toddler normally takes several naps during the day. It is uncommon for toddlers to awaken during the night Which statement is true about the skeletal system of toddlers? The bones of toddlers are less pliable than those of older persons. The bones of toddlers have less cartilage than those of young adults. The bones of toddlers can better withstand falls than those of older adults. The bones of toddlers are more susceptible to osteoporosis than those of women.Which assessment data would cause the nurse to suspect that a toddler-age client is experiencing physical neglect? Abdominal distention Bloody underclothing Recurrent urinary tract infections Bruises in various stages of healing Which assessment data would cause the nurse to suspect that a toddler-age client is experiencing physical abuse? Abdominal distention Bloody underclothing Recurrent urinary tract infections Bruises in various stages of healing What would the student nurse claim is an acceptable respiratory rate range in a toddler of 2 years of age? 20 to 30 breaths/minute 25 to 32 breaths/minute 30 to 50 breaths/minute 35 to 40 breaths/minute The nurse notes that a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure. What is the priority nursing responsibility at this time? Applying restraints Administering oxygen Protecting the child from self-injury Inserting a plastic airway in the child's mouth During which health maintenance visit for a toddler-age client should the nurse assess the ability to throw a ball overhand without losing balance? 12 months 18 months 24 months 30 months While in the playroom of a pediatric unit the nurse sees several toddlers seated at a table trying to copy the same picture from a book. They are not talking to each other or sharing their crayons. What does the nurse conclude about this behavioral interaction? It is a typical expression of toddlers' social development. This is an example of antisocial behavior found in some children. It is a lack of parental role models to demonstrate acceptable behavior.This is an illustration of separation anxiety typical of hospitalized toddlers. At what age is a toddler-age client physiologically and psychologically prepared for toilet training? 13 months 16 months 19 months 22 months 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? Bacon and eggs Macaroni and cheese Tuna salad and rice cakes Chicken leg and corn on the cob Which toddler behavior should the nurse identify as global organization, a characteristic of preoperational thought? Yells at the chair for causing a fall Not wanting to eat food due to the color Refusal to sleep in bedroom because the bed has been moved Inability to understand that others have a different perspective A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and asks what to do. What is the best response by the nurse? Administer syrup of ipecac. Call the Poison Control Center. Take the child to the emergency department. Give the child bread dipped in milk to absorb the poison. Several 3-year-old girls in the daycare center are having a tea party with their dolls. The center's nurse concludes that this behavior is what? Evidence of abstract thought Appropriate make-believe play Inappropriate exclusion of boys Maladaptive use of magical thinking According to Erikson’s theory, which behavior would the student nurse explain that a toddler exhibits? The child gets casual about body appearance. The child starts performing self-care activities. The child suppresses feelings of the superego. The child becomes dependent on his or her siblings.What is the recommended size of the urinary catheter that can be used in a 3-year-old child? 5 to 6 Fr 8 to 10 Fr 14 to 16 Fr 16 to 18 Fr The nurse observes a 2-year-old child at play and concludes that the child is engaging in ageappropriate behavior for a toddler. Which activities lead the nurse to this conclusion? Select all that apply. Is possessive of toys Follows simple directions Can play simple card games Enjoys playing with other children Attempts to stay within the lines when coloring During a well-child visit the parents tell a nurse, "Our 3-year-old doesn't listen to us when we speak and ignores us!" An auditory screening reveals that the child has a mild hearing loss. What should the nurse explain to the parents about this degree of hearing loss? A severe hearing deficit may develop. It will not interfere with progress in school. An immediate follow-up visit is not necessary. Speech therapy in addition to hearing aids may be required. Which statement would the nurse state is true for toddlers? The incidence of poisoning is very common in toddlers. An 18-month-old child uses approximately up to 300 words. The average toddler gains 2 to 3 pounds (0.9 to 1.4 kg) each year. Toddlers prefer to engage in parallel play rather than in solitary play. Which method of drug administration does the nurse state is commonly used in toddlers when the child has poor intravenous (IV) access? Intrathecal Intraarterial Intraosseous Intraperitoneal A nurse is measuring the blood pressure of toddlers during a community health camp. What blood pressure finding is the nurse most often to find in the toddlers? 85/54 mm Hg 95/65 mm Hg 105/65 mm Hg 110/65 mm HgWhich statement is true regarding the importance of play for children? Pretend play hampers the cognitive development of children. Playing is important because it helps children to release frustration. Children should be introduced to reality if they have imaginary playmates. Children should completely avoid television, electronic games, and computer programs. A nurse is teaching the parents of an 18-month-old child the procedure for instilling ear drops. How should this procedure be done? By cleansing the ear canal before instilling the drops By applying medicated ear wicks after instilling the drops By pulling the pinna up and back after drop instillation to promote distribution of the drops By pulling the pinna down and back to straighten the auditory canal before instillation of the drops Which of these diseases would the nurse explain is mostcommon in toddlers? Influenza Lung cancer Hypertension Angina pectoris Which tasks related to dressing should the nurse expect the 2-year-old child to accomplish? Select all that apply. Putting on socks Pulling shoes off Fastening coats and jackets Extending the arm to place clothing Placing the shoe on the correct foot Why is it essential for the nurse to obtain the height and weight of a severely dehydrated toddler? The extent of dehydration is based on these measurements. These measurements are used as the baseline for future growth. The management of dietary needs is based on height and weight. The values are used to calculate fluid replacement and medication dosages. What safety measure should the nurse instruct parents to follow when their child is a toddler? Place window guards on all windows. Have the toddler sleep on the back or side. Start swimming training for the toddler under supervision. Teach the child how to cross streets and walk in parking lots.When teaching the parents of a toddler-age client about normal growth and development, which statements should the nurse include in the teaching session regarding learning through the senses? Select all that apply. "The toddler often puts new objects in the mouth." "The toddler may inspect a new toy by turning it over." "The toddler will touch a new object only once during exploration." "The toddler will shake a new toy when it is first introduced to the play area." "The toddler rarely uses the sense of smell to learn about something new introduced within the environment." Which age group does the nurse observe engaging in parallel play? Infants Toddlers Adolescents Preschoolers On the third day of a 2-year-old toddler's hospitalization the nurse notes that the child, who had been screaming and crying inconsolably, has begun to regress and is now lying quietly in the crib with a blanket. What stage of separation anxiety has developed? Denial Despair Mistrust Rejection Which is the priority topic when teaching the parents of a toddler-age client regarding the selection of toys? Cost Safety Creativity Appropriateness Which topics related to dietary intake should the nurse include in the plan of care for the parents of a toddler? Restriction of 100% juice products Variety of foods increases with age Vitamins to meet nutritional needs Large portions of all foods at each meal n 18-month-old toddler is admitted to the pediatric unit. The child has never been separated from the mother before this admission. What behavior does the nurse expect from the toddler? Sitting quietly, uninterested in playing Crying relentlessly and consoled by no one but a parentLooking sad but becoming content after meeting roommates Screaming when people enter the room but smiling after several minutes A nurse is assessing a toddler with plumbism (lead poisoning). Which organ system is of most concern because of the condition's irreversible effects? Urinary Skeletal Nervous Hematologic Which terms are appropriate for the nurse to use when documenting shaken baby syndrome in the medical record for a toddler-age client? Select all that apply. Stroke Concussion Abusive head trauma Neuroinflicted brain injury Inflicted traumatic head injury A nurse is teaching the parents of a toddler with a recent diagnosis of hemophilia about the disease. What area of the body should the nurse include as the most common site for bleeding? Brain Joints Kidneys Abdomen A nurse in the well-baby clinic determines that a 15-month-old toddler's motor development is age appropriate. Which behavior confirms this conclusion? Hopping on one foot Throwing and catching a ball Completing a four-piece puzzle Holding and scribbling with a crayon Which assessment finding should the nurse identify as a physical readiness cue for a toddler-age client related to toilet training? Having regular bowel movements Willing to invest the time needed Telling a parent that the diaper is wet Expressing a willingness to please parents How are toddlers different from infants? Toddlers grow at a slower rate. Toddlers are more prone to lead poisoning.Toddlers lack the anteroposterior curves of the spine. Toddlers face difficulties in recovering from upper respiratory tract infections (URTI). Which developmental milestone related to feeding does a nurse anticipate for a 36-month-old client? Select all that apply. Using a straw to drink Drinking well from a cup Chewing with the mouth closed during meals Beginning to use a fork by holding it in the fist Spilling small amounts of food when using a spoon A nurse must administer an intramuscular injection to a 15-month-old child. What is the reason that the nurse does not administer the injection into the gluteal muscle? Muscle mass in this area is undeveloped. Intrusive procedures in this area are feared. Toddlers associate this area with punishment. Toddlers wiggle away when positioned to access the area. A 3-year-old child has been experiencing chronic diarrhea, abdominal distention, and muscle wasting, and a tentative diagnosis of celiac disease has been proposed. The nurse determines that the teaching of the parents will need to include what? How to give daily injections The necessity of reading food labels carefully How to pace the child's activities to allow plenty of rest The need for respiratory therapy to keep airways clear of mucus Which is a developmental milestone related to feeding that the nurse anticipates for a 24-monthold client? Using a straw to drink Drinking well from a cup Beginning to use a fork by holding it in the fist Spilling small amounts of food when using a spoon A nurse is caring for a toddler with the diagnosis of nephrotic syndrome. What is the best indicator of kidney function in this toddler? Urine output Daily weights Abdominal girth Improved appetite Which toddler behaviors should the nurse identify as ritualism during the health history portion of the assessment? Select all that apply. Using the same cup with each mealBeing able to use a spoon efficiently Eating the same foods as other family members Refusing to eat if the different foods are touching Rejecting a meal because it is served in a different bowl A parent tells a nurse at the clinic, "Each morning I offer my 24-month-old juice, and all I hear is 'No.' What should I do? I know she needs fluid!" What is the best response by the nurse? Offer the child a choice of two juices. Distract the child with a favorite food. Offer the child the glass in a firm manner. Allow the child to see the parent getting angry. At 1 am a 28-month-old toddler is admitted to the pediatric unit with suspected meningitis. At 3 am, after the child is settled in, the mother tells the nurse, "I have to leave now, but whenever I try to go my child gets upset and then I start to cry." What is the best action by the nurse? Walking the mother to the elevator Encouraging the mother to spend the night Staying with the child while the mother leaves Telling the mother to wait until the child falls asleep The parents of a 2-year-old child tell the nurse that they are having difficulty disciplining their child. What is the most appropriate response by the nurse? "This is a difficult age that your child is going through right now." "Tell me more about your difficulty. I'm not sure what you mean." "It's important to be consistent with toddlers when they need discipline." "I totally understand what you mean. That's why they call it the terrible twos." A nurse in the pediatric clinic discusses the nutrition and feeding needs of an 18-month-old toddler with the child's parents. What information should the nurse include? Growth rate increases, so more protein is needed per pound (kilogram) of body size. Energy requirements become so high that more calories are needed to meet them. Struggling for autonomy may involve refusal of food, but they will eat the amount they need. Three meals a day should be offered, with no between-meal snacks, because they are finicky eaters. A toddler who lacks toilet training is admitted to a hospital. What does the nurse need to do when collecting urine samples from the toddler? Select all that apply. Squeeze urine from the diaper. Place a hat under the toilet seat. Convince the child to void in the unfamiliar receptacle.Attach single-use bags over the child’s urethral meatus. Use the terms for urination that the child can understand. A 13-month-old child is undergoing lumbar puncture for confirmation of a diagnosis of bacterial meningitis. During the procedure the nurse notes that the spinal fluid is cloudy. What does this finding indicate? Healthy spinal fluid Increased glucose level Increased white blood cell (WBC) count Rising number of red blood cells (RBCs) Which type of toy should the nurse recommend to the parents of a toddler-age client to enhance the child’s development? Clay Rattle Video games Musical mobile A 30-month-old child who was transferred to a regional hospital has not seen the parents for 2 weeks. The child now responds to the staff with friendliness and affection. When the mother visits the child turns away from her and ignores her. What should the nurse explain to the mother? "Your child has adapted so well and loves all of us and is so happy." "Your child misses you very much; give the child time to reach for you." "Toddlers usually cry when they see their mothers; your child is so mature." "Toddlers have such short memories; that's why your child doesn't remember you." A mother tells her neighbor, a nurse, that her toddler has been found to have parasites (worms) and that the whole family will need to be treated. She asks the nurse what kind of worm it is. What is the most likely type of worm infestation? Tapeworm ( Taenia) Pinworm ( Enterobius) Roundworm ( Ascaris) Hookworm ( Ancylostoma) A nurse determines that a 22-month-old child uses two- or three-word phrases (telegraphic speech), has a vocabulary of about 20 words, and often uses the word "me." What does the nurse conclude about the child's language development? It is delayed. It is advanced. It is appropriate. It is pathologic.What situation would the student nurse know may predispose a toddler to a sense of shame and doubt? The caregiver’s response is too harsh. The child is unable to establish companionship. The parents try to control the child and limit choices. The parents fail to establish a sense of trust in the child. dehydrated 15-month-old toddler is admitted to the pediatric unit with a diagnosis of intractable diarrhea. After several days of treatment the child is reevaluated. Which finding indicates to the nurse that the child's hydration status has improved? Increased heart rate Decreased blood pressure Increased capillary refill time Decreased urine specific gravity The mother of a 2-year-old toddler tells the nurse that her child is frequently constipated. The nurse asks the mother how she handles the child's toileting. Which response indicates to the nurse that the mother requires further education? "My child drinks a lot of fluids." "I give my child high-fiber foods." "My child has one bowel movement a day." "I schedule my child's toileting for before each meal." The mother of a 3-year-old child with rubeola states that she once heard that it was called by another name. The nurse tells the mother that rubeola commonly is known as what? Measles Chickenpox German measles Whooping cough A toddler who was physically abused is admitted to the pediatric unit. What behavior does the nurse expect when approaching the child? Smiling readily when anyone enters the room Exhibiting fear of physical contact initiated by anyone Beginning to cry when anyone approaches the bedside Paying little attention to anyone standing at the bedside Which assessment data would cause the nurse to initiate treatment for a potential aspirin overdose for a toddler-age child who presents in the emergency department (ED)? Select all that apply. Emesis NauseaTinnitus Ecchymosis Hypoventilation What foods should a nurse order for a 30-month-old toddler on a regular diet? Hamburger with bun and grapes Chicken fingers and French fries Hot dog with bun and potato chips Macaroni and cheese and Cheerios Which social development tasks should the nurse anticipate when assessing a toddler-age client during a health maintenance visit? Select all that apply. Separation Parallel play Irreversibility Individuation Temper tantrums A nurse is assessing a toddler with the diagnosis of lead poisoning. What is the most harmful adverse effect that the nurse anticipates? Inadequate nutrition Delayed development Anemia and constipation Renal and skeletal damage Which physical growth parameters should the nurse anticipate when assessing an 18-month-old client during a scheduled health maintenance visit? Select all that apply. Physiologic anorexia Growth needs decreased Anterior fontanelle remains open Primary dentation of sixteen teeth Chest circumference exceeds head circumference A nurse is teaching the mother of a toddler with celiac disease the specific foods allowed on the gluten-free diet. What is the mostimportant information for the nurse to help the mother understand? Corn flour is not included in the diet. Labels of prepared foods must be read carefully. Caloric intake is increased to compensate for a deficiency of proteins. The gluten-free diet is discontinued when the affected child starts kindergarten. A nurse is assessing an 18-month-old toddler with suspected developmental dysplasia of the left hip. In what position should the nurse place the toddler to elicit the Trendelenburg sign?Standing on the affected leg Supine with the back arched Side-lying on the unaffected side Sitting upright with the legs separated The nurse is teaching the parents of a toddler-age client who is prescribed iron supplements for iron-deficiency anemia. Which food should the nurse encourage the parents to provide to enhance absorption of iron? Cereal Spinach Whole milk Orange juice A nurse is counselling a parent about the changes a toddler may exhibit after the death of a family member. What should the nurse include in the counselling? Select all that apply. "The toddler will be resilient over the loss." "The toddler will understand the cause of the loss." "The toddler may have bowel or bladder disturbances." "The toddler may express changes in sleeping patterns." "The toddler will get disrupted in developing an autonomous sense of self." Which term should the nurse use to document the decreased appetite that often occurs during the toddler stage of development? Physiologic bulimia Psychologic bulimia Physiologic anorexia Psychologic anorexia The nurse is providing care to a toddler-age client during a health maintenance visit whose parents are expecting the birth of another child. Which statements should the nurse include in the teaching session to prepare the toddler-age client for the arrival of a new sibling? Select all that apply. "You should tell your child that a new playmate will be coming home." "You should begin to prepare your child now so there are no surprises." "You should promise your child that normal bedtime routines will continue after the baby is born." "You should buy your child a doll so that she can take care of her baby while you take care of the new baby." "You should include your child in the normal day to day activities with the new baby, such as helping with diaper changes."The parents of a toddler with newly diagnosed cystic fibrosis ask a nurse what causes the problems related to this disorder. What should the nurse consider about the primary pathologic process before responding? Hyperactivity of the eccrine (sweat) glands Hypoactivity of the autonomic nervous system Mechanical obstruction of mucus-secreting glands Atrophic changes in the mucosal lining of the intestines A nurse is caring for an 18-month-old toddler. What findings is the nurse likely to notice? The toddler’s urine appears golden yellow in color. The toddler excretes 400 to 500 mL of urine every day. The toddler can hold urine for a period of 1 to 2 hours. The toddler is unable to communicate his or her sense of urgency. Which teaching points regarding fine motor skills should the nurse include during the health maintenance visit for a 30-month-old toddler-age client? Select all that apply. "Your child should be able to draw circles." "Your child should be able to jump from a chair." "Your child should be able to jump with both feet." "Your child should have good hand-eye coordination." "Your child should be able to build a tower using eight blocks." An 18-month-old toddler who has received the appropriate immunizations on time is visiting the pediatric clinic for the next scheduled immunization. What vaccine should the nurse administer? Second hepatitis B (Hep B) vaccine Fifth inactivated polio vaccine (IPV) First pneumococcal vaccine (PCV) and influenza vaccine (Hib) Fourth diphtheria toxoid, tetanus toxoid, and acellular pertussis (DTaP) vaccine Which information should the nurse refrain from including when teaching a parent about changes that the child will exhibit after the first birthday? "The child won’t sleep as long." "The child will have more food choices." "The child will have an increased need for fats." "The child will exhibit an increased activity level." A nurse who is teaching a growth and development class to a group of parents at the daycare center explains that the toddler strives for a sense of what? Trust Industry Initiative AutonomyA nurse is educating a parent about language and psychosocial development in toddlers. Which statement made by the parent indicates a need for further teaching? "I should allow my child to feed herself." "I should provide graded independence to my child." "I should use the television for language and knowledge development." "I should keep interacting with my child to foster language development." Which neurologic manifestation should the nurse anticipate for a toddler-age client exposed to low doses of lead? Coma Paralysis Convulsions Learning difficulties What should a nurse do if a 2-year-old child insists on drinking milk from a cup without assistance? Select all that apply. Give the child a cup with two handles. Put a plastic bib around the child. Restrict the child to drinking without assistance. Divert the child to do other activities. Punish the child for insisting on drinking milk without assistanc The mother of a 2-year-old child expresses concern to the nurse in the pediatric clinic that her child still takes a bottle of milk to bed at night. How should the nurse explain to the mother that this practice should be stopped? Iron-deficiency anemia may occur. Infantile sucking needs are prolonged. The child is at increased risk for dental caries. Milk at bedtime precipitates inner ear infections. What action should the nurse take when using pulse oximetry to determine a toddler’s oxygen saturation? Using a single-use (tape-on) probe Placing the sensor probe on the finger Placing the sensor probe on the bridge of the nose Turning on the pulse oximeter before placing the sensor A nurse anticipates that an 18-month-old child who does not have hearing loss has acquired a vocabulary sufficient to enable him to communicate. What communication behavior should the nurse expect when assessing the 18-month-old toddler? Saying about 10 words Pointing while gruntingUsing four-word sentences Making babbling sounds A toddler-age child presents in the emergency department (ED) with an infected wound. The child’s mother states, "I don’t have time to take care of this." A review of the child’s medical record indicates that each appointment related to the wound was cancelled. Which should the nurse suspect based on the current data? Physical abuse Physical neglect Emotional neglect Psychologic abuse The nurse accompanies a 3-year-old child to the playroom. The toddler seems afraid to select a toy or activity. What age-appropriate play materials should the nurse offer? Select all that apply. Plastic tea set Mold and clay Play telephone Pencil and paper Simple electronic games The nurse plans to use the tympanic membrane method and an electronic infrared thermometer to measure a 2-year-old toddler’s temperature. What steps should the nurse take? Select all that apply. Pull the pinna up and back. Pull the pinna backward, up, and out. Refrain from applying pressure to the ejection button. Obtain the temperature from patient’s right ear if the nurse is right-handed. Point the covered probe toward the midpoint between the eyebrow and sideburn. A nurse in the pediatric clinic receives a call from a mother who states that her 2½-year-old child, whom she discovered in a kitchen cabinet, is crying that the mouth hurts. The child is drooling, and the tongue and gums are white. The nurse gives the mother the number of the Poison Control Center, telling her to call immediately because the nurse suspects that the child has ingested what? Iron capsules Aspirin tablets Furniture polish Dishwashing detergent Discharge planning for a toddler with newly diagnosed celiac disease includes instructions regarding dietary restrictions. What foods should the nurse recommend? Select all that apply. OatmealIce cream Rice cakes Corn crisps Whole-wheat toast The parents of a toddler with a right ventriculoperitoneal (VP) shunt for the treatment of hydrocephalus are taught about postoperative positioning. The nurse concludes that they understand the teaching when they state that they will place the toddler in what position? In the position that provides the most comfort On the back with a small support beneath the neck On the abdomen with the head turned to the left side Flat on the left side with the head and back supported Which should the nurse include information for at each health maintenance visit for the parents of a toddler-age client? Iron Plants Aspirin Corrosives Which should the nurse include in the plan of care for a toddler-age client who follows a vegetarian or vegan diet? Monitoring an arterial blood gas analysis Monitoring serum sodium concentrations Monitoring for hemoglobin and hematocrit Monitoring serum potassium concentrations A 30-month-old toddler is brought to the emergency department in acute respiratory distress, and a diagnosis of laryngotracheobronchitis (viral croup) is made. What is the mostimportant equipment for the nurse to have available when the child is admitted to the pediatric unit? Intravenous set Tracheotomy set Nasal cannula for oxygen Crib with padded side rails A nurse reviews the diet with the parents of a toddler with recently diagnosed celiac disease. What foods selected by the parents indicate that further teaching is needed? Frankfurters and baked beans Lamb chops and mashed potatoes All natural roast beef and French fries Hamburgers with no added fillers and tortilla chipsWhat behavior does a nurse expect from a toddler subjected to prolonged hospitalization with limited parental visits? Cheerful interactions with staff members Indications of sadness throughout the day Excessive crying when parents are not present Limited emotional response to the environment nursing instructor asks a student nurse about controlling a nosebleed in a toddler. Which statements made by the student indicate the need for further teaching? Select all that apply. "I should keep the child’s head tilted back." "I should keep the child in a sitting position." "I should put ice on the bridge of the child’s nose." "I should apply pressure to the anterior of the nose." "I should keep the child’s mouth closed for some time." For which clinical manifestations should the nurse monitor the toddler-age client diagnosed with lead toxicity associated with the neurologic system? Select all that apply. Anemia Ketonuria Glycosuria Distractibility Hyperactivity A 2-year-old child with previously diagnosed hemophilia is admitted to the pediatric unit for observation after a motor vehicle collision. The toddler has several bruises but no other apparent injuries. What is the nurse's specific concern regarding this child? Risk for falls Undetected injury Deficient fluid volume Development of infection Which statement is true about toddlers? Toddlers grow about 4.2 cm each year. Toddlers develop a sense of autonomy. Toddlers are aware of the danger of water. Toddlers gain approximately 2 to 4 pounds (0.9 to 1.8 kg) each year. A parent brings an 18-month-old toddler to the clinic. The parent reports, "My child is so difficult to please! He has temper tantrums and annoys me by throwing food from the table." What is the best response by the nurse? "Toddlers need discipline to keep them from developing antisocial behaviors.""Toddlers are learning to assert independence, and this behavior is expected at this age." "It's best to leave the toddler alone in the crib after calmly explaining why the behavior is unacceptable." "This is the way a toddler expresses needs, and your child's behavior is acceptable during the initiative stage of development." Based on Erikson’s theory of development, what should the nurse suggest to a mother of a toddler who harshly disciplines her child? "Your behavior may induce a feeling of isolation in your child." "You need to establish a sense of trust or the child may lose trust in you." "Your child needs support and love or may develop feelings of shame and doubt." "You need to control the child’s impulses or the child may suffer guilt and frustration." Which should the nurse share with the parents of a toddler-age client regarding a predominant change that occurs to the gastrointestinal system during this stage of development? Food is rejected due to texture Voluntary control of elimination Capacity of the stomach decreases Acidity of gastric contents increase Which action should the nurse recommend to the parents of a toddler-age client who has a difficult temperament when disciplining the child? Select all that apply. Ignoring the child’s behavior Implementing a time-out with the child Using physical containment with the child Making sustained eye contact with the child Allowing the child an appropriate time to adjust to a new situa The parent of a 2-year-old child with just-diagnosed cystic fibrosis expresses concern about the child's frailty and low weight. What is the most appropriate reply by the nurse? "Digestive enzymes will be given to help your child digest food." "Your child's appetite will improve once respiratory therapy is started." "Your child's coughing and shortness of breath prevent adequate chewing of food." "I suggest that you offer baby foods to your child because they are more easily digested." What would the nurse describe as a similarity between the growth and development of toddlers and preschoolers? Both gain 5 to 7 pounds per year. Both need an equal amount of calories. Both grow about 2.5 inches in height per year.Both need at least 12 hours of sleep every night. The nurse manager of the infection control service is teaching a class for nurses on the care of young children with viral infection–related diarrhea. What therapy should the nurse manager recommend? BRAT diet until after the diarrhea has stopped Antiviral agent until the prescription is finished Oral rehydration therapy until fluid balance is restored Antidiarrheal agent after each stool until stools become formed A nurse must administer a medication by means of injection to a 2-year-old whose parent is not present. What is the mosttherapeutic approach for the nurse to use? Avoiding telling the child beforehand, giving the injection, and then cuddling the child Demonstrating how an injection is given, telling the child why it is needed, and then gathering the equipment Giving a doll the injection, encouraging the child to give the doll an injection, and then giving the injection Warning the child about the injection just before administering it, saying that it is OK to cry, and then comforting the child A 2-year-old child is brought to the emergency department with fever, drooling, and agitation. The child is not coughing and is sitting upright and leaning forward. Which of the following interventions is the priority? Intravenous fluids and antibiotics Immediate removal of the parents from the room to keep the child calm Maintenance of the child in a prone position during transport to radiology Procurement of a crash cart and emergency airway management tools to be kept on hand during examination of the throat A toddler in the pediatric intensive care unit is on a ventilator. One of the nurses asks what should be done when condensation collects in the ventilator tubing. How should the nurse manager respond? Notify the physician assistant. Decrease the amount of humidity. Empty the fluid and reconnect the tubing to the ventilator. Measure the fluid and mark it on the intake and output record. For which client scheduled for a health maintenance visit should the nurse plan to draw initial labs for lead screening? 18-month-old toddler 36-month-old toddler 4-year-old preschooler 6-year-old school-agerThe parents of a 2-year-old child who is being admitted to the hospital tell the nurse that their child is accustomed to sleeping with a favorite blanket. What should the nurse do, knowing that the blanket is worn and dirty? Refuse to allow the parents to leave it. Allow the parents to give it to the child. Offer to wash the blanket later when the child is asleep. Suggest that the parents take this one home when they bring in another blanket. Which drugs should the nurse plan to use when administering chelation therapy to a toddler-age client to decrease the pain associated with intramuscular administration? Select all that apply. LMX-4 Fentanyl Procaine Ibuprofen Acetaminophen Which nursing action is the priority when administering chelation therapy for a toddler-age client? Assessing vital signs Monitoring urine output Conducting a behavioral assessment Providing education to reduce lead exposure The parent of a 14-month-old toddler asks the nurse how to proceed with bowel training. What is the best response by the nurse? Place the child on the toilet every 2 hours. Start by having the child sit on a potty chair. Avoid bowel training until the child is 2 years old. Begin before the child's diet consists mainly of solid foods. An 18-month-old toddler requires an intramuscular injection. As the nurse enters the room with the medication, the child begins to scream and flail about on the bed. The father is sitting at the child's bedside and gets up to leave. What action should the nurse take to best handle this situation? Allow the child to say good-bye to the father and then give the injection. Tell the father to return and comfort the child after the injection is given. Ask the father to stay to comfort the child while the injection is being given. Leave the room and ask another nurse to come in to hold the child during the injection. A 2-year-old child is admitted to the pediatric unit with a diagnosis of thalassemia major (Cooley anemia). The parents are told that there is no cure, but the anemia can be treated with frequentblood transfusions. The father tells the nurse he is glad that there is a treatment that "fixes" his child's problem. Before responding, the nurse should recall that blood transfusions do what? Correct the anemia, but may cause other problems Reverse the anemia, but also present a risk of hepatitis Are a supportive treatment; fewer will be needed as the child grows older Are a replacement for defective red blood cells; they are like giving insulin to a person with diabetes What is the recommended length of insertion of the enema tube in a child of 3 years? 1 to 2.5 cm 5 to 7.5 cm 7.5 to 10 cm 2.5 to 3.7 cm Which stages would the nurse explain that a toddler goes through, according to Freud’s theory? Select all that apply. Oral Anal Phallic Genital Latency The nurse is giving unlicensed assistive personnel (UAP) strategies to care for a 2-year-old child admitted to the hospital with severe diarrhea. Which strategies should the nurse provide? Limiting fluid intake Counting the number of wet diapers Weighing the child at the same time every day Encouraging a BRAT diet (bananas, rice, applesauce, and toast) A toddler has frequent temper tantrums. The parents ask a nurse how to limit this acting-out behavior. What should the nurse recommend? Ignore the tantrum whenever possible. Restrain the child whenever a tantrum begins. Move the child to a quiet area as soon as a tantrum begins. Visit the clinic to request medication to control the tantrum. A nurse is providing preoperative teaching to the parents of a toddler who is to undergo myringotomy. The nurse explains that the type of infection most common in children that are prone to otitis media is what? Viral Fungal BacterialRickettsial A toddler who swallowed drain cleaner is hospitalized for observation because of the risk for vomiting and aspiration. Over the next 24 hours the child does not exhibit any respiratory distress and does not vomit. At discharge the nurse emphasizes that the parents should monitor their child for the onset of what? Tonic-clonic seizures Yellow-tinged sclera Gagging and vomiting Abdominal pain and diarrhea What type of play does a nurse expect to see while observing a toddler in a playroom with other children? Parallel Solitary Cooperative Competitive A nursing instructor asks a nursing student about developmental changes in toddlers. Which statement by the student indicates the need for further teaching? "Toddlers have slightly everted feet while walking." "Toddlers have anteroposterior curves of the spine." "Toddlers have a slight swayback and protruding abdomen." "Toddlers have more gaps between the legs and feet while walking." Which statement regarding toddler behavior associated with animism should the nurse include in a teaching session with the parents during a health maintenance visit? "Your child may yell at his toy for causing a fall." "Your child may not eat green foods." "Your child may not be able to understanding that others have a different perspective." "Your child may refuse to play or sleep in his room when rearranged." Which of these behaviors will a nurse need to explain while counselling the parents of a 2-yearold child? Select all that apply. Animism Imagination Egocentrism Logical reasoning Concrete thinking A nursing instructor asks a nursing student about language development in toddlers. Which statement by the student indicates a need for further learning? "A 24-month-old child uses pronouns.""An 18-month-old child uses approximately 25 words." "A 24-month-old child has a vocabulary of up to 300 words." "A 36-month-old child can use simple sentences and follow some grammatical rules." When reviewing the results of a toddler's complete blood count, a nurse concludes on the basis of decreased hemoglobin and hematocrit levels that the child has iron-deficiency anemia. Which other laboratory findings are indicative of iron-deficiency anemia? Select all that apply. Microcytic red blood cells Hyperchromic red blood cells Low total iron-binding capacity Slightly reduced reticulocyte count Increased erythrocyte sedimentation rate What should the nursing instructor tell a student nurse to do if he or she finds it difficult to hear Korotkoff sounds in a toddler? "Try using an infant cuff instead." "Try giving the child more time to relax." "Try using the pediatric stethoscope bell instead." "Place the stethoscope firmly on the antecubital fossa." Which treatment should the nurse prepare to administer when providing care to a toddler-age client who presents after an accidental overdose of aspirin? Gastric lavage Activated charcoal Peritoneal dialysis Vitamin D injection Which activities can a child perform at 3 years of age? Select all that apply. Jumping rope Drawing triangles Turning doorknobs Holding crayons with fingers Eating with a spoon without rotating it Classifying objects based on size and color A 19-month-old boy who has been in the hospital for 2 weeks becomes increasingly withdrawn and mute. What is the mostappropriate nursing action? Offering distracting toysMoving him into a room with other children Encouraging the parents to stay with him as much as possible Providing sensory stimulation by assigning different nurses to care for him During the course of treatment a toddler is to receive an intramuscular injection. What is the priority nursing intervention that should be included in the plan of care to comfort the child? Distracting the toddler's attention with a toy car Telling the parents exactly what will be done to the toddler Giving the toddler the choice of having the injection now or later Involving the parents in comforting the toddler after the injection What instructions should the nurse give to the parents of a toddler? Select all that apply. "You should direct the actions of your child." "You should serve finger foods to your child." "You should give 5 cups of milk to your child daily." "You should give graded independence to your child." "You should use television to keep the child entertained." While reviewing the admission assessment the nurse finds that a 2-year-old child has not received immunization for measles, mumps, and rubella (MMR). At what age should the child have received this vaccine? 2 months 4 months 6 months 12 months A 2-year-old child who is hospitalized for repair of tetralogy of Fallot is seen squatting in the playroom. In response to this behavior, what should the nurse do? Administer oxygen through a mask. Call the respiratory therapist for a nebulizer treatment. Continue to observe the child if there are no other signs of distress. Notify the hea