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NurseDive Free Nursing Practice Question
A nurse is caring for a 3-year-old child whose parents report that she has an intense fear painful procedures, such as injections. Which of the following strategies should the nurse add to the child's plan of care? (Select all that apply.)
A. Have a parent stay with the child during procedures.
For toddlers, parents are the primary source of security. Their presence helps decrease the child's anxiety and provides emotional support during stressful events.
B. Allow the child to keep a toy from home with her.
Transitional objects (like a favorite teddy bear or blanket) provide a sense of home and safety in an unfamiliar hospital environment.
C. Cluster invasive procedures whenever possible.
While we often cluster care to allow for rest, clustering invasive or painful procedures can be overwhelming and traumatic for a small child. It is better to allow the child time to recover and regain a sense of safety between painful events.
D. Perform the procedure as quickly as possible.
While you should explain the procedure in simple terms right before it happens, toddlers have a limited attention span and high anticipatory anxiety. Completing the task quickly and efficiently reduces the duration of distress.
E. Use mummy restraints during painful procedures
Restraints should be a last resort. For a 3-year-old, therapeutic holding by a staff member or parent is preferred over mechanical or mummy restraints, which can increase fear and a sense of loss of control.
This question is an excerpt from Nurse Dive's nursing test bank - Paediatrics ATI Proctored Exam. Take the full exam now
Similar Questions
A nurse working in a pediatric clinic recognizes the three most common toxins in pediatric care?
A. Pesticides
B. Air pollution
C. Pharmacuetical
D. Lead Poisoning
Full Explanation
Lead is a toxic metal that can be found in old paint, dust, soil, and certain consumer products. Children are particularly vulnerable to lead poisoning, which can lead to developmental delays, learning difficulties, and other health problems.
Pesticides are chemicals used to control pests, such as insects and rodents. Children can be exposed to pesticides through contaminated food, water, or direct contact with treated areas. Pesticide exposure has been linked to various health issues, including neurodevelopmental disorders and respiratory problems.
Certain medications can be toxic to children, especially if taken in excessive amounts or without appropriate supervision. Accidental ingestion of medications, including over-the-counter and prescription drugs, is a significant concern in pediatric care.
While air pollution is a significant environmental factor that can impact children's health, it is not typically considered one of the most common toxins in pediatric care.
A nurse is providing health promotion teaching to the parents of a toddler. Which of the following information should the nurse include in the teaching? (Select all that apply.)
A. Need for increased caloric intake
Toddlers experience slowed growth compared to infancy, leading to a natural decrease in appetite (physiologic anorexia). Instead of increasing caloric intake, parents should be encouraged to offer nutrient-dense foods in small, frequent meals and avoid pressuring the child to eat.
B. Management of tantrums
Tantrums are common in toddlers as they begin to assert independence but struggle with emotional regulation. Parents should use strategies such as remaining calm, setting clear limits, offering choices when appropriate, and using positive reinforcement to help manage tantrums effectively.
C. How to establish trust
Establishing trust is a key developmental task of infancy (Erikson’s trust vs. mistrust stage). In toddlerhood (autonomy vs. shame and doubt stage), the focus is on developing independence, so guidance should focus on setting boundaries, providing choices, and allowing safe exploration rather than trust-building alone.
D. How to encourage cooperative play
Cooperative play is typically aimed at older preschoolers and not toddlers, who are still developing social skills and tend to engage in parallel play rather than cooperative play.
E. Dental care
Early dental hygiene is crucial for preventing cavities and establishing good oral health habits. Parents should begin brushing their toddler's teeth with a soft toothbrush and a small amount of fluoride toothpaste and schedule the first dental visit by 12 months of age or within 6 months of the first tooth eruption.
Full Explanation
A. Toddlers experience slowed growth compared to infancy, leading to a natural decrease in appetite (physiologic anorexia). Instead of increasing caloric intake, parents should be encouraged to offer nutrient-dense foods in small, frequent meals and avoid pressuring the child to eat.
B. Tantrums are common in toddlers as they begin to assert independence but struggle with emotional regulation. Parents should use strategies such as remaining calm, setting clear limits, offering choices when appropriate, and using positive reinforcement to help manage tantrums effectively.
C. Establishing trust is a key developmental task of infancy (Erikson’s trust vs. mistrust stage). In toddlerhood (autonomy vs. shame and doubt stage), the focus is on developing independence, so guidance should focus on setting boundaries, providing choices, and allowing safe exploration rather than trust-building alone.
D. Cooperative play is typically aimed at older preschoolers and not toddlers, who are still developing social skills and tend to engage in parallel play rather than cooperative play.
E. Early dental hygiene is crucial for preventing cavities and establishing good oral health habits. Parents should begin brushing their toddler's teeth with a soft toothbrush and a small amount of fluoride toothpaste and schedule the first dental visit by 12 months of age or within 6 months of the first tooth eruption.
A parent of a toddler asks a nurse at a well-child visit how the child's frequent temper tantrums can best be handled. Which of the following actions should the nurse suggest to the parent?
A. Distract the child by offering to play a game.
Distracting the child with a different activity or redirecting their attention can help diffuse the situation and shift their focus away from the tantrum. Offering to play a game or engage in a preferred activity can help redirect their energy and emotions. Telling the child that temper tantrums are not acceptable may not be effective as toddlers may not fully comprehend or control their emotions yet. Ignoring the tantrums can also be challenging as it may reinforce the behavior or escalate the intensity. Physically restraining the child is not recommended as it can be distressing for the child and potentially cause harm. It is important to use positive and supportive strategies to manage and address temper tantrums in toddlers.
B. Tell the child that temper tantrums are not acceptable.
C. Ignore the temper tantrums.
D. Restrain the child physically.
Full Explanation
Distracting the child with a different activity or redirecting their attention can help diffuse the situation and shift their focus away from the tantrum. Offering to play a game or engage in a preferred activity can help redirect their energy and emotions.
Telling the child that temper tantrums are not acceptable may not be effective as toddlers may not fully comprehend or control their emotions yet. Ignoring the tantrums can also be challenging as it may reinforce the behavior or escalate the intensity.
Physically restraining the child is not recommended as it can be distressing for the child and potentially cause harm. It is important to use positive and supportive strategies to manage and address temper tantrums in toddlers.