The nurse is assessing a 1-year-old infant in the pediatric office.
What finding should the nurse report to the physician immediately?

Choice A rationale:

Ignoring an imaginary friend may not be the best approach, as having an imaginary friend is a normal part of a preschooler's development. Engaging with the child and their imaginary friend can be a positive way to foster their creativity and imagination.

Choice B rationale:

Having imaginary friends is not necessarily a sign of low self-esteem. Imaginary friends are a way for preschoolers to explore their creativity and social development.

Choice C rationale:

It is common for preschoolers to have imaginary friends. Imaginary friends are a normal part of a child's imaginative play and are often seen as a healthy aspect of their development.

Choice D rationale:

Preschoolers often invent imaginary friends as a way to cope with various emotions and situations, but it's not necessarily an indication that they feel overwhelmed. It's more about their natural inclination towards imaginative play.

Choice A rationale:

When providing anticipatory guidance for parents of a toddler, it's important to emphasize positive discipline strategies. Setting limits and boundaries for a toddler's behavior is essential for their development, but it should be done in a positive and constructive way. Praise is an effective tool to reinforce good behavior and encourage positive actions. By praising a toddler when they follow the rules or display desirable behavior, parents can reinforce these behaviors and encourage them to continue. This positive reinforcement helps in shaping the child's behavior in a more effective way. It's important for parents to remember that praise should be specific and genuine to have the desired impact.

Choice B rationale:

Adhering to a rigid schedule because the toddler is ritualistic is not the best approach. While it's true that some toddlers may exhibit ritualistic behavior, imposing a rigid schedule may not always be necessary or beneficial. Each child is unique, and their needs and routines may vary. It's essential for parents to be flexible and responsive to their toddler's individual needs while still providing structure and boundaries.

Choice C rationale:

Dressing the toddler in pants with a zipper is not directly related to anticipatory guidance for parents. While it's important for toddlers to learn self-help skills like zipping and unzipping clothes, this is not the primary focus of anticipatory guidance. Anticipatory guidance should center on broader topics such as discipline, safety, and developmental milestones.

Choice D rationale:

The statement about shoes fitting snugly at the toe and arch is unrelated to anticipatory guidance for parents of toddlers. While proper-fitting shoes are important for a child's comfort and foot health, this is not a central topic when discussing guidance for parents of toddlers. Anticipatory guidance for this age group should focus on developmental milestones, safety, nutrition, and positive discipline strategies.