The nurse is caring for a hospitalized toddler.
What does the nurse determine is the most appropriate play activity for this client?

Choice A rationale

This is a significant underestimation of a 2-3 year old's language skills. While a toddler can follow commands, their expressive language is also developing rapidly. They typically transition from single words to multi-word sentences and have a vocabulary of several hundred words. The lack of speech would be a cause for concern and would require further developmental evaluation.

Choice B rationale

This is the expected language skill level for a 2-3 year old toddler. At this stage, a toddler's vocabulary expands significantly, and they begin to combine words into simple sentences. This two-word stage, often called "telegraphic speech," is a key milestone and indicates the child is beginning to understand and apply grammatical rules.

Choice C rationale

This is an overestimation of a 2-3 year old's language skills. While their vocabulary is growing, their speech is not typically fully clear or understandable to all listeners. They may still mispronounce words or omit certain sounds. Full clarity of speech is usually not achieved until 4 or 5 years of age.

Choice D rationale

This is an overestimation of a 2-3 year old's vocabulary. The typical vocabulary for a 2-year-old is around 50 words, and by age 3, it may increase to around 200-300 words. A vocabulary of 800-900 words is more characteristic of a 4 to 5 year old and is not the expected norm for this age group.

Choice A rationale

Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. Steroids have immunosuppressive properties and can exacerbate bacterial infections by hindering the body’s ability to fight off the pathogens. Therefore, steroid creams are contraindicated and would not effectively treat the sores, as they would likely worsen the condition and delay healing.

Choice B rationale

The statement indicates an understanding of the importance of completing the full course of antibiotics to eradicate all of the bacteria. Discontinuing the medication prematurely can lead to antibiotic resistance and a recurrence of the infection, as some of the bacteria may survive and proliferate. Finishing the entire prescription ensures complete elimination of the pathogens.

Choice C rationale

Impetigo sores should not be covered with a tight dressing, as this can trap moisture and heat, creating an ideal environment for bacterial growth and proliferation. While the sores should be kept clean and dry, covering them daily with an occlusive dressing is generally not recommended. This can worsen the infection and hinder the drying and healing process.

Choice D rationale

Impetigo is highly contagious, but it is primarily spread through direct contact with the sores. While thumb sucking could potentially transfer bacteria from the hands to the face, it is not the primary route of transmission or a specific treatment concern. The focus should be on proper hand hygiene and avoiding scratching or picking at the lesions, which is the main way the infection spreads.