Toddler and Preschool: 1 to 5 Years Practice Questions

62 multiple-choice questions on Toddler and preschool: 1 to 5 years for paramedic and EMT students, from Chapter 10 (Life Span Development). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

62 practice questions

1. The normal heart rate for a toddler is approximately:

   1. A. 90 to 150 beats/min
   2. B. 140 to 180 beats/min
   3. C. 50 to 90 beats/min
   4. D. 60 to 100 beats/min
   Show answer

   Answer: A. 90 to 150 beats/min

   It continues to decline as the child grows.

2. The normal respiratory rate for a preschooler is approximately:

   1. A. 12 to 16 breaths/min
   2. B. 20 to 30 breaths/min
   3. C. 8 to 12 breaths/min
   4. D. 30 to 50 breaths/min
   Show answer

   Answer: B. 20 to 30 breaths/min

   Rates fall gradually toward adult values.

3. Most children begin walking independently by about:

   1. A. 24 to 30 months
   2. B. About 3 years
   3. C. 8 to 10 months
   4. D. 12 to 18 months
   Show answer

   Answer: D. 12 to 18 months

   Falls and household injuries increase sharply once they do.

4. Separation anxiety typically peaks around:

   1. A. 10 to 18 months
   2. B. 5 to 6 years
   3. C. 24 to 36 months
   4. D. 2 to 4 months
   Show answer

   Answer: A. 10 to 18 months

   Keeping a caregiver nearby during assessment reduces distress.

5. Magical thinking in preschoolers means they may:

   1. A. Believe their thoughts caused the illness
   2. B. Understand illness as caused by germs
   3. C. Reason about cause and effect like adults
   4. D. Use fantasy to deny they are hurt at all
   Show answer

   Answer: A. Believe their thoughts caused the illness

   They may believe their thoughts or behavior caused an illness or injury. Reassure them that it was not their fault.

6. When assessing a toddler, the best approach is to:

   1. A. Separate the child from the caregiver first
   2. B. Examine quickly without explaining steps
   3. C. Start at the head and work toward the feet
   4. D. Start distally and save the head for last
   Show answer

   Answer: D. Start distally and save the head for last

   Start with the least threatening areas and leave the head and face for last. Toe-to-head assessment reduces fear in small children.

7. A toddler's language skills typically include:

   1. A. Full sentences by about 12 to 15 months
   2. B. Reading simple sight words by age 2
   3. C. Very little speech until about age 3
   4. D. Simple two-word phrases around 2 years
   Show answer

   Answer: D. Simple two-word phrases around 2 years

   Vocabulary grows rapidly. Use simple words and concrete explanations.

8. Toilet training generally begins:

   1. A. Around 18 months to 3 years
   2. B. Around 9 to 12 months
   3. C. Around 4 to 5 years
   4. D. After starting kindergarten
   Show answer

   Answer: A. Around 18 months to 3 years

   Readiness varies widely between children.

9. The leading cause of death in toddlers is:

   1. A. Infectious disease
   2. B. Childhood cancers
   3. C. Congenital anomalies
   4. D. Unintentional injury
   Show answer

   Answer: D. Unintentional injury

   This includes drowning, falls, and motor vehicle events. Supervision and home safety are the main preventive measures.

10. Toddlers are at particular risk of poisoning because they:

    1. A. Clear toxins more slowly than adults
    2. B. Are often given adult medications
    3. C. Cannot taste bitter substances
    4. D. Explore objects with their mouths
    Show answer

    Answer: D. Explore objects with their mouths

    Toddlers are mobile and curious, explore objects with their mouths, and can open many containers, so medications and cleaning products should be locked up. Toddlers clear many drugs as fast as or faster per kilogram than adults, caregivers do not routinely give them adult medications, and they can taste bitterness but often swallow a mouthful before reacting.

11. Peak incidence of foreign body airway obstruction occurs in:

    1. A. Infants under 6 months
    2. B. Adolescents and young adults
    3. C. Toddlers and preschoolers
    4. D. School-age children
    Show answer

    Answer: C. Toddlers and preschoolers

    Small round foods and toy parts are the common culprits.

12. Erikson described the toddler stage as:

    1. A. Trust versus mistrust
    2. B. Industry versus inferiority
    3. C. Identity versus role confusion
    4. D. Autonomy versus shame and doubt
    Show answer

    Answer: D. Autonomy versus shame and doubt

    This is why offering simple choices helps gain cooperation.

13. Toddlers are defined as ages:

    1. A. 1 to 3 years
    2. B. Birth to 1
    3. C. 5 to 7 years
    4. D. 3 to 5 years
    Show answer

    Answer: A. 1 to 3 years

    Preschool is 3 to 5.

14. A calm 2-year-old with a fever has a resting heart rate of 190. How should you interpret this?

    1. A. Normal for a toddler with a fever
    2. B. Abnormal; well above the normal toddler range
    3. C. Normal, since toddlers run 150 to 200 at rest
    4. D. Abnormal only if the blood pressure is also low
    Show answer

    Answer: B. Abnormal; well above the normal toddler range

    A resting toddler's heart rate is normally about 98 to 140 (PALS). Fever raises it modestly, but 190 at rest is tachycardia that needs evaluation for shock, sepsis, or a dysrhythmia such as SVT. A calm toddler's rate does not normally run 150 to 200. Hypotension is a late sign in children, so it must not be the threshold for concern. (This item replaces one whose range, 80 to 130, conflicted with ch10-s02-q001.)

15. A 3-year-old with a cough is breathing 52 times per minute at rest. This rate is:

    1. A. Tachypneic for her age
    2. B. Normal for a toddler
    3. C. Slow for her age
    4. D. Normal if she is asleep
    Show answer

    Answer: A. Tachypneic for her age

    Normal resting respiratory rates are about 24 to 40 for toddlers and 22 to 34 for preschoolers, so 52 is tachypnea, an early sign of respiratory distress or compensation for acidosis. It is not slow. A sleeping child should breathe at the low end of the range, which makes 52 more concerning, not less.

16. Toddler systolic blood pressure is approximately:

    1. A. 130 to 150
    2. B. 80 to 100
    3. C. 50 to 70
    4. D. 110 to 130
    Show answer

    Answer: B. 80 to 100

    Rough formula: 70 plus 2 times age in years is the lower limit.

17. Toddler growth is characterized by:

    1. A. Slower, steady gain with a leaner body
    2. B. Rapid weight gain similar to infancy
    3. C. Little to no gain until school age
    4. D. A pubertal-type growth spurt and weight gain
    Show answer

    Answer: A. Slower, steady gain with a leaner body

    Appetite decreases.

18. By 18 months, most toddlers can:

    1. A. Speak in full sentences of 5 words
    2. B. Ride a tricycle and jump in place
    3. C. Walk well and say 10 to 20 words
    4. D. Recognize letters and read simple words
    Show answer

    Answer: C. Walk well and say 10 to 20 words

    Vocabulary explodes after this.

19. By 2 years, most toddlers can:

    1. A. Hop on one foot and pedal a tricycle
    2. B. Speak fluently in full sentences
    3. C. Read simple words and write their name
    4. D. Run, climb, and use two-word phrases
    Show answer

    Answer: D. Run, climb, and use two-word phrases

    Terrible twos.

20. By 3 years, most children can:

    1. A. Read short picture books aloud by themselves
    2. B. Write their full first and last names
    3. C. Use short sentences and ride a tricycle
    4. D. Tie their own shoes reliably
    Show answer

    Answer: C. Use short sentences and ride a tricycle

    Many are also toilet trained. Strangers understand most speech.

21. By 4 years, most children can:

    1. A. Ride a two-wheel bicycle without help
    2. B. Write complete sentences without help
    3. C. Hop, draw stick figures, tell stories
    4. D. Read chapter books fluently on their own
    Show answer

    Answer: C. Hop, draw stick figures, tell stories

    Imaginative play.

22. By 5 years, most children can:

    1. A. Skip, dress themselves, and count
    2. B. Reason abstractly about hypotheticals
    3. C. Read fluently at an adult level
    4. D. Write multi-paragraph stories
    Show answer

    Answer: A. Skip, dress themselves, and count

    Ready for school.

23. Toddlers' understanding of cause and effect:

    1. A. Is developing, driving exploration and risk
    2. B. Is absent until the school-age years begin
    3. C. Makes them naturally cautious about hazards
    4. D. Is fully developed, similar to an adult's
    Show answer

    Answer: A. Is developing, driving exploration and risk

    They test everything.

24. Toddlers typically fear:

    1. A. Embarrassment and failure in front of peers
    2. B. Separation from caregivers and strangers
    3. C. Loss of privacy and modesty during exams
    4. D. Death, disability, and permanent scarring
    Show answer

    Answer: B. Separation from caregivers and strangers

    Keep caregiver close.

25. Preschoolers may believe illness is:

    1. A. Punishment for bad behavior
    2. B. A random event with no cause
    3. C. Caused by cold weather exposure
    4. D. Caused by germs passed between people
    Show answer

    Answer: A. Punishment for bad behavior

    Magical thinking.

26. Preschoolers interpret language:

    1. A. Abstractly, grasping metaphors
    2. B. Literally, word for word
    3. C. With adult-level nuance
    4. D. Through tone of voice only
    Show answer

    Answer: B. Literally, word for word

    Avoid phrases like "take your blood." Choose words carefully.

27. How should procedures be explained to a preschooler?

    1. A. After it is done, to avoid causing fear
    2. B. In detail, well ahead of time
    3. C. Simply and honestly, just beforehand
    4. D. In precise medical terminology
    Show answer

    Answer: C. Simply and honestly, just beforehand

    Preschoolers have a limited sense of time and fear the unknown, so use simple, honest words just before the procedure; long waits increase fear. Explaining only afterward removes the chance to prepare the child and erodes trust, detailed advance warnings give fear time to build, and medical terms are not understood at this age.

28. Allowing a toddler to hold a piece of equipment:

    1. A. Delays care without real benefit
    2. B. Reduces fear and builds cooperation
    3. C. Increases fear of the device itself
    4. D. Is unsafe and should be avoided
    Show answer

    Answer: B. Reduces fear and builds cooperation

    A stethoscope works well. Letting a toddler touch or hold a safe piece of equipment makes it familiar, which lowers fear of the device rather than raising it, takes only seconds, and builds cooperation.

29. A frightened 2-year-old has a possible broken forearm. In what order should you examine her?

    1. A. Examine the arm first, since it is the main complaint
    2. B. Start with the feet and trunk, and examine the arm last
    3. C. Examine the head first, as in an adult head-to-toe exam
    4. D. Skip the exam and splint the arm immediately
    Show answer

    Answer: B. Start with the feet and trunk, and examine the arm last

    With toddlers, start with the least threatening areas (toes to head) and examine the painful area last. Hurting them first ends cooperation and makes every later finding unreliable. A rapid look for other injuries is still needed before splinting.

30. Toddler injury patterns commonly include:

    1. A. Firearm injuries and assaults by peers
    2. B. Organized sports and overuse injuries
    3. C. Falls, burns, poisoning, and drowning
    4. D. Motor vehicle crashes as teen drivers
    Show answer

    Answer: C. Falls, burns, poisoning, and drowning

    Foreign body aspiration is also common. Supervision gaps.

31. A 20-month-old was found with an open bottle of his grandmother's pills. Why is this age group at highest risk?

    1. A. Toddlers read labels but misunderstand them
    2. B. Toddlers metabolize most drugs faster than adults do
    3. C. Toddlers explore by putting things in their mouths
    4. D. Toddlers usually take medicine deliberately
    Show answer

    Answer: C. Toddlers explore by putting things in their mouths

    Toddlers are mobile and curious and explore by mouth, but they do not understand danger, so unintentional ingestion peaks between 1 and 3 years. A single adult pill (for example, an opioid, calcium channel blocker, or sulfonylurea) can be fatal. Toddlers cannot read, do not ingest deliberately, and do not clear drugs faster.

32. Foreign body aspiration in toddlers most often involves:

    1. A. Liquids such as milk or juice
    2. B. Pieces of clothing and bedding fabric
    3. C. Small round foods and small toys
    4. D. Large objects such as toy balls
    Show answer

    Answer: C. Small round foods and small toys

    Grapes, nuts, and hot dogs are classic culprits. Cut foods small.

33. Button battery ingestion:

    1. A. A true emergency; burns within hours
    2. B. Safe to observe at home for a day
    3. C. Harmless; it passes in the stool
    4. D. Concerning only if the child is vomiting
    Show answer

    Answer: A. A true emergency; burns within hours

    It can cause esophageal burns within hours. Rapid transport.

34. Toddler drowning typically occurs in:

    1. A. Lakes during supervised swimming
    2. B. Rivers and fast-moving streams
    3. C. Ocean surf and riptides
    4. D. Bathtubs, buckets, and pools
    Show answer

    Answer: D. Bathtubs, buckets, and pools

    Seconds of inattention.

35. Scald burns in toddlers occur when:

    1. A. They touch a hot stove burner directly
    2. B. They pull hot liquids onto themselves
    3. C. They play with matches or lighters
    4. D. They play outdoors in strong sun
    Show answer

    Answer: B. They pull hot liquids onto themselves

    They pull hot liquids off surfaces or are placed in hot water. Turn pot handles in.

36. Which fracture pattern in a young child most strongly suggests abuse?

    1. A. Posterior rib fractures in an infant
    2. B. Toddler's fracture of the distal tibia
    3. C. Clavicle fracture from a short fall
    4. D. Forearm buckle fracture from a fall
    Show answer

    Answer: A. Posterior rib fractures in an infant

    Posterior rib fractures in an infant are highly specific for abuse: they come from forceful squeezing of the chest and almost never from falls, play, or CPR. A toddler's fracture is a subtle spiral fracture of the distal tibia in a newly walking child, usually from a simple twist or trip, so it is typically accidental. A clavicle fracture and a forearm buckle fracture are common accidental injuries when the mechanism (a short fall onto the shoulder or an outstretched hand) fits the story. Any fracture in a child who is not yet walking is concerning, and the mechanism must always fit the history and developmental stage.

37. Toilet training readiness is indicated by:

    1. A. Saying a few single words like no
    2. B. Reaching a set age, such as 12 months
    3. C. Being able to walk without any support
    4. D. Staying dry for periods, showing interest
    Show answer

    Answer: D. Staying dry for periods, showing interest

    Following simple directions is another sign. Pushing too early causes problems.

38. Preschool growth is:

    1. A. Faster than during the first year
    2. B. About 2 kg and 5 to 7 cm per year
    3. C. Minimal until the school-age spurt
    4. D. About 5 kg and 15 cm per year
    Show answer

    Answer: B. About 2 kg and 5 to 7 cm per year

    Body proportions become more adult.

39. Preschoolers' immune systems:

    1. A. Too weak to fight common viral infections
    2. B. Still dependent on maternal antibodies
    3. C. Developing; frequent infections are normal
    4. D. Fully mature and as strong as an adult's
    Show answer

    Answer: C. Developing; frequent infections are normal

    Daycare exposure increases infections. Six to eight colds a year is common.

40. Febrile seizures typically occur between:

    1. A. Birth and 6 months
    2. B. 5 and 10 years
    3. C. School entry and age 10
    4. D. 6 months and 5 years
    Show answer

    Answer: D. 6 months and 5 years

    Usually benign.

41. Toddler airway considerations include:

    1. A. Wide, with small tonsils and adenoids
    2. B. Fully developed and adult-like by age 2
    3. C. Adult-sized, with a rigid trachea
    4. D. Narrow, with large tonsils and adenoids
    Show answer

    Answer: D. Narrow, with large tonsils and adenoids

    Croup and epiglottitis age.

42. Preschoolers' ability to describe symptoms:

    1. A. Better than the caregiver's account
    2. B. Limited; they may point to the pain
    3. C. Absent until they begin attending school
    4. D. Reliable and as precise as an adult's
    Show answer

    Answer: B. Limited; they may point to the pain

    They may point or use simple words. Ask the caregiver too.

43. Preschoolers' concept of death:

    1. A. Death is temporary or reversible
    2. B. Death is an abstract biological event
    3. C. Death is final, as adults understand it
    4. D. Death is universal and inevitable
    Show answer

    Answer: A. Death is temporary or reversible

    They may ask when the person is coming back.

44. Autonomy in toddlers is supported by:

    1. A. Open-ended choices about the care plan
    2. B. Strict, consistent control
    3. C. Doing self-care tasks for them
    4. D. Offering simple choices
    Show answer

    Answer: D. Offering simple choices

    Erikson's toddler stage is autonomy versus shame and doubt. Simple, limited choices support autonomy: which arm for the blood pressure? Open-ended choices overwhelm a toddler, and rigid control or doing tasks for the child undercuts the growing sense of independence.

45. Initiative in preschoolers refers to:

    1. A. Starting play and activities with confidence
    2. B. Feeling guilt for wanting to try things
    3. C. Relying on adults to direct all activities
    4. D. Feeling shame about bodily control and toileting
    Show answer

    Answer: A. Starting play and activities with confidence

    Erikson's third stage.

46. Tantrums in toddlers are:

    1. A. A common indicator of abuse at home
    2. B. An abnormal sign that needs specialist evaluation
    3. C. Rare in healthy, well-parented toddlers
    4. D. Normal frustration with limited language
    Show answer

    Answer: D. Normal frustration with limited language

    They decline as language improves.

47. Separation during assessment of a toddler:

    1. A. Improves cooperation with the provider
    2. B. Is required for an accurate, private exam
    3. C. Has no meaningful effect on behavior
    4. D. Increases distress, so avoid it
    Show answer

    Answer: D. Increases distress, so avoid it

    Keep the caregiver present and examine on the caregiver's lap.

48. Praising a toddler during care:

    1. A. Has little effect yet
    2. B. Builds cooperation
    3. C. Is best saved for the end
    4. D. Prolongs the crying
    Show answer

    Answer: B. Builds cooperation

    You are so brave. Immediate, specific praise builds a toddler's cooperation. Praise does work at this age, it is most effective when given right away rather than saved for later, and it does not reward or prolong crying.

49. Toddler blood pressure should be measured with:

    1. A. An adult cuff for a more stable reading
    2. B. A small cuff covering one-third of the upper arm
    3. C. Whatever cuff is available on the unit
    4. D. A cuff covering two-thirds of the upper arm
    Show answer

    Answer: D. A cuff covering two-thirds of the upper arm

    Wrong cuff gives wrong readings.

50. A toddler who stops crying and becomes quiet during a serious illness:

    1. A. May be deteriorating
    2. B. Is likely improving
    3. C. Has been comforted
    4. D. Has simply fallen asleep
    Show answer

    Answer: A. May be deteriorating

    Quiet can be ominous.

51. A 4-year-old whose father was hurt in a car crash keeps saying, 'It's my fault, I was bad.' What explains this?

    1. A. Abstract reasoning about cause and blame
    2. B. He is lying to get attention from adults
    3. C. Magical thinking: he believes his behavior caused it
    4. D. He is showing signs of an early psychiatric disorder
    Show answer

    Answer: C. Magical thinking: he believes his behavior caused it

    Preschoolers think egocentrically and magically, so they often believe their thoughts or behavior caused illness or injury in themselves or others. Gently and clearly tell him it was not his fault. Children this age cannot yet reason abstractly about cause and blame, and this normal stage of development is not attention-seeking or mental illness.

52. Car seat requirements for toddlers:

    1. A. End when the child turns 2 years old
    2. B. Are optional for short local trips
    3. C. End once the child turns 1 year old
    4. D. Continue, guided by height and weight
    Show answer

    Answer: D. Continue, guided by height and weight

    Keep children rear facing as long as the seat allows, then forward facing with a harness, then a booster. Height and weight guide transitions.

53. Toddler dehydration assessment uses:

    1. A. Heart rate alone as the key indicator
    2. B. Mucous membranes, tears, and urine output
    3. C. Skin turgor alone, pinched on the abdomen
    4. D. Blood pressure as the earliest indicator
    Show answer

    Answer: B. Mucous membranes, tears, and urine output

    Capillary refill also helps. Weight loss is most accurate.

54. Toddlers' stomach capacity:

    1. A. Able to hold a full adult-sized meal
    2. B. Large relative to their small body size
    3. C. Similar in capacity to an adult's stomach
    4. D. Small, so they eat small frequent meals
    Show answer

    Answer: D. Small, so they eat small frequent meals

    Aspiration risk.

55. Vision in preschoolers:

    1. A. Still undeveloped until age 10
    2. B. Near adult acuity by about age 5
    3. C. Declining from its peak in infancy
    4. D. Blurry beyond about 12 inches
    Show answer

    Answer: B. Near adult acuity by about age 5

    Screening catches problems.

56. Which toddler finding is most concerning?

    1. A. Clinging tightly to the parent
    2. B. Active play around the room
    3. C. Crying when a stranger approaches
    4. D. Not resisting the exam at all
    Show answer

    Answer: D. Not resisting the exam at all

    A toddler who does not resist examination or cannot be consoled is seriously ill. Inconsolable or lethargic is serious.

57. Preschool language development includes:

    1. A. Single words only until age 5
    2. B. An adult-sized vocabulary by 4
    3. C. Little speech before school entry
    4. D. Complex sentences by age 5
    Show answer

    Answer: D. Complex sentences by age 5

    Vocabulary reaches thousands of words by age 5. Stuttering can be normal briefly.

58. Imaginary friends in preschoolers are:

    1. A. An early warning sign of psychosis
    2. B. Abnormal once a child reaches age 3
    3. C. Normal and part of imaginative play
    4. D. A common indicator of abuse or neglect
    Show answer

    Answer: C. Normal and part of imaginative play

    They fade with age.

59. Toddler nutrition concerns include:

    1. A. Protein deficiency in most households
    2. B. Picky eating, iron deficiency, choking
    3. C. Overeating from a rapidly growing appetite
    4. D. Dehydration as the only real concern
    Show answer

    Answer: B. Picky eating, iron deficiency, choking

    Reassure caregivers about picky eating.

60. Preschoolers' sense of time:

    1. A. Similar to an adult's sense of time
    2. B. Accurate to within a few minutes
    3. C. Absent until they learn to read
    4. D. Poor; soon means nothing concrete
    Show answer

    Answer: D. Poor; soon means nothing concrete

    Say after this one thing.

61. Reassuring a preschooler that a procedure will not hurt when it will:

    1. A. Is a kind, comforting choice
    2. B. Is standard pediatric practice
    3. C. Reduces fear for the procedure
    4. D. Undermines trust immediately
    Show answer

    Answer: D. Undermines trust immediately

    Say it may pinch for a moment.

62. The best position for examining a frightened toddler is:

    1. A. Prone with the face turned aside
    2. B. Standing beside the stretcher
    3. C. Sitting on the caregiver's lap
    4. D. Supine on the stretcher alone
    Show answer

    Answer: C. Sitting on the caregiver's lap

    Security improves cooperation.