During the assessment of an 18-month-old infant, the mother expresses concern to the nurse about the infant's inability to toilet train. What would be the nurse's best response?
a. "Some children are just more difficult to train, so I wouldn't worry about it yet."
b. "Have you considered reading any of the books on toilet training? They can be very helpful."
c. "This could mean that there is a problem in your baby's development. We'll watch her closely for the next few months."
d. "The nerves that will allow your baby to have control over the passing of stools are not developed until at least 18 to 24 months of age."
ANS: D
The infant passes stools by reflex. Voluntary control of the external anal sphincter cannot occur until the nerves supplying the area have become fully myelinated, usually around 1 to 2 years of age. Toilet training usually starts after the age of 2 years.
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