A nurse is preparing to assess reflexes in a 3-day-old newborn who is currently asleep. Which reflex is most appropriately tested during the newborn's sleep state to evaluate neurological function?

A. Complete a screening test for autism spectrum disorder (ASD): By 12 months, most toddlers use simple words such as “mama” or “dada” with meaning. Absence of first words by 18 months is a red flag for possible developmental delay, including ASD, and warrants immediate standardized screening to allow early identification and intervention.

B. Ask the parent if the toddler has a history of hospitalizations or surgeries: Past medical history is relevant, but it does not address the immediate developmental concern of delayed expressive language. Developmental screening takes priority when milestone delays are identified.

C. Ask the parent about recent immunizations: Immunization history is important for preventive care but is unrelated to delayed speech development and does not guide immediate assessment or intervention for language delay.

D. Educate the parent that toddlers do not typically say their first word until 18–20 months of age: Most toddlers speak their first meaningful word well before 18 months. Providing reassurance without further evaluation delays necessary screening and early referral.

A. Prepare the child for venipuncture to obtain a blood sample for lead level testing: Confirming suspected lead poisoning requires measurement of a venous blood lead level. This diagnostic step is the priority because it establishes exposure severity and guides further management, including environmental interventions and possible chelation therapy.

B. Discuss the need for developmental assessments to evaluate the impact of lead exposure: Developmental evaluation is important because lead exposure can cause cognitive and behavioral effects, but it is addressed after confirming the diagnosis and determining the extent of exposure.

C. Document a detailed history of the child's growth and development, as well as manifestations of lead exposure: A thorough history supports overall assessment, but it does not take priority over obtaining objective laboratory confirmation needed to direct immediate care decisions.

D. Instruct the parents to remove peeling paint and clean dust in the home to reduce the risk of lead exposure: Environmental control measures are essential, but education and remediation should follow confirmation of lead exposure and collaboration with public health resources.