The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish?

Choice A reason: Play dates maintain social contact but disrupt the 3-year-old’s preschool routine, which provides stability. Continuing preschool supports normalcy and security, making this less effective and incorrect compared to maintaining the familiar structure of school for a child with leukemia.

Choice B reason: Keeping the child home for one-on-one time may isolate her, reducing social interaction critical for a 3-year-old’s security. Preschool attendance fosters normalcy, making this overly restrictive and incorrect compared to supporting the child’s routine and social needs during leukemia treatment.

Choice C reason: Continuing preschool as much as possible maintains routine and social connections, fostering security for a 3-year-old with leukemia. This aligns with pediatric psychosocial care for chronic illness, making it the correct recommendation to help the child feel secure during her treatment.

Choice D reason: Special family outings are bonding but disrupt the 3-year-old’s preschool routine, which provides consistent security. Continuing school is more stabilizing, making this less consistent and incorrect compared to maintaining the child’s normal preschool environment to support her sense of security.

Choice A reason: Complying with a babysitter despite being upset shows adaptability, not initiative, which involves self-directed tasks. Attempting to clean cereal reflects proactive behavior, making this less indicative and incorrect compared to an activity demonstrating the 4-year-old’s initiative in the developmental assessment.

Choice B reason: Trying to sweep spilled cereal and crying when failing demonstrates initiative, as the 4-year-old independently attempts a task, a hallmark of Erikson’s initiative stage. This aligns with pediatric developmental milestones, making it the correct activity to document for assessing the child’s growth and development status.

Choice C reason: Refusing to hold hands while crossing the street indicates defiance, not initiative, which involves purposeful self-started activities. Cleaning cereal better reflects initiative, making this incorrect, as it shows autonomy rather than the proactive behavior expected in the initiative stage of development.

Choice D reason: Blaming a broken dish on a fictional friend shows guilt avoidance, not initiative, which involves taking on tasks independently. Attempting a cleanup task is more indicative, making this incorrect compared to the proactive behavior of sweeping cereal in the 4-year-old’s developmental assessment.