The nurse is assessing an 18-month-old patient at a well-child visit. What findings would suggest a developmental delay?

Says two-word sentences.

Uses pincer grasp to eat Cheerio’s.

Removes shoes and socks.

Prefers to use the right hand.

Answer and Explanation

The Correct Answer is D

Choice A reason: Saying two-word sentences is an expected developmental milestone for an 18-month-old child. At this age, children should begin combining two words to form simple sentences, such as "more juice" or "mama go." This indicates normal language development.

Choice B reason: Using a pincer grasp to eat Cheerio’s is a typical fine motor skill for an 18-month-old child. The ability to pick up small objects between the thumb and forefinger demonstrates proper development of fine motor skills and hand-eye coordination.

Choice C reason: Removing shoes and socks is a common developmental milestone for an 18-month-old child. This task shows growing independence and the ability to perform basic self-care activities, which is a sign of normal development.

Choice D reason: Preferring to use the right hand may suggest a developmental delay because children typically do not show a strong hand preference (left or right) until around the age of 2 to 3 years. Early hand dominance can be a sign of an underlying issue, such as asymmetry in muscle strength or neurological development. It is important to assess further if a child shows a strong preference for one hand at this early age.

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Correct Answer is B

Explanation

Choice A reason: Cheese sauce may be high in fat and sodium, but noodles with cheese sauce are generally safe for an 11-month-old infant to consume in moderation. The primary concern for infants' diet is ensuring that foods are safe to swallow and do not pose a choking hazard, which noodles do not.

Choice B reason: Honey is not recommended for children under one year old due to the risk of botulism, a serious illness caused by a toxin produced by the bacterium Clostridium botulinum. Infants have underdeveloped immune systems that cannot fight off the toxin, making honey a potentially dangerous food choice for them.

Choice C reason: Cooked broccoli is generally a safe and nutritious food for an 11-month-old infant. It's a good source of vitamins, minerals, and fibre. However, it should be soft enough for the infant to chew and swallow without risk of choking.

Choice D reason: Cut-up cherry tomatoes are appropriate for an 11-month-old infant as long as they are cut into small, manageable pieces to prevent choking. Cherry tomatoes provide essential nutrients like vitamins A and C and can be a healthy addition to an infant's diet.

A. Feeding the baby while lying in the bassinet B. Periodically pausing the feeding C. Discarding the remaining milk after one hour D. Holding the baby upright during feedings

Correct Answer is A

Explanation

Choice A reason: Feeding the baby while lying in the bassinet can pose a significant risk of choking and improper feeding technique. Babies should be fed while being held in an upright or semi-upright position to ensure proper swallowing and to prevent aspiration of milk into their airways. This practice promotes bonding between the caregiver and the baby and supports the baby’s overall feeding development. Therefore, further teaching is required for parents who feed their baby while the baby is lying in the bassinet.

Choice B reason: Periodically pausing the feeding is actually a recommended practice as it allows the baby to burp and prevents overfeeding. It also gives the baby a break to catch their breath and reset their sucking pattern. This technique can reduce the risk of discomfort and gas. Hence, this behaviour does not require further teaching.

Choice C reason: Discarding the remaining milk after one hour is a proper practice because milk can spoil and become contaminated with bacteria, leading to potential health risks for the baby if consumed. It is important to ensure that the baby is fed with fresh milk to avoid any health issues. Therefore, this behaviour does not require further teaching.

Choice D reason: Holding the baby upright during feedings is a correct and recommended practice. This position helps to prevent ear infections, reduces the risk of choking, and promotes better digestion. It ensures that the milk flows steadily and safely into the baby's mouth, aiding in a more efficient feeding process. Thus, this behaviour does not require further teaching.

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The nurse is assessing an 18-month-old patient at a well-child visit. What findings would suggest a developmental delay?

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