NCLEX-RNHealth Promotion and MaintenanceHard
A nurse is conducting a developmental screening for a 2-year-old child. The child is able to stack 6 blocks, use a spoon independently, and follow simple two-step commands. The parents express concern that the child is not yet putting together 3-word sentences. Which of the following actions should the nurse take?
- AAssess for other developmental delays, such as gross motor skills.
- BReassure the parents that this is within the normal range for language development.
- CProvide teaching on strategies to encourage language development at home.
- DRefer the child immediately for a speech and language evaluation.
Show answer & explanationAnswer & explanation
Correct answer: C. Provide teaching on strategies to encourage language development at home.
At 2 years old, children typically use 2-word phrases and have a vocabulary of 50-100 words, but the expectation for consistent 3-word sentences is closer to 2.5 to 3 years. Given the child is meeting other fine motor and receptive language milestones, there's no immediate need for a referral. However, providing parents with strategies to encourage language development is a proactive, appropriate nursing action to support the child's progress and address parental concerns.
Why the other options are wrong
- A. Assessing for other delays is part of a comprehensive screening, but the specific concern is language. Given the child's other reported skills, focusing on language support is more targeted.
- B. While within a broad normal range, simply reassuring without offering supportive strategies might miss an opportunity to encourage optimal development and address parental concern proactively.
- D. An immediate referral is premature. The child is meeting other milestones, and language development has a wide range of normal. Providing strategies first is a better approach.
Toddler Language Development
The process by which toddlers acquire and use language, including vocabulary, sentence structure, and communication skills.
- 18 months: 10-20 words, points to body parts.
- 24 months: 50-100 words, 2-word phrases.
- 36 months: 200+ words, 3-4 word sentences.
Memory trick: Words Build, Sentences Grow