A nurse is caring for a client who has borderline personality disorder (BPD). As part of the client's plan of care, the nurse reviews the day's schedule with the client each morning. As the nurse begins to review the schedule with the client, the client says, "Why don't you shut up already? I can read it myself, you know!" Which of the following responses should the nurse give the client?

A. 6 years:

By the age of 6, children typically have developed more advanced motor skills and coordination. Descending stairs by placing both feet on each step and holding onto the railing may be considered overly cautious for a 6-year-old.

B. 5 years:

At the age of 5, children may still be refining their motor skills, but they are usually capable of descending stairs using a more fluid motion, such as placing one foot on each step. Holding onto the railing for support is common but may not be as necessary as in younger children.

C. 4 years:

This is the correct answer. At the age of 4, children often descend stairs by placing both feet on each step and holding onto the railing for support. This method allows for increased stability and safety as they continue to develop balance and coordination.

D. 3 years:

While some children may start to learn how to descend stairs independently by the age of 3, they are more likely to use a one-foot-per-step method or require close supervision. Placing both feet on each step and holding onto the railing for support is less common at this age.

Therefore, option C is the most appropriate age for the described behavior, as it aligns with typical developmental milestones for stair-descending skills in children.

A. "Try switching to a different formula." While switching formula might be an option if the infant is having feeding issues, projectile vomiting in a 2-month-old infant could indicate a more serious condition, such as pyloric stenosis. It's essential for the nurse to assess the infant's condition in person rather than recommending a formula change over the phone.

B. "Burp your baby more frequently during feedings." Burping the baby more frequently might help reduce gas but is unlikely to resolve projectile vomiting, which can be a sign of a medical issue requiring prompt attention.

C. "Bring your baby in to the clinic today." This response is the most appropriate because projectile vomiting in an infant, especially when combined with increased hunger, could indicate a serious condition like pyloric stenosis or other gastrointestinal problems. The infant needs to be assessed by a healthcare provider as soon as possible to determine the cause and initiate appropriate treatment.

D. "Give your infant an oral rehydration solution." Oral rehydration solutions are typically used to replenish fluids lost due to vomiting or diarrhea. However, in this case, the priority is to determine the cause of the projectile vomiting, which requires a thorough assessment by a healthcare provider.