The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this child?

The child does not point to named body parts.

The child cannot say name, age, and gender.

The child cannot follow a series of two independent commands.

The child has a vocabulary of 40 to 50 words.

Answer and Explanation

The Correct Answer is A

A. The child does not point to named body parts. By the age of 2, most children can point to at least two body parts when asked. This ability indicates that the child understands and can process verbal instructions, which is a key cognitive milestone.

B. The child cannot say name, age, and gender. While knowing their name, age, and gender is important, it is more typical for children to achieve this milestone closer to 3 years old. Therefore, this would not necessarily indicate a developmental delay at 2 years.

C. The child cannot follow a series of two independent commands. By 2 years old, children should be able to follow simple two-step commands, such as "Pick up the toy and give it to me." This ability demonstrates their understanding and processing of sequential instructions.

D. The child has a vocabulary of 40 to 50 words. A vocabulary of 40 to 50 words is within the normal range for a 2-year-old. Most children at this age are expected to have a vocabulary of at least 50 words and start combining them into simple sentences.

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Correct Answer is B

Explanation

A. Raw carrots pose a choking hazard for a 2-year-old due to their hard texture. They should be cooked or cut into very small, soft pieces to be safe.
B. Bananas are soft and easily chewable, making them a safe and nutritious choice for a 2-year-old.
C. Grapes can also pose a choking hazard unless they are cut into small pieces or halved to prevent choking.
D. Celery is fibrous and can also pose a choking risk unless it is cut into very small pieces or prepared in a way that eliminates the risk of choking.

A. Encourage the parents to speak English to the child. B. Refer the child to a developmental specialist. C. Perform a developmental evaluation of the child. D. Ask the mother if the child uses Spanish words.

Correct Answer is C

Explanation

A. Encouraging the parents to speak English to the child may influence language acquisition but might not be the priority if there are concerns about speech development.
B. Referring the child to a developmental specialist could be considered, but conducting a developmental evaluation should be the first step to determine if intervention is needed.
C. Performing a developmental evaluation will provide a clearer understanding of the child's speech and language development to ascertain if there are delays or concerns.
D. While understanding if the child uses Spanish words is relevant, it may not be the priority over a comprehensive developmental assessment.

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