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Difficulty: HardDevelopmental Stages and Transitions

At an outpatient health center, a practical nurse assists with a 12-month-old infant's wellness examination. Which finding should the nurse recognize as a deviation from expected developmental transitions that requires reporting to the registered nurse?

  1. The infant uses a raking motion with the entire hand to pick up small oat cereals.Answer
  2. B
    The infant's anterior fontanel remains open, flat, and soft to the touch.
  3. C
    The infant's head circumference measurement is equal to their chest circumference.
  4. D
    The infant repeatedly drops a toy from the examination table and looks down to watch it fall.

Answer

The infant using a raking motion with the entire hand to pick up small oat cereals.
By 12 months of age, an infant should have developed a neat, precise pincer grasp (using the thumb and index finger) to pick up small objects. Using a whole-hand raking motion is a fine motor milestone typically expected around 6 to 7 months of age. The persistence of a raking grasp at one year indicates a developmental delay in fine motor skills that must be reported for further evaluation.

Step-by-Step Solution

1
Analyze the fine motor behavior described in the options.
The infant is using a raking grasp instead of a pincer grasp.
Fine motor skills progress from gross hand movements to precise finger movements. A 12-month-old should use a neat pincer grasp. A raking grasp indicates a delay.
2
Evaluate the anatomical finding regarding the fontanel.
The anterior fontanel is open, flat, and soft.
This is a normal finding because the anterior fontanel does not typically close until 12 to 18 months of age.
3
Evaluate the physical growth measurements.
The head circumference equals the chest circumference.
This equalization occurs naturally around 1 to 2 years of age and represents normal physical development.
4
Analyze the cognitive and play behavior.
The infant drops a toy and watches it fall.
This behavior confirms the development of object permanence and cause-and-effect understanding, which are expected cognitive milestones at 1 year.

Key Concept

Infant Developmental Milestones (12 Months)
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Topics

Developmental Stages and Transitions

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