Examkin

Question

Difficulty: MediumDevelopmental Stages and Transitions

A pediatric nurse is performing a comprehensive developmental assessment on an 18-month-old client during a health maintenance visit. Which of the following assessment findings should the nurse identify as indicating a potential developmental delay?

  1. The toddler uses a whole-hand palmar grasp to pick up small objects.Answer
  2. B
    The toddler turns multiple pages of a cardboard book simultaneously.
  3. C
    The toddler plays with toys independently next to other children without interacting.
  4. D
    The toddler exhibits strong resistance and crying when the caregiver leaves the room.

Answer

The toddler using a whole-hand palmar grasp to pick up small objects indicates a developmental delay.
Fine motor development follows a predictable proximodistal pattern. The palmar grasp reflex disappears by 4 to 6 months, and voluntary grasping evolves until a mature pincer grasp (using the thumb and index finger) is fully developed by 10 to 12 months of age. An 18-month-old child who continues to use a whole-hand palmar grasp to pick up small objects is demonstrating a significant fine motor delay that requires further neurological and developmental evaluation.

Step-by-Step Solution

1
Evaluate the fine motor skills of the 18-month-old client.
Identify that using a palmar grasp is abnormal, as a mature pincer grasp should develop by 10 to 12 months.
Fine motor development progresses from gross whole-hand movements to precise finger movements.
2
Assess the play behavior presented in the scenario.
Recognize that parallel play is the expected social norm for the toddler age group.
Toddlers play alongside, but not directly with, other children until associative play begins in the preschool years.
3
Analyze psychosocial and behavioral findings.
Determine that separation anxiety and turning multiple pages at once are age-appropriate behaviors for an 18-month-old.
Differentiating normal developmental stages from pathological delays is critical in pediatric nursing to avoid unnecessary referrals.

Key Concept

Developmental Milestones of the Toddler
Rate this question

Topics

Developmental Stages and Transitions

More questions from this topic