Review the infant's developmental timeline and determine the most appropriate nursing response.
Trend
Choose your responses, then check the answer.
Explanation
Developmental surveillance must address both failure to gain skills and loss of previously acquired skills. Regression across communication, social gesture, and motor domains is a red flag regardless of a normal newborn hearing screen. The nurse should validate the caregiver's concern, arrange prompt standardized developmental screening and medical-developmental evaluation, and initiate early-intervention referral as appropriate without adopting a wait-and-see approach. Screening supports assessment but does not itself establish a diagnosis.
Correct Answer The pattern is developmental regression requiring prompt evaluation and referral.
Why It Fits The infant first acquired skills and later lost words, gestures, and standing ability across more than one domain.
Clinical Picture A prior normal screening result does not negate new developmental loss reported by a caregiver.
Memory Link Missing a milestone matters; losing a milestone escalates.
NCLEX Rule Developmental concerns arising during surveillance should trigger standardized screening and timely referral rather than waiting for the next routine interval.
Why the Alternatives Fail Reassurance alone, a delayed recheck, or assigning a diagnosis from screening evidence can delay needed assessment and services.
Sources
1AAP Developmental Surveillance and Screening Clinical Report
2NCSBN 2026 NCLEX-RN Test Plan
Pediatric primary careThe nurse compares milestone surveillance recorded at prior visits with the caregiver's current observations. Hearing screening at birth was documented as passed, and the infant has had no acute illness.
Developmental regression — Loss of a skill that a child had previously acquired.
Developmental surveillance — An ongoing process of eliciting concerns, observing the child, reviewing history, and tracking development at health visits.
Standardized developmental screening — Use of a validated tool to identify children who need more detailed developmental evaluation.