The nurse reviews an 18-month-old child’s developmental history. Which findings require follow-up? Highlight the findings that warrant developmental screening or early evaluation.
Highlight in Table
Choose your responses, then check the answer.
Explanation
Not walking independently, using only parent names, and losing a previously acquired gesture require follow-up. Missed milestones or skill loss should prompt timely screening and referral.
Quick answer Highlight not walking independently, saying only “mama” and “dada,” and losing the ability to wave. These are absent or lost skills expected in developmental surveillance at 18 months.
Why this is correct CDC milestones describe skills that most children can do by a given age, including independent walking and trying at least 3 words beyond parent names. A missed milestone or regression should lead to prompt discussion, validated screening, and early-intervention referral when indicated.[2]
Easy analogy or mental picture Think of milestones as dashboard lights, not a final diagnosis. One light that has not appeared or a light that turns off calls for a closer check; the picture supports early action but cannot replace standardized developmental screening.
Memory hook Missing, lost, or concerning: screen and act early.
NCLEX decision rule For pediatric development, distinguish normal variation from a missed age-based milestone or any regression; do not reassure away lost skills, and use validated screening plus referral rather than diagnosing from a checklist alone.
Why the other choices are wrong Finger feeding, pointing to share interest, following a one-step direction without gestures, scribbling, and simple toy play are expected 18-month skills. Their presence supports development but does not erase concern about another missing or lost domain.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
CDC: Milestones by 18 MonthsCenters for Disease Control and Prevention