# Stage 2 — Analyze cues. Complete the four statements that distinguish safe sleep, developmental screening, iron screening, and car-seat transition criteria.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=373869&lang=en  
> language: en  
> subject: Assignment/Delegation/Supervision  
> category: HPM

## Question

Stage 2 — Analyze cues. Complete the four statements that distinguish safe sleep, developmental screening, iron screening, and car-seat transition criteria.

Place Baby J ::선택::prone whenever she sleeps longer that wayon her side until she can sit alonesupine at the start of every sleep; if she rolls both ways, she may remain in a self-selected position in an empty safe sleep space. Continue developmental surveillance at every visit and complete ::선택::a validated general developmental screen at 9 months or sooner if surveillance identifies concernthe same milestone checklist as a diagnostic test at every visitno further assessment unless a skill is lost. Because human milk is her primary nutrition source, plan ::선택::CBC and serum ferritin screening at 9 to 12 months under current AAP guidanceroutine weekly hemoglobin testing through the first yearscreening only after whole cow milk replaces human milk. Keep her car seat rear-facing until ::선택::her legs appear crowdedshe reaches the manufacturer's rear-facing height or weight limither second birthday regardless of the seat limits.

## Explanation

Four current rules
Begin every sleep supine; an infant who rolls both ways may remain in a self-selected position in an empty safe sleep space. Continue developmental surveillance at every visit and use a standardized screen at 9 months or sooner when concern arises. For an infant whose primary nutrition is human milk, current AAP guidance recommends CBC and serum ferritin at 9 to 12 months. Rear-facing continues until the manufacturer's rear-facing height or weight limit.

## In-depth explanation

Safe sleep
Rolling ability changes whether the caregiver must reposition an infant who rolled independently; it does not change the instruction to place the infant supine at the start of every sleep.

Monitoring is not screening
Developmental surveillance belongs at each visit. A milestone checklist supports monitoring but is not a validated screen. Standardized general screening is recommended at 9, 18, and 30 months and whenever concern appears.

Updated iron timing
The 2026 AAP report individualizes the screening window by primary nutrition. Human-milk-fed infants are screened at 9 to 12 months with CBC and serum ferritin, or at minimum hemoglobin if both cannot be obtained.

Car seat
The seat's rear-facing limits govern transition; neither a fixed age of two nor apparently crowded legs overrides those limits.

## Clinical scenario

Scenario (Stage 2 — Analyze cues)
The nurse converts common parent questions into precise, current decision rules rather than age slogans.

## Key concepts

- **Developmental surveillance** — Longitudinal observation and parent-clinician discussion at health visits; it is broader and less formal than standardized developmental screening.
- **Standardized developmental screening** — Use of a validated instrument at recommended ages and whenever surveillance raises concern; a milestone checklist alone is not a substitute.
- **Nutrition-timed iron screening** — Laboratory screening scheduled during the interval of greatest risk based on whether human milk or iron-fortified formula was the primary nutrition source.

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