When assessing physical development of the five year old, you would find it abnormal if he

ESIC Nursing Officer - 2019 (Shift-2)

Child Health Nursing (Pediatrics)

Easy

Appeared in: ESIC Nursing Officer - 2019 (Shift-2)

Explanation

A five-year-old is expected to have well-developed gross motor skills, including the ability to walk up and down stairs by alternating feet.
This skill of alternating feet on stairs is typically mastered by age 3-4 years.
Needing to go up a stairway one step at a time (placing both feet on each step) is a characteristic of a younger child (toddler) and is considered a developmental delay or an abnormal finding in a five-year-old.

Option A: This describes a fine motor skill (stacking six blocks) that is typically achieved by age 2. A five-year-old can easily perform this task, so it is a normal, not abnormal, finding.
Option C: Jumping or hopping on one foot is a gross motor skill that is expected to develop around age 4-5. Therefore, this is a normal finding for a five-year-old.
Option D: Catching a large ball is a gross motor skill that is typically developed by age 3-4. This is an expected and normal ability for a five-year-old.

Visual 1: Chart: A visual chart comparing the gross motor milestones of toddlers (2-3 years) and preschoolers (4-5 years), highlighting skills like climbing stairs, jumping, and balancing.
Visual 2: Illustration: A simple side-by-side drawing showing the two ways of climbing stairs: 'one step at a time' (toddler) versus 'alternating feet' (preschooler).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Gross motor developmental milestones in a 5-year-old child as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in developmental surveillance during routine health check-ups. Identifying gross motor delays early is essential for timely intervention and improved outcomes.
If a delay is suspected, the nurse should perform a more detailed developmental screening (e.g., using the Denver II tool) and consider referring the child to a pediatrician or a specialist like a physical therapist (PT) for a comprehensive evaluation.
What if? If the child in the question was 3 years old, needing to go up a stairway one step at a time would be less concerning, as the skill of alternating feet is just emerging at this age. However, at age 5, it is a clear red flag for developmental delay.

How to Approach the Question

First, identify the core of the question: it asks to find an 'abnormal' developmental finding for a 5-year-old.
This requires recalling the expected gross motor milestones for a 5-year-old child.
Evaluate each option against the known developmental timeline for preschoolers.
Option A (stacking blocks): This is a skill for a much younger child (age 2), so a 5-year-old can easily do it. It's not abnormal.
Options C & D (jumping on one foot, catching a ball): These are skills for a 4-5 year old. They are normal.
Option B (one step at a time on stairs): This is a pattern for a 2-3 year old. For a 5-year-old, this represents a delay and is therefore 'abnormal'.

Concept Tested & Keywords

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