Which of the following behaviours by a 36-month-old child supports a nursing diagnosis of altered growth and development?

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

The question requires identifying a behavior that signals a developmental delay in a 36-month-old child.
"Sits down from a standing position" is a gross motor skill that is typically mastered by infants around 10-12 months of age.
Observing this as a primary skill in a 3-year-old child indicates a significant developmental lag of approximately two years.
This finding is a strong piece of assessment data that supports a nursing diagnosis of Altered Growth and Development.

Option A: Walking up stairs by alternating feet is an expected gross motor skill for a 36-month-old child.
Option C: Pushing and pulling toys is a milestone typically achieved around 18 months of age.
Option D: Throwing a ball overhead is an age-appropriate gross motor skill for a 3-year-old child.

Clinical Relevance

Nursing practice connection: Use the key finding related to Gross motor developmental milestones in toddlers to guide bedside assessment, documentation, and the next nursing action.
Nurses are responsible for performing developmental surveillance and using screening tools (like the Denver II) during well-child visits to assess for delays.
Early identification of developmental delays is crucial for initiating timely referrals to specialists and early intervention programs, which significantly improves long-term outcomes for the child.
What if? If the child were 18 months old, being able to push and pull toys (Option C) would be an expected, normal finding, and an inability to walk alone would be the primary concern.

How to Approach the Question

First, identify the key information in the question: the child's age is 36 months (3 years), and the goal is to find a sign of 'altered growth and development,' which implies a developmental delay.
Next, recall the expected gross motor milestones for a 3-year-old child. Key skills include riding a tricycle, walking up stairs with alternating feet, and jumping.
Evaluate each option against this 3-year-old standard.
Options A (alternating feet on stairs) and D (throwing a ball) are age-appropriate, indicating normal development.
Options B (sitting from standing) and C (pushing toys) are milestones for younger children, indicating a delay.
Compare the two delayed options. Sitting from standing is a 12-month skill, while pushing toys is an 18-month skill. The 12-month skill represents a more significant delay in a 3-year-old.

Concept Tested & Keywords

Concept Tested: Gross motor developmental milestones in toddlers.
Stem keywords: 36-month-old child, altered growth and development, behaviour
Lead-in keywords: supports a nursing diagnosis
Clinical cues: Age of child (36 months) is the most critical piece of data for comparison against developmental norms.
Negative lead-in flag: false

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Practise the full AIIMS Bhatinda NO - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.