The nurse is conducting a developmental assessment on a 4-year-old child. Which finding, if present, would warrant further investigation and potentially referral for developmental screening?

Question: The nurse is conducting a developmental assessment on a 4-year-old child. Which finding, if present, would warrant further investigation and potentially referral for developmental screening?

Answer options:

• The child can draw a circle and copy a cross.
• The child frequently engages in imaginative play with peers. ✅ The child mostly uses two-word sentences and struggles to understand complex instructions.
• The child can alternate feet going up and down stairs without assistance.

Correct answer: The child mostly uses two-word sentences and struggles to understand complex instructions.

Explanation: By age 4, a child should typically be using longer, more complex sentences (4-5 words) and be able to understand 2-3 step commands. Frequently using only two-word sentences and struggling with complex instructions at this age suggests a potential delay in language development, warranting further assessment. The other options describe age-appropriate or advanced developmental milestones for a 4-year-old.