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健康促進與維護 · EASY · MCQ

護理師正對一名 2 歲幼兒進行例行性身體評估。護理師應預期下列哪項發展發現?

A nurse is conducting a routine physical assessment on a 2-year-old child. Which developmental finding should the nurse expect?

  • AThe child uses sentences of 4 to 5 words
    該兒童使用 4 至 5 個字的句子
  • BThe child can skip on alternating feet
    該兒童可以交替雙腳跳
  • CThe child uses a spoon effectively to eat✓ 正解
    該兒童能有效使用湯匙進食
  • DThe child can tie their shoelaces
    該兒童可以綁鞋帶
Explanation · 中文詳解

本題重點在於 2 歲幼兒(Toddler)的精細動作與自理能力。2 歲幼兒正處於發展自主性的階段,生理上已能控制手部肌肉來完成簡單的任務。正確答案 C 是典型的發展指標,雖然進食過程可能仍會弄髒,但已能自主使用湯匙。選項 D(繫鞋帶)通常要到 5 歲左右的學齡前期才能達成,因為這需要極高的精細動作協調。選項 B(交替腳跳躍)屬於學齡前(4-5 歲)的粗大動作里程碑。選項 A(4-5 個字的句子)也超出了 2 歲的語言能力,2 歲通常只能說 2-3 個字的短句(如「媽媽抱」)。臨床安全優先原則提醒護理師,評估發展時應考量個別差異,但若 2 歲仍無法握持餐具,可能需評估是否有神經肌肉發展問題。

By age two, toddlers typically have the fine motor skills to use a spoon effectively for eating, although some spilling may still occur. Other options represent later milestones: 2-3 word phrases are typical for this age, while skipping, tying shoelaces, and longer sentences develop between ages three and five.

✦ 台美臨床差異

美國護理實務強調「發展篩檢工具」(如 ASQ)的標準化應用;台灣則多仰賴「兒童健康手冊」的檢核表。護理師在兩地皆扮演衛教與早期發現的角色。

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