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健康促進與維護 · MEDIUM · MCQ

護理師正在評估一名 2 歲兒童。哪項發現會引起發展方面的擔憂?

A nurse is assessing a 2-year-old child. Which finding would be a cause for developmental concern?

  • AThe child cannot hop on one foot.
    孩童無法單腳跳
  • BThe child exhibits negative behavior and says 'No'.
    孩童表現出負面行為並說「不」
  • CThe child's vocabulary is limited to 5 words.✓ 正解
    孩童的詞彙量僅限於5個單字
  • DThe child uses two-word phrases.
    孩童使用兩字短句
Explanation · 中文詳解

本題旨在評估護理師對於幼兒發展里程碑的了解,特別是 2 歲兒童的語言發展。在兒童健康照護中,評估發展里程碑是護理師的重要職責,能及早發現發展遲緩並轉介介入,對兒童的長期發展至關重要。護理師需透過觀察、與家長訪談,綜合判斷兒童的發展狀況。 正確答案 C 指出 2 歲兒童詞彙量僅限於 5 個單字,這明顯低於該年齡層的語言發展預期。一般而言,2 歲兒童的詞彙量應達到 50 個單字以上,並能開始說出兩字短句。語言發展遲緩可能影響認知、社交和情緒發展,因此需引起護理師的擔憂並進一步評估。 其他選項所描述的行為或能力,則屬於 2 歲兒童的正常發展範疇,或尚未達到該年齡的預期能力,因此不構成發展擔憂。

This question evaluates knowledge of toddler developmental milestones, specifically language development at age 2. Assessing milestones is an important nursing responsibility because early identification of developmental delays and referral for intervention are crucial. The nurse uses observation and parental interview to assess developmental status. The correct answer C indicates a vocabulary limited to only 5 words at age 2, which is significantly below expected milestones. Typically, a 2-year-old has a vocabulary of 50+ words and uses two-word phrases. Language delay may impact cognitive, social, and emotional development and requires further evaluation. The other options describe normal toddler behavior or skills not yet expected at this age.

✦ 台美臨床差異

台美兩地的幼兒發展評估工具和里程碑標準大致相同,主要依據美國兒科學會(AAP)或世界衛生組織(WHO)的建議。護理師在評估兒童發展時,會使用標準化的篩檢工具,如丹佛發展篩檢量表(Denver Developmental Screening Test),並結合文化背景考量。無論在美國或台灣,及早發現兒童發展遲緩並提供早期療育轉介,都是兒科護理的重要目標。

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