A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks to her toys and makes up stories. The mother wants her child to have a psychological evaluation. The nurse's best initial response is to

a. refer the child to a psychologist immediately.
b. explain that playing make believe is normal at this age.
c. complete a developmental screening using a validated tool.
d. separate the child from the mother to get more information.


ANS: B
By the end of the fourth year, it is expected that a child will engage in fantasy, so this is normal at this age. A referral to a psychologist would be premature based only on the complaint of the mother. Completing a developmental screening would be very appropriate but not the initial response. The nurse would certainly want to get more information, but separating the child from the mother is not necessary at this time.

Nursing

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