Certified Pediatric Nurse (CPN)

In evaluating a 4-year-old child, which behavior would raise the greatest concern for the nurse?

1. She cannot tie her shoes

2. She doesn't have a best friend

3. She doesn't enjoy board games

4. She cannot throw a ball overhand

The correct answer is: She cannot throw a ball overhand

The behavior that would raise the greatest concern for the nurse is the inability to throw a ball overhand. This skill is a significant gross motor milestone for children around the age of four. Typically, by this age, children should be able to engage in activities that require coordination, such as throwing a ball. If a child is unable to perform this task, it may indicate potential developmental delays or issues with physical coordination. While the other behaviors listed may vary among children and could be influenced by individual personality traits or experiences, not being able to throw a ball overhand specifically points to gross motor development, which is a critical element of a child’s overall physical development. Understanding typical developmental milestones is essential for nurses to identify potential areas of concern and support children's growth effectively.