A public health nurse is providing education to a group of caregivers of children in a community where all the homes are older. Which of the following screening tests should the nurse recommend for toddlers who are between 1 and 2 years of age?

Rationale: A. Toddlers aged 1 to 2 years are at high risk for lead exposure, especially in older homes that may contain lead-based paint, contaminated dust, or lead pipes. Because young children frequently engage in hand-to-mouth behavior, they are more likely to ingest lead particles. Routine screening for blood lead levels is recommended in high-risk environments such as older housing communities to detect and prevent lead toxicity, which can cause irreversible neurologic damage. B. Screening for sickle cell disease is typically performed at birth using newborn screening programs, not during toddlerhood. The diagnosis is established early in life, and ongoing screening at 1–2 years is not standard unless follow-up testing is indicated. C. Hearing loss is screened in newborns shortly after birth using newborn hearing screening programs. While ongoing developmental surveillance is important, routine screening at 1–2 years is not specifically indicated as a primary community-level recommendation in this context. D. Cystic fibrosis is also identified through newborn screening and early diagnostic testing (such as sweat chloride testing). It is not routinely screened for in toddlers unless there are clinical symptoms or a positive newborn screen requiring follow-up.