Question 1

A nurse is teaching the parents of a 1-year-old infant with otitis media. Which statement regarding predisposing factors for otitis media would be the most accurate for the nurse to make?

Accepted Answer

Answer reason: A shorter, wider, more horizontal tube provides less effective clearance and makes obstruction and fluid retention more likely, creating an environment for bacterial growth. Upright positioning tends to improve, not worsen, drainage compared with lying flat, so the “sit up pooling” idea is inconsistent with physiology. Additionally, infants have relatively immature immune defenses, so claiming humoral defenses decrease infection risk does not explain the predisposition.

Question 2

When performing a physical examination on a 2-year-old client, the nurse?

Accepted Answer

Answer reason: In toddlers, the exam should be organized to minimize distress because crying and agitation can quickly alter respiratory effort and auscultated findings. Auscultation is noninvasive and can be completed early while the child is calm or sitting with the caregiver, improving accuracy of heart, lung, and bowel sounds. More intrusive steps (e.g., otoscopic and oral exams) are typically delayed until the end because they often provoke resistance and make the rest of the assessment difficult. Sedation is not an appropriate routine strategy for cooperation in a standard physical exam.

Question 3

At different stages of life, families must master certain developmental tasks in order to maintain psychological health. Families with young adults who are launching into society have family developmental tasks to master including?

Accepted Answer

Answer reason: Families in the stage with young adults leaving home are expected to help members separate and become independent while still providing emotional support and a stable “launching pad.” The key task is restructuring family relationships so the young adult can function autonomously but knows the family remains a reliable source of support and connection. One common distractor is maintaining kinship ties, which is more emphasized in later stages (e.g., families in midlife maintaining connections with extended family and aging parents). Coping with energy depletion aligns more with older adulthood, and thinking about future/education/work is primarily an individual young-adult developmental focus rather than the family-system task.

Question 4

The nurse is preparing to care for the 4-year-old hospitalized for moderate burns. Which response from the child should the nurse anticipate based on the child's developmental age?

Accepted Answer

Answer reason: Hospitalization and painful burn care can intensify this self-blame and guilt, so nurses should anticipate and address these misconceptions with simple, reassuring explanations. Boundary-pushing for autonomy is more typical of toddlers, while wanting detailed treatment instructions aligns more with school-age cognitive development. Anger/hostility to avoid appearing young is more characteristic of adolescents concerned with identity and peer perception.

Question 5

Which guideline would be appropriate for the nurse to implement when teaching an 11-year-old child who was recently diagnosed with diabetes about insulin injections?

Accepted Answer

Answer reason: School-age children typically have the cognitive ability and fine-motor skills to learn and perform insulin self-injection with supervision, promoting autonomy and long-term adherence. Teaching at diagnosis supports development of self-management habits while still ensuring safety through coaching and monitoring by caregivers. Parents should remain involved to verify technique, rotate sites, and recognize hypoglycemia/hyperglycemia, making the “no parent involvement” approach unsafe. Waiting until age 16 unnecessarily delays skill acquisition and independence. Requiring the child to reach all injection sites is not necessary because caregivers can assist with sites that are hard to access.

Question 6

The nurse is counseling the parents of the infant who was born blind. Which statement indicates that the parents need additional teaching?

Accepted Answer

Answer reason:  Congenital blindness primarily affects visual exploration and may delay some motor and social milestones, but it does not inherently impair language acquisition or verbal learning. Many blind infants develop strong auditory attention and typical speech/language skills when provided with normal interaction and enriched communication. Suggesting an automatic need for speech therapy reflects a misconception and indicates a need for additional teaching about expected development. By contrast, purposeful stimulation through play and promoting independence with adaptive strategies are appropriate counseling points.

Question 7

While teaching the parents of a child with short stature, the nurse discusses familial short stature. What is the most appropriate information for the nurse to include in the discussion?

Accepted Answer

Answer reason: Familial short stature reflects a normal variant of growth driven by genetic potential, so the child’s growth velocity is typically normal while tracking along a lower percentile curve consistent with family patterns. This option correctly highlights a family history of shorter adult stature with otherwise appropriate childhood growth. Delayed skeletal and sexual maturation with delayed linear growth is more characteristic of constitutional growth delay, not familial short stature. Socioeconomic deprivation can contribute to failure to thrive or malnutrition-related growth issues, which is a different etiology than familial short stature.

Question 8

A 10-year-old female client is seen in the clinic. The client’s mother asks the nurse when puberty will begin and what corresponding signs will be evident. The nurse replies?

Accepted Answer

Answer reason: The average age for puberty is approximately 11 years old. Breast buds, enlarged areolae, and a small amount of pigmented labial hair are typically seen. Normal female pubertal development follows a predictable sequence, with thelarche (breast budding) as the earliest visible sign, followed by pubic hair development. Average onset is around 10–11 years, so providing this timeframe and the expected early findings is accurate and reassuring. This option correctly links timing with Tanner stage II characteristics (breast buds/areolar enlargement and early pigmented hair). A vague statement about unpredictability is less helpful because the parent asked for typical onset and signs, and the other options describe incorrect features or timelines.

Question 9

In the office for a yearly physical examination, a 30-year-old client reports that the client and husband used to be very happy before the children were born. Now the client is struggling with the current situation. The nurse understands that?

Accepted Answer

Answer reason: This scenario reflects a normal family developmental transition in early adulthood as a couple adapts to parenting and the expanded family system. The key nursing concept is recognizing expected role and relationship strain when shifting from a dyad to a family with children, requiring new communication, time management, and role distribution. This option directly identifies the age-appropriate developmental task rather than labeling the client’s behavior as pathological or presumptive. Assuming an affair is unsupported and judgmental, and immediate psychotherapy referral is not indicated without evidence of a mental health disorder or safety risk. While mobilizing social support can help, it is an intervention suggestion rather than the underlying developmental understanding the question is testing.

Question 10

The home health nurse is using Piaget’s developmental theory to assess a 3-year-old’s cognitive development. Which of these developmental tasks should the nurse anticipate observing?

Accepted Answer

Answer reason: Being able to group items by a single attribute (e.g., color) matches expected cognitive abilities for this stage. In contrast, taking another person’s perspective reflects decreased egocentrism and is more consistently demonstrated later in development. Washing independently and printing letters/numbers are more aligned with self-care/fine-motor milestones rather than the core Piaget cognitive skill being assessed here.

Question 11

Asperger's syndrome is a...?

Accepted Answer

Answer reason: Neurodevelopmental disorders present with developmental differences/impairments rather than progressive neuronal loss or primary muscle/nerve pathology. This makes a developmental category the best fit among the options provided. A key distinction is that degenerative disorders worsen due to ongoing tissue breakdown over time, which is not the defining mechanism here. Metabolic disorders are driven by biochemical pathway defects and typically produce systemic metabolic signs, not the core social-communication phenotype.

Question 12

Which statement is true regarding growth and development during the first 6 months?

Accepted Answer

Answer reason: Normal infant growth in the first 6 months includes rapid weight gain, with average gain about 5–7 oz per week, which approximates 2 lb per month. This matches expected pediatric growth patterns used for well-child assessment and anticipatory guidance. By contrast, newborns typically regain birth weight by 10–14 days, making the 1-week timeframe too early for many infants. Head circumference increases about 1 inch per month mainly during the first 3 months and then slows, so stating that rate for the entire first 6 months is not consistently accurate.

Question 13

The nurse is caring for a 10-year-old child on the pediatric unit. The nurse, when caring for this age group, should be aware that?

Accepted Answer

Answer reason: At about 10 years old, children are typically in Kohlberg’s conventional level of moral development, where behavior is guided by approval from others and maintaining relationships. They tend to follow rules to be viewed favorably by parents, teachers, and peers and to avoid disapproval. This aligns with an “interpersonal concordance/good boy–good girl” orientation. In contrast, doing something only for reciprocal benefit reflects an earlier preconventional stage, and consistently prioritizing abstract societal good is usually more mature and develops later.

Question 14

The mother of a 24-month-old child tells the nurse that she is concerned that her child’s language abilities are delayed. Which of the following language milestones does the nurse expect the child to exhibit?

Accepted Answer

Answer reason: A vocabulary in the hundreds with frequent 2–3 word combinations is consistent with expected 24-month language development. The other options reflect earlier stages of speech and language (single words, small word counts, simple pointing) more consistent with the end of the first year or early second year. Therefore, this milestone best matches normal expectations for a 24-month-old child.

Question 15

At what age should the walking/stepping reflex disappear?

Accepted Answer

Answer reason: The stepping (walking) reflex is normally present at birth and fades by about 2 months, but many nursing/NCLEX-style references list disappearance by around 4 months as the expected upper limit for integration. Among the choices given, this best matches the expected developmental timeframe and avoids labeling a normal infant as abnormal too early. Later ages like 6 or 12 months would represent abnormal persistence and warrant further assessment.

Question 16

What type of play does a nurse expect when observing a toddler in a playroom with other children?

Accepted Answer

Answer reason: This reflects normal psychosocial development in which social awareness is emerging, but cooperative social skills are still limited. Solitary play is more typical of infants and young toddlers when they are primarily self-focused and not oriented to peers. Competitive and cooperative play generally develop later, with cooperative play becoming more common in the preschool years as turn-taking and shared rules mature.

Question 17

The nurse assesses an infant client who is nine months of age. Which finding indicates to the nurse a need for additional assessment?

Accepted Answer

Answer reason: Failure to do so is a potential red flag for hearing impairment or neurodevelopmental delay and warrants further assessment (e.g., formal hearing screening and focused neurologic/developmental evaluation). In contrast, discriminating a circle from a square is a later cognitive/visual-perceptual skill and would not be expected at this age. Visual tracking of rapidly moving objects can vary and is less specific than absent sound localization for identifying a possible sensory deficit.

Question 18

What is the characteristic play present among toddlers?

Accepted Answer

Answer reason: This pattern fits parallel play: children use similar toys near each other but remain focused on their own activity. Onlooker play is more typical in younger children observing others, and associative play involves more interaction and sharing. Cooperative play requires organized roles and teamwork and is more typical of preschool and school-age children.

Question 19

The nurse notes that a 6-year-old child does not recognize that objects exist even when the objects are outside of the visual field. Based on this observation, which action should the nurse take?

Accepted Answer

Answer reason: Object permanence is typically achieved in infancy; absence of this concept at age 6 is a significant developmental red flag that suggests possible neurodevelopmental, cognitive, or sensory processing impairment rather than a normal variation. The nurse’s safest priority is to escalate the finding for formal evaluation and diagnosis so the child can receive appropriate testing and early intervention services. The other options are compensatory strategies that may help a child with vision field loss or low vision, but they do not address the abnormal developmental finding itself or ensure medical follow-up. Prompt reporting supports timely assessment and management, which is critical for long-term outcomes.

Question 20

Which parenting style is high control, low warmth, with inflexible rules and little communication?

Accepted Answer

Answer reason: Authoritarian parenting is defined by high demandingness with low responsiveness, meaning strict control is prioritized over emotional warmth. The hallmark features include rigid, inflexible rules, expectation of obedience, and limited bidirectional communication (often “because I said so”). This fits the stem’s emphasis on high control and low warmth with little communication. By contrast, authoritative parenting maintains firm limits but pairs them with warmth and open communication, which the stem explicitly does not describe.

Question 21

Psychosexual development stage of a toddler?

Accepted Answer

Answer reason: According to Freud’s psychosexual development theory, toddlers (approximately 1–3 years old) are in the anal stage, which focuses on bowel and bladder control. The oral stage occurs in infancy, the phallic stage in preschool age, and the genital stage in adolescence.

Question 22

The parents of a child with celiac disease ask the nurse how they can help promote a normal life for their child. What is the best response by the nurse?

Accepted Answer

Answer reason: Connecting the child with a peer who has the same condition supports normalization, social acceptance, and adaptive coping. It helps the child feel less isolated and promotes a sense of belonging while managing dietary restrictions. The other options either encourage isolation, reinforce differences, or suppress emotional expression, all of which hinder healthy psychosocial development.

Question 23

An adolescent who is suffering from gender identity disorder is unable to progress through which developmental task?

Accepted Answer

Answer reason: According to Erikson’s psychosocial development theory, adolescence is characterized by the stage of identity versus role confusion, where individuals explore and form a stable sense of self, including gender identity. Difficulty with gender identity directly interferes with successful resolution of this developmental task, leading to confusion about roles and self-concept. The other stages correspond to different age groups (initiative vs guilt in early childhood, industry vs inferiority in school-age children, intimacy vs isolation in young adulthood).

Question 24

Nurse Walter should expect a 3-year-old child to be able to perform which action?

Accepted Answer

Answer reason: By about age 3, children commonly can pedal a tricycle, reflecting adequate lower-extremity strength and coordination for alternating leg movements. Tying shoelaces requires more advanced fine motor dexterity and bilateral coordination typically seen closer to school age. Jumping rope and roller-skating demand higher-level balance, rhythm, and coordination and are more consistent with older preschool or early school-age development.

Question 25

According to Piaget’s theory of cognitive development, which stage would a patient be in if they are developing object permanence?

Accepted Answer

Answer reason: This cognitive ability emerges during Piaget’s sensorimotor stage as infants learn through sensory input and motor actions, progressing from reflexive behavior to purposeful problem-solving. Later stages (preoperational, concrete operational, formal operational) build on this foundation and are characterized by symbolic thought, logical operations, and abstract reasoning rather than the initial acquisition of object permanence. Therefore, identifying object permanence directly maps to the earliest stage of cognitive development in Piaget’s model.

Question 26

A child states that they live at home with their mother, step-father, and half-sister, and step-brother. The nurse correctly identifies this as which type of family?

Accepted Answer

Answer reason: The presence of a step-parent and a step-sibling, along with a half-sibling, indicates remarriage/repPartnering with children from different parental relationships living together. A nuclear family would be two parents and their children without step-relations, and an extended family centers on multiple generations (e.g., grandparents) in the household. “Binuclear” typically refers to children living across two households after divorce, not everyone living together in one home.

Question 27

The mother of a 2-year-old boy states to the nurse during their check-up: “I just don’t get it. He just sits there and plays on his own while all his other cousins play with each other. Is there anything wrong with him?” Which response by the nurse is most appropriate?

Accepted Answer

Answer reason: “Your child is a toddler. It’s normal for his age to just play all by himself while other children play too.” Toddlers commonly demonstrate parallel play, where they play independently alongside other children rather than engaging in cooperative group play. This behavior is developmentally expected around age 2 and does not by itself suggest a problem. The therapeutic nursing response is to provide accurate anticipatory guidance and reassurance based on normal developmental milestones. Blaming the parent or escalating to specialist evaluation is unnecessary without additional red flags (e.g., language delay, lack of eye contact, failure to respond to name, loss of skills).

Question 28

Which age group has the greatest potential to demonstrate regression when they are sick?

Accepted Answer

Answer reason: Toddlers may temporarily revert to earlier behaviors (e.g., increased clinginess, loss of newly acquired toileting or language skills) as a self-soothing response and because routines and sense of control are disrupted. This age group is also highly sensitive to separation anxiety and environmental changes, which amplifies regressive behaviors during illness or hospitalization. Adolescents and young adults have more mature coping mechanisms, and infants have fewer previously mastered milestones to “lose,” making regression less apparent compared with toddlers.

Question 29

Which finding indicates that a child has reached the stage of concrete operations according to Piaget?

Accepted Answer

Answer reason: In the concrete operational stage, children develop logical thinking about real and concrete situations. They can understand cause-and-effect relationships and reason through practical situations. Recognizing that homework is both time-consuming and necessary reflects this emerging logical reasoning.

Question 30

Which of the following is the best method for performing a physical examination on a toddler?

Accepted Answer

Answer reason: Starting with nonthreatening, simple observations (general appearance, breathing, skin, heart/lung sounds as tolerated) helps establish trust and preserves cooperation for the remainder of the exam. More distressing components (otoscopic exam, oral exam, palpation of tender areas) are best delayed until the end to avoid escalating crying that can invalidate findings and prevent completion. A strict head-to-toe sequence is less effective in this age group because it often forces early invasive steps that disrupt the entire assessment.

Question 31

The Denver II is a test used to assess children. What does it evaluate?

Accepted Answer

Answer reason: The Denver II Developmental Screening Test evaluates a child’s developmental progress across key domains such as personal-social, fine motor-adaptive, language, and gross motor skills. It is specifically designed to identify delays in overall developmental status, not isolated behavior issues, BMI, or infection risk.

Question 32

A new-born weighed 7 pounds at birth at 6 months of age, the infant could be expected to weigh?

Accepted Answer

Answer reason: A key growth milestone is that infants typically double their birth weight by around 5–6 months of age. Therefore, a newborn weighing 7 pounds would be expected to weigh approximately 14 pounds at 6 months. The other options are either too low or excessively high for normal growth patterns.

Question 33

When educating a new family on weight gain of their infant, the nurse should explain that the baby should triple their weight at how many months?

Accepted Answer

Answer reason: This makes the 12-month milestone the expected time for tripling weight in a healthy term infant. The earlier time frames (3, 6, or 9 months) would suggest a growth rate faster than standard expectations and would be inaccurate for routine anticipatory guidance. Using these milestones helps families recognize typical growth and identify when follow-up is needed if weight gain is significantly delayed.

Question 34

Which of the following factors affect growth of newborn?

Accepted Answer

Answer reason: Newborn growth is influenced by multiple factors including genetic predisposition, biological sex, and environmental/social conditions such as nutrition and care.

Question 35

Which of the following milestone is a red flag sign in child development if not attained?

Accepted Answer

Answer reason: Absence of a social smile by 3 months is a significant developmental red flag indicating possible neurologic or social development delay. Other milestones have wider normal variation ranges.

Question 36

Because of academic failure, a 10-year old is to repeat a grade in school. When counseling the parents of this child, the school nurse who ascribes to Erickson's theories will advise the parents to be alert for indicationsa of which of the following?

Accepted Answer

Answer reason: inferiority, where competence is built through successful school and skill mastery. Repeating a grade after academic failure threatens the child’s sense of competence and can lead to feelings of inadequacy, low self-esteem, and avoidance of challenges. This aligns directly with inferiority as the maladaptive response when the child perceives repeated failure or negative comparison to peers. By contrast, shame and guilt are more characteristic of earlier stages (toddlerhood and preschool years), and role confusion is typical of adolescence.

Question 37

The nurse is providing community education about autism to a group of parents. The nurse concludes that teaching has been effective if the parents describe which of the following as common behavioral signs of autism?

Accepted Answer

Answer reason: Reduced social reciprocity can present as limited comfort-seeking, decreased response to affection, and seeming detachment from caregivers’ physical closeness. This makes lack of interest in being held or hugged a typical behavioral sign parents may report. In contrast, advanced language development and highly imaginative play are not common early features, and many children have limited or atypical affection rather than consistently excessive affection.

Question 38

The client is a 5-year old whose pet cat has died within the past two days. Which of the following statements about this is the nurse most likely to hear?

Accepted Answer

Answer reason: "She'll be back tomorrow. She's dead today." Preschool-aged children (about 3–5 years) commonly view death as temporary and reversible and may show magical thinking about events. This statement reflects an expected developmental misunderstanding that death can change quickly and the pet can return soon. In contrast, a concrete, irreversible understanding (“won’t ever see my cat again”) is more typical of older school-aged children. Nursing anticipatory guidance focuses on using simple, concrete explanations and allowing repeated questions as the child processes loss.

Question 39

A nurse is caring for 3-year-old child having their hearing checked at an audiology clinic due to a referral by the pediatrician. It is determined the child has moderate hearing loss. The audiologist recommends hearing aids as soon as possible since hearing loss can greatly affect young children. The nurse teaches the parents that which skills are most affected by hearing loss?

Accepted Answer

Answer reason: Moderate hearing loss reduces access to spoken language, leading to delayed vocabulary, grammar, and comprehension even when the child is otherwise cognitively typical. Speech articulation can also be affected, but it is downstream of language exposure and typically reflects the primary disruption in language acquisition. Social interaction and play may be impacted secondarily, yet the most directly and strongly affected developmental domain is language.

Question 40

Nurse Olivia is assessing a 4-month-old infant during a routine checkup. Based on the infant's age, which motor skill would Nurse Olivia expect to observe?

Accepted Answer

Answer reason: Expected infant motor development follows a predictable sequence, with early months emphasizing improving grasp and hand-to-mouth coordination. By around 4 months, infants commonly can grasp and hold a rattle placed in the hand and may briefly shake it. Waving “bye-bye” and banging two blocks together are typically later social/fine-motor milestones seen closer to about 9 months, and drinking from a cup usually emerges well after infancy with more advanced oral-motor control. Therefore this skill best matches a normal 4-month developmental expectation.

Question 41

While examining a 2-year-old child, Nurse Victoria sees that the anterior fontanel is open. She should?

Accepted Answer

Answer reason: This can be associated with conditions such as hypothyroidism, increased intracranial pressure, or skeletal/metabolic disorders, which require provider assessment and possible diagnostic workup. The most appropriate nursing action is to report the abnormal assessment finding for timely medical evaluation rather than labeling it normal. Abuse is more strongly suggested by bruising patterns, fractures, or inconsistent history rather than an isolated delayed fontanel closure, and Tay-Sachs is not a typical cause of delayed fontanel closure.

Question 42

A parent of a 14-year old client has asked the nurse to explain the client's current difficulty mastering usual psychosocial tasks. If the nurse bases a response on the theories of Erickson, the nurse should say, "Erickson believed that:"?

Accepted Answer

Answer reason: Erikson’s adolescent stage centers on identity vs role confusion, where the primary psychosocial task is forming a stable sense of self while negotiating increasing independence. Difficulty mastering “usual psychosocial tasks” at age 14 most directly aligns with challenges resolving identity formation and role confusion. Social context (peers, school, broader culture) can intensify this stage’s conflicts, making identity struggle prominent and clinically relevant in adolescents. The other options overemphasize family as the dominant developmental driver or describe concepts (e.g., “mastery of doubts”) that do not match Erikson’s adolescent crisis.

Question 43

While conducting a mental status examination with an 8-year old girl, the nurse asks the client to explain the meaning of an expression "Don't cry over spilled milk." The child looks puzzled and shrugs her shoulder. The nurse using Piaget's theory will view the child's response as suggestive of which of the following?

Accepted Answer

Answer reason: Interpreting proverbs requires abstract thinking and understanding figurative language, which is not yet well developed at this stage. An 8-year-old appearing puzzled by an idiom is therefore expected and reflects developmental level rather than pathology. Formal operational thinking (abstract reasoning) generally emerges in adolescence, making that option less consistent with the child’s age-appropriate response.

Question 44

A 5-year-old child has been recently admitted to the pediatric unit following a minor accident at school. The child appears hesitant to engage in play activities organized by the hospital’s child life specialist and frequently asks if it’s “okay” to play with certain toys. The parents express concern about their child’s behavior, noting that he was previously very active and curious at home. Based on Erik Erikson’s psychosocial development stages and the child’s age and behavior, the nurse recognizes that the child is primarily navigating which developmental stage?

Accepted Answer

Answer reason: Erikson’s preschool stage (about 3–6 years) centers on developing initiative through exploring, trying new activities, and asserting purpose; when this is disrupted, children may show guilt, hesitation, and excessive need for permission. A 5-year-old who repeatedly asks whether it is “okay” to play and becomes less exploratory after an accident fits this conflict, suggesting fear of doing something “wrong” and reduced confidence to initiate play. Autonomy vs. shame and doubt is typical of toddlers (1–3 years) and focuses more on independence with self-care and control, not planning/initiating play activities. Trust vs. mistrust (infancy) and intimacy vs. isolation (young adulthood) are age-incongruent.

Question 45

A nurse reviewing a toddler should understand that the client's psychosocial crisis, according to Erik Erickson's stages of psychosocial development, corresponds with which of the following?

Accepted Answer

Answer reason: Autonomy vs. Shame and Doubt Erikson’s psychosocial stages are tied to age-specific developmental tasks and the caregiver responses that either support or hinder healthy development. Toddlers (about 1–3 years) are centered on gaining independence in self-care and decision-making (e.g., toileting, feeding, saying “no”), which is the autonomy-versus-shame/doubt conflict. Supportive limit-setting and allowing safe choices foster autonomy, whereas excessive criticism, overcontrol, or punishment promotes shame and doubt. A common distractor is trust-versus-mistrust, which is the infant stage (birth to 1 year) focused on reliable caregiving rather than independent behavior. Recognizing the correct stage helps the nurse tailor anticipatory guidance and parent teaching to encourage age-appropriate independence.

Question 46

You are the LPN assessing sexual maturity levels, based on your knowledge you expect to use which of the following?

Accepted Answer

Answer reason: The Tanner scale is specifically designed to rate these physical changes and helps determine pubertal progression and timing. Denver II is a developmental screening tool for early childhood milestones rather than pubertal sexual maturation. Antibody testing does not assess maturity, and the nursing process is a general problem-solving framework, not a sexual maturity scale.

Question 47

A nurse is contributing to the care plan of an 18-month-old child who has pneumonia. Which of the following items should the nurse select for the child's play activities?

Accepted Answer

Answer reason: At 18 months, toddlers benefit from large, simple, manipulative toys that support gross and fine motor development and allow quiet play in bed or near the caregiver. Small items like beads increase aspiration/choking risk and require higher fine-motor precision than expected at this age. Scissors and structured academic tasks (flash cards) are not developmentally appropriate and can increase frustration or safety risk when the child is ill.

Question 48

A nurse is preparing a preschooler for a surgical procedure. Which of the following is an appropriate action by the nurse?

Accepted Answer

Answer reason: Preschool-aged children learn best through play and have limited ability to understand abstract explanations. Therapeutic play allows them to explore medical equipment in a non-threatening way, reducing anxiety and increasing familiarity with the procedure. Long teaching sessions exceed their attention span, early discussions increase anxiety, and peer discussions are less effective than hands-on play at this developmental stage.

Question 49

To assess the development of a 1-month-old, the nurse asks the parent if the infant is able to?

Accepted Answer

Answer reason: At about 1 month, infants are expected to demonstrate early gross-motor control such as briefly lifting the head and moving it side-to-side when prone, reflecting developing neck extensor strength. This milestone is commonly assessed by parental report and is appropriate for the age in the stem. Social laughter and rolling are typically later achievements, and purposeful grasping/holding a rattle emerges after neonatal reflexes mature. Therefore the option describing early head control best matches normal 1-month development.

Question 50

To assess a 9-year-old's social development, the nurse asks the parent if the child?

Accepted Answer

Answer reason: School-age children (about 6–12 years) demonstrate social development through increasing peer orientation and forming close friendships. Having a “best friend” reflects the expected psychosocial task of industry vs. inferiority and the ability to cooperate, share rules, and develop loyalty within peer groups. The other choices primarily assess cognitive development (independent thinking; organizing and planning) or physical/gross-motor activity (enjoys active play) rather than social milestones. Asking about a close friendship directly targets social functioning at this age.

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