Question 1

In terms of cognitive development, a 2-year-old would be expected to?

Accepted Answer

Answer reason: A 2-year-old is in Piaget’s preoperational stage, characterized by egocentrism and magical thinking. They do not think abstractly, understand conservation, or take others’ perspectives.

Question 2

Which of the following best describes the language of a 24-month-old?

Accepted Answer

Answer reason: By 24 months, toddlers typically use two-word phrases and can express needs. They do understand yes/no, and frequent “why?” questioning is more typical around age 3.

Question 3

The nurse is planning care for a two year-old hospitalized child. Which of the following is the MAJOR stressor of hospitalization for this age?

Accepted Answer

Answer reason: Toddlers experience all stressors of hospitalization, but the predominant one is separation from parents/caregivers (separation anxiety).

Question 4

While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child's developmental needs?

Accepted Answer

Answer reason: Toddlers are in Erikson’s autonomy vs. shame/doubt stage and need opportunities to use new motor and cognitive skills to explore. The other statements reflect overprotection or control that would hinder autonomy.

Question 5

The nurse knows that which psychosocial stage should be a priority to consider while planning care for a 20-year-old client?

Accepted Answer

Answer reason: A 20-year-old is in Erikson's young adulthood stage, where the primary task is intimacy versus isolation. The other options correspond to adolescence (identity vs diffusion), late adulthood (integrity vs despair), and school age (industry vs inferiority).

Question 6

The nurse is planning care for an 8 year-old child. Which of the following should be included in the plan of care?

Accepted Answer

Answer reason: An 8-year-old is in Erikson’s industry vs. inferiority stage; promoting task-oriented play and activities supports industry. Playroom activities best match this developmental need.

Question 7

In providing care to a 14 year-old adolescent with scoliosis, which of the following will be MOST difficult for this client?

Accepted Answer

Answer reason: At age 14, peer acceptance and body image are paramount; scoliosis and its treatments may alter appearance, making looking different from peers the greatest challenge.

Question 8

The nurse measures the head and chest circumferences of a 20 month-old infant. After comparing the measurements, the nurse finds that they are approximately the same. The appropriate action for the nurse to take would be to?

Accepted Answer

Answer reason: By 1–2 years of age, head circumference typically equals chest circumference; equal measurements at 20 months are normal, so the nurse should document the findings.

Question 9

The nurse caring for a 14 year-old boy with severe Hemophilia A, who was admitted after a fall while playing basketball. In understanding his behavior and in planning care for this client, the nurse must recognize that adolescents with hemophilia?

Accepted Answer

Answer reason: Adolescents often engage in risky, peer-influenced activities for acceptance; thus, teens with hemophilia may still participate in active sports despite bleeding risks.

Question 10

An anxious parent of a 4 year-old consults the nurse for guidance in how to answer the child's question, "Where do babies come from?" What is the BEST response to the parent?

Accepted Answer

Answer reason: Preschoolers need brief, honest, age-appropriate responses. Provide a simple, direct answer to the specific question rather than detailed information.

Question 11

Which of the following statements describes what the nurse must know in order to provide anticipatory guidance to parents of a toddler about readiness for toilet training?

Accepted Answer

Answer reason: Toilet training requires voluntary sphincter control, which becomes possible after completion of spinal cord myelination around 18–24 months.

Question 12

While planning care for a preschool aged child, the nurse understands developmental needs. Which of the following would be of the MOST concern to the nurse?

Accepted Answer

Answer reason: In Erikson’s stages, preschoolers are in initiative vs. guilt; shame and doubt should have been resolved during toddlerhood. Therefore a preschooler expressing shame is most concerning.

Question 13

The nurse is performing a developmental assessment on an 8 month-old. Which of the following should be reported to the physician?

Accepted Answer

Answer reason: By 8 months infants typically sit without support; falling forward while sitting suggests a developmental delay and should be reported. The other behaviors are expected by or before this age.

Question 14

The father of an eight month-old infant asks the nurse if his infant's vocalizations are normal for his age. Which of the following would the nurse expect at this age?

Accepted Answer

Answer reason: At around 8 months, infants typically imitate sounds (e.g., "da-da"). Cooing and laughter occur earlier in infancy; throaty sounds are seen in newborns.

Question 15

A mother asks the nurse if she should be concerned about the tendency of her child to stutter. What assessment data will be MOST useful in counseling the parent?

Accepted Answer

Answer reason: Normal developmental dysfluency (stuttering) commonly occurs in preschool-aged children as language outpaces motor speech skills; therefore the child’s age is the most useful data for counseling.

Question 16

The nurse assesses delayed gross motor development in a three year-old child. Which of the following observations confirms this finding? The child cannot?

Accepted Answer

Answer reason: By age 3, a typical gross motor milestone is the ability to briefly balance on one foot; inability to do so indicates delay. Skipping and riding a bicycle are skills expected at older ages.

Question 17

A mother wants to switch her 9 month-old infant from an iron-fortified formula to whole milk because of the expense. Upon further assessment, the nurse finds that the baby eats table foods well, but drinks less milk than before. The advice by the nurse should be to?

Accepted Answer

Answer reason: Whole cow's milk is not recommended before 12 months due to low iron content and risk of iron-deficiency anemia; the infant should remain on iron-fortified formula. Adding syrup or offering fruit juice is inappropriate.

Question 18

A 2 1/2 year-old child is admitted to the hospital unit. Which of the following toys would be appropriate for the nurse to select from the toy room for this child?

Accepted Answer

Answer reason: Toddlers (about 2–3 years) need safe, simple toys with large pieces that foster fine-motor and problem-solving skills; wooden puzzles are appropriate. Scissors are unsafe, stickers may be a choking risk, and a beach ball is less developmentally targeted.

Question 19

The nurse is preparing a five year-old for a scheduled tonsillectomy and adenoidectomy. The parents are anxious and concerned about the child's reaction to impending surgery. Which nursing intervention would be BEST to prepare the child?

Accepted Answer

Answer reason: A 5-year-old can understand simple explanations; providing preparation about a week before surgery is developmentally appropriate and reduces anxiety. Meeting all staff or touring the OR is unnecessary and may increase anxiety; bringing a toy offers comfort but does not best prepare the child.

Question 20

While working with an obese adolescent, it is important for the nurse to recognize that obesity in adolescents is most often associated with?

Accepted Answer

Answer reason: Adolescent obesity is strongly linked to decreased self-esteem and dissatisfaction with appearance, leading to poor body image; the other options are less consistently associated.

Question 21

A mother asks about expected motor skills for a 3 year-old child. Which of the following would the nurse emphasize as normal at this age?

Accepted Answer

Answer reason: At 3 years, normal gross motor milestones include pedaling a tricycle. Jumping rope, hopscotch, and tying shoelaces require more advanced coordination, typically at 5–6 years.

Question 22

In evaluating growth of a 12 month-old child, the nurse expects to find that the infant has?

Accepted Answer

Answer reason: By 12 months, infants typically triple their birth weight. Length increases about 50%, they usually have 6–8 teeth, and head and chest circumferences approximate around 1–2 years.

Question 23

The nurse is assessing a healthy child at the 2 year check up. Which of the following should the nurse report IMMEDIATELY to the physician?

Accepted Answer

Answer reason: At age 2, height and weight percentiles should track similarly on the growth curve; a wide discrepancy suggests possible underlying pathology and warrants immediate reporting. Differences between recumbent and standing height and minor short-term weight fluctuations can be normal, and slight slowing of growth may occur around this age.

Question 24

The parents of a two year-old child report that he has been holding his breath whenever he has temper tantrums. The BEST response of the nurse would be to?

Accepted Answer

Answer reason: Breath-holding spells in toddlers are typically benign and self-limited; respiration resumes reflexively. Ignoring the behavior avoids reinforcement. Giving in rewards tantrums, CPR is unnecessary, and reasoning is ineffective at this developmental stage.

Question 25

The nurse is discussing negativism with the parents of a 30 month-old child. The nurse should tell the parents that their BEST response to this behavior would be to?

Accepted Answer

Answer reason: Negativism is typical in toddlers developing autonomy. The most therapeutic parental response is patience and humor, not punitive time-outs (15 minutes is excessive for age), permissiveness, or authoritarian limit-setting.

Question 26

In planning care for an infant, the nurse is aware that the six month-old infant's development of trust is met PRIMARILY by providing?

Accepted Answer

Answer reason: Erikson’s trust vs. mistrust stage: consistent, responsive caregiving that provides a sense of security fosters trust more than merely meeting physical needs like food or warmth.

Question 27

Parents of a 6 month-old breast fed baby ask the nurse about increasing the baby's diet. Which of the following should be added FIRST?

Accepted Answer

Answer reason: At about 6 months the first solid food recommended is iron-fortified single-grain cereal; high-allergen foods like eggs and complex proteins like meat are introduced later, and juice is not recommended as a first addition.

Question 28

In terms of cognitive development, a three-year-old would be expected to?

Accepted Answer

Answer reason: At about age 3 (Piaget preoperational stage), children typically exhibit magical thinking and egocentrism; they do not yet understand conservation, perspective-taking, or abstract thought.

Question 29

The nurse is performing a physical assessment on a toddler. Which of the following should be the FIRST action?

Accepted Answer

Answer reason: Toddlers are often fearful and uncooperative; beginning with minimal physical contact helps gain trust and cooperation. Traumatic procedures should be last, strict head-to-toe order is not necessary, and detailed explanations are not effective at this age.

Question 30

What nursing observation signifies that a client has attained the stage of concrete operations (Piaget)?

Accepted Answer

Answer reason: Concrete operational stage (school-age) is marked by logical thinking and emerging moral judgments; A corresponds to sensorimotor, B to preoperational symbolism, and D suggests more advanced/formal reasoning.

Question 31

While the nurse assesses a 2 month-old infant, the mother expresses concern because a flat pink birthmark on the baby's forehead and eyelid has not gone away. The nurse should tell the parents that?

Accepted Answer

Answer reason: A flat pink patch on the forehead/eyelid in an infant is a telangiectatic nevus (salmon patch/stork bite), a benign normal variant that typically fades by 1–2 years. The other options do not address this lesion or suggest unnecessary concern or intervention.

Question 32

The parents of a 4 year-old hospitalized child tell the nurse they will leave for a time and return at 6 PM. When the child asks when the parents will come again, the nurse can BEST respond by saying?

Accepted Answer

Answer reason: Preschoolers have limited understanding of clock time; they understand time best when anchored to routine events. Linking the return to a familiar event (supper) is clearest and most developmentally appropriate.

Question 33

The nurse is aware that which of the following psychosocial needs are BEST described in the adolescent when hospitalized?

Accepted Answer

Answer reason: Adolescents prioritize privacy, desire for autonomy, and strong peer relationships, which are key psychosocial needs during hospitalization.

Question 34

Which of the following interventions BEST demonstrates the nurse's sensitivity to a 16 year-old's appropriate need for autonomy?

Accepted Answer

Answer reason: Adolescents seek autonomy and privacy. Offering time to discuss concerns without parents supports independence and decision making, best addressing this developmental need.

Question 35

What is the normal birth weight of a 4-year-old child?

Accepted Answer

Answer reason: Expected weight for a 4-year-old is about 14–16 kg; using the common formula (age × 2) + 6 ≈ 14 kg. Thus 14 kg is the best answer; 2.5 kg is newborn birth weight and the other values are less consistent.

Question 36

At what age does a child typically begin to make self-decisions?

Accepted Answer

Answer reason: Around age 7, children enter the concrete operational stage and can provide assent and make simple, independent choices, reflecting emerging self-decision making.

Question 37

A nurse is assessing a newborn’s primitive reflexes. Which finding indicates a normal neonatal reflex response?

Accepted Answer

Answer reason: The stepping reflex—automatic walking-like movements—indicates normal neurologic development and is expected in healthy newborns.

Question 38

Taste perception of baby develops at?

Accepted Answer

Answer reason: Neonates have functional taste buds at birth and show clear behavioral responses to different tastes, preferring sweet and grimacing to bitter or sour. Fetal taste receptors develop in utero and are innervated by cranial nerves VII, IX, and X before delivery. Thus, taste perception is present from birth.

Question 39

The usual age of closure of the anterior fontanelle is?

Accepted Answer

Answer reason: The anterior fontanelle normally closes between 12 and 18 months as cranial bones and sutures mature. In contrast, the posterior fontanelle closes much earlier, around 1–2 months. Premature closure suggests craniosynostosis or dehydration, while delayed closure beyond 24 months may be associated with hypothyroidism or rickets. Therefore, 12–18 months is the expected timeframe.

Question 40

A period of transition from breast milk or bottle feeding to solid food is termed as?

Accepted Answer

Answer reason: The transition from exclusive breastfeeding or bottle feeding to complementary solid foods is called weaning. It typically begins when the infant shows readiness cues and is developmentally able to handle solids. Dieting refers to intentional intake restriction, digestion is the physiological breakdown of food, and nutrition is the overall process of nutrient intake and use—none name the transition itself.

Question 41

At what age do most babies begin to crawl?

Accepted Answer

Answer reason: Crawling typically emerges after infants develop sitting balance and strength, most commonly around 9 months, with a normal range of about 7–10 months. Earlier ages (3–7 months) are more associated with rolling and supported sitting rather than reciprocal crawling. Ages 11–14 months reflect later gross-motor milestones such as cruising and independent walking for many children. Therefore, 7–10 months best represents when most babies begin to crawl.

Question 42

Normal age range for onset of puberty in girls?

Accepted Answer

Answer reason: Normal pubertal onset in girls (thelarche as the first sign) typically begins between ages 8 and 13 years. Onset before age 8 is generally considered precocious puberty and warrants evaluation. Ranges like 6–9 include many abnormal early cases, while 10–14 starts too late and would miss normal early puberty.

Question 43

Normal age range for onset of puberty in boys?

Accepted Answer

Answer reason: The typical onset of puberty in boys occurs around ages 9–14 years, with testicular enlargement generally being the first clinical sign. Earlier onset than about age 9 suggests precocious puberty, while lack of pubertal signs by about age 14 raises concern for delayed puberty. Therefore, the best matching normal range among the options is 9–14 years.

Question 44

A nurse is assessing several clients on the pediatric floor. Which of the following clients would warrant further evaluation?

Accepted Answer

Answer reason: The posterior fontanelle normally closes by about 1–2 months of age; an open posterior fontanelle at 7 months is delayed and warrants further assessment for underlying issues (e.g., hypothyroidism, increased intracranial pressure, skeletal/metabolic disorders). In contrast, rolling from supine to prone may not be expected until closer to 5–6 months, so a 3-month-old not doing this can be normal. Drawing a cross is typically a ~4–5 year fine-motor milestone, so “just started” at age 4 can still be within normal variation, and a natal/neonatal tooth can occur and mainly raises feeding/aspiration/ulceration considerations rather than being an automatic developmental red flag.

Question 45

Tanner stage 1 represents?

Accepted Answer

Answer reason: Tanner stage 1 indicates no pubertal development and is considered the prepubertal stage. In females, breast development begins at Tanner stage 2 (the breast bud stage), not stage 1. Peak height velocity typically occurs later during mid-puberty rather than at stage 1. Adult-type development corresponds to Tanner stage 5.

Question 46

Growth spurt in girls occurs?

Accepted Answer

Answer reason: In girls, the peak height velocity typically occurs during early-to-mid puberty, after the onset of breast development (thelarche) and usually before the first menstrual period (menarche). Menarche tends to occur after the peak growth spurt, and growth slows afterward with only a small additional gain in height. Therefore, the best timing description is between thelarche and menarche.

Question 47

What is the Toddler Age?

Accepted Answer

Answer reason: In standard pediatric developmental staging, the toddler period generally spans from 1 year (12 months) to 3 years (36 months). Ages 0–1 year correspond to infancy, while 3–5 years is typically classified as the preschool period. Therefore, 1–3 years is the best match for the toddler age range among the options provided.

Question 48

Growth spurt in boys occurs?

Accepted Answer

Answer reason: In male puberty, the peak height velocity (adolescent growth spurt) typically occurs in mid-puberty and generally precedes some later secondary sex characteristics such as the most noticeable voice deepening. Testicular enlargement is usually the first sign of puberty, occurring before the growth spurt, so option A is incorrect. Boys also have their growth spurt later than girls, making option D incorrect, and it is driven by rising sex steroids and growth hormone rather than occurring after peak testosterone (option B).

Question 49

SCENARIO A 5-year-old child who has mild developmental delay is learning to self-dress. Most recently, the child has mastered putting on and taking off a coat, as well as buttoning and unbuttoning it. From the dressing tasks listed, which should the child learn to do NEXT based on the typical developmental sequence for dressing?

Accepted Answer

Answer reason: Dressing skills progress from simpler gross-motor tasks to more complex fine-motor and bilateral coordination tasks. After mastering buttons, a child typically learns zippering next because it requires less refined dexterity than threading a belt through loops or managing a buckle. Shoelace tying is usually the most complex and is generally learned later due to the need for advanced bilateral coordination, sequencing, and finger dexterity. Therefore, pulling up a jacket zipper is the most appropriate next step in the developmental sequence.

Question 50

Nurse Adams is caring for a 2-year-old toddler who has been admitted to the hospital. Which nursing intervention should Nurse Adams expect to implement?

Accepted Answer

Answer reason: A hospitalized 2-year-old is at high risk for separation anxiety, and the presence of a parent/caregiver promotes security, cooperation, and decreased distress during care. Allowing the caregiver to remain also supports attachment and helps the child adapt to the unfamiliar environment. Asking the parent to leave increases anxiety; removing comfort items (like a blanket) is unnecessary and may worsen distress. Toddlers have limited impulse control, so reprimanding screaming is less therapeutic than providing comfort and developmentally appropriate support.

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