Question 1

Parents of a 15-year-old state that he is moody and rude. The nurse should advise his parents to?

Accepted Answer

Answer reason: Adolescence commonly involves mood variability, boundary testing, and intermittent oppositional behavior as part of normal developmental transition toward autonomy. The safest first-line guidance is to promote open, respectful communication so parents can set clear expectations while also exploring stressors (school, peers, sleep, substance use, depression) and reinforcing supportive parenting. This approach strengthens the parent–teen relationship and helps identify whether behavior is within normal limits or signals a problem requiring further evaluation. Restricting activities is primarily punitive and can escalate conflict without addressing underlying causes. Family counseling may be appropriate if communication fails or there are red flags, but it is not the initial recommendation for typical adolescent moodiness.

Question 2

The infant period is from birth up to?

Accepted Answer

Answer reason: g., head control, sitting, standing, early language) are expected. This cutoff is used to guide anticipatory guidance, immunization timing, feeding recommendations, and safety counseling. Ages beyond 12 months are classified as toddlerhood, which has distinct developmental tasks and risk profiles. Options extending infancy to 2 or 5 years would incorrectly merge infant and toddler/preschool stages and would misalign routine developmental screening expectations.

Question 3

When assessing for pain in a toddler, which of the following methods should be the most appropriate?

Accepted Answer

Answer reason: Toddlers have limited language and cognitive skills, so pain assessment is most reliable when based on observable behavioral cues rather than self-report. Restlessness, irritability, guarding, and changes in activity/interaction are common manifestations of pain in this age group. Numeric pain scales require abstract understanding of quantity and are generally inappropriate for toddlers. Vital signs can support suspicion of pain but are nonspecific and may be normal even when significant pain is present.

Question 4

When developing the teaching plan about illness for the mother of a preschooler, which of the following should the nurse include about how a preschooler perceives illness?

Accepted Answer

Answer reason: Preschoolers are in a preoperational stage of cognitive development with magical thinking and egocentrism, so they often link events to their own actions. They may believe illness happens because they were “bad” or did something wrong, leading to guilt and fear. Teaching should therefore emphasize that illness is not caused by misbehavior and provide simple, concrete explanations. Options reflecting mature abstract or spiritual interpretations are more typical of older children or adults and are less developmentally appropriate for preschoolers.

Question 5

A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. Which of the following should the nurse try first?

Accepted Answer

Answer reason: Toddlers commonly experience separation anxiety and fear of unfamiliar procedures, so the least restrictive, most developmentally appropriate first step is to use the parent as a source of security and cooperation. Having the parent hold/comfort the child can improve compliance and allows a safer ear exam by reducing sudden movement. Immediately restraining the child is more invasive and can escalate distress, and should be reserved for when necessary to prevent injury. Waiting for the child to calm without intervention may prolong care and is often ineffective at this age, while calling another nurse is usually unnecessary before using the caregiver.

Question 6

Which of the following findings during an adolescent health screening requires further teaching?

Accepted Answer

Answer reason: The key principle is that “growing pains” is not a diagnosis and can be an imprecise label that may delay evaluation of red-flag musculoskeletal conditions. Adolescents should be taught to report specifics (location, timing, severity, activity limitation) and seek assessment if pain is persistent, unilateral, associated with swelling, fever, limp, nighttime waking, or functional impairment. This response suggests a need for education to avoid normalizing potentially abnormal pain. In contrast, menarche two years ago is typically within expected development, and the other findings may or may not be concerning depending on context but are not inherently incorrect statements requiring teaching.

Question 7

A nurse is assessing the growth and development of a 10-year-old. What is the expected behavior of this child?

Accepted Answer

Answer reason: School-age children (about 6–12 years) are in Erikson’s industry vs. inferiority stage, where they develop competence through rules, teamwork, and achievement. By around age 10, peers and structured games become important, and children commonly show increased respect for rules and fairness. This aligns with a growing conscience and moral reasoning that emphasizes “right vs. wrong” and equal treatment. The other choices describe traits more typical of toddlers/preschoolers (egocentrism, need for overt physical affection) or suggest maladaptive social functioning rather than expected development.

Question 8

After teaching a group of parents about temper tantrums, the nurse knows the teaching has been effective when one of the parents states which of the following?

Accepted Answer

Answer reason: ” Temper tantrums in toddlers are common and are reinforced by attention from caregivers. Planned ignoring of the behavior (while ensuring safety) helps extinguish the tantrum by removing the reward of attention. Talking to the child or picking the child up during the tantrum can unintentionally reinforce and prolong the behavior. Time-out can be appropriate for aggression or unsafe behavior, but the foundational teaching for typical tantrums is to avoid giving attention until the child calms, then reinforce calm behavior.

Question 9

A parent brings a 4-month-old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which findings in the infant would indicate the need for further developmental screening?

Accepted Answer

Answer reason: Persistent head lag at 4 months suggests delayed gross motor and neuromuscular development, because infants should have improving head control by this age. This is a concerning red flag on developmental surveillance that warrants further standardized screening and possible referral. By contrast, lack of interest in peek-a-boo is not expected to be well established until later in infancy, making it less specific at 4 months. Not rolling front-to-back and limited babbling can still fall within normal variation at this exact age, whereas ongoing head lag is more strongly associated with developmental delay.

Question 10

A nurse is instructing a group of day care providers about child development. Which of the following is an example of how toddlers usually play?

Accepted Answer

Answer reason: Sitting near each other while each child plays independently with their own toy matches this normal developmental pattern. The other choices involve cooperative behaviors such as sharing, turn-taking, or collaborating on a single task, which are more typical of later preschool developmental stages. Recognizing expected play patterns helps caregivers set realistic expectations and identify potential developmental delays.

Question 11

An uncle is shopping for a toy to give his niece. He has no children of his own and asks his neighbor, a nurse, what would be the most appropriate toy to give a 15-month-old child. Which toy should the nurse recommend to facilitate learning and development?

Accepted Answer

Answer reason: A 15-month-old is a toddler developing gross motor skills, balance, and increasing independence through walking and active exploration. Push-pull toys promote ambulation, coordination, and cause-and-effect learning as the child moves and manipulates the toy. Options like a nursery mobile are more appropriate for younger infants with limited mobility, and a music box is largely passive play. A stuffed animal can support comfort and pretend play, but it does not target the key gross-motor developmental tasks typical at this age as strongly as push-pull activity toys.

Question 12

Which of the following is appropriate language development for an 8-month-old? The child should be?

Accepted Answer

Answer reason: At around 6–10 months, infants commonly begin babbling with consonant sounds and may use “mama/dada” without consistent meaning or correct referent. Specific use of “mama” and “dada” for the correct parent is more typical closer to 10–12 months as receptive/expressive language and object permanence strengthen. Saying several additional clear words is generally expected later, around 12–15 months. Naming an object on request (e.g., saying “ball” when pointed to) is also a later expressive milestone that usually develops after the first year.

Question 13

The parent of the 7-year-old child is dying. The nurse anticipates the child will have which concept of death?

Accepted Answer

Answer reason: By the school-age years (about 6–12), children typically develop a more mature understanding of death that includes universality and irreversibility. A 7-year-old can usually grasp that death happens to all living things and that the person will not return. Younger preschool children are more likely to view death as temporary or reversible (similar to sleep) and may use magical thinking. This developmental expectation guides the nurse to use clear, concrete explanations and allow questions to support coping.

Question 14

A mother states that she thinks her 9-month-old "is developing slowly." When assessing the infant's development, the nurse is also concerned because the infant should be demonstrating which of the following characteristics?

Accepted Answer

Answer reason: By around 9 months, infants typically demonstrate early expressive language such as babbling with single syllables, reflecting expected neurologic and social development for this age. Absence of this milestone can be an early sign of developmental delay and warrants further developmental screening and hearing evaluation. Standing alone and building a two-cube tower are generally later gross/fine motor milestones closer to 11–15 months. Drinking from a cup with minimal spilling is also usually a later self-feeding skill, so its absence at 9 months is less concerning than lack of babbling.

Question 15

The parent of a 9-month-old infant is concerned that the infant's front soft spot is still open. The nurse should tell the parent?

Accepted Answer

Answer reason: " The anterior fontanel normally remains open through late infancy and typically closes around 12–18 months, so an open “front soft spot” at 9 months is an expected finding. This response provides anticipatory guidance and reassurance, which is appropriate when the finding is within normal developmental timing. Escalation to urgent evaluation or referral is reserved for concerning associated findings (e.g., bulging fontanel with fever, sunken fontanel with dehydration, abnormal head growth patterns). Measuring head circumference is an important assessment in general, but it does not directly address the parent’s concern about normal closure timing.

Question 16

The nurse is caring for a 4-year-old child with human immunodeficiency virus (HIV) infection. The nurse should expect which statement that is aligned with the psychosocial expectations of this age?

Accepted Answer

Answer reason:  Preschool-age children (around 3–5 years) commonly demonstrate magical thinking and an incomplete understanding of illness, often expecting quick recovery and viewing events in a simplistic, reversible way. This makes optimistic, concrete statements about getting better developmentally expected even in the setting of a chronic condition. In contrast, detailed awareness of death’s meaning and pain is not typical for this age and reflects more advanced cognitive development. Feeling distinctly “different than other kids” is more characteristic of older children who can make sustained social comparisons.

Question 17

The school nurse is invited to attend a meeting with several parents who express frustration with the amount of time their adolescents spend in front of the mirror and the length of time it takes them to get dressed. The nurse explains that this behavior indicates?

Accepted Answer

Answer reason: Adolescence is characterized by rapid physical changes and heightened concern about appearance as identity and self-image are being formed. Spending extended time grooming and choosing clothes commonly reflects experimentation with roles, peer comparison, and striving for a desired self-presentation. This is generally a normal developmental behavior unless it causes significant functional impairment or is accompanied by other concerning symptoms. Labeling it as pathological or primarily oppositional misinterprets a typical developmental task in this age group.

Question 18

The mother of a 4-year-old expresses concern that her child may be hyperactive. She describes the child as always in motion, constantly dropping and spilling things. Which of the following actions would be appropriate at this time?

Accepted Answer

Answer reason: Developmentally appropriate behavior and situational stressors must be assessed before labeling a preschool child as hyperactive or pursuing specialty referral. Recent changes in the home environment (e.g., new sibling, caregiver changes, conflict, disrupted routines, sleep changes) can commonly present as increased activity, clumsiness, or difficulty with impulse control. This action is a nonjudgmental, developmentally focused assessment that helps distinguish normal preschool behavior or adjustment reactions from a persistent disorder. Reassurance without assessment risks missing contributing factors, and raising abuse or neurology referral is premature without red flags or broader assessment data.

Question 19

After having a blood sample drawn, a 5-year-old child insists that the site be covered with a bandage. When the parent tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse encourages the parent to leave the bandage in place and tells the parent that the child?

Accepted Answer

Answer reason: Preschool-aged children have preoperational thinking and may use magical, literal interpretations of body functions. They can fear that an opening in the skin means body contents can "leak out," reflecting an immature concept of body boundaries and integrity. Leaving the bandage in place supports the child’s developmental need for reassurance and reduces anxiety without escalating the situation. This is more consistent with a developmental misconception than pain or fear of another procedure.

Question 20

A mother of a toilet-trained 3-year-old expresses concern over her child's bed-wetting while hospitalized. The nurse should tell the mother?

Accepted Answer

Answer reason:  Hospitalization is a major stressor that can cause temporary regression in previously mastered developmental skills, including toileting, especially in toddlers and preschoolers. This response normalizes the behavior and supports the parent by framing it as an expected coping response to illness, unfamiliar routines, and disrupted sleep. It also avoids blaming the parent or child and reduces anxiety, which can further worsen regression. In contrast, attributing it to immaturity or “too much fluid” is inaccurate and misses the psychosocial and developmental basis of the symptom.

Question 21

A 10-year-old child proudly tells the nurse that brushing and flossing her teeth is her responsibility. The nurse interprets her statement as indicating which of the following about the child?

Accepted Answer

Answer reason: School-age children (about 6–12 years) are developing industry and increasing independence with self-care routines. A 10-year-old typically has the fine motor coordination and cognitive ability to manage daily oral hygiene with minimal supervision. The child’s pride suggests appropriate autonomy and mastery of a health habit rather than unreliability. The “too young” option underestimates normal developmental capabilities for this age group.

Question 22

The nurse is caring for an infant that was brought to the emergency room with a diagnosis of malnutrition. The nurse identifies that the infant is likely experiencing what component of the stages of development?

Accepted Answer

Answer reason: Malnutrition in an infant suggests basic physiologic needs have not been reliably met, which undermines the development of trust and promotes mistrust. The other options correspond to later developmental periods (isolation—young adulthood; initiative—preschool; generativity—middle adulthood), making them age-inappropriate for an infant. Therefore the developmental component most consistent with this presentation is mistrust.

Question 23

When caring for a 3-year-old child, the nurse should provide which toy for the child?

Accepted Answer

Answer reason: A toy set with animals and familiar objects allows the child to create stories, practice naming and sorting, and engage in symbolic play typical of this age. Puzzles can be appropriate but are more task-oriented and may be better matched to older toddlers/preschoolers depending on complexity, whereas pretend-play sets are broadly developmentally aligned at age 3. The other options are less directly targeted to symbolic, role-based play that is the hallmark developmental task for preschool children.

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Developmental Stages and Transitions Practice Test 7

Developmental Stages and Transitions NCLEX Practice Test

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