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VERSION 1: Pediatric Proctored Exam
Growth & Development (Questions 1-15)
Q1: A nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone would the nurse expect to observe?
A. The infant pulls to a standing position
B. The infant transfers objects from hand to hand [CORRECT]
C. The infant builds a tower of two cubes
D. The infant uses a pincer grasp to pick up small objects
Correct Answer: B
Rationale: By 6 months, infants typically transfer objects from hand to hand,
demonstrating improved bilateral coordination. Option A (pulling to stand) occurs
around 9 months. Option C (building a tower of two cubes) is a 15-month milestone.
Option D (pincer grasp) develops around 9-10 months. This question tests knowledge of
,fine motor development sequences; confusing these milestones could lead to missed
developmental delays.
Q2: The parent of a 2-year-old expresses concern that their child says "no" to everything
and has frequent tantrums. Which response by the nurse demonstrates understanding
of toddler development?
A. "This behavior indicates your child is spoiled and needs more discipline"
B. "This is normal behavior as your child develops autonomy; offer simple choices to
foster independence [CORRECT]"
C. "Your child is showing signs of oppositional defiant disorder and needs evaluation"
D. "This behavior will stop if you ignore the tantrums completely"
Correct Answer: B
Rationale: According to Erikson's psychosocial theory, toddlers (1-3 years) are in the
autonomy vs. shame and doubt stage. Saying "no" and tantrums reflect normal
struggles for independence. Option A pathologizes normal development. Option C
incorrectly labels normal behavior as a disorder. Option D suggests neglect rather than
appropriate guidance. Offering choices supports autonomy while maintaining limits.
Q3: A school nurse is preparing a health education program for fifth graders (age
10-11). According to Piaget's theory of cognitive development, which teaching strategy
is most appropriate?
,A. Use simple concrete examples and hands-on activities [CORRECT]
B. Focus on abstract concepts and hypothetical scenarios
C. Emphasize learning through repetition and sensory experiences
D. Teach primarily through lecture and complex theoretical discussion
Correct Answer: A
Rationale: Fifth graders are typically in Piaget's concrete operational stage (7-11 years),
characterized by logical thinking about concrete events. Option B describes formal
operational thinking (11+ years). Option C describes sensorimotor/preoperational
stages. Option D exceeds their cognitive capacity. Understanding developmental stages
prevents educational mismatches that reduce learning effectiveness.
Q4: During a routine checkup, a nurse notes that a 4-month-old infant cannot hold the
head steady when upright. Which action should the nurse prioritize?
A. Reassure the parents that this is normal for a 4-month-old
B. Document the finding and schedule follow-up in 3 months
C. Notify the provider immediately for further evaluation [CORRECT]
D. Teach the parents exercises to strengthen neck muscles
Correct Answer: C
Rationale: Head control should be achieved by 4 months; inability to hold the head
steady suggests developmental delay or neurological issues requiring immediate
, evaluation. Option A is dangerous reassurance. Option B delays necessary intervention.
Option D is inappropriate without medical clearance. Early identification of
developmental delays enables timely early intervention services.
Q5: A nurse is caring for a hospitalized 8-year-old. Which approach best supports the
child's psychosocial needs according to developmental stage?
A. Encourage dependence on parents for all care activities
B. Provide opportunities for decision-making and schoolwork [CORRECT]
C. Treat the child as an infant to reduce anxiety
D. Avoid discussing the illness to prevent fear
Correct Answer: B
Rationale: School-age children (6-12 years) are in Erikson's industry vs. inferiority stage,
valuing achievement and competence. They benefit from age-appropriate
responsibilities and continued education. Option A promotes regression. Option C is
developmentally inappropriate. Option D increases anxiety through uncertainty.
Supporting industry prevents feelings of inferiority during hospitalization.
Q6: Which finding during a developmental assessment of a 9-month-old requires
immediate nursing intervention?
A. The infant crawls backward