GCU NSG 434 Exam 1 – Nursing Care of Children – (2026) Actual Questions &
Answers.
Section 1: Growth and Development (Questions 1-30)
Question 1
A nurse is evaluating a child's growth pattern over the past year. The child's
height has decreased from the 25th percentile to the 10th percentile, while
weight has remained at the 50th percentile. Which interpretation is most
appropriate?
A) The child is experiencing catch-up growth
B) The child may have a growth hormone deficiency
C) This is a normal variation in growth velocity
D) The child is likely entering a period of rapid growth
Answer: B
Rationale: A decrease in height percentile with stable weight percentile suggests
deceleration in linear growth, which is a red flag for growth hormone deficiency
or other endocrine disorders. Catch-up growth would show an increase in
percentile. Normal variation typically maintains a consistent channel. Rapid
growth would increase percentile .
,Question 2
According to Erikson's psychosocial theory, a toddler who is not allowed to make
simple choices (e.g., which cup to use) is at risk for developing which of the
following?
A) Inferiority
B) Guilt
C) Shame and doubt
D) Mistrust
Answer: C
Rationale: Erikson's stage for toddlers is "Autonomy vs. Shame and Doubt." When
autonomy is thwarted, the child develops shame and doubt. Inferiority is from the
school-age stage (Industry vs. Inferiority), guilt from the preschool stage (Initiative
vs. Guilt), and mistrust from infancy (Trust vs. Mistrust) .
Question 3
A nurse is assessing a child who can build a tower of 8 cubes, copy a circle, and
button large buttons. Which age range is most consistent with these fine motor
skills?
,A) 12-15 months
B) 18-24 months
C) 30-36 months
D) 48-60 months
Answer: C
Rationale: Building a tower of 8 cubes, copying a circle, and buttoning large
buttons are typical of a 3-year-old (30-36 months). At 12-15 months, a child can
build a tower of 2 cubes and scribble. At 18-24 months, a tower of 4-6 cubes and
imitating a vertical line. At 4-5 years, copying a square and tying shoes .
Question 4
A nurse is providing anticipatory guidance to the family of a child with a new
diagnosis of type 1 diabetes. Which developmental consideration is most
important to include?
A) School-age children can independently manage insulin dosing
B) Adolescents may have difficulty adhering to the regimen due to peer pressure
C) Toddlers are able to recognize symptoms of hypoglycemia
D) Preschoolers can understand the concept of balancing food and activity
, Answer: B
Rationale: Adolescents often struggle with adherence due to peer pressure and
desire for normalcy. School-age children need supervision, not independence.
Toddlers cannot recognize hypoglycemia. Preschoolers cannot grasp abstract
concepts like balance .
Question 5
A nurse is using the Denver Developmental Screening Test II (DDST-II) on a child.
The child passes all items in the personal-social, fine motor, and language sectors
but fails two items in the gross motor sector that are to the right of the age line.
Which conclusion is most appropriate?
A) The child has a developmental delay in gross motor skills
B) The child is advanced in gross motor skills
C) The child's gross motor development is within normal limits
D) The test is invalid because the child refused some items
Answer: A
Rationale: On the DDST-II, items passed or failed are compared to the age line.
Failure of items to the right of the age line (which are expected to be passed by
Answers.
Section 1: Growth and Development (Questions 1-30)
Question 1
A nurse is evaluating a child's growth pattern over the past year. The child's
height has decreased from the 25th percentile to the 10th percentile, while
weight has remained at the 50th percentile. Which interpretation is most
appropriate?
A) The child is experiencing catch-up growth
B) The child may have a growth hormone deficiency
C) This is a normal variation in growth velocity
D) The child is likely entering a period of rapid growth
Answer: B
Rationale: A decrease in height percentile with stable weight percentile suggests
deceleration in linear growth, which is a red flag for growth hormone deficiency
or other endocrine disorders. Catch-up growth would show an increase in
percentile. Normal variation typically maintains a consistent channel. Rapid
growth would increase percentile .
,Question 2
According to Erikson's psychosocial theory, a toddler who is not allowed to make
simple choices (e.g., which cup to use) is at risk for developing which of the
following?
A) Inferiority
B) Guilt
C) Shame and doubt
D) Mistrust
Answer: C
Rationale: Erikson's stage for toddlers is "Autonomy vs. Shame and Doubt." When
autonomy is thwarted, the child develops shame and doubt. Inferiority is from the
school-age stage (Industry vs. Inferiority), guilt from the preschool stage (Initiative
vs. Guilt), and mistrust from infancy (Trust vs. Mistrust) .
Question 3
A nurse is assessing a child who can build a tower of 8 cubes, copy a circle, and
button large buttons. Which age range is most consistent with these fine motor
skills?
,A) 12-15 months
B) 18-24 months
C) 30-36 months
D) 48-60 months
Answer: C
Rationale: Building a tower of 8 cubes, copying a circle, and buttoning large
buttons are typical of a 3-year-old (30-36 months). At 12-15 months, a child can
build a tower of 2 cubes and scribble. At 18-24 months, a tower of 4-6 cubes and
imitating a vertical line. At 4-5 years, copying a square and tying shoes .
Question 4
A nurse is providing anticipatory guidance to the family of a child with a new
diagnosis of type 1 diabetes. Which developmental consideration is most
important to include?
A) School-age children can independently manage insulin dosing
B) Adolescents may have difficulty adhering to the regimen due to peer pressure
C) Toddlers are able to recognize symptoms of hypoglycemia
D) Preschoolers can understand the concept of balancing food and activity
, Answer: B
Rationale: Adolescents often struggle with adherence due to peer pressure and
desire for normalcy. School-age children need supervision, not independence.
Toddlers cannot recognize hypoglycemia. Preschoolers cannot grasp abstract
concepts like balance .
Question 5
A nurse is using the Denver Developmental Screening Test II (DDST-II) on a child.
The child passes all items in the personal-social, fine motor, and language sectors
but fails two items in the gross motor sector that are to the right of the age line.
Which conclusion is most appropriate?
A) The child has a developmental delay in gross motor skills
B) The child is advanced in gross motor skills
C) The child's gross motor development is within normal limits
D) The test is invalid because the child refused some items
Answer: A
Rationale: On the DDST-II, items passed or failed are compared to the age line.
Failure of items to the right of the age line (which are expected to be passed by
