NSG 3600 Exam 3 Children's Health
Guide Official Practice Exam Actual
Exam 2026/2027 with Detailed Rationales
| Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
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SECTION 1: GROWTH & DEVELOPMENT Q1 – Q10
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Question 1 of 50
A nurse is conducting a well-child visit for a 4-month-old infant who was born at 38 weeks gestation.
The mother reports the infant can hold the head steady when upright, brings hands to the mouth,
and smiles spontaneously. During the exam, the nurse notes the infant cannot yet roll from prone to
supine. The nurse should recognize this developmental pattern as:
A. Expected for a 4-month-old, with rolling typically emerging closer to 6 months
B. Delayed gross motor development requiring immediate physical therapy referral
C. Normal for a preterm infant who needs adjusted age calculations until 24 months
D. Concerning for cerebral palsy given the inability to roll at this age ✓ CORRECT
Correct Answer: D
Rationale: The inability to roll from prone to supine by 4 months, combined with the described motor
patterns, raises concern for cerebral palsy, particularly given the infant's gestational age and the
asymmetry often seen in early presentations. Rolling typically emerges between 4-6 months, but the
overall pattern of limited mobility warrants further evaluation rather than reassurance. Early
identification and intervention are critical for optimizing neurodevelopmental outcomes in infants
with suspected motor delays.
Question 2 of 50
During a routine 12-month well-child visit, a mother tells the nurse her son says "mama" and "dada"
specifically, pulls to stand, and uses a pincer grasp to pick up small cereal pieces. However, she is
worried because he will not let go of objects when asked and becomes frustrated. The nurse's best
response is:
,A. "This behavior suggests he may have an emerging behavioral disorder that we should monitor
closely."
B. "At 12 months, children typically cannot follow commands to release objects, so this is expected." ✓
CORRECT
C. "He should be able to follow simple commands like 'give me' by now, so let's schedule a speech
evaluation."
D. "This indicates fine motor delay since he cannot coordinate the release of objects voluntarily."
Correct Answer: B
Rationale: Voluntary release of objects typically emerges around 12-15 months, so an inability to let
go on command at 12 months is developmentally appropriate and not a concern. The infant's use of
specific words, pulling to stand, and pincer grasp all meet expected 12-month milestones. Reassuring
the mother with accurate developmental expectations prevents unnecessary anxiety and promotes
positive parent-child interactions.
Question 3 of 50
A school nurse is assessing a 6-year-old child in first grade who was recently adopted from an
international orphanage. The child can draw a person with 6 parts, ties shoelaces independently, and
understands the concept of tomorrow versus yesterday. However, the child struggles to skip and
cannot consistently catch a bounced ball. The nurse should prioritize which nursing action?
A. Refer the child for occupational therapy due to suspected fine motor deficits
B. Notify the teacher that the child likely has a learning disability requiring an IEP
C. Recognize that gross motor skills like skipping typically develop around age 5-6 and monitor
progress ✓ CORRECT
D. Recommend immediate developmental screening for autism spectrum disorder
Correct Answer: C
Rationale: Skipping and catching a bounced ball are gross motor skills that typically mature between
ages 5 and 6, so inconsistent performance at age 6 falls within normal variation, especially
considering the child's background of institutional care. The child's cognitive and fine motor skills,
including drawing a person with 6 parts and understanding time concepts, meet expected 6-year
milestones. Monitoring with culturally sensitive developmental surveillance is the most appropriate
initial approach rather than pathologizing normal developmental variability.
Question 4 of 50
A pediatric nurse is teaching a new mother about age-appropriate play for her 9-month-old infant.
The mother asks what toys would best support her baby's current developmental stage. The nurse
should recommend:
, A. Simple board games that teach turn-taking and rule-following
B. Push-pull toys that encourage early walking and gross motor practice
C. Nesting cups and soft blocks that promote object permanence and fine motor skills ✓ CORRECT
D. Crayons and paper for early scribbling and creative expression
Correct Answer: C
Rationale: At 9 months, infants are developing object permanence and refining their pincer grasp,
making nesting cups and soft blocks ideal for this stage as they support both cognitive and fine
motor development. Push-pull toys are more appropriate for 12-18 months when walking emerges,
while board games and crayons target preschool developmental stages. Selecting toys that match
the infant's current abilities prevents frustration and supports optimal developmental progression
through appropriate stimulation.
Question 5 of 50
A nurse is caring for a hospitalized 3-year-old who is having a tonsillectomy tomorrow. The child
keeps asking the same question about whether the surgery will hurt, despite the nurse providing a
calm, honest answer multiple times. The child's mother becomes frustrated and tells the child to stop
asking. The nurse's most therapeutic response is:
A. "Your child is being manipulative and testing boundaries, which is common before surgery."
B. "Three-year-olds often need repeated explanations to process information, so patience is
important." ✓ CORRECT
C. "Let's distract your child with a video so they stop focusing on the surgery."
D. "You should tell your child that the surgery won't hurt at all to reduce anxiety."
Correct Answer: B
Rationale: Preschool-aged children process information through repetition and magical thinking, so
asking the same question repeatedly is a normal cognitive strategy for managing anxiety and
understanding upcoming events. Providing honest, developmentally appropriate explanations with
patience supports the child's emotional coping and builds trust in the healthcare team. Dismissing the
behavior as manipulative or using distraction avoids addressing the child's genuine need for
reassurance and may increase preoperative anxiety.
Question 6 of 50
During a home health visit, a nurse observes a 15-month-old toddler climbing onto the coffee table,
opening cabinet doors, and attempting to use a spoon during snack time. The mother states the
toddler has about 5 words and walks independently. The nurse identifies which behavior as requiring
immediate safety intervention?
Guide Official Practice Exam Actual
Exam 2026/2027 with Detailed Rationales
| Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: GROWTH & DEVELOPMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A nurse is conducting a well-child visit for a 4-month-old infant who was born at 38 weeks gestation.
The mother reports the infant can hold the head steady when upright, brings hands to the mouth,
and smiles spontaneously. During the exam, the nurse notes the infant cannot yet roll from prone to
supine. The nurse should recognize this developmental pattern as:
A. Expected for a 4-month-old, with rolling typically emerging closer to 6 months
B. Delayed gross motor development requiring immediate physical therapy referral
C. Normal for a preterm infant who needs adjusted age calculations until 24 months
D. Concerning for cerebral palsy given the inability to roll at this age ✓ CORRECT
Correct Answer: D
Rationale: The inability to roll from prone to supine by 4 months, combined with the described motor
patterns, raises concern for cerebral palsy, particularly given the infant's gestational age and the
asymmetry often seen in early presentations. Rolling typically emerges between 4-6 months, but the
overall pattern of limited mobility warrants further evaluation rather than reassurance. Early
identification and intervention are critical for optimizing neurodevelopmental outcomes in infants
with suspected motor delays.
Question 2 of 50
During a routine 12-month well-child visit, a mother tells the nurse her son says "mama" and "dada"
specifically, pulls to stand, and uses a pincer grasp to pick up small cereal pieces. However, she is
worried because he will not let go of objects when asked and becomes frustrated. The nurse's best
response is:
,A. "This behavior suggests he may have an emerging behavioral disorder that we should monitor
closely."
B. "At 12 months, children typically cannot follow commands to release objects, so this is expected." ✓
CORRECT
C. "He should be able to follow simple commands like 'give me' by now, so let's schedule a speech
evaluation."
D. "This indicates fine motor delay since he cannot coordinate the release of objects voluntarily."
Correct Answer: B
Rationale: Voluntary release of objects typically emerges around 12-15 months, so an inability to let
go on command at 12 months is developmentally appropriate and not a concern. The infant's use of
specific words, pulling to stand, and pincer grasp all meet expected 12-month milestones. Reassuring
the mother with accurate developmental expectations prevents unnecessary anxiety and promotes
positive parent-child interactions.
Question 3 of 50
A school nurse is assessing a 6-year-old child in first grade who was recently adopted from an
international orphanage. The child can draw a person with 6 parts, ties shoelaces independently, and
understands the concept of tomorrow versus yesterday. However, the child struggles to skip and
cannot consistently catch a bounced ball. The nurse should prioritize which nursing action?
A. Refer the child for occupational therapy due to suspected fine motor deficits
B. Notify the teacher that the child likely has a learning disability requiring an IEP
C. Recognize that gross motor skills like skipping typically develop around age 5-6 and monitor
progress ✓ CORRECT
D. Recommend immediate developmental screening for autism spectrum disorder
Correct Answer: C
Rationale: Skipping and catching a bounced ball are gross motor skills that typically mature between
ages 5 and 6, so inconsistent performance at age 6 falls within normal variation, especially
considering the child's background of institutional care. The child's cognitive and fine motor skills,
including drawing a person with 6 parts and understanding time concepts, meet expected 6-year
milestones. Monitoring with culturally sensitive developmental surveillance is the most appropriate
initial approach rather than pathologizing normal developmental variability.
Question 4 of 50
A pediatric nurse is teaching a new mother about age-appropriate play for her 9-month-old infant.
The mother asks what toys would best support her baby's current developmental stage. The nurse
should recommend:
, A. Simple board games that teach turn-taking and rule-following
B. Push-pull toys that encourage early walking and gross motor practice
C. Nesting cups and soft blocks that promote object permanence and fine motor skills ✓ CORRECT
D. Crayons and paper for early scribbling and creative expression
Correct Answer: C
Rationale: At 9 months, infants are developing object permanence and refining their pincer grasp,
making nesting cups and soft blocks ideal for this stage as they support both cognitive and fine
motor development. Push-pull toys are more appropriate for 12-18 months when walking emerges,
while board games and crayons target preschool developmental stages. Selecting toys that match
the infant's current abilities prevents frustration and supports optimal developmental progression
through appropriate stimulation.
Question 5 of 50
A nurse is caring for a hospitalized 3-year-old who is having a tonsillectomy tomorrow. The child
keeps asking the same question about whether the surgery will hurt, despite the nurse providing a
calm, honest answer multiple times. The child's mother becomes frustrated and tells the child to stop
asking. The nurse's most therapeutic response is:
A. "Your child is being manipulative and testing boundaries, which is common before surgery."
B. "Three-year-olds often need repeated explanations to process information, so patience is
important." ✓ CORRECT
C. "Let's distract your child with a video so they stop focusing on the surgery."
D. "You should tell your child that the surgery won't hurt at all to reduce anxiety."
Correct Answer: B
Rationale: Preschool-aged children process information through repetition and magical thinking, so
asking the same question repeatedly is a normal cognitive strategy for managing anxiety and
understanding upcoming events. Providing honest, developmentally appropriate explanations with
patience supports the child's emotional coping and builds trust in the healthcare team. Dismissing the
behavior as manipulative or using distraction avoids addressing the child's genuine need for
reassurance and may increase preoperative anxiety.
Question 6 of 50
During a home health visit, a nurse observes a 15-month-old toddler climbing onto the coffee table,
opening cabinet doors, and attempting to use a spoon during snack time. The mother states the
toddler has about 5 words and walks independently. The nurse identifies which behavior as requiring
immediate safety intervention?
