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Pediatric Nursing Practice Exam – 2026 Formatted: Centered
Formatted: Top: (Single solid line, Auto, 2.25 pt Line
Case Studies & MCQs width), Bottom: (Single solid line, Auto, 2.25 pt Line
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Section 1: Growth & Development (Questions 1-20)
1. The nurse is assessing a 12-month-old infant during a well-child visit. Which finding indicates
normal development for this age?
A) Walks independently without support
B) Uses a pincer grasp to pick up small objects
C) Speaks 10-15 words clearly
D) Builds a tower of 4 blocks
Answer: B) Uses a pincer grasp to pick up small objects
Rationale: At 12 months, infants typically use a pincer grasp, may say 1-2 words, and may walk with
assistance. Walking independently usually occurs around 12-15 months.
2. The nurse is assessing a 4-year-old child. Which developmental milestone should the child have
achieved?
A) Uses scissors to cut out a picture
B) Rides a tricycle
C) Writes their name
D) Ties shoelaces
Answer: B) Rides a tricycle
Rationale: At 4 years, children can ride a tricycle, use scissors, and draw a person with 3-4 body parts.
Tying shoelaces typically occurs at 6 years.
3. According to Erikson's theory, the developmental task of the toddler (1-3 years) is:
A) Trust vs. mistrust
B) Autonomy vs. shame and doubt
C) Initiative vs. guilt
D) Industry vs. inferiority
Answer: B) Autonomy vs. shame and doubt
Rationale: Erikson's toddler stage (1-3 years) is characterized by the conflict of autonomy versus shame
and doubt, where children develop independence and self-control.
,4. The nurse is teaching parents about toilet training. Which statement indicates understanding of
readiness cues?
A) "We will start toilet training at 12 months."
B) "We will wait until our child can stay dry for 2 hours."
C) "We will use a reward system for successful toileting."
D) "We will begin toilet training when our child turns 2."
Answer: B) "We will wait until our child can stay dry for 2 hours."
Rationale: Readiness cues for toilet training include staying dry for 2 hours, showing interest in the potty,
and being able to follow simple instructions. Starting too early can lead to frustration.
5. The nurse is assessing a newborn. Which reflex is expected to be present at birth?
A) Moro reflex
B) Parachute reflex
C) Pincer grasp
D) Neck righting reflex
Answer: A) Moro reflex
Rationale: The Moro (startle) reflex is present at birth and disappears around 4-6 months. The parachute
reflex appears around 7-9 months. The pincer grasp develops at 9-12 months.
6. The nurse is assessing a 2-year-old child. Which finding indicates normal language development?
A) Uses 2-3 word phrases
B) Speaks in complete sentences
C) Has a vocabulary of 100 words
D) Asks "why" questions
Answer: A) Uses 2-3 word phrases
Rationale: At 2 years, children typically use 2-3 word phrases and have a vocabulary of about 50 words.
Complete sentences and "why" questions usually appear at 3 years.
7. The nurse is educating parents about the nutritional needs of a 6-month-old infant. Which food
should be introduced first?
A) Strained meat
B) Iron-fortified cereal
C) Pureed fruits
D) Pureed vegetables
,Answer: B) Iron-fortified cereal
Rationale: Iron-fortified cereal is typically the first solid food introduced at 4-6 months. It is easily
digested and provides essential iron. Single-grain cereals are introduced first.
8. The nurse is assessing a school-age child's cognitive development according to Piaget. The child is in
which stage?
A) Sensorimotor stage
B) Preoperational stage
C) Concrete operational stage
D) Formal operational stage
Answer: C) Concrete operational stage
Rationale: According to Piaget, school-age children (7-11 years) are in the concrete operational stage,
characterized by logical thinking about concrete events and understanding of conservation.
9. The nurse is teaching parents about safety for a 6-month-old infant. Which instruction is most
important?
A) "Place the crib away from windows."
B) "Keep small objects out of reach."
C) "Use a car seat for every ride."
D) "Install safety gates at the top of stairs."
Answer: C) "Use a car seat for every ride."
Rationale: Car seats are essential for infant safety during travel and should be used every time. Infants
should be in a rear-facing car seat until age 2.
10. The nurse is assessing an adolescent. According to Erikson, the developmental task of adolescence
is:
A) Identity vs. role confusion
B) Intimacy vs. isolation
C) Generativity vs. stagnation
D) Integrity vs. despair
Answer: A) Identity vs. role confusion
Rationale: Adolescence (12-18 years) is characterized by Erikson's stage of identity vs. role confusion,
where adolescents explore their identity and roles.
11. The nurse is assessing a 15-month-old toddler. Which gross motor skill should the child have
achieved?
A) Walking independently
, B) Running and kicking a ball
C) Standing on one foot
D) Riding a tricycle
Answer: A) Walking independently
Rationale: By 15 months, most toddlers can walk independently. Running typically occurs at 2 years, and
standing on one foot at 4-5 years.
12. The nurse is assessing a 3-year-old child. Which fine motor skill should be expected?
A) Drawing a circle
B) Drawing a square
C) Using scissors
D) Tying shoelaces
Answer: A) Drawing a circle
Rationale: At 3 years, children can draw a circle and copy a vertical line. Drawing a square and using
scissors occur at 4 years. Tying shoelaces occurs at 6 years.
13. The nurse is teaching parents about dental health for a 2-year-old child. Which instruction is
appropriate?
A) "Use a small amount of fluoridated toothpaste."
B) "Use a pea-sized amount of fluoride toothpaste."
C) "Use toothpaste only when the child spits."
D) "Use non-fluoridated toothpaste."
Answer: A) "Use a small amount of fluoridated toothpaste."
Rationale: For children under 3 years, use a smear (grain of rice size) of fluoridated toothpaste. For
children 3-6 years, use a pea-sized amount.
14. The nurse is assessing a newborn for the presence of primitive reflexes. Which reflex is present at
birth?
A) Stepping reflex
B) Landau reflex
C) Parachute reflex
D) Neck righting reflex
Answer: A) Stepping reflex
Rationale: The stepping (walking) reflex is present at birth and disappears around 2 months. The Landau
reflex appears around 3-4 months, and the parachute reflex at 7-9 months.
Pediatric Nursing Practice Exam – 2026 Formatted: Centered
Formatted: Top: (Single solid line, Auto, 2.25 pt Line
Case Studies & MCQs width), Bottom: (Single solid line, Auto, 2.25 pt Line
width), Left: (Single solid line, Auto, 2.25 pt Line width),
Right: (Single solid line, Auto, 2.25 pt Line width)
Section 1: Growth & Development (Questions 1-20)
1. The nurse is assessing a 12-month-old infant during a well-child visit. Which finding indicates
normal development for this age?
A) Walks independently without support
B) Uses a pincer grasp to pick up small objects
C) Speaks 10-15 words clearly
D) Builds a tower of 4 blocks
Answer: B) Uses a pincer grasp to pick up small objects
Rationale: At 12 months, infants typically use a pincer grasp, may say 1-2 words, and may walk with
assistance. Walking independently usually occurs around 12-15 months.
2. The nurse is assessing a 4-year-old child. Which developmental milestone should the child have
achieved?
A) Uses scissors to cut out a picture
B) Rides a tricycle
C) Writes their name
D) Ties shoelaces
Answer: B) Rides a tricycle
Rationale: At 4 years, children can ride a tricycle, use scissors, and draw a person with 3-4 body parts.
Tying shoelaces typically occurs at 6 years.
3. According to Erikson's theory, the developmental task of the toddler (1-3 years) is:
A) Trust vs. mistrust
B) Autonomy vs. shame and doubt
C) Initiative vs. guilt
D) Industry vs. inferiority
Answer: B) Autonomy vs. shame and doubt
Rationale: Erikson's toddler stage (1-3 years) is characterized by the conflict of autonomy versus shame
and doubt, where children develop independence and self-control.
,4. The nurse is teaching parents about toilet training. Which statement indicates understanding of
readiness cues?
A) "We will start toilet training at 12 months."
B) "We will wait until our child can stay dry for 2 hours."
C) "We will use a reward system for successful toileting."
D) "We will begin toilet training when our child turns 2."
Answer: B) "We will wait until our child can stay dry for 2 hours."
Rationale: Readiness cues for toilet training include staying dry for 2 hours, showing interest in the potty,
and being able to follow simple instructions. Starting too early can lead to frustration.
5. The nurse is assessing a newborn. Which reflex is expected to be present at birth?
A) Moro reflex
B) Parachute reflex
C) Pincer grasp
D) Neck righting reflex
Answer: A) Moro reflex
Rationale: The Moro (startle) reflex is present at birth and disappears around 4-6 months. The parachute
reflex appears around 7-9 months. The pincer grasp develops at 9-12 months.
6. The nurse is assessing a 2-year-old child. Which finding indicates normal language development?
A) Uses 2-3 word phrases
B) Speaks in complete sentences
C) Has a vocabulary of 100 words
D) Asks "why" questions
Answer: A) Uses 2-3 word phrases
Rationale: At 2 years, children typically use 2-3 word phrases and have a vocabulary of about 50 words.
Complete sentences and "why" questions usually appear at 3 years.
7. The nurse is educating parents about the nutritional needs of a 6-month-old infant. Which food
should be introduced first?
A) Strained meat
B) Iron-fortified cereal
C) Pureed fruits
D) Pureed vegetables
,Answer: B) Iron-fortified cereal
Rationale: Iron-fortified cereal is typically the first solid food introduced at 4-6 months. It is easily
digested and provides essential iron. Single-grain cereals are introduced first.
8. The nurse is assessing a school-age child's cognitive development according to Piaget. The child is in
which stage?
A) Sensorimotor stage
B) Preoperational stage
C) Concrete operational stage
D) Formal operational stage
Answer: C) Concrete operational stage
Rationale: According to Piaget, school-age children (7-11 years) are in the concrete operational stage,
characterized by logical thinking about concrete events and understanding of conservation.
9. The nurse is teaching parents about safety for a 6-month-old infant. Which instruction is most
important?
A) "Place the crib away from windows."
B) "Keep small objects out of reach."
C) "Use a car seat for every ride."
D) "Install safety gates at the top of stairs."
Answer: C) "Use a car seat for every ride."
Rationale: Car seats are essential for infant safety during travel and should be used every time. Infants
should be in a rear-facing car seat until age 2.
10. The nurse is assessing an adolescent. According to Erikson, the developmental task of adolescence
is:
A) Identity vs. role confusion
B) Intimacy vs. isolation
C) Generativity vs. stagnation
D) Integrity vs. despair
Answer: A) Identity vs. role confusion
Rationale: Adolescence (12-18 years) is characterized by Erikson's stage of identity vs. role confusion,
where adolescents explore their identity and roles.
11. The nurse is assessing a 15-month-old toddler. Which gross motor skill should the child have
achieved?
A) Walking independently
, B) Running and kicking a ball
C) Standing on one foot
D) Riding a tricycle
Answer: A) Walking independently
Rationale: By 15 months, most toddlers can walk independently. Running typically occurs at 2 years, and
standing on one foot at 4-5 years.
12. The nurse is assessing a 3-year-old child. Which fine motor skill should be expected?
A) Drawing a circle
B) Drawing a square
C) Using scissors
D) Tying shoelaces
Answer: A) Drawing a circle
Rationale: At 3 years, children can draw a circle and copy a vertical line. Drawing a square and using
scissors occur at 4 years. Tying shoelaces occurs at 6 years.
13. The nurse is teaching parents about dental health for a 2-year-old child. Which instruction is
appropriate?
A) "Use a small amount of fluoridated toothpaste."
B) "Use a pea-sized amount of fluoride toothpaste."
C) "Use toothpaste only when the child spits."
D) "Use non-fluoridated toothpaste."
Answer: A) "Use a small amount of fluoridated toothpaste."
Rationale: For children under 3 years, use a smear (grain of rice size) of fluoridated toothpaste. For
children 3-6 years, use a pea-sized amount.
14. The nurse is assessing a newborn for the presence of primitive reflexes. Which reflex is present at
birth?
A) Stepping reflex
B) Landau reflex
C) Parachute reflex
D) Neck righting reflex
Answer: A) Stepping reflex
Rationale: The stepping (walking) reflex is present at birth and disappears around 2 months. The Landau
reflex appears around 3-4 months, and the parachute reflex at 7-9 months.
