PEDIATRIC NURSING TEST BANK 2026 |
CHILD HEALTH NURSING PRACTICE
QUESTIONS | GROWTH &
DEVELOPMENT REVIEW | CLINICAL
JUDGMENT & PRIORITIZATION
SCENARIOS | NURSING EXAM PREP
Question 1
Category: Growth and Development Across Infancy, Childhood,
and Adolescence
NCLEX Client Needs Category: Health Promotion and
Maintenance
CJMM Clinical Judgment Step: Analyzing Cues
Clinical Scenario
The nurse in a pediatric primary care clinic is performing a well-
child assessment on a 9-month-old infant brought in by the
mother.
,Nursing Assessment Notes:
• Vital Signs: Temperature 36.8°C (98.2°F) axillary, Heart
Rate 118 bpm, Respiratory Rate 30 breaths/min.
• Growth: Weight is at the 50th percentile, length is at the
45th percentile.
• Physical Assessment: Anterior fontanelle is open, soft, and
flat. Posterior fontanelle is closed.
• Developmental Observations: Sitting unsupported,
transfers objects from hand to hand, uses a crude pincer
grasp, responds to own name, displays stranger anxiety
when approached by the nurse.
The mother asks, "My baby isn't walking or speaking words yet
like my friend's 1-year-old. Should I be worried?"
Question Prompt
Which interpretation of the infant’s development should guide
the nurse’s response?
Options
• A. The infant exhibits developmental delay requiring
immediate referral for early intervention services.
• B. The infant demonstrates appropriate fine motor skills
but is delayed in gross motor development.
, • C. The infant meets expected developmental milestones
for a 9-month-old child.
• D. The infant exhibits normal gross motor development
but delayed language acquisition.
Correct Answer
C. The infant meets expected developmental milestones for a
9-month-old child.
Comprehensive Rationale
Why the Correct Answer is Correct
At 9 months of age, expected developmental milestones
include:
• Gross Motor: Sitting steadily without support, pulling to a
stand, and crawling/creeping. Walking typically occurs
between 11 and 15 months.
• Fine Motor: Transferring objects between hands, crude
pincer grasp (using thumb and index finger), and banging
objects together.
• Language/Cognitive: Responding to name, understanding
"no," making repetitive syllable sounds ("mama," "dada"
non-specifically). Spoken words with specific meaning
usually emerge around 12 months.
, • Psychosocial: Displaying stranger anxiety and separation
anxiety, which are healthy socio-emotional indicators of
attachment.
Physical findings, including the closed posterior fontanelle
(closes at 2–3 months) and open anterior fontanelle (closes at
12–18 months), are normal. The mother should be reassured
that comparing a 9-month-old to a 12-month-old is
developmentally inappropriate.
Why the Other Options are Incorrect
• A: Incorrect because the infant shows no signs of
developmental delay. Ordering early intervention would
cause unnecessary parental anxiety and waste resources.
• B: Incorrect because sitting unsupported and pulling to
stand are appropriate gross motor milestones for 9
months. Walking is not expected at this stage.
• D: Incorrect because responding to name and babbling are
appropriate language cues for a 9-month-old; formal
words are not expected yet.
NCLEX Pediatric Nursing Pearl
Posterior fontanelles close by 2–3 months, whereas anterior
fontanelles close between 12 and 18 months; walking and first
words are 12-month milestones, not 9-month expectations.
CHILD HEALTH NURSING PRACTICE
QUESTIONS | GROWTH &
DEVELOPMENT REVIEW | CLINICAL
JUDGMENT & PRIORITIZATION
SCENARIOS | NURSING EXAM PREP
Question 1
Category: Growth and Development Across Infancy, Childhood,
and Adolescence
NCLEX Client Needs Category: Health Promotion and
Maintenance
CJMM Clinical Judgment Step: Analyzing Cues
Clinical Scenario
The nurse in a pediatric primary care clinic is performing a well-
child assessment on a 9-month-old infant brought in by the
mother.
,Nursing Assessment Notes:
• Vital Signs: Temperature 36.8°C (98.2°F) axillary, Heart
Rate 118 bpm, Respiratory Rate 30 breaths/min.
• Growth: Weight is at the 50th percentile, length is at the
45th percentile.
• Physical Assessment: Anterior fontanelle is open, soft, and
flat. Posterior fontanelle is closed.
• Developmental Observations: Sitting unsupported,
transfers objects from hand to hand, uses a crude pincer
grasp, responds to own name, displays stranger anxiety
when approached by the nurse.
The mother asks, "My baby isn't walking or speaking words yet
like my friend's 1-year-old. Should I be worried?"
Question Prompt
Which interpretation of the infant’s development should guide
the nurse’s response?
Options
• A. The infant exhibits developmental delay requiring
immediate referral for early intervention services.
• B. The infant demonstrates appropriate fine motor skills
but is delayed in gross motor development.
, • C. The infant meets expected developmental milestones
for a 9-month-old child.
• D. The infant exhibits normal gross motor development
but delayed language acquisition.
Correct Answer
C. The infant meets expected developmental milestones for a
9-month-old child.
Comprehensive Rationale
Why the Correct Answer is Correct
At 9 months of age, expected developmental milestones
include:
• Gross Motor: Sitting steadily without support, pulling to a
stand, and crawling/creeping. Walking typically occurs
between 11 and 15 months.
• Fine Motor: Transferring objects between hands, crude
pincer grasp (using thumb and index finger), and banging
objects together.
• Language/Cognitive: Responding to name, understanding
"no," making repetitive syllable sounds ("mama," "dada"
non-specifically). Spoken words with specific meaning
usually emerge around 12 months.
, • Psychosocial: Displaying stranger anxiety and separation
anxiety, which are healthy socio-emotional indicators of
attachment.
Physical findings, including the closed posterior fontanelle
(closes at 2–3 months) and open anterior fontanelle (closes at
12–18 months), are normal. The mother should be reassured
that comparing a 9-month-old to a 12-month-old is
developmentally inappropriate.
Why the Other Options are Incorrect
• A: Incorrect because the infant shows no signs of
developmental delay. Ordering early intervention would
cause unnecessary parental anxiety and waste resources.
• B: Incorrect because sitting unsupported and pulling to
stand are appropriate gross motor milestones for 9
months. Walking is not expected at this stage.
• D: Incorrect because responding to name and babbling are
appropriate language cues for a 9-month-old; formal
words are not expected yet.
NCLEX Pediatric Nursing Pearl
Posterior fontanelles close by 2–3 months, whereas anterior
fontanelles close between 12 and 18 months; walking and first
words are 12-month milestones, not 9-month expectations.
