PN PEDIATRIC NURSING COMPREHENSIVE EXAM
STUDY GUIDE | PRACTICE QUESTIONS & ANSWERS
WITH DETAILED RATIONALES | NCLEX-PN
PEDIATRIC EXAM PREP
SECTION 1: GROWTH AND DEVELOPMENT (Questions 1-30)
1. A nurse is assessing a 4-month-old infant during a well-child visit. Which developmental
milestone should the nurse expect to observe?
A. Sits without support
B. Transfers objects hand-to-hand
C. Rolls from back to side
D. Pincer grasp present
Answer: C
Rationale: At 4 months, infants typically roll from back to side. Sitting without support
occurs around 8 months, hand-to-hand transfer at 7 months, and pincer grasp at 9-10
months.
2. A nurse is assessing a 9-month-old infant. Which developmental milestone should the
nurse expect?
A. Walks independently
B. Pulls to standing position
C. Builds a tower of two blocks
D. Uses a spoon without spilling
Answer: B
,Rationale: By 9 months, infants typically pull to a standing position. Walking independently
occurs around 12-15 months, building a tower of two blocks at 15-18 months, and using a
spoon without spilling at 24 months.
3. According to the cephalocaudal principle of development, which ability would develop
first?
A. Walking
B. Sitting
C. Head control
D. Standing
Answer: C
Rationale: The cephalocaudal principle states that development proceeds from head to
tail. Head control develops before sitting, which develops before standing and walking.
4. A nurse is providing anticipatory guidance to parents of a 10-month-old infant. Which
safety measure should the nurse emphasize?
A. Installing car seat facing forward
B. Removing small objects from the floor
C. Placing gates at top and bottom of stairs
D. Keeping medications in a locked cabinet
Answer: C
Rationale: At 10 months, infants are typically crawling and beginning to pull to stand,
making falls down stairs a significant risk. Safety gates at stairs are essential.
5. A 2-year-old toddler is exhibiting negativism, saying "no" to everything. The nurse
explains to the parents that this behavior is:
A. A sign of developmental delay
B. An indication of ineffective parenting
C. A normal expression of autonomy
D. A response to sibling rivalry
Answer: C
,Rationale: Negativism is a normal developmental behavior in toddlers as they strive for
autonomy and independence. It reflects Erikson's stage of autonomy versus shame and
doubt.
6. Which developmental milestone would the nurse expect a 2-year-old child to have
achieved?
A. Rides a tricycle
B. Uses two- to three-word phrases
C. Ties shoelaces
D. Draws a circle
Answer: B
Rationale: By age 2, children typically use two- to three-word phrases. Riding a tricycle
occurs around age 3, tying shoelaces at 5-6 years, and drawing a circle at 3 years.
7. A nurse is assessing a 6-month-old infant's reflexes. Which reflex should have
disappeared by this age?
A. Moro reflex
B. Rooting reflex
C. Palmar grasp
D. All of the above
Answer: D
Rationale: The Moro reflex disappears by 4-6 months, the rooting reflex by 3-4 months, and
the palmar grasp by 4-6 months.
8. A 3-year-old child is in Erikson's stage of:
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: C
Rationale: Erikson's initiative vs. guilt stage occurs from ages 3 to 6 years. Children begin to
assert power and control over their environment through play and social interaction.
, 9. According to Piaget, a 7-year-old child is in which stage of cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: C
Rationale: Piaget's concrete operational stage occurs from ages 7 to 11 years. Children
develop logical thinking but are still concrete in their reasoning.
10. The nurse is assessing a newborn and notes the presence of the Babinski reflex. Which
finding would be considered abnormal?
A. The toes fan out when the sole is stroked
B. The toes curl downward when the sole is stroked
C. The infant withdraws the foot when the sole is stroked
D. The infant shows no response when the sole is stroked
Answer: A
Rationale: The Babinski reflex (toes fanning out) is normal in infants up to 12 months. The
absence of this reflex or persistence beyond 12 months may indicate neurological
problems.
11. A nurse is teaching parents about infant sleep safety. Which recommendation is most
important?
A. Place the infant on the back to sleep
B. Use a soft mattress for comfort
C. Place stuffed animals in the crib
D. Use a blanket to keep the infant warm
Answer: A
Rationale: Placing infants on their backs to sleep is the most important recommendation to
reduce the risk of Sudden Infant Death Syndrome (SIDS).
STUDY GUIDE | PRACTICE QUESTIONS & ANSWERS
WITH DETAILED RATIONALES | NCLEX-PN
PEDIATRIC EXAM PREP
SECTION 1: GROWTH AND DEVELOPMENT (Questions 1-30)
1. A nurse is assessing a 4-month-old infant during a well-child visit. Which developmental
milestone should the nurse expect to observe?
A. Sits without support
B. Transfers objects hand-to-hand
C. Rolls from back to side
D. Pincer grasp present
Answer: C
Rationale: At 4 months, infants typically roll from back to side. Sitting without support
occurs around 8 months, hand-to-hand transfer at 7 months, and pincer grasp at 9-10
months.
2. A nurse is assessing a 9-month-old infant. Which developmental milestone should the
nurse expect?
A. Walks independently
B. Pulls to standing position
C. Builds a tower of two blocks
D. Uses a spoon without spilling
Answer: B
,Rationale: By 9 months, infants typically pull to a standing position. Walking independently
occurs around 12-15 months, building a tower of two blocks at 15-18 months, and using a
spoon without spilling at 24 months.
3. According to the cephalocaudal principle of development, which ability would develop
first?
A. Walking
B. Sitting
C. Head control
D. Standing
Answer: C
Rationale: The cephalocaudal principle states that development proceeds from head to
tail. Head control develops before sitting, which develops before standing and walking.
4. A nurse is providing anticipatory guidance to parents of a 10-month-old infant. Which
safety measure should the nurse emphasize?
A. Installing car seat facing forward
B. Removing small objects from the floor
C. Placing gates at top and bottom of stairs
D. Keeping medications in a locked cabinet
Answer: C
Rationale: At 10 months, infants are typically crawling and beginning to pull to stand,
making falls down stairs a significant risk. Safety gates at stairs are essential.
5. A 2-year-old toddler is exhibiting negativism, saying "no" to everything. The nurse
explains to the parents that this behavior is:
A. A sign of developmental delay
B. An indication of ineffective parenting
C. A normal expression of autonomy
D. A response to sibling rivalry
Answer: C
,Rationale: Negativism is a normal developmental behavior in toddlers as they strive for
autonomy and independence. It reflects Erikson's stage of autonomy versus shame and
doubt.
6. Which developmental milestone would the nurse expect a 2-year-old child to have
achieved?
A. Rides a tricycle
B. Uses two- to three-word phrases
C. Ties shoelaces
D. Draws a circle
Answer: B
Rationale: By age 2, children typically use two- to three-word phrases. Riding a tricycle
occurs around age 3, tying shoelaces at 5-6 years, and drawing a circle at 3 years.
7. A nurse is assessing a 6-month-old infant's reflexes. Which reflex should have
disappeared by this age?
A. Moro reflex
B. Rooting reflex
C. Palmar grasp
D. All of the above
Answer: D
Rationale: The Moro reflex disappears by 4-6 months, the rooting reflex by 3-4 months, and
the palmar grasp by 4-6 months.
8. A 3-year-old child is in Erikson's stage of:
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: C
Rationale: Erikson's initiative vs. guilt stage occurs from ages 3 to 6 years. Children begin to
assert power and control over their environment through play and social interaction.
, 9. According to Piaget, a 7-year-old child is in which stage of cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: C
Rationale: Piaget's concrete operational stage occurs from ages 7 to 11 years. Children
develop logical thinking but are still concrete in their reasoning.
10. The nurse is assessing a newborn and notes the presence of the Babinski reflex. Which
finding would be considered abnormal?
A. The toes fan out when the sole is stroked
B. The toes curl downward when the sole is stroked
C. The infant withdraws the foot when the sole is stroked
D. The infant shows no response when the sole is stroked
Answer: A
Rationale: The Babinski reflex (toes fanning out) is normal in infants up to 12 months. The
absence of this reflex or persistence beyond 12 months may indicate neurological
problems.
11. A nurse is teaching parents about infant sleep safety. Which recommendation is most
important?
A. Place the infant on the back to sleep
B. Use a soft mattress for comfort
C. Place stuffed animals in the crib
D. Use a blanket to keep the infant warm
Answer: A
Rationale: Placing infants on their backs to sleep is the most important recommendation to
reduce the risk of Sudden Infant Death Syndrome (SIDS).
