NUR 203/NUR203 Exam 1 V3 | Pediatric Nursing
Q&A with Rationale | Fortis College
1. A nurse is caring for a 6-month-old infant. According to Erikson’s stages of psychosocial
development, which task should the nurse expect the infant to be working on?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust
D. Industry vs. Inferiority
Correct Answer: C
Explanation: The Trust vs. Mistrust stage occurs from birth to approximately 1 year of age.
During this phase, infants learn to rely on their caregivers for basic needs such as food and
comfort. Consistent care allows the infant to develop a sense of security and trust in the
world around them.
2. When performing a physical assessment on a toddler, in which order should the nurse
complete the examination to minimize distress?
A. Head, chest, abdomen, then throat and ears
B. Chest, abdomen, head, then throat and ears
C. Throat, ears, head, then chest and abdomen
D. The nurse should follow a strict head-to-toe sequence regardless of age
,Correct Answer: B
Explanation: In pediatric assessments, invasive or frightening procedures like checking
the ears and throat should be saved for last. Starting with less intrusive actions such as
auscultating the chest or palpating the abdomen helps build rapport and decreases anxiety.
This approach follows the principles of atraumatic care to ensure the child remains
cooperative as long as possible.
3. A mother of a 4-month-old infant asks the nurse when she should start introducing solid
foods. Which of the following is the best response?
A. Around 2 months of age to promote weight gain
B. At 12 months, once the infant can use a spoon independently
C. Only after the first tooth erupts, usually at 8 months
D. Around 4 to 6 months of age, when the tongue extrusion reflex disappears
Correct Answer: D
Explanation: The American Academy of Pediatrics recommends starting solids between 4
and 6 months when the infant shows developmental readiness. A key indicator is the
disappearance of the extrusion reflex, which otherwise pushes food out of the mouth.
Introducing solids too early can increase the risk of allergies and choking.
4. According to Piaget, a 10-month-old infant who looks for a toy that has been hidden under
a blanket has developed which cognitive skill?
A. Egocentrism
, B. Object permanence
C. Conservation
D. Animism
Correct Answer: B
Explanation: Object permanence is the realization that objects continue to exist even when
they are out of sight. This milestone typically develops during the sensorimotor stage
between 8 and 12 months. It marks a significant transition in cognitive development where
the child begins to hold mental representations of objects.
5. A nurse is preparing to administer an immunization to a 4-year-old child. Which action
represents the use of atraumatic care?
A. Telling the child it won’t hurt at all
B. Asking the parent to leave the room so the child focuses on the nurse
C. Restraining the child firmly without explanation to get it over with quickly
D. Using a distraction technique, such as blowing bubbles or using a colorful toy
Correct Answer: D
Explanation: Atraumatic care focuses on minimizing physical and psychological distress
for children in healthcare settings. Distraction is an effective evidence-based strategy that
redirects the child’s attention away from the painful stimulus. Using honest communication
and allowing the parent to remain for support further reduces the child’s fear.
Q&A with Rationale | Fortis College
1. A nurse is caring for a 6-month-old infant. According to Erikson’s stages of psychosocial
development, which task should the nurse expect the infant to be working on?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust
D. Industry vs. Inferiority
Correct Answer: C
Explanation: The Trust vs. Mistrust stage occurs from birth to approximately 1 year of age.
During this phase, infants learn to rely on their caregivers for basic needs such as food and
comfort. Consistent care allows the infant to develop a sense of security and trust in the
world around them.
2. When performing a physical assessment on a toddler, in which order should the nurse
complete the examination to minimize distress?
A. Head, chest, abdomen, then throat and ears
B. Chest, abdomen, head, then throat and ears
C. Throat, ears, head, then chest and abdomen
D. The nurse should follow a strict head-to-toe sequence regardless of age
,Correct Answer: B
Explanation: In pediatric assessments, invasive or frightening procedures like checking
the ears and throat should be saved for last. Starting with less intrusive actions such as
auscultating the chest or palpating the abdomen helps build rapport and decreases anxiety.
This approach follows the principles of atraumatic care to ensure the child remains
cooperative as long as possible.
3. A mother of a 4-month-old infant asks the nurse when she should start introducing solid
foods. Which of the following is the best response?
A. Around 2 months of age to promote weight gain
B. At 12 months, once the infant can use a spoon independently
C. Only after the first tooth erupts, usually at 8 months
D. Around 4 to 6 months of age, when the tongue extrusion reflex disappears
Correct Answer: D
Explanation: The American Academy of Pediatrics recommends starting solids between 4
and 6 months when the infant shows developmental readiness. A key indicator is the
disappearance of the extrusion reflex, which otherwise pushes food out of the mouth.
Introducing solids too early can increase the risk of allergies and choking.
4. According to Piaget, a 10-month-old infant who looks for a toy that has been hidden under
a blanket has developed which cognitive skill?
A. Egocentrism
, B. Object permanence
C. Conservation
D. Animism
Correct Answer: B
Explanation: Object permanence is the realization that objects continue to exist even when
they are out of sight. This milestone typically develops during the sensorimotor stage
between 8 and 12 months. It marks a significant transition in cognitive development where
the child begins to hold mental representations of objects.
5. A nurse is preparing to administer an immunization to a 4-year-old child. Which action
represents the use of atraumatic care?
A. Telling the child it won’t hurt at all
B. Asking the parent to leave the room so the child focuses on the nurse
C. Restraining the child firmly without explanation to get it over with quickly
D. Using a distraction technique, such as blowing bubbles or using a colorful toy
Correct Answer: D
Explanation: Atraumatic care focuses on minimizing physical and psychological distress
for children in healthcare settings. Distraction is an effective evidence-based strategy that
redirects the child’s attention away from the painful stimulus. Using honest communication
and allowing the parent to remain for support further reduces the child’s fear.
