NUR 106 – Module G2: Pediatric Growth &
Development, Nursing Original Practice Questions &
Answers | Comprehensive Pediatric Nursing Course
Study Guide & Exam Preparation | Pediatric
Growth Patterns, Developmental Milestones,
Physical & Psychosocial Development, Infant &
Toddler Development, Preschool & School-Age
Development, Adolescent Development, Growth
Assessment, Nutrition, Safety, Health Promotion,
Developmental Screening, Family-Centered Care &
Detailed Rationales
Question 1: A 2-year-old child is brought to the clinic for a well-child visit. The
nurse observes the child using a palmar grasp to hold a crayon and scribbling
spontaneously. Which developmental milestone does this behavior best
represent?
A. Fine motor skill appropriate for a 6-month-old
B. Gross motor skill appropriate for a 12-month-old
C. Fine motor skill appropriate for a 2-year-old
D. Cognitive skill appropriate for a 4-year-old
CORRECT ANSWER: C. Fine motor skill appropriate for a 2-year-old
Rationale: At 2 years of age, a child typically develops the fine motor skill of holding a
crayon with a palmar grasp and scribbling spontaneously. This represents progression in
hand-eye coordination and fine motor control, which are key developmental milestones
assessed during well-child visits. A palmar grasp is typical for a 2-year-old, whereas a
more refined tripod grasp develops later.
Question 2: The nurse is assessing a 4-month-old infant during a routine
checkup. Which finding indicates that the infant is achieving an appropriate
gross motor milestone for this age?
A. Sitting without support
B. Rolling from back to abdomen
C. Holding the head erect and steady when held upright
D. Standing while holding onto furniture
CORRECT ANSWER: C. Holding the head erect and steady when held upright
Rationale: By 4 months of age, an infant should be able to hold the head erect and
steady when held in a sitting or upright position. This represents significant neck muscle
control and is an expected gross motor milestone. Rolling over typically occurs around
,5-6 months, sitting without support at 7-8 months, and standing while holding onto
furniture around 9-10 months.
Question 3: The nurse is educating the parents of a 9-month-old infant about
safety measures. Based on the infant's developmental stage, which
intervention is the highest priority for injury prevention?
A. Placing padding on sharp furniture corners
B. Installing safety gates at the top and bottom of stairs
C. Keeping small objects out of reach to prevent aspiration
D. Using a rear-facing car seat in the back seat
CORRECT ANSWER: B. Installing safety gates at the top and bottom of stairs
Rationale: At 9 months, infants typically begin to crawl and may pull to a stand,
significantly increasing their risk of falls, especially on stairs. Safety gates are the most
critical intervention to prevent falls, which are a common and serious injury at this age.
While other options are appropriate, the mobility of a 9-month-old makes stair safety the
highest priority.
Question 4: The nurse is performing a developmental screening on a 3-year-
old child. Which language milestone is expected for this age?
A. Using 2-to-3-word sentences
B. Using 4-to-5-word sentences
C. Repeating a rhyme or simple poem
D. Speaking in full, grammatically correct paragraphs
CORRECT ANSWER: B. Using 4-to-5-word sentences
Rationale: A 3-year-old typically uses sentences of 4 to 5 words, has a vocabulary of
several hundred words, and is understandable to strangers about 75% of the time. Two-
to-3-word sentences are typical for a 2-year-old, while rhyming and more complex
language structures are seen in older preschoolers and school-age children.
Question 5: The nurse is teaching a group of parents about Piaget's theory of
cognitive development. According to Piaget, a child in the preoperational stage
(ages 2-7) has difficulty understanding which concept?
A. Object permanence
B. Conservation of mass
C. Abstract reasoning
D. Cause-and-effect relationships
CORRECT ANSWER: B. Conservation of mass
,Rationale: According to Piaget, children in the preoperational stage have not yet
mastered the concept of conservation, which is the understanding that quantity remains
the same despite changes in shape or appearance. For example, a child in this stage
would believe that a tall, thin glass contains more liquid than a short, wide glass. Object
permanence is mastered earlier in the sensorimotor stage.
Question 6: A 14-year-old adolescent is discussing body image concerns with
the school nurse. The nurse understands that this concern is primarily related
to which psychosocial developmental task according to Erikson?
A. Trust vs. Mistrust
B. Initiative vs. Guilt
C. Industry vs. Inferiority
D. Identity vs. Role Confusion
CORRECT ANSWER: D. Identity vs. Role Confusion
Rationale: According to Erikson, the psychosocial task of adolescence (ages 12-18) is
identity vs. role confusion. During this stage, adolescents explore their independence
and develop a sense of self. Body image is a significant component of identity formation,
and concerns about physical appearance are common as they integrate their self-
perception with societal expectations.
Question 7: The nurse is assessing the growth of a 6-year-old child. Using the
principles of pediatric growth, which pattern of physical development is most
typical for this school-age child?
A. Rapid growth spurt of 4-5 inches per year
B. Steady growth of about 2-3 inches per year
C. Plateau in growth with no measurable change
D. Deceleration of growth in height but rapid weight gain
CORRECT ANSWER: B. Steady growth of about 2-3 inches per year
Rationale: School-age children (6-12 years) experience a period of slow, steady growth,
averaging about 2 to 3 inches in height and 5 to 7 pounds in weight per year. This
contrasts with the rapid growth of infancy and the adolescent growth spurt. A plateau is
not typical for this age group, and rapid growth spurts are associated with puberty.
Question 8: A nurse is counseling the parents of a 5-year-old who is exhibiting
fears of the dark and monsters. Which action by the parents is most
developmentally appropriate to help the child manage these fears?
A. Telling the child that monsters do not exist and to be brave
B. Allowing the child to sleep in the parents' bed until the fear subsides
, C. Using a nightlight and checking for "monsters" under the bed together
D. Ignoring the fear to avoid reinforcing the behavior
CORRECT ANSWER: C. Using a nightlight and checking for "monsters" under
the bed together
Rationale: At 5 years of age, children have vivid imaginations and may have difficulty
distinguishing fantasy from reality. Validating the child's feelings while providing a
practical, reassuring solution (e.g., using a nightlight and checking for monsters together)
helps build trust and security. Dismissing the fear or ignoring it can increase anxiety,
while bed-sharing may create dependency issues.
Question 9: The nurse is evaluating the fine motor skills of an 18-month-old
toddler. Which finding is consistent with typical development for this age?
A. Building a tower of 4 cubes
B. Scribbling spontaneously with a crayon
C. Using a spoon without significant spilling
D. Turning pages of a book one at a time
CORRECT ANSWER: A. Building a tower of 4 cubes
Rationale: An 18-month-old can typically build a tower of 3 to 4 cubes, demonstrating
emerging fine motor control and coordination. Scribbling spontaneously is a skill of a
15- to 18-month-old but is more refined by age 2. Using a spoon without spilling is
typically achieved by age 3-4, and turning pages one at a time is a 30-month (2.5-year)
milestone.
Question 10: The nurse is assessing the immunization status of a 2-month-old
infant. Which vaccines are expected to have been administered by this age
according to the standard CDC schedule?
A. DTaP, IPV, Hib, PCV, and HepB
B. DTaP, IPV, Hib, PCV, and RV
C. DTaP, IPV, Hib, PCV, and MMR
D. DTaP, IPV, Hib, and Varicella
CORRECT ANSWER: B. DTaP, IPV, Hib, PCV, and RV
Rationale: According to the CDC standard immunization schedule, by 2 months of age,
an infant should have received the first dose of DTaP, IPV, Hib, PCV, and RV. The HepB
vaccine is typically given at birth and again at 1-2 months, but the first dose of MMR
and Varicella are not given until 12-15 months of age.
Development, Nursing Original Practice Questions &
Answers | Comprehensive Pediatric Nursing Course
Study Guide & Exam Preparation | Pediatric
Growth Patterns, Developmental Milestones,
Physical & Psychosocial Development, Infant &
Toddler Development, Preschool & School-Age
Development, Adolescent Development, Growth
Assessment, Nutrition, Safety, Health Promotion,
Developmental Screening, Family-Centered Care &
Detailed Rationales
Question 1: A 2-year-old child is brought to the clinic for a well-child visit. The
nurse observes the child using a palmar grasp to hold a crayon and scribbling
spontaneously. Which developmental milestone does this behavior best
represent?
A. Fine motor skill appropriate for a 6-month-old
B. Gross motor skill appropriate for a 12-month-old
C. Fine motor skill appropriate for a 2-year-old
D. Cognitive skill appropriate for a 4-year-old
CORRECT ANSWER: C. Fine motor skill appropriate for a 2-year-old
Rationale: At 2 years of age, a child typically develops the fine motor skill of holding a
crayon with a palmar grasp and scribbling spontaneously. This represents progression in
hand-eye coordination and fine motor control, which are key developmental milestones
assessed during well-child visits. A palmar grasp is typical for a 2-year-old, whereas a
more refined tripod grasp develops later.
Question 2: The nurse is assessing a 4-month-old infant during a routine
checkup. Which finding indicates that the infant is achieving an appropriate
gross motor milestone for this age?
A. Sitting without support
B. Rolling from back to abdomen
C. Holding the head erect and steady when held upright
D. Standing while holding onto furniture
CORRECT ANSWER: C. Holding the head erect and steady when held upright
Rationale: By 4 months of age, an infant should be able to hold the head erect and
steady when held in a sitting or upright position. This represents significant neck muscle
control and is an expected gross motor milestone. Rolling over typically occurs around
,5-6 months, sitting without support at 7-8 months, and standing while holding onto
furniture around 9-10 months.
Question 3: The nurse is educating the parents of a 9-month-old infant about
safety measures. Based on the infant's developmental stage, which
intervention is the highest priority for injury prevention?
A. Placing padding on sharp furniture corners
B. Installing safety gates at the top and bottom of stairs
C. Keeping small objects out of reach to prevent aspiration
D. Using a rear-facing car seat in the back seat
CORRECT ANSWER: B. Installing safety gates at the top and bottom of stairs
Rationale: At 9 months, infants typically begin to crawl and may pull to a stand,
significantly increasing their risk of falls, especially on stairs. Safety gates are the most
critical intervention to prevent falls, which are a common and serious injury at this age.
While other options are appropriate, the mobility of a 9-month-old makes stair safety the
highest priority.
Question 4: The nurse is performing a developmental screening on a 3-year-
old child. Which language milestone is expected for this age?
A. Using 2-to-3-word sentences
B. Using 4-to-5-word sentences
C. Repeating a rhyme or simple poem
D. Speaking in full, grammatically correct paragraphs
CORRECT ANSWER: B. Using 4-to-5-word sentences
Rationale: A 3-year-old typically uses sentences of 4 to 5 words, has a vocabulary of
several hundred words, and is understandable to strangers about 75% of the time. Two-
to-3-word sentences are typical for a 2-year-old, while rhyming and more complex
language structures are seen in older preschoolers and school-age children.
Question 5: The nurse is teaching a group of parents about Piaget's theory of
cognitive development. According to Piaget, a child in the preoperational stage
(ages 2-7) has difficulty understanding which concept?
A. Object permanence
B. Conservation of mass
C. Abstract reasoning
D. Cause-and-effect relationships
CORRECT ANSWER: B. Conservation of mass
,Rationale: According to Piaget, children in the preoperational stage have not yet
mastered the concept of conservation, which is the understanding that quantity remains
the same despite changes in shape or appearance. For example, a child in this stage
would believe that a tall, thin glass contains more liquid than a short, wide glass. Object
permanence is mastered earlier in the sensorimotor stage.
Question 6: A 14-year-old adolescent is discussing body image concerns with
the school nurse. The nurse understands that this concern is primarily related
to which psychosocial developmental task according to Erikson?
A. Trust vs. Mistrust
B. Initiative vs. Guilt
C. Industry vs. Inferiority
D. Identity vs. Role Confusion
CORRECT ANSWER: D. Identity vs. Role Confusion
Rationale: According to Erikson, the psychosocial task of adolescence (ages 12-18) is
identity vs. role confusion. During this stage, adolescents explore their independence
and develop a sense of self. Body image is a significant component of identity formation,
and concerns about physical appearance are common as they integrate their self-
perception with societal expectations.
Question 7: The nurse is assessing the growth of a 6-year-old child. Using the
principles of pediatric growth, which pattern of physical development is most
typical for this school-age child?
A. Rapid growth spurt of 4-5 inches per year
B. Steady growth of about 2-3 inches per year
C. Plateau in growth with no measurable change
D. Deceleration of growth in height but rapid weight gain
CORRECT ANSWER: B. Steady growth of about 2-3 inches per year
Rationale: School-age children (6-12 years) experience a period of slow, steady growth,
averaging about 2 to 3 inches in height and 5 to 7 pounds in weight per year. This
contrasts with the rapid growth of infancy and the adolescent growth spurt. A plateau is
not typical for this age group, and rapid growth spurts are associated with puberty.
Question 8: A nurse is counseling the parents of a 5-year-old who is exhibiting
fears of the dark and monsters. Which action by the parents is most
developmentally appropriate to help the child manage these fears?
A. Telling the child that monsters do not exist and to be brave
B. Allowing the child to sleep in the parents' bed until the fear subsides
, C. Using a nightlight and checking for "monsters" under the bed together
D. Ignoring the fear to avoid reinforcing the behavior
CORRECT ANSWER: C. Using a nightlight and checking for "monsters" under
the bed together
Rationale: At 5 years of age, children have vivid imaginations and may have difficulty
distinguishing fantasy from reality. Validating the child's feelings while providing a
practical, reassuring solution (e.g., using a nightlight and checking for monsters together)
helps build trust and security. Dismissing the fear or ignoring it can increase anxiety,
while bed-sharing may create dependency issues.
Question 9: The nurse is evaluating the fine motor skills of an 18-month-old
toddler. Which finding is consistent with typical development for this age?
A. Building a tower of 4 cubes
B. Scribbling spontaneously with a crayon
C. Using a spoon without significant spilling
D. Turning pages of a book one at a time
CORRECT ANSWER: A. Building a tower of 4 cubes
Rationale: An 18-month-old can typically build a tower of 3 to 4 cubes, demonstrating
emerging fine motor control and coordination. Scribbling spontaneously is a skill of a
15- to 18-month-old but is more refined by age 2. Using a spoon without spilling is
typically achieved by age 3-4, and turning pages one at a time is a 30-month (2.5-year)
milestone.
Question 10: The nurse is assessing the immunization status of a 2-month-old
infant. Which vaccines are expected to have been administered by this age
according to the standard CDC schedule?
A. DTaP, IPV, Hib, PCV, and HepB
B. DTaP, IPV, Hib, PCV, and RV
C. DTaP, IPV, Hib, PCV, and MMR
D. DTaP, IPV, Hib, and Varicella
CORRECT ANSWER: B. DTaP, IPV, Hib, PCV, and RV
Rationale: According to the CDC standard immunization schedule, by 2 months of age,
an infant should have received the first dose of DTaP, IPV, Hib, PCV, and RV. The HepB
vaccine is typically given at birth and again at 1-2 months, but the first dose of MMR
and Varicella are not given until 12-15 months of age.
