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NCLEX-Style Exam: Chapter 25 - Growth and Development of the
Newborn and Infant
Multiple Choice Questions (Single Answer)
1. A nurse is assessing a 6-month-old infant during a well-baby check-up. Which of the
following findings would require further evaluation?
a. A. Doubling of birth weight
b. B. Presence of the Moro reflex
c. C. Ability to roll from back to front
d. D. Beginning to sit with support
Answer: B. Presence of the Moro reflex
Rationale: The Moro reflex (startle reflex) typically disappears by 4 months of age. Its
persistence beyond 6 months may indicate neurological immaturity or dysfunction.
2. The nurse is educating new parents about safe sleep practices. Which statement
indicates the need for further teaching?
a. A. "We always put our baby to sleep on their back."
b. B. "We have a firm mattress in the crib."
c. C. "We use a small pillow to support their head."
d. D. "We keep stuffed animals and blankets out of the crib."
Answer: C. "We use a small pillow to support their head."
Rationale: Pillows, loose bedding, and stuffed animals increase the risk of suffocation and
Sudden Infant Death Syndrome (SIDS). A firm mattress and placing the baby on their back
are appropriate practices.
3. At what age does the anterior fontanel typically close?
a. A. 6 months
b. B. 9 months
c. C. 12-18 months
d. D. 24 months
Answer: C. 12-18 months
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Rationale: The anterior fontanel typically closes between 12-18 months, allowing for
continued brain growth.
4. A nurse is assessing an infant’s motor development. Which milestone should a 9-
month-old be able to perform?
a. A. Sitting without support
b. B. Walking independently
c. C. Using a pincer grasp
d. D. Transferring objects from one hand to another
Answer: D. Transferring objects from one hand to another
Rationale: By 9 months, infants should be able to transfer objects between hands. A
pincer grasp typically develops closer to 10-12 months.
5. The nurse is teaching parents about introducing solid foods. What is the best first
food to introduce?
a. A. Pureed meats
b. B. Iron-fortified rice cereal
c. C. Mashed bananas
d. D. Whole milk
Answer: B. Iron-fortified rice cereal
Rationale: Iron-fortified rice cereal is typically introduced first due to its low allergenic
potential and essential iron content.
Select-All-That-Apply (SATA)
6. Which of the following are appropriate teaching points for parents introducing solid
foods to their infant? (Select all that apply.)
a. A. Introduce one new food every 3-5 days
b. B. Start with honey-sweetened foods
c. C. Avoid adding salt or sugar to baby food
d. D. Introduce cow’s milk at 6 months
e. E. Observe for signs of food allergies
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Answers: A, C, E
Rationale: Introducing one new food at a time helps identify food allergies. Avoid adding
salt or sugar. Cow’s milk should not be introduced before 12 months due to its low iron
content.
7. A nurse is teaching about normal sleep patterns in infants. Which of the following
statements are correct? (Select all that apply.)
a. A. Infants sleep up to 20 hours per day in the first month.
b. B. By 3 months, infants sleep about 6-8 hours per night.
c. C. By 12 months, most infants require 8-12 hours of sleep per night.
d. D. Co-sleeping is the safest practice for promoting bonding.
e. E. Establishing a bedtime routine helps infants sleep better.
Answers: A, B, C, E
Rationale: Infants sleep a lot initially and gradually consolidate nighttime sleep. A bedtime
routine supports sleep habits. Co-sleeping is discouraged due to the risk of SIDS.
8. What are expected gross motor skills in a 6-month-old? (Select all that apply.)
a. A. Rolling from back to stomach
b. B. Sitting without support
c. C. Bearing weight on legs when held upright
d. D. Holding a bottle independently
e. E. Crawling
Answers: A, C
Rationale: A 6-month-old should be able to roll in both directions and bear weight on legs
when supported. Sitting without support and crawling typically occur later.
Scenario-Based Questions
9. A mother is concerned that her 10-month-old baby does not say "mama" or "dada"
yet. What is the best response by the nurse?
a. A. "This could be a sign of a speech delay."
b. B. "Babies at this age should be using full words."
c. C. "Not all babies develop at the same rate, but we will monitor speech
milestones."
d. D. "This is a serious concern; I will refer you to a specialist immediately."
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Answer: C. "Not all babies develop at the same rate, but we will monitor speech
milestones."
Rationale: While most 9-12 month-old infants begin to say simple words, developmental
variation exists. Continued monitoring is appropriate.
10. A nurse is performing an assessment on a 4-month-old infant. Which of the
following findings would be considered abnormal?
a. A. Moro reflex is still present
b. B. Infant smiles responsively
c. C. Infant rolls from tummy to back
d. D. Infant begins to reach for objects
Answer: A. Moro reflex is still present
Rationale: The Moro reflex should disappear by 3-4 months; its persistence may indicate
neurological issues.
11. A 12-month-old is in the clinic for a routine visit. The parent asks about transitioning
to cow’s milk. What should the nurse recommend?
a. A. "Start with whole cow’s milk, and limit to 16-24 ounces per day."
b. B. "Introduce skim milk to reduce fat intake."
c. C. "Only use formula until 2 years old."
d. D. "Cow’s milk should never be introduced before 18 months."
Answer: A. "Start with whole cow’s milk, and limit to 16-24 ounces per day."
Rationale: Whole milk is recommended for brain development. Skim milk lacks necessary
fat.
Multiple Choice Questions (Single Answer)
12. A nurse is assessing a newborn’s primitive reflexes. Which reflex normally
disappears by 4 months of age?
• A. Babinski reflex
• B. Moro reflex
• C. Rooting reflex
• D. Parachute reflex
Answer: B. Moro reflex
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NCLEX-Style Exam: Chapter 25 - Growth and Development of the
Newborn and Infant
Multiple Choice Questions (Single Answer)
1. A nurse is assessing a 6-month-old infant during a well-baby check-up. Which of the
following findings would require further evaluation?
a. A. Doubling of birth weight
b. B. Presence of the Moro reflex
c. C. Ability to roll from back to front
d. D. Beginning to sit with support
Answer: B. Presence of the Moro reflex
Rationale: The Moro reflex (startle reflex) typically disappears by 4 months of age. Its
persistence beyond 6 months may indicate neurological immaturity or dysfunction.
2. The nurse is educating new parents about safe sleep practices. Which statement
indicates the need for further teaching?
a. A. "We always put our baby to sleep on their back."
b. B. "We have a firm mattress in the crib."
c. C. "We use a small pillow to support their head."
d. D. "We keep stuffed animals and blankets out of the crib."
Answer: C. "We use a small pillow to support their head."
Rationale: Pillows, loose bedding, and stuffed animals increase the risk of suffocation and
Sudden Infant Death Syndrome (SIDS). A firm mattress and placing the baby on their back
are appropriate practices.
3. At what age does the anterior fontanel typically close?
a. A. 6 months
b. B. 9 months
c. C. 12-18 months
d. D. 24 months
Answer: C. 12-18 months
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Rationale: The anterior fontanel typically closes between 12-18 months, allowing for
continued brain growth.
4. A nurse is assessing an infant’s motor development. Which milestone should a 9-
month-old be able to perform?
a. A. Sitting without support
b. B. Walking independently
c. C. Using a pincer grasp
d. D. Transferring objects from one hand to another
Answer: D. Transferring objects from one hand to another
Rationale: By 9 months, infants should be able to transfer objects between hands. A
pincer grasp typically develops closer to 10-12 months.
5. The nurse is teaching parents about introducing solid foods. What is the best first
food to introduce?
a. A. Pureed meats
b. B. Iron-fortified rice cereal
c. C. Mashed bananas
d. D. Whole milk
Answer: B. Iron-fortified rice cereal
Rationale: Iron-fortified rice cereal is typically introduced first due to its low allergenic
potential and essential iron content.
Select-All-That-Apply (SATA)
6. Which of the following are appropriate teaching points for parents introducing solid
foods to their infant? (Select all that apply.)
a. A. Introduce one new food every 3-5 days
b. B. Start with honey-sweetened foods
c. C. Avoid adding salt or sugar to baby food
d. D. Introduce cow’s milk at 6 months
e. E. Observe for signs of food allergies
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Answers: A, C, E
Rationale: Introducing one new food at a time helps identify food allergies. Avoid adding
salt or sugar. Cow’s milk should not be introduced before 12 months due to its low iron
content.
7. A nurse is teaching about normal sleep patterns in infants. Which of the following
statements are correct? (Select all that apply.)
a. A. Infants sleep up to 20 hours per day in the first month.
b. B. By 3 months, infants sleep about 6-8 hours per night.
c. C. By 12 months, most infants require 8-12 hours of sleep per night.
d. D. Co-sleeping is the safest practice for promoting bonding.
e. E. Establishing a bedtime routine helps infants sleep better.
Answers: A, B, C, E
Rationale: Infants sleep a lot initially and gradually consolidate nighttime sleep. A bedtime
routine supports sleep habits. Co-sleeping is discouraged due to the risk of SIDS.
8. What are expected gross motor skills in a 6-month-old? (Select all that apply.)
a. A. Rolling from back to stomach
b. B. Sitting without support
c. C. Bearing weight on legs when held upright
d. D. Holding a bottle independently
e. E. Crawling
Answers: A, C
Rationale: A 6-month-old should be able to roll in both directions and bear weight on legs
when supported. Sitting without support and crawling typically occur later.
Scenario-Based Questions
9. A mother is concerned that her 10-month-old baby does not say "mama" or "dada"
yet. What is the best response by the nurse?
a. A. "This could be a sign of a speech delay."
b. B. "Babies at this age should be using full words."
c. C. "Not all babies develop at the same rate, but we will monitor speech
milestones."
d. D. "This is a serious concern; I will refer you to a specialist immediately."
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Answer: C. "Not all babies develop at the same rate, but we will monitor speech
milestones."
Rationale: While most 9-12 month-old infants begin to say simple words, developmental
variation exists. Continued monitoring is appropriate.
10. A nurse is performing an assessment on a 4-month-old infant. Which of the
following findings would be considered abnormal?
a. A. Moro reflex is still present
b. B. Infant smiles responsively
c. C. Infant rolls from tummy to back
d. D. Infant begins to reach for objects
Answer: A. Moro reflex is still present
Rationale: The Moro reflex should disappear by 3-4 months; its persistence may indicate
neurological issues.
11. A 12-month-old is in the clinic for a routine visit. The parent asks about transitioning
to cow’s milk. What should the nurse recommend?
a. A. "Start with whole cow’s milk, and limit to 16-24 ounces per day."
b. B. "Introduce skim milk to reduce fat intake."
c. C. "Only use formula until 2 years old."
d. D. "Cow’s milk should never be introduced before 18 months."
Answer: A. "Start with whole cow’s milk, and limit to 16-24 ounces per day."
Rationale: Whole milk is recommended for brain development. Skim milk lacks necessary
fat.
Multiple Choice Questions (Single Answer)
12. A nurse is assessing a newborn’s primitive reflexes. Which reflex normally
disappears by 4 months of age?
• A. Babinski reflex
• B. Moro reflex
• C. Rooting reflex
• D. Parachute reflex
Answer: B. Moro reflex
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