NR 328 PEDIATRIC NURSING - MIDTERM EXAM GUIDE (125
Questions, Answers and Rationales)
Chamberlain University - NR 328: Pediatric Nursing
Comprehensive Practice & Review Guide
--------------------------------------------------------------------------------
📋 Growth & Development / Milestones (Piaget, Erikson, Freud, Kohlberg)
Q1. At what age should a pediatric nurse expect a healthy infant to double their birth
weight?
Correct Answer: 5 to 6 months.
Rationale: Infants typically double their birth weight by 5-6 months and triple it by 1 year of
age.
Q2. According to Erikson, what is the primary psychosocial developmental stage for an
infant (0-1 year)?
Correct Answer: Trust vs. Mistrust.
Rationale: Infants learn to trust when their basic biological and emotional needs are
consistently met by caregivers.
Q3. Which developmental milestone is typical for a 4-month-old infant?
Correct Answer: Good head control and rolls from stomach to back.
Rationale: By 4 months, infants have minimal head lag when pulled to sit and can roll from
abdomen to back.
Q4. What cognitive developmental stage is an 18-month-old toddler in according to
Piaget?
Correct Answer: Sensorimotor stage (specifically tertiary circular reactions/mental
combinations).
Rationale: Piaget's sensorimotor stage lasts from birth to 2 years, where infants learn about
the world through senses and motor actions.
Q5. A nurse notes a toddler playing side-by-side with another child without interaction.
What type of play is this?
Correct Answer: Parallel play.
Rationale: Parallel play is characteristic of toddlers who play near other children but do not
interact or play cooperatively.
Q6. According to Piaget, what stage of cognitive development is a 4-year-old preschooler
in?
Correct Answer: Preoperational stage.
, Rationale: The preoperational stage spans ages 2 to 7 years and is characterized by
egocentrism, animism, and magical thinking.
Q7. What psychosocial stage does a school-age child (6-12 years) experience according
to Erikson?
Correct Answer: Industry vs. Inferiority.
Rationale: School-age children focus on mastering skills, completing tasks, and achieving
success to develop competence.
Q8. What type of play is most characteristic of school-age children?
Correct Answer: Cooperative/Competitive play.
Rationale: School-age children participate in structured games with rules, team sports, and
organized group activities.
Q9. At what age does the posterior fontanel typically close?
Correct Answer: 6 to 8 weeks.
Rationale: The posterior fontanel closes early in infancy, between 2 and 3 months (6-8
weeks).
Q10. At what age does the anterior fontanel typically close?
Correct Answer: 12 to 18 months.
Rationale: The anterior fontanel closes later, allowing for rapid brain growth during the first
year of life.
Q11. An adolescent is exploring identities and values. Which Erikson stage does this
represent?
Correct Answer: Identity vs. Role Confusion.
Rationale: Adolescents (12-18 years) seek to establish a stable identity and sense of self.
Q12. What is the typical age an infant can sit unsupported?
Correct Answer: 8 months.
Rationale: Most infants can sit steadily unsupported by 8 months of age; tripod sitting begins
around 6 months.
Q13. A 9-month-old cries when separated from their parents. What is this developmental
behavior?
Correct Answer: Stranger anxiety / Separation anxiety.
Rationale: Separation anxiety typically peaks between 6 and 9 months as object
permanence develops.
Q14. How many words should a typical 2-year-old toddler be able to use in short
phrases?
Correct Answer: 2-word to 3-word sentences with a vocabulary of about 200-300
words.
, Rationale: Two-year-olds typically use telegraphic speech consisting of short, multi-word
phrases.
Q15. Which gross motor skill should a nurse expect from a 3-year-old child?
Correct Answer: Riding a tricycle.
Rationale: Riding a tricycle and balancing on one foot for a few seconds are classic gross
motor milestones for a 3-year-old.
Q16. According to Kohlberg, what stage of moral development applies to most
preschoolers?
Correct Answer: Preconventional morality.
Rationale: Preschoolers operate on preconventional moral reasoning, focusing on
obedience and avoiding punishment.
📋 Pediatric Assessment & Pain Management (FLACC, FACES, NIPS,
Numeric)
Q17. Which pain assessment tool should a nurse use for a 2-month-old infant post-
surgery?
Correct Answer: FLACC scale.
Rationale: The FLACC tool evaluates Face, Legs, Activity, Cry, and Consolability for non-
verbal infants and young children.
Q18. For which age group is the Wong-Baker FACES Pain Rating Scale most
appropriate?
Correct Answer: Children aged 3 years and older.
Rationale: The FACES scale utilizes visual descriptions that children as young as 3 can
successfully point to.
Q19. What pain scale is designed specifically for assessing procedural pain in premature
and term neonates?
Correct Answer: NIPS (Neonatal Infant Pain Scale).
Rationale: NIPS measures facial expression, cry, breathing patterns, arms, legs, and state
of arousal in newborns.
Q20. At what age can a child reliably use a Numeric Pain Rating Scale (0-10)?
Correct Answer: 5 years or older (typically 7-8 years for reliable use).
Rationale: Children must have adequate abstract conceptual skills to link numbers with pain
intensity, usually achieved around school age.
Q21. When performing a pediatric physical assessment, in what order should the nurse
proceed?
Correct Answer: Least invasive to most invasive.
Questions, Answers and Rationales)
Chamberlain University - NR 328: Pediatric Nursing
Comprehensive Practice & Review Guide
--------------------------------------------------------------------------------
📋 Growth & Development / Milestones (Piaget, Erikson, Freud, Kohlberg)
Q1. At what age should a pediatric nurse expect a healthy infant to double their birth
weight?
Correct Answer: 5 to 6 months.
Rationale: Infants typically double their birth weight by 5-6 months and triple it by 1 year of
age.
Q2. According to Erikson, what is the primary psychosocial developmental stage for an
infant (0-1 year)?
Correct Answer: Trust vs. Mistrust.
Rationale: Infants learn to trust when their basic biological and emotional needs are
consistently met by caregivers.
Q3. Which developmental milestone is typical for a 4-month-old infant?
Correct Answer: Good head control and rolls from stomach to back.
Rationale: By 4 months, infants have minimal head lag when pulled to sit and can roll from
abdomen to back.
Q4. What cognitive developmental stage is an 18-month-old toddler in according to
Piaget?
Correct Answer: Sensorimotor stage (specifically tertiary circular reactions/mental
combinations).
Rationale: Piaget's sensorimotor stage lasts from birth to 2 years, where infants learn about
the world through senses and motor actions.
Q5. A nurse notes a toddler playing side-by-side with another child without interaction.
What type of play is this?
Correct Answer: Parallel play.
Rationale: Parallel play is characteristic of toddlers who play near other children but do not
interact or play cooperatively.
Q6. According to Piaget, what stage of cognitive development is a 4-year-old preschooler
in?
Correct Answer: Preoperational stage.
, Rationale: The preoperational stage spans ages 2 to 7 years and is characterized by
egocentrism, animism, and magical thinking.
Q7. What psychosocial stage does a school-age child (6-12 years) experience according
to Erikson?
Correct Answer: Industry vs. Inferiority.
Rationale: School-age children focus on mastering skills, completing tasks, and achieving
success to develop competence.
Q8. What type of play is most characteristic of school-age children?
Correct Answer: Cooperative/Competitive play.
Rationale: School-age children participate in structured games with rules, team sports, and
organized group activities.
Q9. At what age does the posterior fontanel typically close?
Correct Answer: 6 to 8 weeks.
Rationale: The posterior fontanel closes early in infancy, between 2 and 3 months (6-8
weeks).
Q10. At what age does the anterior fontanel typically close?
Correct Answer: 12 to 18 months.
Rationale: The anterior fontanel closes later, allowing for rapid brain growth during the first
year of life.
Q11. An adolescent is exploring identities and values. Which Erikson stage does this
represent?
Correct Answer: Identity vs. Role Confusion.
Rationale: Adolescents (12-18 years) seek to establish a stable identity and sense of self.
Q12. What is the typical age an infant can sit unsupported?
Correct Answer: 8 months.
Rationale: Most infants can sit steadily unsupported by 8 months of age; tripod sitting begins
around 6 months.
Q13. A 9-month-old cries when separated from their parents. What is this developmental
behavior?
Correct Answer: Stranger anxiety / Separation anxiety.
Rationale: Separation anxiety typically peaks between 6 and 9 months as object
permanence develops.
Q14. How many words should a typical 2-year-old toddler be able to use in short
phrases?
Correct Answer: 2-word to 3-word sentences with a vocabulary of about 200-300
words.
, Rationale: Two-year-olds typically use telegraphic speech consisting of short, multi-word
phrases.
Q15. Which gross motor skill should a nurse expect from a 3-year-old child?
Correct Answer: Riding a tricycle.
Rationale: Riding a tricycle and balancing on one foot for a few seconds are classic gross
motor milestones for a 3-year-old.
Q16. According to Kohlberg, what stage of moral development applies to most
preschoolers?
Correct Answer: Preconventional morality.
Rationale: Preschoolers operate on preconventional moral reasoning, focusing on
obedience and avoiding punishment.
📋 Pediatric Assessment & Pain Management (FLACC, FACES, NIPS,
Numeric)
Q17. Which pain assessment tool should a nurse use for a 2-month-old infant post-
surgery?
Correct Answer: FLACC scale.
Rationale: The FLACC tool evaluates Face, Legs, Activity, Cry, and Consolability for non-
verbal infants and young children.
Q18. For which age group is the Wong-Baker FACES Pain Rating Scale most
appropriate?
Correct Answer: Children aged 3 years and older.
Rationale: The FACES scale utilizes visual descriptions that children as young as 3 can
successfully point to.
Q19. What pain scale is designed specifically for assessing procedural pain in premature
and term neonates?
Correct Answer: NIPS (Neonatal Infant Pain Scale).
Rationale: NIPS measures facial expression, cry, breathing patterns, arms, legs, and state
of arousal in newborns.
Q20. At what age can a child reliably use a Numeric Pain Rating Scale (0-10)?
Correct Answer: 5 years or older (typically 7-8 years for reliable use).
Rationale: Children must have adequate abstract conceptual skills to link numbers with pain
intensity, usually achieved around school age.
Q21. When performing a pediatric physical assessment, in what order should the nurse
proceed?
Correct Answer: Least invasive to most invasive.
