PED-BC 2026 Study Guide: Pediatric Nursing
Certification Practice Questions Answer
Explanations & Child Assessment, Growth &
Development, Pediatric Disorders, Clinical
Management Exam Preparation
Section 1: Assessment and Diagnosis (Questions 1–42)
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit.
Which developmental milestone is most appropriate for this age?
A. Walking independently
B. Using two-word phrases
C. Sitting without support
D. Drawing a circle
Rationale: At 6 months, infants typically achieve sitting without support (6–8
months), demonstrating developing truncal control and gross motor progression.
Independent walking emerges at 12–15 months. Two-word phrases develop at 18–
24 months. Drawing shapes emerges in preschool years (3–5 years).
Question 2: During assessment of a 2-year-old toddler, which behavior is expected
based on Erikson's psychosocial development theory?
A. Engaging in parallel play and asserting independence ("no")
B. Demonstrating cooperative play and school readiness
C. Developing intimate relationships and identity exploration
D. Showing trust versus mistrust resolution
Rationale: Erikson's toddler stage (autonomy vs. shame and doubt, 1–3 years)
features asserting independence, negativism ("no"), parallel play (playing beside
but not with peers), and developing self-control. Cooperative play characterizes
preschool stage. Intimacy and identity exploration characterize adolescence. Trust
vs. mistrust is the infant stage (0–1 year).
Question 3: A nurse is assessing a 5-year-old child admitted with suspected
appendicitis. Which pain assessment tool is most appropriate?
,A. Visual Analog Scale (VAS)
B. Numeric Rating Scale (NRS)
C. FACES Pain Scale-Revised
D. CRIES scale
Rationale: The FACES Pain Scale-Revised (FPS-R) is validated for children ages
3–18 years, using six cartoon faces with neutral to crying expressions. VAS
requires abstract thinking and sustained attention. NRS requires numerical
understanding (typically ages 8+). CRIES is used for neonates.
Question 4: A 4-month-old infant is brought to the clinic for a well-child visit.
Which developmental milestone should the nurse expect to observe?
A. Head control when pulled to a sitting position
B. Rolling from back to stomach
C. Transferring objects from hand to hand
D. Sitting without support
Rationale: At 4 months, infants typically achieve head control when pulled to a
sitting position. Rolling from back to stomach occurs at 4–6 months. Transferring
objects occurs at 6–7 months. Sitting without support occurs at 6–8 months.
Question 5: A nurse is assessing a 12-month-old infant. Which language milestone
is most appropriate for this age?
A. Using one or two words with meaning
B. Speaking in two-word phrases
C. Using 50 or more words
D. Speaking in complete sentences
Rationale: At 12 months, infants typically use one or two words with meaning
(e.g., "mama," "dada"). Two-word phrases develop at 18–24 months. Fifty or more
words develop at 2 years. Complete sentences develop at 3–4 years.
Question 6: A 3-year-old child is being assessed for growth. The nurse plots the
child's height and weight on a growth chart. Which percentile range is considered
normal for a 3-year-old?
A. Below the 5th percentile
B. Between the 5th and 95th percentiles
C. Above the 95th percentile
D. At the 50th percentile only
,Rationale: Normal growth is defined as height and weight between the 5th and
95th percentiles. Below the 5th percentile may indicate failure to thrive or
underlying pathology. Above the 95th percentile may indicate obesity or endocrine
disorders. The 50th percentile is the average but not the only normal value.
Question 7: A nurse is assessing a 7-year-old child's cognitive development.
According to Piaget, which stage is the child in?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Rationale: Piaget's concrete operational stage (7–11 years) is characterized by
logical thinking about concrete events, conservation, and classification.
Sensorimotor (0–2 years) involves sensory and motor exploration. Preoperational
(2–7 years) involves symbolic thought and egocentrism. Formal operational (11+
years) involves abstract reasoning.
Question 8: A 2-month-old infant is being assessed for immunization readiness.
Which immunizations are typically administered at this age?
A. DTaP, IPV, Hib, PCV, and rotavirus
B. MMR, varicella, and hepatitis A
C. Tdap and HPV
D. Influenza only
Rationale: At 2 months, infants receive DTaP (diphtheria, tetanus, acellular
pertussis), IPV (inactivated poliovirus), Hib (Haemophilus influenzae type b), PCV
(pneumococcal conjugate vaccine), and rotavirus. MMR, varicella, and hepatitis A
are given at 12–15 months. Tdap and HPV are given in adolescence.
Question 9: A nurse is assessing a 5-year-old child for signs of physical abuse.
Which finding is most concerning?
A. A single bruise on the shin
B. Bruises in various stages of healing on the back and buttocks
C. A scraped knee from a recent fall
D. A small burn on the fingertip
Rationale: Bruises in various stages of healing on the back and buttocks (protected
areas) are highly concerning for physical abuse. Bruises on the shin and scraped
, knees are common in active children. A small burn on the fingertip may be
accidental.
Question 10: A 10-year-old child is being assessed for scoliosis. Which screening
technique is most appropriate?
A. Adams forward bend test
B. Brudzinski's sign
C. Kernig's sign
D. Ortolani maneuver
Rationale: The Adams forward bend test is used to screen for scoliosis by
observing for asymmetry of the back when the child bends forward. Brudzinski's
and Kernig's signs are used to assess for meningitis. Ortolani maneuver is used to
assess for developmental dysplasia of the hip in infants.
Question 11: A nurse is assessing a 6-month-old infant's feeding patterns. Which
finding indicates a need for further evaluation?
A. Poor head control and difficulty swallowing
B. Interest in solid foods
C. Drinking 6–8 ounces of formula per feeding
D. Sleeping through the night
Rationale: Poor head control and difficulty swallowing at 6 months may indicate a
neurological or developmental issue requiring further evaluation. Interest in solid
foods, drinking 6–8 ounces per feeding, and sleeping through the night are normal
at this age.
Question 12: A 15-year-old adolescent is being assessed for depression. Which
screening tool is most appropriate?
A. PHQ-9 modified for adolescents (PHQ-A)
B. Denver II
C. Apgar score
D. Glasgow Coma Scale
Rationale: The PHQ-A is a validated tool for screening adolescents for
depression. Denver II assesses developmental milestones in young children. Apgar
assesses newborns. Glasgow Coma Scale assesses level of consciousness.
Certification Practice Questions Answer
Explanations & Child Assessment, Growth &
Development, Pediatric Disorders, Clinical
Management Exam Preparation
Section 1: Assessment and Diagnosis (Questions 1–42)
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit.
Which developmental milestone is most appropriate for this age?
A. Walking independently
B. Using two-word phrases
C. Sitting without support
D. Drawing a circle
Rationale: At 6 months, infants typically achieve sitting without support (6–8
months), demonstrating developing truncal control and gross motor progression.
Independent walking emerges at 12–15 months. Two-word phrases develop at 18–
24 months. Drawing shapes emerges in preschool years (3–5 years).
Question 2: During assessment of a 2-year-old toddler, which behavior is expected
based on Erikson's psychosocial development theory?
A. Engaging in parallel play and asserting independence ("no")
B. Demonstrating cooperative play and school readiness
C. Developing intimate relationships and identity exploration
D. Showing trust versus mistrust resolution
Rationale: Erikson's toddler stage (autonomy vs. shame and doubt, 1–3 years)
features asserting independence, negativism ("no"), parallel play (playing beside
but not with peers), and developing self-control. Cooperative play characterizes
preschool stage. Intimacy and identity exploration characterize adolescence. Trust
vs. mistrust is the infant stage (0–1 year).
Question 3: A nurse is assessing a 5-year-old child admitted with suspected
appendicitis. Which pain assessment tool is most appropriate?
,A. Visual Analog Scale (VAS)
B. Numeric Rating Scale (NRS)
C. FACES Pain Scale-Revised
D. CRIES scale
Rationale: The FACES Pain Scale-Revised (FPS-R) is validated for children ages
3–18 years, using six cartoon faces with neutral to crying expressions. VAS
requires abstract thinking and sustained attention. NRS requires numerical
understanding (typically ages 8+). CRIES is used for neonates.
Question 4: A 4-month-old infant is brought to the clinic for a well-child visit.
Which developmental milestone should the nurse expect to observe?
A. Head control when pulled to a sitting position
B. Rolling from back to stomach
C. Transferring objects from hand to hand
D. Sitting without support
Rationale: At 4 months, infants typically achieve head control when pulled to a
sitting position. Rolling from back to stomach occurs at 4–6 months. Transferring
objects occurs at 6–7 months. Sitting without support occurs at 6–8 months.
Question 5: A nurse is assessing a 12-month-old infant. Which language milestone
is most appropriate for this age?
A. Using one or two words with meaning
B. Speaking in two-word phrases
C. Using 50 or more words
D. Speaking in complete sentences
Rationale: At 12 months, infants typically use one or two words with meaning
(e.g., "mama," "dada"). Two-word phrases develop at 18–24 months. Fifty or more
words develop at 2 years. Complete sentences develop at 3–4 years.
Question 6: A 3-year-old child is being assessed for growth. The nurse plots the
child's height and weight on a growth chart. Which percentile range is considered
normal for a 3-year-old?
A. Below the 5th percentile
B. Between the 5th and 95th percentiles
C. Above the 95th percentile
D. At the 50th percentile only
,Rationale: Normal growth is defined as height and weight between the 5th and
95th percentiles. Below the 5th percentile may indicate failure to thrive or
underlying pathology. Above the 95th percentile may indicate obesity or endocrine
disorders. The 50th percentile is the average but not the only normal value.
Question 7: A nurse is assessing a 7-year-old child's cognitive development.
According to Piaget, which stage is the child in?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Rationale: Piaget's concrete operational stage (7–11 years) is characterized by
logical thinking about concrete events, conservation, and classification.
Sensorimotor (0–2 years) involves sensory and motor exploration. Preoperational
(2–7 years) involves symbolic thought and egocentrism. Formal operational (11+
years) involves abstract reasoning.
Question 8: A 2-month-old infant is being assessed for immunization readiness.
Which immunizations are typically administered at this age?
A. DTaP, IPV, Hib, PCV, and rotavirus
B. MMR, varicella, and hepatitis A
C. Tdap and HPV
D. Influenza only
Rationale: At 2 months, infants receive DTaP (diphtheria, tetanus, acellular
pertussis), IPV (inactivated poliovirus), Hib (Haemophilus influenzae type b), PCV
(pneumococcal conjugate vaccine), and rotavirus. MMR, varicella, and hepatitis A
are given at 12–15 months. Tdap and HPV are given in adolescence.
Question 9: A nurse is assessing a 5-year-old child for signs of physical abuse.
Which finding is most concerning?
A. A single bruise on the shin
B. Bruises in various stages of healing on the back and buttocks
C. A scraped knee from a recent fall
D. A small burn on the fingertip
Rationale: Bruises in various stages of healing on the back and buttocks (protected
areas) are highly concerning for physical abuse. Bruises on the shin and scraped
, knees are common in active children. A small burn on the fingertip may be
accidental.
Question 10: A 10-year-old child is being assessed for scoliosis. Which screening
technique is most appropriate?
A. Adams forward bend test
B. Brudzinski's sign
C. Kernig's sign
D. Ortolani maneuver
Rationale: The Adams forward bend test is used to screen for scoliosis by
observing for asymmetry of the back when the child bends forward. Brudzinski's
and Kernig's signs are used to assess for meningitis. Ortolani maneuver is used to
assess for developmental dysplasia of the hip in infants.
Question 11: A nurse is assessing a 6-month-old infant's feeding patterns. Which
finding indicates a need for further evaluation?
A. Poor head control and difficulty swallowing
B. Interest in solid foods
C. Drinking 6–8 ounces of formula per feeding
D. Sleeping through the night
Rationale: Poor head control and difficulty swallowing at 6 months may indicate a
neurological or developmental issue requiring further evaluation. Interest in solid
foods, drinking 6–8 ounces per feeding, and sleeping through the night are normal
at this age.
Question 12: A 15-year-old adolescent is being assessed for depression. Which
screening tool is most appropriate?
A. PHQ-9 modified for adolescents (PHQ-A)
B. Denver II
C. Apgar score
D. Glasgow Coma Scale
Rationale: The PHQ-A is a validated tool for screening adolescents for
depression. Denver II assesses developmental milestones in young children. Apgar
assesses newborns. Glasgow Coma Scale assesses level of consciousness.
