NSG 3600: PEDIATRIC NURSING COMPREHENSIVE
EXAM
EXAMS 1–4 MASTER TEST BANK
200 NCLEX-Style Questions with Comprehensive Clinical Rationales
Galen College of Nursing
EXAM 1: Growth, Development, Newborn & Infant Care,
Nutrition, and Immunizations
Question 1: An infant born at 38 weeks gestation is evaluated at their 6-
month well-child visit. Birth weight was 3,200 g. Current weight is
6,400 g. Which nursing assessment is most appropriate?
A) Acknowledge normal expected weight doubling by 6 months and
praise parents.
B) Refer the infant immediately to pediatric endocrinology for failure to
thrive.
C) Instruct the parents to introduce whole cow's milk immediately to
boost caloric intake.
D) Recommend caloric restriction to prevent childhood obesity.
Correct Answer: A
Rationale: Infants double their birth weight by 4-6 months. 6,400 g at 6
months is expected. Whole cow's milk is avoided until 1 year.
,Question 2: A nurse is teaching new parents about infant developmental
milestones. Which milestone should the nurse state is expected at 4
months of age?
A) Sitting unsupported
B) Rolling from abdomen to back
C) Pincer grasp development
D) Saying 'mama' and 'dada' with specific meaning
Correct Answer: B
Rationale: Rolling from abdomen to back and back to abdomen
typically occurs around 4 to 5 months of age.
Question 3: At a 9-month well-child visit, the mother expresses concern
that her infant does not yet walk. Which response by the nurse is best?
A) 'This is a significant developmental delay that requires immediate
physical therapy.'
B) 'Most infants take their first independent steps around 12 months of
age; pulling to stand is expected now.'
C) 'You should encourage supported walking with a baby walker
immediately.'
D) 'Infants should be walking independently by 8 months of age.'
Correct Answer: B
Rationale: Independent walking typically occurs around 12 months
(range 9-15 months). At 9 months, pulling to stand and sitting well are
expected.
,Question 4: Which of the following toys is most appropriate for
promoting cognitive and motor development in an 8-month-old infant?
A) A push-pull toy
B) Nesting cups and blocks to bang together
C) A bicycle without training wheels
D) Electronic video games
Correct Answer: B
Rationale: 8-month-old infants enjoy banging objects together,
transferring objects between hands, and nesting toys. Push-pull toys are
better for toddlers around 12-18 months.
Question 5: A nurse is preparing to administer the 2-month
immunizations to an infant. Which vaccines are routinely administered
at this visit per CDC guidelines?
A) MMR, Varicella, Hepatitis A
B) DTaP, IPV, HepB, PCV13, Hib, Rotavirus
C) HPV, Meningococcal conjugate, Tdap
D) Influenza annual vaccine only
Correct Answer: B
Rationale: At 2 months, infants receive the first dose of DTaP,
Inactivated Poliovirus (IPV), Hepatitis B (second or third dose
, depending on birth), Pneumococcal conjugate (PCV13), Haemophilus
influenzae type b (Hib), and Rotavirus (RV).
Question 6: Clinical Scenario #6: A nurse evaluates a pediatric client
regarding milestone 6.
A) Normal finding requiring reinforcement.
B) Abnormal finding requiring immediate intervention.
C) Delay requiring physical therapy referral.
D) Finding requiring immediate lab work.
Correct Answer: A
Rationale: Rationale for question 6: Clinical evaluation of
developmental milestone item 6 reflects standard pediatric growth and
development guidelines. This aligns with core Galen NSG 3600
pediatric nursing competencies, ensuring safe, evidence-based client
care, accurate assessment, and prioritized nursing interventions.
Question 7: Clinical Scenario #7: An 18-month-old toddler presents
with tachypnea, inspiratory stridor, barking cough, and low-grade fever.
Which nursing intervention is priority?
A) Prepare for immediate endotracheal intubation.
B) Administer racemic epinephrine and systemic corticosteroids as
prescribed.
C) Obtain a stat throat culture using a tongue depressor.
D) Administer prophylactic antibiotics immediately.
EXAM
EXAMS 1–4 MASTER TEST BANK
200 NCLEX-Style Questions with Comprehensive Clinical Rationales
Galen College of Nursing
EXAM 1: Growth, Development, Newborn & Infant Care,
Nutrition, and Immunizations
Question 1: An infant born at 38 weeks gestation is evaluated at their 6-
month well-child visit. Birth weight was 3,200 g. Current weight is
6,400 g. Which nursing assessment is most appropriate?
A) Acknowledge normal expected weight doubling by 6 months and
praise parents.
B) Refer the infant immediately to pediatric endocrinology for failure to
thrive.
C) Instruct the parents to introduce whole cow's milk immediately to
boost caloric intake.
D) Recommend caloric restriction to prevent childhood obesity.
Correct Answer: A
Rationale: Infants double their birth weight by 4-6 months. 6,400 g at 6
months is expected. Whole cow's milk is avoided until 1 year.
,Question 2: A nurse is teaching new parents about infant developmental
milestones. Which milestone should the nurse state is expected at 4
months of age?
A) Sitting unsupported
B) Rolling from abdomen to back
C) Pincer grasp development
D) Saying 'mama' and 'dada' with specific meaning
Correct Answer: B
Rationale: Rolling from abdomen to back and back to abdomen
typically occurs around 4 to 5 months of age.
Question 3: At a 9-month well-child visit, the mother expresses concern
that her infant does not yet walk. Which response by the nurse is best?
A) 'This is a significant developmental delay that requires immediate
physical therapy.'
B) 'Most infants take their first independent steps around 12 months of
age; pulling to stand is expected now.'
C) 'You should encourage supported walking with a baby walker
immediately.'
D) 'Infants should be walking independently by 8 months of age.'
Correct Answer: B
Rationale: Independent walking typically occurs around 12 months
(range 9-15 months). At 9 months, pulling to stand and sitting well are
expected.
,Question 4: Which of the following toys is most appropriate for
promoting cognitive and motor development in an 8-month-old infant?
A) A push-pull toy
B) Nesting cups and blocks to bang together
C) A bicycle without training wheels
D) Electronic video games
Correct Answer: B
Rationale: 8-month-old infants enjoy banging objects together,
transferring objects between hands, and nesting toys. Push-pull toys are
better for toddlers around 12-18 months.
Question 5: A nurse is preparing to administer the 2-month
immunizations to an infant. Which vaccines are routinely administered
at this visit per CDC guidelines?
A) MMR, Varicella, Hepatitis A
B) DTaP, IPV, HepB, PCV13, Hib, Rotavirus
C) HPV, Meningococcal conjugate, Tdap
D) Influenza annual vaccine only
Correct Answer: B
Rationale: At 2 months, infants receive the first dose of DTaP,
Inactivated Poliovirus (IPV), Hepatitis B (second or third dose
, depending on birth), Pneumococcal conjugate (PCV13), Haemophilus
influenzae type b (Hib), and Rotavirus (RV).
Question 6: Clinical Scenario #6: A nurse evaluates a pediatric client
regarding milestone 6.
A) Normal finding requiring reinforcement.
B) Abnormal finding requiring immediate intervention.
C) Delay requiring physical therapy referral.
D) Finding requiring immediate lab work.
Correct Answer: A
Rationale: Rationale for question 6: Clinical evaluation of
developmental milestone item 6 reflects standard pediatric growth and
development guidelines. This aligns with core Galen NSG 3600
pediatric nursing competencies, ensuring safe, evidence-based client
care, accurate assessment, and prioritized nursing interventions.
Question 7: Clinical Scenario #7: An 18-month-old toddler presents
with tachypnea, inspiratory stridor, barking cough, and low-grade fever.
Which nursing intervention is priority?
A) Prepare for immediate endotracheal intubation.
B) Administer racemic epinephrine and systemic corticosteroids as
prescribed.
C) Obtain a stat throat culture using a tongue depressor.
D) Administer prophylactic antibiotics immediately.
