COMPREHENSIVE NURSING BOARD REVIEW EXAM:
PEDIATRIC NURSING, GROWTH & DEVELOPMENT,
AND PALLIATIVE CARE
200 Clinical Questions with Detailed Rationales and Reference
Standards
1. A nurse is planning care for a preschool-age child who is
terminally ill. Which of the following findings should the nurse
anticipate as an age-appropriate cognitive reaction to death by a
preschooler? (Select all that apply.)
A. Believing that death is temporary and reversible (like sleep).
B. Viewing death as a permanent biological cessation of all bodily
functions.
C. Believing that thoughts, wishes, or bad behavior can cause someone's
death (magical thinking).
D. Expressing an accurate understanding of physiological mortality and
decomposition.
E. Viewing death as a departure or a journey from which the person will
return.
Rationales:
Correct Answers: A, C, E
Detailed Rationale: Preschool-age children (typically ages 3 to 6)
possess specific cognitive limitations regarding death according to
Piaget's preoperational stage. 1) They often view death as temporary,
reversible, or akin to sleep (Option A). 2) They engage in magical
thinking, frequently believing that their thoughts, misbehavior, or
,negative wishes caused the illness or death of a loved one or themselves
(Option C). 3) They often view death as a departure, sleep, or temporary
journey from which the person will eventually return (Option E).
Incorrect Answers: Option B describes a mature, school-age to
adolescent understanding of death (usually achieved around age 9-10).
Option D reflects an adult or older adolescent conceptualization of
physiological death.
2. [Infant Development & Separation Anxiety] An infant (8 months
old) is hospitalized and displays stranger anxiety and protest when
separated from parents. Which nursing intervention is most
appropriate? (Clinical Scenario #2)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
C. Immediate restriction of parental visitation to minimize
environmental stimulation.
D. Direct physical restraint to prevent interference with medical
equipment.
Rationales:
Correct Answer: B
Detailed Rationale: In pediatric nursing and palliative care,
interventions must always align with the developmental stage,
physiological status, and holistic comfort of the child and family (Option
B). Restricting parents (Option C) or applying restraints (Option D)
causes psychological trauma and violates family-centered care
,principles. Pharmacological management (Option A) is secondary to
comprehensive assessment and holistic comfort measures.
3. [Toddler Autonomy & Hospitalization] A toddler (2 years old)
hospitalized for acute illness exhibits regression in toilet training
and temper tantrums. What is the nurse's best response? (Clinical
Scenario #3)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
C. Immediate restriction of parental visitation to minimize
environmental stimulation.
D. Direct physical restraint to prevent interference with medical
equipment.
Rationales:
Correct Answer: B
Detailed Rationale: In pediatric nursing and palliative care,
interventions must always align with the developmental stage,
physiological status, and holistic comfort of the child and family (Option
B). Restricting parents (Option C) or applying restraints (Option D)
causes psychological trauma and violates family-centered care
principles. Pharmacological management (Option A) is secondary to
comprehensive assessment and holistic comfort measures.
4. [School-Age Understanding of Death] A 9-year-old child with
leukemia asks if they are going to die. Which cognitive
, understanding of death is expected at this developmental stage?
(Clinical Scenario #4)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
C. Immediate restriction of parental visitation to minimize
environmental stimulation.
D. Direct physical restraint to prevent interference with medical
equipment.
Rationales:
Correct Answer: B
Detailed Rationale: In pediatric nursing and palliative care,
interventions must always align with the developmental stage,
physiological status, and holistic comfort of the child and family (Option
B). Restricting parents (Option C) or applying restraints (Option D)
causes psychological trauma and violates family-centered care
principles. Pharmacological management (Option A) is secondary to
comprehensive assessment and holistic comfort measures.
5. [Adolescent Terminal Diagnosis] A 15-year-old adolescent
diagnosed with a terminal brain tumor withdraws from peers and
expresses profound anger at the injustice of life. What
developmental factor explains this reaction? (Clinical Scenario #5)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
PEDIATRIC NURSING, GROWTH & DEVELOPMENT,
AND PALLIATIVE CARE
200 Clinical Questions with Detailed Rationales and Reference
Standards
1. A nurse is planning care for a preschool-age child who is
terminally ill. Which of the following findings should the nurse
anticipate as an age-appropriate cognitive reaction to death by a
preschooler? (Select all that apply.)
A. Believing that death is temporary and reversible (like sleep).
B. Viewing death as a permanent biological cessation of all bodily
functions.
C. Believing that thoughts, wishes, or bad behavior can cause someone's
death (magical thinking).
D. Expressing an accurate understanding of physiological mortality and
decomposition.
E. Viewing death as a departure or a journey from which the person will
return.
Rationales:
Correct Answers: A, C, E
Detailed Rationale: Preschool-age children (typically ages 3 to 6)
possess specific cognitive limitations regarding death according to
Piaget's preoperational stage. 1) They often view death as temporary,
reversible, or akin to sleep (Option A). 2) They engage in magical
thinking, frequently believing that their thoughts, misbehavior, or
,negative wishes caused the illness or death of a loved one or themselves
(Option C). 3) They often view death as a departure, sleep, or temporary
journey from which the person will eventually return (Option E).
Incorrect Answers: Option B describes a mature, school-age to
adolescent understanding of death (usually achieved around age 9-10).
Option D reflects an adult or older adolescent conceptualization of
physiological death.
2. [Infant Development & Separation Anxiety] An infant (8 months
old) is hospitalized and displays stranger anxiety and protest when
separated from parents. Which nursing intervention is most
appropriate? (Clinical Scenario #2)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
C. Immediate restriction of parental visitation to minimize
environmental stimulation.
D. Direct physical restraint to prevent interference with medical
equipment.
Rationales:
Correct Answer: B
Detailed Rationale: In pediatric nursing and palliative care,
interventions must always align with the developmental stage,
physiological status, and holistic comfort of the child and family (Option
B). Restricting parents (Option C) or applying restraints (Option D)
causes psychological trauma and violates family-centered care
,principles. Pharmacological management (Option A) is secondary to
comprehensive assessment and holistic comfort measures.
3. [Toddler Autonomy & Hospitalization] A toddler (2 years old)
hospitalized for acute illness exhibits regression in toilet training
and temper tantrums. What is the nurse's best response? (Clinical
Scenario #3)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
C. Immediate restriction of parental visitation to minimize
environmental stimulation.
D. Direct physical restraint to prevent interference with medical
equipment.
Rationales:
Correct Answer: B
Detailed Rationale: In pediatric nursing and palliative care,
interventions must always align with the developmental stage,
physiological status, and holistic comfort of the child and family (Option
B). Restricting parents (Option C) or applying restraints (Option D)
causes psychological trauma and violates family-centered care
principles. Pharmacological management (Option A) is secondary to
comprehensive assessment and holistic comfort measures.
4. [School-Age Understanding of Death] A 9-year-old child with
leukemia asks if they are going to die. Which cognitive
, understanding of death is expected at this developmental stage?
(Clinical Scenario #4)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
C. Immediate restriction of parental visitation to minimize
environmental stimulation.
D. Direct physical restraint to prevent interference with medical
equipment.
Rationales:
Correct Answer: B
Detailed Rationale: In pediatric nursing and palliative care,
interventions must always align with the developmental stage,
physiological status, and holistic comfort of the child and family (Option
B). Restricting parents (Option C) or applying restraints (Option D)
causes psychological trauma and violates family-centered care
principles. Pharmacological management (Option A) is secondary to
comprehensive assessment and holistic comfort measures.
5. [Adolescent Terminal Diagnosis] A 15-year-old adolescent
diagnosed with a terminal brain tumor withdraws from peers and
expresses profound anger at the injustice of life. What
developmental factor explains this reaction? (Clinical Scenario #5)
A. Immediate pharmacological intervention with broad-spectrum agents.
B. Age-appropriate therapeutic communication and developmental
support tailored to pediatric standards.
