SAUNDERS COMPREHENSIVE REVIEW FOR THE NCLEX-
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1) (Developmental milestone — 6 months)
A 6-month-old infant is brought to clinic for routine well-care.
Which milestone would be most appropriate to expect at this
visit?
A. Sits unsupported for several seconds.
B. Walks unassisted.
C. Uses a pencil to draw a circle.
D. Forms a 2-word sentence.
Answer: A — Sits unsupported for several seconds.
Rationale: By ~6 months many infants can sit unsupported
(core gross-motor milestone). Walking (B) and drawing (C) are
much later (walk ~12–15 months, draw circle ~3–4 years). Two-
word combinations (D) typically appear around 2 years.
Developmentally appropriate expectations guide screening and
,teaching; failing to expect age-appropriate tasks can lead to
missed screening or unnecessary interventions. (CDC milestone
guidance). CDC
Incorrect options — B, C, D: These are milestones for older
ages; selecting them risks false-positive developmental delay
labelling and inappropriate referrals.
2) (Fine motor — 9–12 months)
A 10-month-old demonstrates picking up small cheerios
between thumb and forefinger. The nurse documents this as
which milestone?
A. Palmar grasp.
B. Pincer grasp.
C. Palmer-to-radial transfer.
D. Inferior pincer grasp.
Answer: B — Pincer grasp.
Rationale: The pincer grasp (using thumb and index finger)
develops around 9–12 months and reflects fine-motor and
neuromotor maturation necessary for self-feeding and safe
introduction of solids. Palmar grasp (A) is an earlier reflex;
palmar-to-radial transfer (C) occurs earlier (~6–7 months).
“Inferior pincer” (D) is a more primitive variant — by 10 months
a refined pincer is expected. Correct recognition informs
feeding safety and anticipatory guidance (choking risk for
certain foods).
,3) (Language — 2 years)
Which behavior in a 24-month-old would indicate age-
appropriate expressive language development?
A. Says 2–3 word phrases and knows ~50+ words.
B. Uses complete sentences of 8–10 words.
C. Says single words only.
D. Babbling with repeated consonant–vowel sounds only.
Answer: A — Says 2–3 word phrases and knows ~50+ words.
Rationale: At ~2 years most children combine words into short
phrases and have a rapidly expanding vocabulary (roughly 50+
words). Option B describes an older child, C and D are earlier
stages. This informs teaching (promote language exposure,
reading, and screening when delayed) and safety
(communication affects ability to report pain/illness).
4) (School-age / social development — 4 years)
A 4-year-old is hospitalized and refuses medications from an
unfamiliar nurse. Which approach is developmentally
appropriate?
A. Use simple, concrete explanations and offer limited choices
(e.g., “Do you want the red cup or blue cup?”).
B. Explain the abstract future benefits of the medication.
C. Insist and administer by restraint if needed.
, D. Tell the child that not taking meds will make them never play
again.
Answer: A — Use simple, concrete explanations and offer
limited choices.
Rationale: Preschool children respond to concrete language and
benefit from limited choices to increase sense of control.
Explaining abstract future benefits (B) is beyond their cognitive
level. Restraint (C) should be last resort and unethical for
routine medication refusal; D is coercive and damaging to trust.
This choice supports developmental needs and therapeutic
rapport, improving safety by promoting cooperation.
5) (NGN-style — prioritization / safety)
A 2-year-old in the ED has quick shallow respirations, nasal
flaring, and oxygen saturation (SpO₂) 88% on room air. Which
is the immediate priority?
A. Administer supplemental oxygen and continuous monitoring.
B. Obtain a chest x-ray.
C. Start oral antibiotics.
D. Provide age-appropriate distraction.
Answer: A — Administer supplemental oxygen and continuous
monitoring.
Rationale: Hypoxemia (SpO₂ <90%) and signs of respiratory
distress require immediate stabilization (oxygen, continuous
observation, prepare for potential escalation). Diagnostics (B)
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1) (Developmental milestone — 6 months)
A 6-month-old infant is brought to clinic for routine well-care.
Which milestone would be most appropriate to expect at this
visit?
A. Sits unsupported for several seconds.
B. Walks unassisted.
C. Uses a pencil to draw a circle.
D. Forms a 2-word sentence.
Answer: A — Sits unsupported for several seconds.
Rationale: By ~6 months many infants can sit unsupported
(core gross-motor milestone). Walking (B) and drawing (C) are
much later (walk ~12–15 months, draw circle ~3–4 years). Two-
word combinations (D) typically appear around 2 years.
Developmentally appropriate expectations guide screening and
,teaching; failing to expect age-appropriate tasks can lead to
missed screening or unnecessary interventions. (CDC milestone
guidance). CDC
Incorrect options — B, C, D: These are milestones for older
ages; selecting them risks false-positive developmental delay
labelling and inappropriate referrals.
2) (Fine motor — 9–12 months)
A 10-month-old demonstrates picking up small cheerios
between thumb and forefinger. The nurse documents this as
which milestone?
A. Palmar grasp.
B. Pincer grasp.
C. Palmer-to-radial transfer.
D. Inferior pincer grasp.
Answer: B — Pincer grasp.
Rationale: The pincer grasp (using thumb and index finger)
develops around 9–12 months and reflects fine-motor and
neuromotor maturation necessary for self-feeding and safe
introduction of solids. Palmar grasp (A) is an earlier reflex;
palmar-to-radial transfer (C) occurs earlier (~6–7 months).
“Inferior pincer” (D) is a more primitive variant — by 10 months
a refined pincer is expected. Correct recognition informs
feeding safety and anticipatory guidance (choking risk for
certain foods).
,3) (Language — 2 years)
Which behavior in a 24-month-old would indicate age-
appropriate expressive language development?
A. Says 2–3 word phrases and knows ~50+ words.
B. Uses complete sentences of 8–10 words.
C. Says single words only.
D. Babbling with repeated consonant–vowel sounds only.
Answer: A — Says 2–3 word phrases and knows ~50+ words.
Rationale: At ~2 years most children combine words into short
phrases and have a rapidly expanding vocabulary (roughly 50+
words). Option B describes an older child, C and D are earlier
stages. This informs teaching (promote language exposure,
reading, and screening when delayed) and safety
(communication affects ability to report pain/illness).
4) (School-age / social development — 4 years)
A 4-year-old is hospitalized and refuses medications from an
unfamiliar nurse. Which approach is developmentally
appropriate?
A. Use simple, concrete explanations and offer limited choices
(e.g., “Do you want the red cup or blue cup?”).
B. Explain the abstract future benefits of the medication.
C. Insist and administer by restraint if needed.
, D. Tell the child that not taking meds will make them never play
again.
Answer: A — Use simple, concrete explanations and offer
limited choices.
Rationale: Preschool children respond to concrete language and
benefit from limited choices to increase sense of control.
Explaining abstract future benefits (B) is beyond their cognitive
level. Restraint (C) should be last resort and unethical for
routine medication refusal; D is coercive and damaging to trust.
This choice supports developmental needs and therapeutic
rapport, improving safety by promoting cooperation.
5) (NGN-style — prioritization / safety)
A 2-year-old in the ED has quick shallow respirations, nasal
flaring, and oxygen saturation (SpO₂) 88% on room air. Which
is the immediate priority?
A. Administer supplemental oxygen and continuous monitoring.
B. Obtain a chest x-ray.
C. Start oral antibiotics.
D. Provide age-appropriate distraction.
Answer: A — Administer supplemental oxygen and continuous
monitoring.
Rationale: Hypoxemia (SpO₂ <90%) and signs of respiratory
distress require immediate stabilization (oxygen, continuous
observation, prepare for potential escalation). Diagnostics (B)
