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 (Milestones — 2 months)
A 2-month-old infant is brought to the clinic. Which finding is
most consistent with expected development for a 2-month-old?
A. Sits unsupported for several seconds.
B. Uses a mature pincer grasp to pick up small objects.
C. Demonstrates a social (reciprocal) smile when spoken to.
D. Says two clear words (“mama,” “dada”).
Correct answer: C
Rationale — Correct (C): By about 2 months most infants
demonstrate a social (reciprocal) smile and increased social
responsiveness. This is an early social/communication
milestone used to assess normal social development. CDC
Rationale — Incorrect:
, • A: Sitting unsupported is expected later (≈6 months). Not
appropriate for 2 months.
• B: Mature pincer grasp develops nearer 9–12 months. At 2
months infants have a palmar grasp reflex, not pincer.
• D: Clear words such as “mama/dada” purposeful to refer
to a person occur around 9–12 months.
Test plan mapping (knowledge area): Health Promotion &
Maintenance — Growth and development.
2 (Milestones — 6 months)
Which behavior in a 6-month-old should concern the nurse?
A. Sits unsupported momentarily and begins to feed self with
hands.
B. Babbles and makes consonant sounds (e.g., “ba,” “da”).
C. Laughs aloud and recognizes familiar people.
D. Does not roll from front to back or back to front.
Correct answer: D
Rationale — Correct (D): Rolling (front to back, back to front)
typically appears by ~4–6 months. Failure to roll by 6 months is
a warning sign and should prompt developmental
surveillance/screening. This is a safety/early-intervention
concept. Stanford Medicine
Rationale — Incorrect:
, • A, B, C are expected behaviors around 6 months (sitting
with minimal support, feeding self with hands, babbling,
laughing, recognizing caregivers).
Test plan mapping: Health Promotion & Maintenance —
Growth and development.
3 (Milestones — 2 years)
A 2-year-old child is expected to demonstrate which of the
following?
A. Copies a circle and uses 3–4 word sentences.
B. Runs, uses two- to three-word phrases, and begins parallel
play.
C. Rides a tricycle and dresses self completely.
D. Skips on alternating feet and counts to 10.
Correct answer: B
Rationale — Correct (B): At about 2 years children run, use two-
to three-word phrases, and begin parallel play — matching
expected gross motor, language, and social milestones. Drawing
a circle and tricycle skills develop later (3–4 years). Counting
and skipping are older skills. CDC
Rationale — Incorrect:
• A: Copying a circle usually emerges ~3–4 years.
• C: Tricycle (3 years) and independent dressing later than 2
years.
, • D: Skipping and counting to 10 are preschool to early
school-age milestones.
4 (Asthma — priority intervention)
A 7-year-old with moderate asthma exacerbation is admitted.
Which nursing action is the highest priority?
A. Teach the child and caregiver about peak expiratory flow
monitoring.
B. Administer prescribed short-acting beta-agonist (albuterol)
via nebulizer now.
C. Provide written environmental trigger-avoidance strategies
on discharge.
D. Arrange referral to school nurse for inhaler use training.
Correct answer: B
Rationale — Correct (B): In an acute moderate exacerbation,
rapid bronchodilation (short-acting beta-agonist) to relieve
bronchospasm and improve oxygenation is immediate priority
— addressing airway/breathing (physiological integrity; safety).
Education and referrals are important but secondary until the
acute issue is treated.
Rationale — Incorrect:
• A: Peak flow teaching is important for long-term
management, not immediate relief.
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1 (Milestones — 2 months)
A 2-month-old infant is brought to the clinic. Which finding is
most consistent with expected development for a 2-month-old?
A. Sits unsupported for several seconds.
B. Uses a mature pincer grasp to pick up small objects.
C. Demonstrates a social (reciprocal) smile when spoken to.
D. Says two clear words (“mama,” “dada”).
Correct answer: C
Rationale — Correct (C): By about 2 months most infants
demonstrate a social (reciprocal) smile and increased social
responsiveness. This is an early social/communication
milestone used to assess normal social development. CDC
Rationale — Incorrect:
, • A: Sitting unsupported is expected later (≈6 months). Not
appropriate for 2 months.
• B: Mature pincer grasp develops nearer 9–12 months. At 2
months infants have a palmar grasp reflex, not pincer.
• D: Clear words such as “mama/dada” purposeful to refer
to a person occur around 9–12 months.
Test plan mapping (knowledge area): Health Promotion &
Maintenance — Growth and development.
2 (Milestones — 6 months)
Which behavior in a 6-month-old should concern the nurse?
A. Sits unsupported momentarily and begins to feed self with
hands.
B. Babbles and makes consonant sounds (e.g., “ba,” “da”).
C. Laughs aloud and recognizes familiar people.
D. Does not roll from front to back or back to front.
Correct answer: D
Rationale — Correct (D): Rolling (front to back, back to front)
typically appears by ~4–6 months. Failure to roll by 6 months is
a warning sign and should prompt developmental
surveillance/screening. This is a safety/early-intervention
concept. Stanford Medicine
Rationale — Incorrect:
, • A, B, C are expected behaviors around 6 months (sitting
with minimal support, feeding self with hands, babbling,
laughing, recognizing caregivers).
Test plan mapping: Health Promotion & Maintenance —
Growth and development.
3 (Milestones — 2 years)
A 2-year-old child is expected to demonstrate which of the
following?
A. Copies a circle and uses 3–4 word sentences.
B. Runs, uses two- to three-word phrases, and begins parallel
play.
C. Rides a tricycle and dresses self completely.
D. Skips on alternating feet and counts to 10.
Correct answer: B
Rationale — Correct (B): At about 2 years children run, use two-
to three-word phrases, and begin parallel play — matching
expected gross motor, language, and social milestones. Drawing
a circle and tricycle skills develop later (3–4 years). Counting
and skipping are older skills. CDC
Rationale — Incorrect:
• A: Copying a circle usually emerges ~3–4 years.
• C: Tricycle (3 years) and independent dressing later than 2
years.
, • D: Skipping and counting to 10 are preschool to early
school-age milestones.
4 (Asthma — priority intervention)
A 7-year-old with moderate asthma exacerbation is admitted.
Which nursing action is the highest priority?
A. Teach the child and caregiver about peak expiratory flow
monitoring.
B. Administer prescribed short-acting beta-agonist (albuterol)
via nebulizer now.
C. Provide written environmental trigger-avoidance strategies
on discharge.
D. Arrange referral to school nurse for inhaler use training.
Correct answer: B
Rationale — Correct (B): In an acute moderate exacerbation,
rapid bronchodilation (short-acting beta-agonist) to relieve
bronchospasm and improve oxygenation is immediate priority
— addressing airway/breathing (physiological integrity; safety).
Education and referrals are important but secondary until the
acute issue is treated.
Rationale — Incorrect:
• A: Peak flow teaching is important for long-term
management, not immediate relief.
