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NACE Care of the Child Real Exam | High-Yield Practice
with Expert Rationales
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental
milestone would the nurse expect to observe?
A. The infant walks while holding onto furniture
B. The infant uses a pincer grasp to pick up small objects
C. The infant rolls from prone to supine and sits with support
D. The infant says "mama" and "dada" with specific meaning
☑ Correct Answer: C
☑ Explanation: At 6 months, infants typically roll from prone to supine and can sit
with support. Cruising (A) occurs around 9-10 months. Pincer grasp (B) develops at 9-12
months. Meaningful "mama/dada" (D) occurs around 10-12 months.
2. A school nurse is evaluating a 5-year-old child's cognitive development. Which behavior
demonstrates appropriate cognitive functioning for this age?
A. The child understands that a ball of clay maintains its mass when flattened
B. The child believes that dreams are caused by external events
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C. The child can classify objects by multiple characteristics simultaneously
D. The child engages in magical thinking and believes inanimate objects have lifelike
qualities
☑ Correct Answer: D
☑ Explanation: According to Piaget, 5-year-olds are in the preoperational stage (2-
7 years), characterized by magical thinking and animism. Conservation (A) develops in
the concrete operational stage (7+ years). Distinguishing internal from external events
(B) and classifying by multiple characteristics (C) are concrete operational skills.
3. During a routine check-up, a nurse notes that a 12-month-old child is not yet pulling to
stand. The child can sit independently and crawl. What is the most appropriate nursing
action?
A. Document this as a normal variation and schedule routine follow-up
B. Refer the child for immediate developmental evaluation
C. Assess the child's birth history and current muscle tone, then determine if referral is
needed
D. Reassure parents that some children skip the standing milestone entirely
☑ Correct Answer: C
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☑ Explanation: Pulling to stand is expected by 12 months, but a comprehensive
assessment including birth history, muscle tone, and overall developmental trajectory is
essential before determining if a delay requires intervention. Option A is premature
without assessment; Option B is excessive without context; Option D provides false
reassurance.
4. A nurse is counseling parents of a 15-year-old about adolescent brain development.
Which statement accurately describes the adolescent brain?
A. "The brain is fully mature by age 15, so your teen should have complete impulse
control"
B. "The prefrontal cortex, responsible for decision-making and impulse control,
continues developing until approximately age 25"
C. "Adolescents process emotions in the prefrontal cortex, making them less reactive
than adults"
D. "Brain development is complete by puberty, around age 12-13"
☑ Correct Answer: B
☑ Explanation: Neuroscience research confirms the prefrontal cortex, responsible
for executive function, impulse control, and risk assessment, continues maturing into the
, 4
mid-20s, while the limbic system (emotions) develops earlier. Option A, C, and D are
incorrect based on current understanding of adolescent brain development.
5. A nurse is assessing a 2-year-old child during a well-child visit. Which fine motor skill
would the nurse expect to observe?
A. The child can build a tower of six cubes
B. The child can turn pages of a book one at a time
C. The child can scribble spontaneously
D. The child can draw a circle
☑ Correct Answer: C
☑ Explanation: At 2 years, children can scribble spontaneously. Building a tower of
six cubes (A) is expected at 4 years. Turning pages one at a time (B) is expected at 3
years. Drawing a circle (D) is expected at 3 years.
6. A nurse is providing anticipatory guidance to parents of a 4-month-old infant. Which
developmental milestone should the nurse include?
A. The infant will begin to sit without support
B. The infant will roll from back to side
C. The infant will grasp objects with a pincer grasp
NACE Care of the Child Real Exam | High-Yield Practice
with Expert Rationales
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental
milestone would the nurse expect to observe?
A. The infant walks while holding onto furniture
B. The infant uses a pincer grasp to pick up small objects
C. The infant rolls from prone to supine and sits with support
D. The infant says "mama" and "dada" with specific meaning
☑ Correct Answer: C
☑ Explanation: At 6 months, infants typically roll from prone to supine and can sit
with support. Cruising (A) occurs around 9-10 months. Pincer grasp (B) develops at 9-12
months. Meaningful "mama/dada" (D) occurs around 10-12 months.
2. A school nurse is evaluating a 5-year-old child's cognitive development. Which behavior
demonstrates appropriate cognitive functioning for this age?
A. The child understands that a ball of clay maintains its mass when flattened
B. The child believes that dreams are caused by external events
,2
C. The child can classify objects by multiple characteristics simultaneously
D. The child engages in magical thinking and believes inanimate objects have lifelike
qualities
☑ Correct Answer: D
☑ Explanation: According to Piaget, 5-year-olds are in the preoperational stage (2-
7 years), characterized by magical thinking and animism. Conservation (A) develops in
the concrete operational stage (7+ years). Distinguishing internal from external events
(B) and classifying by multiple characteristics (C) are concrete operational skills.
3. During a routine check-up, a nurse notes that a 12-month-old child is not yet pulling to
stand. The child can sit independently and crawl. What is the most appropriate nursing
action?
A. Document this as a normal variation and schedule routine follow-up
B. Refer the child for immediate developmental evaluation
C. Assess the child's birth history and current muscle tone, then determine if referral is
needed
D. Reassure parents that some children skip the standing milestone entirely
☑ Correct Answer: C
,3
☑ Explanation: Pulling to stand is expected by 12 months, but a comprehensive
assessment including birth history, muscle tone, and overall developmental trajectory is
essential before determining if a delay requires intervention. Option A is premature
without assessment; Option B is excessive without context; Option D provides false
reassurance.
4. A nurse is counseling parents of a 15-year-old about adolescent brain development.
Which statement accurately describes the adolescent brain?
A. "The brain is fully mature by age 15, so your teen should have complete impulse
control"
B. "The prefrontal cortex, responsible for decision-making and impulse control,
continues developing until approximately age 25"
C. "Adolescents process emotions in the prefrontal cortex, making them less reactive
than adults"
D. "Brain development is complete by puberty, around age 12-13"
☑ Correct Answer: B
☑ Explanation: Neuroscience research confirms the prefrontal cortex, responsible
for executive function, impulse control, and risk assessment, continues maturing into the
, 4
mid-20s, while the limbic system (emotions) develops earlier. Option A, C, and D are
incorrect based on current understanding of adolescent brain development.
5. A nurse is assessing a 2-year-old child during a well-child visit. Which fine motor skill
would the nurse expect to observe?
A. The child can build a tower of six cubes
B. The child can turn pages of a book one at a time
C. The child can scribble spontaneously
D. The child can draw a circle
☑ Correct Answer: C
☑ Explanation: At 2 years, children can scribble spontaneously. Building a tower of
six cubes (A) is expected at 4 years. Turning pages one at a time (B) is expected at 3
years. Drawing a circle (D) is expected at 3 years.
6. A nurse is providing anticipatory guidance to parents of a 4-month-old infant. Which
developmental milestone should the nurse include?
A. The infant will begin to sit without support
B. The infant will roll from back to side
C. The infant will grasp objects with a pincer grasp
