NSG434 Exam 1 Actual Exam Style V2 |
NSG 434 Nursing Care of Children | Grand
Canyon University
1. According to Erikson’s stages of psychosocial development, which task is primary for an
infant (birth to 1 year)?
A. Autonomy vs. Shame and Doubt
B. Trust vs. Mistrust
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: B
Rationale: During the first year of life, infants learn to trust that their basic needs will be
met by their caregivers. If these needs are inconsistently met, the infant may develop a
pervasive sense of mistrust. Establishing trust is considered the foundation for all future
psychosocial development.
2. A nurse is preparing to assess a 2-year-old child. In what order should the vital signs be
taken to ensure accuracy?
A. Blood pressure, Temperature, Pulse, Respirations
B. Temperature, Blood pressure, Pulse, Respirations
C. Respirations, Pulse, Temperature, Blood pressure
,D. Pulse, Respirations, Blood pressure, Temperature
Answer: C
Rationale: In pediatric nursing, assessment should proceed from the least invasive to the
most invasive procedures. Respirations and pulse should be counted while the child is
quiet to obtain the most accurate baseline. Invasive or distressing procedures like blood
pressure and temperature should be performed last to avoid agitating the child.
3. At what age should a nurse expect the posterior fontanelle of an infant to close?
A. 24 months
B. 6 to 8 months
C. 12 to 18 months
D. 2 to 3 months
Answer: D
Rationale: The posterior fontanelle is the smaller of the two soft spots and typically closes
by 2 to 3 months of age. Monitoring fontanelle closure is a critical part of the physical
assessment for brain and skull growth. In contrast, the anterior fontanelle is larger and
remains open until about 12 to 18 months.
4. A 4-year-old child is hospitalized and begins wetting the bed despite being toilet trained for
a year. How should the nurse interpret this?
A. A sign of a urinary tract infection
, B. A normal regressive behavior due to the stress of hospitalization
C. A need for stricter discipline regarding bathroom use
D. Delayed gross motor development
Answer: B
Rationale: Regression is a common defense mechanism used by children when they face
the stress of illness or hospitalization. It involves returning to an earlier developmental
stage where they felt safer or more nurtured. Nurses should reassure parents that this
behavior is temporary and will resolve as the child feels better.
5. Which pain scale is most appropriate for a 4-year-old child who is conscious and
communicative?
A. FLACC Behavioral Scale
B. Wong-Baker FACES Pain Rating Scale
C. Numeric Rating Scale (0-10)
D. CRIES Pain Scale
Answer: B
Rationale: The Wong-Baker FACES scale uses six cartoon faces ranging from a happy face
for ‘no pain’ to a crying face for ‘worst pain.’ It is specifically designed for children as young
as 3 years old who can point to a picture. This self-report method is more accurate for
preschoolers than numeric scales which require abstract thinking.
NSG 434 Nursing Care of Children | Grand
Canyon University
1. According to Erikson’s stages of psychosocial development, which task is primary for an
infant (birth to 1 year)?
A. Autonomy vs. Shame and Doubt
B. Trust vs. Mistrust
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: B
Rationale: During the first year of life, infants learn to trust that their basic needs will be
met by their caregivers. If these needs are inconsistently met, the infant may develop a
pervasive sense of mistrust. Establishing trust is considered the foundation for all future
psychosocial development.
2. A nurse is preparing to assess a 2-year-old child. In what order should the vital signs be
taken to ensure accuracy?
A. Blood pressure, Temperature, Pulse, Respirations
B. Temperature, Blood pressure, Pulse, Respirations
C. Respirations, Pulse, Temperature, Blood pressure
,D. Pulse, Respirations, Blood pressure, Temperature
Answer: C
Rationale: In pediatric nursing, assessment should proceed from the least invasive to the
most invasive procedures. Respirations and pulse should be counted while the child is
quiet to obtain the most accurate baseline. Invasive or distressing procedures like blood
pressure and temperature should be performed last to avoid agitating the child.
3. At what age should a nurse expect the posterior fontanelle of an infant to close?
A. 24 months
B. 6 to 8 months
C. 12 to 18 months
D. 2 to 3 months
Answer: D
Rationale: The posterior fontanelle is the smaller of the two soft spots and typically closes
by 2 to 3 months of age. Monitoring fontanelle closure is a critical part of the physical
assessment for brain and skull growth. In contrast, the anterior fontanelle is larger and
remains open until about 12 to 18 months.
4. A 4-year-old child is hospitalized and begins wetting the bed despite being toilet trained for
a year. How should the nurse interpret this?
A. A sign of a urinary tract infection
, B. A normal regressive behavior due to the stress of hospitalization
C. A need for stricter discipline regarding bathroom use
D. Delayed gross motor development
Answer: B
Rationale: Regression is a common defense mechanism used by children when they face
the stress of illness or hospitalization. It involves returning to an earlier developmental
stage where they felt safer or more nurtured. Nurses should reassure parents that this
behavior is temporary and will resolve as the child feels better.
5. Which pain scale is most appropriate for a 4-year-old child who is conscious and
communicative?
A. FLACC Behavioral Scale
B. Wong-Baker FACES Pain Rating Scale
C. Numeric Rating Scale (0-10)
D. CRIES Pain Scale
Answer: B
Rationale: The Wong-Baker FACES scale uses six cartoon faces ranging from a happy face
for ‘no pain’ to a crying face for ‘worst pain.’ It is specifically designed for children as young
as 3 years old who can point to a picture. This self-report method is more accurate for
preschoolers than numeric scales which require abstract thinking.
