Sheridan College NURS Final Exam Scans combined | Complete questions and Answers Latest 100% Updated 2026.
Version B
1. A nurse is planning anticipatory guidance for a caregiver of a preschool-age child. The nurse
will explain that permanent teeth begin erupting at what age?
a. 4 years old
b. 6 years old
c. 8 years old
d. 10 years old
Explanation: Permanent teeth usually start to erupt at around age 6, beginning with the first
molars and central incisors.
2. What activity would the nurse choose to meet Erikson’s developmental task of industry when
caring for a 7-year-old child?
a. Completing a 50-piece jigsaw puzzle
b. Looking at a comic book
c. Playing a game of “I Spy” with the nurse
d. Colouring a picture in a colouring book
Explanation: School-age children in Erikson’s Industry vs. Inferiority stage build confidence
through skill-based, goal-directed tasks like puzzles.
3. The mother of a 7-month-old infant states, “The baby is eating food now. Should I give him
regular milk, too?” What is a nurse’s best response?
a. “You should give the baby low-fat milk.”
b. “Try the milk. See if he has any digestive problems.”
c. “Continue breast milk or iron-fortified formula until 9–1 year of age.”
d. “At this age, infants can tolerate lactose-free or soy-based milk.”
Explanation: Infants under 12 months should continue breast milk or formula to meet
nutritional and iron needs and avoid cow’s milk–related anemia.
4. A nurse is providing parenting information to parents of a toddler. What information is most
important for the nurse to include in the teaching?
a. “It is helpful to learn your child’s cues so you can anticipate their needs.”
b. “Give them opportunities to try new things within their capabilities. Expect them to make a
mess sometimes.”
c. “It is appropriate to provide the child with chores to do.”
d. “Understand that the child is trying to develop their own identity so try not to interfere with
this.”
Explanation: Encouraging safe exploration supports autonomy and development in toddlers.5. A nurse would teach a family who have a child with a gluten intolerance that the child should
not eat flours made from which of the following?
a. Corn
b. Wheat
c. Rice
d. Soybean
Explanation: Wheat contains gluten, which must be eliminated in gluten intolerance or celiac
disease.
6. A nurse is assessing a 13-year-old boy. Which physical change indicates that male puberty
has begun?
a. Development of axillary and facial hair
b. Enlargement of penis
c. Enlargement of testicles
d. Pigmentation of the scrotum
Explanation: Testicular enlargement is the first physical sign of male puberty, followed by
scrotal changes and hair growth.
7. A nurse is planning a safety program for high school students. Which is the top cause of
accidental deaths during adolescence?
a. Firearms
b. Automobiles
c. Drowning
d. Diving injuries
Explanation: Motor vehicle accidents are the leading cause of unintentional death in
adolescents.
8. A 16-year-old boy excitedly tells his parents that he was offered a part-time job. Which
response represents an effective problem-solving approach for his parents?
a. “Your studies are too important for you to have a part-time job.”
b. “When we went to high school, academics were our priority.”
c. “We want you to put your earnings in a savings account.”
d. “How do you think you will manage your schoolwork and a job?”
Explanation: Asking the teen to reflect encourages problem-solving and responsibility, rather
than imposing a decision.9. What are the best breakfast choices for a nurse to point out prior to a big exam, to provide
high levels of alertness and increased memory? (Select all that apply)
a. Pancakes and syrup
b. Coffee and chocolate-covered donuts
c. Bacon and fried eggs
d. Whole grain cereal and yogurt
e. Oatmeal and sliced apples
Explanation: Balanced breakfasts with whole grains, protein, and fruit support steady energy
and improved cognitive function.
10. A nurse is discussing challenges of the adolescent years with a group of high school
students in health class. What challenges toward adolescent development will the nurse
include? (Select all that apply)
a. Developing intimacy
b. Maintaining dependence on parents
c. Searching for identity
d. Adjusting to body changes
e. Establishing future goals
Explanation: Adolescence focuses on identity formation, body changes, independence, and
planning for the future; intimacy development begins in later adolescence.
11. A preschool child is asked, “Why do trees have leaves?” Which response would be an
example of animism?
a. “So I can have shade over my sandbox.”
b. “Because God made them that way.”
c. “To hide behind when they are scared.”
d. “For the squirrels to play in.”
Explanation: Animism is attributing human feelings or intentions to non-human objects; here,
the tree is “scared” and “hides.”
12. A nurse would report the following vital sign of a school-age child to a primary health care
provider:
a. Heart rate 120
b. Respiratory rate 20
c. Blood pressure 100/66
d. Oxygen saturation 95%
Explanation: A heart rate of 120 is elevated for a school-age child (normal resting range is
about 70–110 bpm).13. What is a nurse’s best advice to a parent about a preschooler’s “imaginary friend”?
a. Having imaginary friends is a sign that the child has low self-esteem.
b. It is common for preschoolers to have imaginary friends.
c. Preschoolers invent an imaginary friend when they feel overwhelmed.
d. The best approach to dealing with an imaginary friend is to ignore them.
Explanation: Imaginary friends are a normal part of preschool imaginative play and are not
usually a cause for concern.
14. Caregivers of a 3½-year-old child tell a nurse, “My daughter points instead of speaking
whenever she wants me to get something for her, but she understands me when I ask her to do
something.” Based on the parent’s comment, what does the nurse suspect?
a. Age-appropriate language development
b. An expressive language delay
c. A receptive language delay
d. A potential hearing deficit
Explanation: The child understands language (receptive skills) but struggles to express herself
verbally, indicating an expressive delay.
15. What fear is unique to the preschool period?
a. Water
b. Animals
c. Bodily harm
d. Death
Explanation: Preschoolers often fear bodily harm because they have an active imagination
and a developing sense of body integrity.
16. A nurse observes three toddlers playing side by side with dolls. Closer observation revealed
that the children were not interacting with one another. What type of play is this?
a. Solitary
b. Parallel
c. Associative
d. Cooperative
Explanation: Parallel play is when children play alongside each other without direct interaction.17. How would a nurse advise a parent who states, “I never know how much food to feed my
child”?
a. Serving sizes should not exceed 1 teaspoon of each type of food.
b. Food quantities must be carefully measured to avoid overfeeding.
c. Let your child decide how much they want to eat.
d. A toddler should eat three balanced meals. Snacks are not necessary.
Explanation: Allowing children to self-regulate intake encourages healthy eating habits and
prevents mealtime battles.
18. A nurse is discussing toilet independence with parents. What behaviour by the child would
most identify toilet independence readiness?
a. Willing to sit on the potty for 15 to 20 minutes
b. Dry in the daytime for 4-hour periods
c. Able to communicate that he or she is wet
d. Curious about bathroom activities
Explanation: Staying dry for extended periods during the day indicates physiological readiness
for toilet training.
19. What could a nurse recommend to a child’s mother to encourage her toddler son to practise
independence?
a. Offer a variety of items to choose from to stimulate his mind.
b. Allow the child to determine his own daily routine.
c. Offer him a choice between two items.
d. Set the routine herself but discuss with her toddler how he or she would have done it
differently.
Explanation: Giving toddlers two simple choices promotes independence while avoiding
overwhelming them.
20. A nurse is caring for a 2-year-old child in the Emergency Department who has a fever and is
irritable. The nurse knows that which of the following conditions are common in toddlers and
could be the cause of the fever? (Select all that apply)
a. Otitis media
b. Appendicitis
c. Tonsillitis
d. Upper respiratory tract infections
e. Urinary tract infections
Explanation: Ear infections, tonsillitis, and respiratory infections are frequent causes of fever in
toddlers.21. What type of relationships are the preferred social interactions for a younger school-age
child?
a. Heterosexual interest groups
b. Association with one “best friend”
c. Rigidly organized groups with complex rules
d. Same-sex peer groups
Explanation: Younger school-age children often prefer friendships with same-sex peers as part
of normal social development.
22. When asked about her activities, a 10-year-old girl responded, “I like school. I play the flute
in the school band, and I take tennis lessons.” What does a nurse know these activities will help
this child develop?
a. Initiative
b. Industry
c. Identity
d. Intimacy
Explanation: Industry is built through achievement in school, hobbies, and extracurricular
activities, fostering competence and self-esteem.
23. A mother reports that she has a new job and her 11-year-old child is home alone for a time
after school. Which statement made by the parent alerts a nurse to a potentially unsafe situation
for this child?
a. “I told him that he could invite a few friends after school.”
b. “I put a list of emergency numbers next to the telephone.”
c. “Last week we made a first aid kit together.”
d. “There is a neighbour available in case of an emergency.”
Explanation: Allowing friends over without supervision could lead to safety issues; children
might take risks or get into unsafe situations.
24. Which stage of cognitive development is a 9-year-old child in according to Piaget?
a. Formal operations
b. Preoperational
c. Concrete operations
d. Sensorimotor
Explanation: In the concrete operational stage (ages ~7–11), children develop logical thinking
about concrete events but struggle with abstract concepts.25. A nurse is planning sex education classes for school-age children. What should the nurse
be sure to do?
a. Use simple terms.
b. Avoid slang or “street” words and concepts.
c. Place emphasis on biological aspects of sexual development.
d. Limit questions to keep content clear.
Explanation: School-age children learn best when concepts are explained in age-appropriate,
clear, and simple language.
26. A nurse must make a room assignment for a 16-year-old adolescent with cystic fibrosis.
Which roommate would be the most appropriate?
a. A 4-year-old child who had an appendectomy
b. A 10-year-old child with sickle cell disease in vaso-occlusive crisis
c. A 15-year-old adolescent with type 1 diabetes mellitus
d. No roommate
Explanation: Cystic fibrosis patients require private rooms to prevent cross-infection due to risk
of respiratory pathogens.
27. A nurse notices that the mother of a child with cerebral palsy corrects and redoes many of
the things a nurse does for her child. What is the nurse’s most appropriate response to this
mother?
a. “Would you like to do all of your child’s care?”
b. “I’m doing the very best job that I can with your child.”
c. “Why don’t you go have a cup of coffee? You are going to be exhausted if you don’t take a
break.”
d. “I’d love for you to share with me some of the special things you do for your child.”
Explanation: This acknowledges the mother’s expertise and invites collaboration, supporting
family-centered care.
28. A 4-year-old child begins to cry when his mother tells him it is time for his operation. A nurse
understands this is an expected reaction. On which particular fear of the preschooler does the
nurse base this understanding?
a. Loss of control
b. Restricted mobility
c. Unfamiliar routines
d. Invasive procedures
Explanation: Preschoolers often fear bodily harm and invasive procedures due to a developing
sense of body integrity.29. An anxious caregiver asks if there is a danger of her 2-year-old child becoming addicted to
the opioid pain reliever. What is a nurse’s most helpful response?
a. “Although this drug is addictive, the health care provider monitors the dose very carefully.”
b. “Don’t worry. Addicted children are very easy to wean off the medication.”
c. “Addiction is rare in children when opiates are given for pain.”
d. “Addictive behaviours are easy to assess. The medication will be stopped if that happens.”
Explanation: When opioids are used appropriately for pain management in children, addiction
is rare.
30. What statement by a patient’s mother leads a nurse to determine she understands
instructions about administering an oral antibiotic for otitis media?
a. “I will continue using the medication until symptoms are gone.”
b. “I will share the medication with siblings if their symptoms are relieved.”
c. “I will give the medication with siblings if their symptoms are the same.”
d. “I will administer prescribed doses until all the medication is used.”
Explanation: Antibiotics must be taken for the full prescribed course to prevent recurrence and
resistance.
31. What is the best way for a nurse to communicate with a 10-year-old child who has a hearing
impairment?
a. Use gestures and signs as much as possible.
b. Let the child’s parents communicate for the child.
c. Face the child and speak clearly in short sentences.
d. Recognize that the child’s ability to communicate will be on a 6-year-old child’s level.
Explanation: Facing the child, speaking clearly, and using concise sentences improve
understanding for hearing-impaired children.
32. A parent reports that her child has begun to do poorly at school and experiences episodes
where he appears to be staring into space. Of which type of seizure is this behaviour a
characteristic?
a. Absence
b. Akinetic
c. Myoclonic
d. Complex partial
Explanation: Absence seizures involve brief lapses in awareness and staring spells, often
mistaken for daydreaming.33. A child diagnosed with epilepsy had a generalized tonic–clonic seizure that lasted 90
seconds. What would a nurse expect to assess after a generalized tonic–clonic seizure?
a. Restlessness
b. Sleepiness
c. Nausea
d. Anxiety
Explanation: Postictal drowsiness or sleepiness is common after generalized tonic–clonic
seizures.
34. A child is brought to the emergency department after he fell and hit his head on the ground.
Which nursing assessment suggests the child has a concussion?
a. Sleepy but easily arousable
b. States symptoms of a stiff neck
c. Cannot remember what happened
d. Pupils react sluggishly to light
Explanation: Amnesia surrounding the event is a hallmark sign of concussion.
35. What finding would a nurse assessing the neurovascular status of a child report
immediately?
a. Skin that is warm to the touch
b. Capillary refill less than 3 seconds
c. Ability to wiggle toes
d. Bluish colouration of skin
Explanation: Cyanosis indicates compromised blood flow and oxygenation and requires urgent
intervention.
36. Why does a child’s fracture heal more rapidly than an adult’s?
a. A child’s bones are less porous than adult bone.
b. A child’s bones are covered by a thicker periosteum.
c. A child’s bones are not affected by bone overgrowth.
d. A child’s bones have faster callus formation.
Explanation: A thicker periosteum in children provides better blood supply and supports faster
bone healing.37. Which assessment performed by a nursing student performing a neurovascular check alerts
the instructor that further education is necessary?
a. Pulses
b. Capillary refill
c. Movement
d. Pupils
Explanation: Pupils are part of a neurological assessment, not a limb-specific neurovascular
assessment.
38. What factor(s) may trigger abuse in a parent? (Select all that apply)
a. Being abused as a child
b. High self-esteem
c. Substance abuse
d. Overwhelming responsibility
e. Knowledge deficit relative to childcare
Explanation: A history of abuse, stress, substance abuse, and lack of parenting knowledge
increase the risk for child abuse.
39. When bathing an infant, what sign does the nurse recognize as a sign of developmental
dysplasia of the hip?
a. Hypotonicity of the leg muscles
b. One leg is shorter than the other
c. Broadening and flattening of the buttocks
d. Two skinfolds on the back of each thigh
Explanation: A shorter leg length on one side can indicate hip dysplasia due to improper
alignment of the femoral head.
40. On what understanding does a nurse plan the care of a child with a new diagnosis of type 1
diabetes mellitus?
a. There is an absolute deficiency of insulin.
b. Oral hypoglycemic agents can control it.
c. Insufficient quantities of insulin are produced by the pancreas.
d. Insulin deficiency is caused by another disease affecting the pancreas.
Explanation: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells,
causing a complete lack of insulin production.41. Which comment made by a school-age child indicates that he needs more teaching about
diabetes mellitus and exercise?
a. “I carry a piece of hard candy with me in case I start to feel shaky.”
b. “I make sure I have emergency money when I have soccer practice or a game.”
c. “Sometimes I skip my breakfast when I have a game in the morning.”
d. “I play in soccer games that are scheduled after dinner.”
Explanation: Skipping meals before exercise increases the risk of hypoglycemia and should be
avoided in children with diabetes.
42. Which general dietary measure should a nurse include in a teaching plan for the child with
type 1 diabetes mellitus?
a. Control intake of carbohydrates and consume fewer calories.
b. Focus on complex carbohydrates and eat foods high in fibre.
c. Obtain most calories from proteins and fats.
d. Eat a diet low in fat and low in complex carbohydrates.
Explanation: Complex carbohydrates and fibre help maintain stable blood glucose and prevent
spikes.
43. A mother reports that her 6-month-old infant is lethargic, sleeps 18 hours a day, and snores.
The nurse recognizes these signs are characteristic of which condition?
a. Hypothyroidism
b. Hyperthyroidism
c. Type 1 diabetes mellitus
d. Tay–Sachs disease
Explanation: Hypothyroidism in infants often presents with lethargy, excessive sleep, and poor
muscle tone.
44. A nurse discusses treatment of hypoglycemia with an adolescent. Which statement by the
adolescent leads the nurse to determine the patient understood the instructions?
a. “When my blood glucose is low or if I begin to feel hungry and weak, I will eat six
LifeSavers.”
b. “When my blood glucose is low or if I begin to feel hungry and weak, I will give myself Lispro
insulin.”
c. “When my blood glucose is low or if I begin to feel hungry and weak, I will have a slice of
cheese.”
d. “When my blood glucose is low or if I begin to feel hungry and weak, I will drink a diet soda.”
Explanation: Fast-acting glucose like candy is the recommended immediate treatment for
hypoglycemia.45. Which statement by a caregiver may indicate a cause for a 9-month-old’s iron deficiency
anemia?
a. “Formula is so expensive. We switched to regular milk right away.”
b. “She almost never drinks water.”
c. “She doesn’t really like peaches or pears, so we stick to bananas for fruit.”
d. “I give her a piece of bread now and then. She likes to chew on it.”
Explanation: Switching to cow’s milk before 12 months can lead to iron deficiency anemia.
46. Which statement made by a parent is the best indication of an understanding of health
maintenance of a child with sickle cell disease?
a. “I should give my child a daily iron supplement.”
b. “It is important for my child to drink plenty of fluids.”
c. “My child should wear protective equipment when playing contact sports.”
d. “My child shouldn’t receive any immunizations until older.”
Explanation: Hydration is critical in sickle cell disease to prevent vaso-occlusive crises.
47. A couple who are considering pregnancy are seeking genetic counselling because they are
both carriers of the sickle cell trait. How can a nurse best explain the children’s risk of inheriting
this disease?
a. Every fourth child will have the disease; two others will be carriers.
b. All of their children will be carriers, just as they are.
c. Each child has a one in four chance of having the disease and a two in four chance of
being a carrier.
d. The risk levels of their children cannot be determined by this information.
Explanation: With two carrier parents, each pregnancy has a 25% chance of producing a child
with the disease, 50% chance of a carrier, and 25% chance of unaffected.
48. A child with thalassemia major receives blood transfusions frequently. A nurse is aware that
which of the following is a complication of repeated blood transfusions?
a. Hemarthrosis
b. Hematuria
c. Hemoptysis
d. Hemosiderosis
Explanation: Frequent transfusions can lead to iron overload (hemosiderosis), requiring
chelation therapy.49. The most recent blood count for a child who received chemotherapy last week shows
neutropenia. What is the priority nursing diagnosis for this child?
a. Risk for infection
b. Risk for hemorrhage
c. Altered skin integrity
d. Disturbance in body image
Explanation: Neutropenia means low neutrophils, making infection prevention the top priority.
50. Which symptoms are indicative of rheumatic fever (RF)? (Select all that apply)
a. Abdominal pain
b. Migratory polyarthritis
c. Peeling skin
d. Chorea
e. Vomiting
Explanation: Major manifestations of rheumatic fever include migratory polyarthritis, chorea,
and other systemic signs such as abdominal pain.
51. A nurse is interviewing parents of an infant with hypertrophic pyloric stenosis. What would
the nurse expect the parents to report?
a. Diarrhea
b. Projectile vomiting
c. Poor appetite
d. Constipation
Explanation: Hypertrophic pyloric stenosis presents with forceful projectile vomiting due to
gastric outlet obstruction.
52. What description of a child’s stool characteristic leads a nurse to suspect intussusception?
a. Currant jelly
b. Black and tarry
c. Green liquid
d. Greasy and foul-smelling
Explanation: “Currant jelly” stools (blood and mucus) are classic for intussusception.53. What does a nurse expect the appearance of the stools of a child with celiac disease to be?
a. Ribbon like
b. Hard, constipated
c. Bulky, frothy
d. Loose, foul-smelling
Explanation: Celiac disease causes malabsorption, leading to bulky, frothy, and foul-smelling
stools due to fat content.
54. A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis.
What will be a nurse’s priority goal of the infant’s care?
a. Prevent fluid and electrolyte imbalance.
b. Prevent nutritional deficiency.
c. Prevent skin breakdown.
d. Prevent malabsorption.
Explanation: Dehydration from gastroenteritis can quickly become life-threatening in infants;
restoring fluid and electrolyte balance is the top priority.
55. A nurse is speaking to the parent of a 3-year-old child who has mild diarrhea. What dietary
modification would the nurse advise?
a. Soft foods with rice, bananas, toast, and applesauce
b. Small amounts of clear fluids such as gelatin
c. An oral rehydrating solution, such as Pedialyte
d. Chicken soup because it is high in sodium
Explanation: Oral rehydration solutions replace lost fluids and electrolytes in mild diarrhea
without causing imbalances.
56. What would be the appropriate nursing response to an adolescent who states, “This has
been the worst day of my life”?
a. “You should focus your mind on positive thoughts.”
b. “Everybody has a bad day now and then.”
c. “You’re young. What could be so terrible?”
d. “Tell me about the worst day of your life.”
Explanation: Encouraging the adolescent to talk openly shows active listening and empathy.57. A 15-year-old boy was previously active in a band and saved money to buy a special guitar.
What would a nurse assess as an early sign of depression in this boy?
a. He gives up the band to spend time with his girlfriend.
b. He spends all of his time at the library studying to qualify for the honour society.
c. He gives his guitar away and spends his time listening to music in his room.
d. He withdraws all of his money out of the bank to buy an expensive leather jacket.
Explanation: Loss of interest in previously enjoyed activities is a key early sign of depression.
58. A 14-year-old girl with obsessive-compulsive disorder (OCD) tells a nurse other adolescents
tease her because she washes her hands many times during the school day. For what does this
disorder put the adolescent at greater risk?
a. Anorexia nervosa
b. Anxiety
c. ADHD
d. A learning disability
Explanation: OCD is an anxiety disorder; repetitive compulsions are driven by anxiety and can
increase its severity over time.
59. A nurse is planning to speak with a parent support group about childhood autism. What will
the nurse include in the class?
a. Significant signs of the disorder manifest by 2 years of age.
b. The earliest signs of autism are impulsivity and overactivity.
c. Autism is usually diagnosed when the child goes to elementary school.
d. Medications can cure childhood autism.
Explanation: Early signs of autism, such as delayed speech and social interaction difficulties,
typically appear by age 2.
60. An adolescent states that life is not worth living and that he has a stock of pills that he is
going to take that evening. What is the most important intervention a nurse can do?
a. Tell him that life is not that bad.
b. Tell him that you will keep this information confidential.
c. Encourage him to talk about his feelings.
d. Call his parents and tell them to get rid of the pills.
Explanation: This is an immediate suicide risk and requires urgent action to ensure the
adolescent’s safety.61. A nurse discusses strategies with a parent to prevent a recurrence of urinary tract infection
in the child. Which statement made by the parent indicates a need for further teaching?
a. “My daughter should wash and wipe the perineal area from front to back.”
b. “I am only going to have my daughter wear cotton underwear.”
c. “It is acceptable to take frequent bubble baths.”
d. “She needs to drink lots of fluids and void frequently.”
Explanation: Bubble baths can irritate the urethra and increase UTI risk, so they should be
avoided.
62. What is important to assess in a child receiving prednisone to treat nephrotic syndrome?
a. Infection
b. Urinary retention
c. Easy bruising
d. Hypoglycemia
Explanation: Prednisone suppresses the immune system, making infection prevention and
monitoring a priority.
63. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined
to bed. What is the most important nursing intervention for this child?
a. Providing activities for the child on restricted activity
b. Feeding the child a protein-restricted diet
c. Carefully handling edematous extremities
d. Observing the child for evidence of hypotension
Explanation: Bed rest can lead to boredom; quiet activities help maintain emotional well-being
while limiting physical strain.
64. Which physical assessment technique will a nurse omit when caring for a 2-year-old child
diagnosed with Wilms tumour?
a. Performing range-of-motion exercises on lower extremities
b. Palpating the abdomen
c. Assessing for bowel sounds
d. Percussing ankle and knee reflexes
Explanation: Abdominal palpation is avoided in Wilms tumour to prevent rupture and spread of
cancerous cells.65. A 6-year-old child with daytime enuresis has symptoms of dysuria and urgency. What does a
nurse recognize these signs and symptoms indicate?
a. Nephrotic syndrome
b. Urinary tract infection
c. Nephritic syndrome
d. Vesicoureteral reflux
Explanation: Dysuria and urgency are hallmark symptoms of a urinary tract infection in
children.
66. Which is a priority nursing diagnosis in a child admitted with acute asthma?
a. Risk for infection
b. Imbalanced nutrition
c. Ineffective breathing pattern
d. Disturbed body image
Explanation: The primary concern in acute asthma is impaired ventilation and oxygenation due
to airway obstruction.
67. Which can best prevent acute rheumatic fever?
a. Keeping children with fever home
b. Sending children with sore throats home from school
c. Obtaining a culture of a sore throat and treating if necessary
d. Treating all colds with antibiotics
Explanation: Prompt diagnosis and treatment of strep throat (group A strep) can prevent
rheumatic fever.
68. When would a nurse initiate a discussion about available treatment with a child and family
who are displaying emotional or behavioural symptoms of a mental health disorder?
a. At the parents’ request
b. When a referral is made by the teacher
c. At the next scheduled appointment
d. When there is impairment in daily functioning
Explanation: Significant interference with daily life indicates the need to begin treatment
discussions.69. Why would a nurse teach the child with diabetes to rotate sites of insulin injection?
a. To prevent subcutaneous deposit of the medication
b. To prevent lipoatrophy of subcutaneous fat
c. To decrease the pain of injection
d. To increase absorption of insulin
Explanation: Rotating injection sites helps prevent fat tissue loss (lipoatrophy) or hypertrophy,
which can alter insulin absorption.
70. Which statement by the parent of a hospitalized 4-year-old child indicates an understanding
of the child’s needs?
a. “I am going to buy him a box of new toys to keep him busy while in the hospital.”
b. “I am going to bring some of his favorite toys from home for him to play with while in
the hospital.”
c. “I’m glad there is a television in the room for him to watch all day.”
d. “I will stay every day until he falls asleep and then I will go home.”
Explanation: Familiar toys from home provide comfort, security, and help reduce stress in
hospitalized preschoolers.
Version C1. A nurse is answering phone calls at a local suicide prevention hotline. Which statement would
be recognized as the greatest risk of suicide?
a. “I just needed to talk to someone to keep myself from thinking silly thoughts about killing
myself.”
b. “My parents aren’t home and won’t be back for 4 hours. That should be enough time
for the pills to work. I’ve got a hundred of them.”
c. “My dad will be home first, so he’ll find me. So I think I’ll use his gun. I hope he didn’t lock the
cabinet.”
d. “My girlfriend is here with me. She told me to call because I was talking crazy about killing
myself.”
Explanation: This statement shows a specific plan, means, and a set time frame, which
indicates the highest suicide risk.
2. An adolescent is brought to the emergency department after an automobile accident. When a
nurse approaches the adolescent, he is relaxed and denies feeling any pain. The nurse notes
he has an increased pulse and dilated pupils. What does the nurse suspect the adolescent has
used?
a. Alcohol
b. Cocaine
c. Amphetamines
d. Cannabis
Explanation: Cocaine is a stimulant that causes tachycardia, dilated pupils, and a euphoric or
relaxed state.
3. A child who has a parent with depression has increased risk for which of the following
conditions? (Select all that apply)
a. Anxiety disorder
b. Mood disorder
c. Substance-use disorder
d. Attention deficit hyperactivity disorder
e. Conduct disorder
Explanation: Children of parents with depression are at greater risk for a range of psychiatric
and behavioural disorders.4. What should a nurse teach a teenager who is taking antidepressants?
a. Do not report any suicidal thoughts
b. Psychological counselling will complement the medication
c. It is okay to continue to drink alcohol
d. The use of cannabis will enhance the effect of the medication
Explanation: Combining therapy with medication provides the most effective treatment for
depression in adolescents.
5. A child is diagnosed with attention-deficit/hyperactivity disorder (ADHD). Which
characteristics would the nurse assess in this child? (Select all that apply)
a. Social anxiety
b. Impulsivity
c. Hyperactivity
d. Distractibility
e. Inattention
Explanation: ADHD is characterized by inattention, hyperactivity, distractibility, and impulsivity,
which can vary in severity.
6. What does a nurse instruct a 12-year-old to do when teaching how to administer insulin?
a. Make sure injection sites are 10 cm apart.
b. Select an injection site that was recently exercised.
c. Inject the needle at a 90-degree angle.
d. Give the injection deep into the muscle. (Correct answer: Inject the needle at a
90-degree angle.)
Explanation: Insulin should be injected subcutaneously at a 90-degree angle (or 45 degrees if
very thin), not intramuscularly.
7. What would be the most appropriate nursing response to a woman who says, “My sister had
a child with Tay–Sachs disease, and I want to know if I could have a child with this condition”?
a. “The disease is rare. It is unlikely that you would have a child with Tay–Sachs disease.”
b. “A screening test can be done to determine if you are a carrier of the gene.”
c. “The gene for Tay–Sachs disease is transmitted by the father.”
d. “The cause of Tay–Sachs disease is thought to be an autoimmune response to a virus.”
Explanation: Carrier screening is the correct step for someone with a family history of
Tay–Sachs.8. What condition does a nurse suspect when a child with type 1 diabetes mellitus has
hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
c. Honeymoon effect
d. Ketoacidosis
Explanation: The Somogyi phenomenon is rebound hyperglycemia after nighttime
hypoglycemia due to counterregulatory hormone release.
9. A mother of a 5-year-old child taking prednisone for nephrotic syndrome tells a nurse the
child requires immunizations prior to entering kindergarten. What does the nurse clarify about
receiving immunizations while on prednisone?
a. Can interfere with the treatment for nephrosis
b. Require that the child have antibiotic coverage
c. Can be given in smaller, divided doses
d. Should be delayed
Explanation: Live vaccines should be delayed in immunosuppressed patients to prevent
infection risk.
10. Parents are speaking with the urologist about their son’s undescended testicle. Which
statement by the child’s father causes a nurse to determine he understands the information
presented?
a. “An undescended testicle can reduce fertility.”
b. “The testicle usually descends spontaneously during the first month of life.”
c. “Surgical correction reduces the risk for testicular tumours.”
d. “The optimal time to surgically correct the condition is at diagnosis.”
Explanation: Cryptorchidism increases infertility risk due to higher temperatures in the
abdomen; surgery can reduce but not eliminate the risk for tumours.
11. A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the
child’s history, what is a nurse expecting as the probable cause?
a. Skin infection from German measles 2 months ago
b. Sore throat within the previous night
c. History of allergy
d. A sore throat 2 weeks ago
Explanation: Acute glomerulonephritis often follows a group A beta-hemolytic streptococcal
infection, typically a sore throat 1–3 weeks earlier.12. Parents of a newborn are concerned that their son’s scrotum is enlarged and swollen on one
side. What is a nurse’s best response?
a. “It is very common in the newborn that one gonad is larger than the other.”
b. “Birth trauma caused bruising to the scrotum. It will reduce in size in a few days.”
c. “It is a collection of fluid that will most likely correct itself in a year.”
d. “The health care provider will drain this collection of blood before your baby is discharged.”
Explanation: This describes hydrocele, which usually resolves spontaneously within the first
year of life.
13. Which is the most appropriate intervention for a 3-month-old infant who has
gastroesophageal reflux?
a. Position the infant upright for 30 minutes after feeding.
b. Administer medication as ordered to stimulate the pyloric sphincter.
c. Give thin rice cereal with formula before feeding solid foods.
d. Place the infant in an infant seat after feedings.
Explanation: Keeping the infant upright after feeds helps reduce reflux; infant seats can
worsen it by increasing abdominal pressure.
14. What would a nurse expect to find in a child admitted to the hospital for failure to thrive?
a. Cries to be picked up
b. Has vomiting or diarrhea
c. Responsive to cuddling
d. Weight in the 10th percentile for age
Explanation: Failure to thrive is characterized by weight significantly below the expected
percentile.
15. Which nursing interventions will be implemented for the mother of a 10-month-old infant with
failure to thrive?
a. Pointing out errors that the nurse observes when the mother is caring for the infant
b. Discussing negative characteristics of the infant with the mother
c. Having the nurse provide as much of the infant’s care as possible
d. Teaching the mother about the developmental milestones to expect in the next few
months
Explanation: Education and support help improve caregiving skills and bonding.16. Why are infants more vulnerable to fluid and electrolyte imbalances than adults?
a. They have a smaller surface area than adults in proportion to body weight.
b. Water needs and losses per kilogram are lower than those for adults.
c. A greater percentage of body water in infants is extracellular.
d. Infants have a lower metabolic turnover of water.
Explanation: Infants’ higher proportion of extracellular fluid makes them more prone to rapid
fluid shifts and dehydration.
17. What will a nurse teach the parents of a child with a low platelet count to avoid?
a. Benadryl
b. Aspirin
c. Codeine
d. Penicillin
Explanation: Aspirin impairs platelet function, increasing the risk of bleeding in a child with
thrombocytopenia.
18. A child receiving a transfusion states symptoms of back pain and itching. What is the best
initial action by a nurse?
a. Notify the charge nurse
b. Disconnect intravenous lines immediately
c. Give diphenhydramine (Benadryl)
d. Clamp off blood and keep line open with normal saline
Explanation: The first step in a suspected transfusion reaction is to stop the transfusion
immediately while maintaining IV access with normal saline.
19. A nurse finds an adolescent with Hodgkin disease crying. The adolescent says, “I am so
scared.” What is the most appropriate nursing response to this comment?
a. “I understand how you must feel.”
b. “You shouldn’t feel that way.”
c. “Is this the strongest feeling you’ve had today?”
d. “Tell me what’s got you scared.”
Explanation: This open-ended response invites the adolescent to express fears and promotes
therapeutic communication.20. The family of a child receiving chemotherapy for leukemia should be taught to focus on
which aspect(s) of the child’s care? (Select all that apply.)
a. Using a support group
b. Stimulating appetite
c. Maintaining adequate hydration
d. Continuing with scheduled immunizations
e. Reporting exposure to infectious diseases
Explanation: Immunizations are typically postponed during chemotherapy; other measures
focus on nutrition, hydration, emotional support, and infection prevention.
21. A nurse explains how to position an infant with tetralogy of Fallot if the infant suddenly
becomes cyanotic. Which statement by the caregiver leads the nurse to determine the parent
understood the instructions?
a. “If the baby turns blue, I will immediately put the baby upright in an infant seat.”
b. “If the baby turns blue, I will lay him down on a firm surface with his head lower than the rest
of his body.”
c. “If the baby turns blue, I will put the baby in supine position with his head elevated.”
d. “If the baby turns blue, I will hold him against my shoulder with his knees bent up
toward his chest.”
Explanation: The knee–chest position helps increase systemic vascular resistance and reduce
right-to-left shunting in tetralogy of Fallot.
22. A child with rheumatic fever begins involuntary, purposeless movements of the limbs. What
does a nurse recognize that this indicates?
a. Hypoxia
b. Seizure activity
c. Decreasing level of consciousness
d. Sydenham’s chorea
Explanation: Sydenham’s chorea is a neurological manifestation of rheumatic fever
characterized by involuntary, purposeless movements.
23. A nurse would observe a child for frequent swallowing after a tonsillectomy and
adenoidectomy (T&A). What might this indicate?
a. Pain at the incision area
b. Bleeding from the surgical site
c. Potential vomiting
d. Sore throat from postnasal drip
Explanation: Frequent swallowing post-tonsillectomy often indicates bleeding, which can be
life-threatening and requires immediate assessment.24. What is the best choice for fluid replacement that a nurse can offer a child who has just had
a tonsillectomy?
a. Orange juice
b. Cola drink
c. A popsicle
d. Chocolate milk
Explanation: Popsicles help maintain hydration, are soothing, and do not irritate the surgical
site (unlike acidic or dairy products).
25. What is the best intervention for a nurse caring for a child experiencing an acute asthma
attack?
a. Administer sedatives as ordered to decrease anxiety
b. Place the child in a humidified cool mist tent with oxygen
c. Offer plenty of fluids, particularly carbonated beverages
d. Position the child with arms resting on the overbed table
Explanation: The tripod position facilitates lung expansion and helps ease breathing during an
acute asthma episode.
26. A nurse is planning to teach parents about preventing sudden infant death syndrome
(SIDS). What significant information would the nurse include?
a. Sitting the infant up in an infant seat
b. Wrapping the infant snugly for rest periods
c. Placing infants on their backs for sleep
d. Positioning the infant prone for sleep
Explanation: The "Back to Sleep" campaign reduces SIDS risk by recommending supine sleep
position for infants.
27. How does the pediatric skeletal system differ from that of the adult?
a. More ossification
b. Open epiphyses
c. Less porosity
d. Not as strong
Explanation: Open epiphyseal plates in children allow for bone growth until skeletal maturity.28. A nurse performing a neurovascular check on a limb in traction would report and document
which finding(s) as indicative of altered circulation?
a. Pulse is equal to an uncasted limb
b. Patient is unaware of touch and warm and cold application
c. Limb is cool to the touch
d. Distal limb can flex and extend
Explanation: A cool limb indicates impaired circulation, which requires prompt reporting.
29. Approximately how old does a nurse assess a large green bruise on the thigh of a
4-year-old to be?
a. 2 days
b. 4 days
c. 6 days
d. 8 days
Explanation: Bruises typically appear green as hemoglobin breaks down, which happens
around 5–7 days after injury.
30. What nursing action will significantly decrease the risk of serious complications for a child
who has suffered a fracture and is in a cast?
a. Neurovascular checks are done frequently
b. Bandages are wrapped tightly
c. The child is restrained from rolling over
d. The child’s buttocks are resting on the bed
Explanation: Frequent neurovascular checks detect early signs of compartment syndrome or
circulation compromise.
31. What would a nurse include when planning postoperative teaching for a child who has had a
tympanostomy with insertion of tubes?
a. Keeping the infant flat after feeding
b. Giving over-the-counter decongestants
c. Avoiding getting water in the ears
d. Putting cotton balls into the ear canal to prevent debris from entering the tubes
Explanation: Water can introduce infection through tympanostomy tubes, so precautions
should be taken to keep ears dry.32. What does a nurse explain to parents of a child with febrile seizures?
a. They occur when the body temperature exceeds 38.3 °C (101 °F)
b. They can be prevented by anticonvulsant medication
c. They usually lead to the development of epilepsy
d. They occur when the temperature rises quickly
Explanation: Febrile seizures are typically triggered by a rapid spike in body temperature, not
necessarily the absolute temperature.
33. What is an appropriate nursing action when a child is experiencing a generalized
tonic–clonic seizure?
a. Assist the child to bed and then go for help
b. Move objects out of the child’s immediate area
c. Stick a padded tongue blade between the child’s teeth
d. Manually restrain the child
Explanation: Clearing the area prevents injury. Restraining or placing objects in the mouth is
contraindicated.
34. A nurse teaches a mother of a 6-month-old child about the importance of getting her child
inoculated with Haemophilus influenzae type B. What does this immunization protect against?
a. Encephalitis
b. Influenza
c. Bacterial meningitis
d. Otitis media
Explanation: The Hib vaccine protects primarily against bacterial meningitis caused by
Haemophilus influenzae type B.
35. Which assessments would cause a pediatric nurse to suspect the probability of an ear
infection in a 6-month-old child?
a. Hypersensitivity to noise
b. Erythematotic ear canal
c. Temperature of 37.4 °C
d. Rolls head side to side
Explanation: Infants with ear discomfort often roll or rub their heads to relieve pain or pressure.36. What is the best pulse location for a nurse to use when assessing the pulse rate on a
12-month-old infant?
a. Brachial
b. Apical
c. Radial
d. Femoral
Explanation: In children under 2 years, the apical pulse is preferred for accuracy.
37. A nurse has taught an adolescent female about collecting a clean-catch urine specimen.
What statement made by the adolescent indicates understanding?
a. "I should wash my perineum with soap and water, then begin to urinate."
b. "I clean the perineum from front to back with an antiseptic wipe before I urinate."
c. "I’ll collect the first stream of urine in a sterile container."
d. "I will discard the first void and collect a freshly voided specimen 30 minutes later."
Explanation: Cleaning from front to back with an antiseptic wipe prevents contamination from
perineal bacteria.
38. Where is the best site for giving an IM injection to a 15-month-old child?
a. Ventrogluteal muscle
b. Dorsogluteal muscle
c. Deltoid muscle
d. Vastus lateralis muscle
Explanation: The vastus lateralis is the safest and most developed muscle for IM injections in
toddlers.
39. A nurse enters the hospital room and decides parents of a 1-year-old infant could benefit
from safety education to prevent unintentional injury based on which of the following
observations?
a. The blanket is not tucked into the mattress.
b. Diapers and wipes are stacked at the foot of the crib.
c. The crib side is locked in the up position.
d. Pillows are stacked on the bedside table.
Explanation: Items like diapers and wipes in the crib can pose choking or suffocation hazards
for infants.40. A 2-year-old child has been crying constantly for his mother since he was hospitalized 3
days ago. What does this behavior suggest?
a. The toddler feels abandoned by his mother.
b. The child still has not adjusted to his hospitalization.
c. The child is not separated from his mother often.
d. There is a poor mother–child bond.
Explanation: Prolonged crying in toddlers during hospitalization often reflects separation
anxiety and feelings of abandonment.
41. Which statement best corresponds to a preschooler’s understanding of hospitalization?
a. "A germ made me get sick."
b. "I got sick because I was mad at my brother."
c. "My tonsils are sick and they have to come out."
d. "I have a cast because I broke my leg."
Explanation: Preschoolers often use magical thinking, believing their thoughts or actions can
cause illness.
42. The mother of a hospitalized toddler states, "He cries when I visit. Maybe I should just stay
away." What is a nurse’s best response?
a. "Perhaps you are right. He only gets upset when you have to leave."
b. "It is important that you are here. This is a common reaction in children when they are
separated from their caregivers."
c. "It might be easier for your child if you would stay with him, but this decision is up to you."
d. "We take good care of him and he seems fine when you are not here."
Explanation: Reassurance and education about separation anxiety encourage parents to
maintain presence and support.
43. A child who was not immunized is admitted to the pediatric unit due to complications from
measles. What is the best approach a nurse can take with the parents?
a. Ask the parents why they did not get the child immunized.
b. Report the parents to the local health unit.
c. Encourage the parents to verbalize any concerns.
d. Provide care for the child and ignore the parents.
Explanation: Addressing parental concerns through open communication promotes trust and
can encourage future adherence to immunization.44. A nurse considers what “rites of passage” are valued by the adolescent in Canadian
society? (Select all that apply.)
a. Attaining legal drinking age
b. Selection of a career
c. Religious affiliation
d. Obtaining a driver’s licence
e. High school graduation
Explanation: Common adolescent milestones include legal age privileges, career choices,
driving, and school completion.
45. A nurse is educating high school students about guidelines to be followed when participating
in sports. Which statement by a student alerts the nurse of the need for further information?
a. "I will eat carbohydrates and protein after practice."
b. "I drink sports drinks when I play a long soccer game."
c. "I wear protective gear every time I play sports."
d. "I will drink caffeine when participating in sports."
Explanation: Caffeine can have adverse effects on hydration, heart rate, and performance in
youth athletes.
46. What does an adolescent’s peer group serve as related to development?
a. Social outlet
b. Association to blur personal identity
c. Platform for “group think”
d. Initial separation from family
Explanation: Peer groups provide adolescents with important opportunities for socialization,
identity exploration, and emotional support.
47. When planning to answer a 16-year-old girl’s questions about menstruation, a nurse must
consider cognitive development. What is developed during adolescence according to Piaget?
a. The ability to view a situation from multiple perspectives
b. The ability to focus more on the past than present situations
c. The ability to exercise concrete reasoning
d. The ability to consider hypothetical situations
Explanation: Adolescents enter the formal operational stage, enabling abstract and
hypothetical reasoning.48. What should a nurse keep in mind when planning to teach a class on nutrition to
fourth-grade students?
a. School-age children can concentrate on only one aspect of a situation.
b. School-age children can think abstractly.
c. School-age children are egocentric in their thinking.
d. School-age children think logically and concretely.
Explanation: Concrete operational thinking allows logical reasoning but still relies on tangible
concepts.
49. What statement by an 11-year-old child leads a nurse to determine the child has moved from
the mind-set of egocentrism?
a. "I am a member of the best Cub Scout group in the world."
b. "I must do my homework before I can play."
c. "My dad can do anything!"
d. "I’m sorry. I bet that hurt your feelings."
Explanation: Demonstrating empathy and understanding another’s feelings indicates
decreased egocentrism.
50. A school-age child becomes frustrated with a school assignment and says, “I can’t do this!”
What is the most developmentally supportive action from a parent?
a. Ask, “What is it that is so difficult?”
b. Allow the child to quit the effort.
c. Tell an older sibling to help.
d. Finish the project for them.
Explanation: Asking about the difficulty encourages problem-solving and persistence,
supporting developmental growth.
51. Parents ask a pediatric nurse how school life might influence their growing child. What area
of development will the nurse indicate that school affects the least?
a. Moral development
b. Social development
c. Physical development
d. Cognitive development
Explanation: School most strongly impacts cognitive, social, and moral growth; physical
development is less directly influenced.52. What is best for a nurse to suggest to parents of an overweight 9-year-old child to help
prevent obesity?
a. Use whole milk as a between-meal snack because it is more filling than skim milk.
b. Feed the child before family meal times to monitor intake more closely.
c. Encourage the child to engage in physical activity for at least an hour a day.
d. Remove all sweets and junk food from the house.
Explanation: Daily physical activity is key for weight management and overall health in
children.
53. What is the most appropriate intervention when dealing with occasional aggression in a
4-year-old child?
a. Have the child take a time-out in the corner for 4 minutes.
b. Spank the child at the time of the incident.
c. Take away television privileges for the day.
d. Send the child to their room for 30 minutes.
Explanation: Time-outs are developmentally appropriate and allow the child to calm down
without harsh punishment.
54. A nurse is discussing preschoolers’ sexual curiosity with the parent. What statement by the
mother leads the nurse to determine that the mother understands the information?
a. “Make up funny words for body parts.”
b. “Distract the child with a toy if they ask about sex.”
c. “Answer their questions when they ask.”
d. “Tell them to ask you again when they are 6 years old.”
Explanation: Honest, age-appropriate responses foster trust and healthy sexual development.
55. Caregivers of a 1 1/2-year-old child tell a nurse, “Bedtime is difficult. We can’t get our son to
go to bed at night.” What intervention is the most appropriate choice?
a. Allow the child to put himself to bed when tired
b. Let the child read in his room until he falls asleep
c. Establish a bedtime routine and use it consistently
d. Tire him out with physical activity before bedtime
Explanation: Consistent bedtime routines help toddlers develop predictable sleep patterns and
reduce bedtime struggles.56. Which of the following will a child who is unable to express themselves with words often do?
a. Become reclusive and introspective
b. Develop other methods of verbal communication
c. Engage in more creative play
d. Have tantrums and act out
Explanation: Young children often respond to frustration from limited verbal skills with
behavioral outbursts.
57. A nurse is educating a group of preschool parents about the importance of safety. Which
statement by a parent indicates the need for further education?
a. “I continue to provide a great deal of indirect supervision for my child.”
b. “My stairway is always free of clutter.”
c. “I only leave my child in the car for brief moments.”
d. “Medications are kept in a locked cabinet.”
Explanation: Leaving a child unattended in a car is unsafe under any circumstances.
58. What is the best advice a nurse can offer a parent concerned because her very active
2-year-old does not eat much?
a. Insist that the child eat one food on the plate
b. Encourage more physical activity to increase hunger
c. Maintain a routine around an eating schedule with the family
d. Serve meals with a variety of interesting plates, cups, and utensils
Explanation: Consistent mealtime routines encourage better eating habits in toddlers.
59. On a home visit, a nurse notes that parents of a 15-month-old child require safety teaching.
What observation would lead the nurse to this conclusion?
a. The fireplace has a screen
b. The dining room table has a tablecloth on it
c. There are paintings on the wall
d. The kitchen floor is clean but not shiny
Explanation: Tablecloths pose a hazard because toddlers can pull them down and injure
themselves.60. What would be an expected finding when assessing language development in a 2-year-old
child?
a. A 900-word vocabulary
b. Use of two-word sentences
c. Use of pronouns and prepositions
d. 100% of speech is understandable
Explanation: At age 2, children typically combine words into short phrases but do not yet have
fully clear speech.
61. The parent of a toddler says, “My daughter’s appetite has decreased. I think it’s because
she loves to drink milk.” What is the most appropriate nursing response?
a. “How much milk does she drink in a day?”
b. “Has she become a fussy eater, too?”
c. “Has your daughter been sick recently?”
d. “Have you tried offering her finger foods?”
Explanation: Assessing milk intake first is important because excessive milk consumption can
decrease appetite for other foods.
62. Parents say they are frustrated with their toddler’s recent behavior and refusal to agree with
anything. What term describes when a toddler tests their own power?
a. Negativism
b. Dawdling
c. Tantrums
d. Food fads
Explanation: Negativism is a normal developmental stage in toddlers characterized by
frequent use of “no” as they assert independence.
63. When does the posterior fontanelle close?
a. 3 months
b. 6 months
c. 9 months
d. 12 months
Explanation: The posterior fontanelle usually closes by 6–8 weeks, but 3 months is the latest
normal timeframe.64. What would a nurse expect a 4-month-old infant to be able to accomplish?
a. Hold a cup
b. Stand with assistance
c. Lift head and shoulders
d. Sit with back straight
Explanation: By 4 months, infants typically have enough neck strength to lift their head and
shoulders when prone.
65. Which statement by the mother of a 9-month-old indicates unsafe behavior?
a. “I put covers on all of the electrical outlets.”
b. “In the car, she rides in a front-facing car seat.”
c. “There are locks on all of the cabinets in the house.”
d. “I have a gate at the top and bottom of the stairs.”
Explanation: Children under age 2 should ride in a rear-facing car seat for safety.
66. A nurse observes a 10-month-old using the index finger and thumb to pick up cereal. What
does this behavior indicate?
a. The pincer grasp
b. A grasp reflex
c. Prehension ability
d. The parachute reflex
Explanation: The pincer grasp—using the thumb and index finger—is a fine motor milestone
typically developed by 9–10 months.
67. A nurse is helping parents teach their toddler how to use a diaper pail. What is the best
action?
b. Expose the diapers only (correct answer written in note)
Explanation: Limiting exposure reduces odor and contamination risk while the toddler learns
appropriate disposal.
68. When a small group of preschool-age children play house, each child assuming the role of a
particular family member, what type of play is this?
a. Parallel
b. Cooperative
c. Symbolic
d. Fantasy
Explanation: Cooperative play involves organized activity where children take on roles and
work toward a common goal.69. The mother of a 7-year-old asks how much sleep her child should get. What is the most
accurate nursing response?
c. “11 to 13 hours a night.”
Explanation: School-age children generally require about 11–13 hours of sleep for proper
growth and development.
70. Which approaches should a nurse suggest for introducing a 6-month-old infant to new
foods? (Select all that apply)
a. Serve one food at a time.
b. Provide food with different textures.
c. Offer foods in small amounts, less than a teaspoon.
d. Offer fruit first.
e. Eat together as a family.
Explanation: Introducing one food at a time in small amounts helps identify allergies and
prevents overwhelming the infant.Version D
1. A child with diabetes mellitus is observed to have cold symptoms. What signs and symptoms
will alert parents of the possibility of ketoacidosis? (Select all that apply).
a. Chest congestion
b. Ear pain
c. Fruity smelling breath
d. Hyperactivity
e. Nausea
2. A child with diabetes is brought to the emergency department. The child is flushed and
drowsy, and the skin is dry. The child's caregiver states that the child has been feeling
progressively worse since the morning. What is this child most likely experiencing?
a. Somogyi phenomenon
b. Dawn syndrome
c. Ketoacidosis
d. Water intoxication
3. Which statement made by a parent of a child with nephrotic syndrome indicates an
understanding of discharge teaching?
a. "I will make sure he gets his measles vaccine as soon as he gets home."
b. "He can stop taking his medication next week."
c. "I will delay routine immunizations for 11–12 months."
d. "He should eat a low-protein diet for the next few weeks."
4. A nurse has reviewed dietary restrictions for celiac disease with concerned parents. Which
grain will the nurse explain can be eaten with celiac disease?
a. Wheat
b. Oats
c. Barley
d. Rice
5. What would a nurse include in a teaching plan about mouth care of a child receiving
chemotherapy?
a. Use a commercial mouthwash.
b. Clean teeth with a soft toothbrush.
c. Avoid use of a Water-Pik.
d. Inspect the mouth weekly for ulcerations.6. The parent of a 1-year-old child with tetralogy of Fallot asks a nurse, "Why do my child's
fingertips look like that?" On what understanding does the nurse base a response?
a. Clubbing occurs as a result of decreased cardiac output.
b. Clubbing occurs as a result of a left-to-right shunting of blood.
c. Clubbing occurs as a result of untreated congestive heart failure.
d. Clubbing occurs as a result of chronic hypoxia.
7. What assessment made by the nurse would lead the nurse to suspect hip dysplasia?
a. Asymmetrical gluteal folds
b. Limited adduction of the affected side
c. Foot turned inward
d. Deep inguinal creases
8. What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic
seizure?
a. Assist the child to bed and then go for help.
b. Move objects out of the child's immediate area.
c. Stick a padded tongue blade between the child's teeth.
d. Manually restrain the child.
9. A 4-year-old child asks tearfully if the IM injection will hurt. What is a nurse's most effective
response?
a. "No. It is over before you know it."
b. "Yes. It will sting a little."
c. "No. Would you like to see the syringe?"
d. "Yes. Your mom and I are going to hold you to help you be still."
10. The mother of a 3-year-old child tells a nurse that she will be in to visit tomorrow around
12:00 PM. The next morning, the child asks the nurse, "When is my mommy coming?" What is
the nurse's best response?
a. "Your mommy will be here around noon."
b. "Your mommy will be here when you have lunch."
c. "Mommy will be here very soon."
d. "Your mommy is coming in 4 hours."11. A 13-year-old girl tells a nurse she is concerned because she has not had her first menstrual
period. What is the best initial response from the nurse?
a. "Your hormone levels may be irregular."
b. "Could you be pregnant?"
c. "Age of first menstrual cycle varies."
d. "Do not worry about it."
12. A mother tells a nurse, "My 11-month-old son is not as active as my other children were at
this age. He is the youngest of four, and the older children love to dote on him."
Content preview
Version B
1. A nurse is planning anticipatory guidance for a caregiver of a preschool-age child. The nurse
will explain that permanent teeth begin erupting at what age?
a. 4 years old
b. 6 years old
c. 8 years old
d. 10 years old
Explanation: Permanent teeth usually start to erupt at around age 6, beginning with the first
molars and central incisors.
2. What activity would the nurse choose to meet Erikson’s developmental task of industry when
caring for a 7-year-old child?
a. Completing a 50-piece jigsaw puzzle
b. Looking at a comic book
c. Playing a game of “I Spy” with the nurse
d. Colouring a picture in a colouring book
Explanation: School-age children in Erikson’s Industry vs. Inferiority stage build confidence
through skill-based, goal-directed tasks like puzzles.
3. The mother of a 7-month-old infant states, “The baby is eating food now. Should I give him
regular milk, too?” What is a nurse’s best response?
a. “You should give the baby low-fat milk.”
b. “Try the milk. See if he has any digestive problems.”
c. “Continue breast milk or iron-fortified formula until 9–1 year of age.”
d. “At this age, infants can tolerate lactose-free or soy-based milk.”
Explanation: Infants under 12 months should continue breast milk or formula to meet
nutritional and iron needs and avoid cow’s milk–related anemia.
4. A nurse is providing parenting information to parents of a toddler. What information is most
important for the nurse to include in the teaching?
a. “It is helpful to learn your child’s cues so you can anticipate their needs.”
b. “Give them opportunities to try new things within their capabilities. Expect them to make a
mess sometimes.”
c. “It is appropriate to provide the child with chores to do.”
d. “Understand that the child is trying to develop their own identity so try not to interfere with
this.”
Explanation: Encouraging safe exploration supports autonomy and development in toddlers.
,5. A nurse would teach a family who have a child with a gluten intolerance that the child should
not eat flours made from which of the following?
a. Corn
b. Wheat
c. Rice
d. Soybean
Explanation: Wheat contains gluten, which must be eliminated in gluten intolerance or celiac
disease.
6. A nurse is assessing a 13-year-old boy. Which physical change indicates that male puberty
has begun?
a. Development of axillary and facial hair
b. Enlargement of penis
c. Enlargement of testicles
d. Pigmentation of the scrotum
Explanation: Testicular enlargement is the first physical sign of male puberty, followed by
scrotal changes and hair growth.
7. A nurse is planning a safety program for high school students. Which is the top cause of
accidental deaths during adolescence?
a. Firearms
b. Automobiles
c. Drowning
d. Diving injuries
Explanation: Motor vehicle accidents are the leading cause of unintentional death in
adolescents.
8. A 16-year-old boy excitedly tells his parents that he was offered a part-time job. Which
response represents an effective problem-solving approach for his parents?
a. “Your studies are too important for you to have a part-time job.”
b. “When we went to high school, academics were our priority.”
c. “We want you to put your earnings in a savings account.”
d. “How do you think you will manage your schoolwork and a job?”
Explanation: Asking the teen to reflect encourages problem-solving and responsibility, rather
than imposing a decision.
,9. What are the best breakfast choices for a nurse to point out prior to a big exam, to provide
high levels of alertness and increased memory? (Select all that apply)
a. Pancakes and syrup
b. Coffee and chocolate-covered donuts
c. Bacon and fried eggs
d. Whole grain cereal and yogurt
e. Oatmeal and sliced apples
Explanation: Balanced breakfasts with whole grains, protein, and fruit support steady energy
and improved cognitive function.
10. A nurse is discussing challenges of the adolescent years with a group of high school
students in health class. What challenges toward adolescent development will the nurse
include? (Select all that apply)
a. Developing intimacy
b. Maintaining dependence on parents
c. Searching for identity
d. Adjusting to body changes
e. Establishing future goals
Explanation: Adolescence focuses on identity formation, body changes, independence, and
planning for the future; intimacy development begins in later adolescence.
11. A preschool child is asked, “Why do trees have leaves?” Which response would be an
example of animism?
a. “So I can have shade over my sandbox.”
b. “Because God made them that way.”
c. “To hide behind when they are scared.”
d. “For the squirrels to play in.”
Explanation: Animism is attributing human feelings or intentions to non-human objects; here,
the tree is “scared” and “hides.”
12. A nurse would report the following vital sign of a school-age child to a primary health care
provider:
a. Heart rate 120
b. Respiratory rate 20
c. Blood pressure 100/66
d. Oxygen saturation 95%
Explanation: A heart rate of 120 is elevated for a school-age child (normal resting range is
about 70–110 bpm).
, 13. What is a nurse’s best advice to a parent about a preschooler’s “imaginary friend”?
a. Having imaginary friends is a sign that the child has low self-esteem.
b. It is common for preschoolers to have imaginary friends.
c. Preschoolers invent an imaginary friend when they feel overwhelmed.
d. The best approach to dealing with an imaginary friend is to ignore them.
Explanation: Imaginary friends are a normal part of preschool imaginative play and are not
usually a cause for concern.
14. Caregivers of a 3½-year-old child tell a nurse, “My daughter points instead of speaking
whenever she wants me to get something for her, but she understands me when I ask her to do
something.” Based on the parent’s comment, what does the nurse suspect?
a. Age-appropriate language development
b. An expressive language delay
c. A receptive language delay
d. A potential hearing deficit
Explanation: The child understands language (receptive skills) but struggles to express herself
verbally, indicating an expressive delay.
15. What fear is unique to the preschool period?
a. Water
b. Animals
c. Bodily harm
d. Death
Explanation: Preschoolers often fear bodily harm because they have an active imagination
and a developing sense of body integrity.
16. A nurse observes three toddlers playing side by side with dolls. Closer observation revealed
that the children were not interacting with one another. What type of play is this?
a. Solitary
b. Parallel
c. Associative
d. Cooperative
Explanation: Parallel play is when children play alongside each other without direct interaction.