NSG434 Exam 1 Actual Exam Style V1 |
NSG 434 Nursing Care of Children | Grand
Canyon University
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting up without support
B. Using a pincer grasp to pick up small objects
C. Rolling from back to abdomen
D. Walking while holding onto furniture
Answer: C
Rationale: By 6 months of age, most infants should be able to roll from their back to their
abdomen and vice versa. This period marks a significant transition in gross motor skills as
the infant gains core strength. Sitting without support typically occurs around 8 months,
while the pincer grasp and cruising develop closer to 9 to 10 months. Understanding these
milestones is critical for pediatric nurses to identify potential developmental delays early.
2. According to Erikson’s psychosocial theory, which developmental task is primary for a
toddler aged 1 to 3 years?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
,C. Trust vs. Mistrust
D. Industry vs. Inferiority
Answer: A
Rationale: The primary developmental task for a toddler is Autonomy vs. Shame and
Doubt, where children begin to assert their independence through ‘no’ and doing things
themselves. Successful navigation of this stage leads to self-confidence and self-control.
Trust vs. Mistrust applies to infancy, Initiative vs. Guilt to preschoolers, and Industry
vs. Inferiority to school-aged children. Nurses should encourage age-appropriate choices to
support the toddler’s sense of autonomy.
3. A nurse is preparing to administer an immunization to a 4-year-old child. Which approach
best demonstrates family-centered care and atraumatic principles?
A. Using a therapeutic hugging technique with the parent holding the child.
B. Allowing the child to play with the syringe and needle before the injection.
C. Asking the parents to leave the room so the child does not associate them with pain.
D. Telling the child that the injection will not hurt at all.
Answer: A
Rationale: Family-centered care emphasizes the importance of the parent’s presence as a
source of comfort and security during stressful procedures. Using a therapeutic hug allows
the parent to support the child safely while the nurse performs the task. Nurses should
,never lie to a child about pain, as it destroys trust. Providing a simple explanation and using
comfort measures aligns with the goal of atraumatic care.
4. Which type of play is most characteristic of a group of toddlers in a daycare setting?
A. Solitary play
B. Associative play
C. Parallel play
D. Cooperative play
Answer: C
Rationale: Toddlers typically engage in parallel play, where they play alongside other
children with similar toys but do not interact directly. This reflects their developing social
skills and transition from solitary play, which is common in infants. Associative play is
common in preschoolers who share materials but lack a formal plan. Cooperative play
involves organized activities and is seen in school-aged children.
5. A nurse is providing nutritional guidance to the mother of a 9-month-old infant. Which
food should the nurse recommend introducing next?
A. Whole cow’s milk
B. Honey as a natural sweetener
C. Finely mashed table foods or finger foods
D. Citrus fruits in large quantities
, Answer: C
Rationale: At 9 months, infants are developing the pincer grasp and can handle finely
mashed table foods or soft finger foods. Whole cow’s milk should not be introduced until
after 12 months because it is difficult to digest and lacks proper nutrients. Honey is strictly
contraindicated for infants under 12 months due to the risk of botulism. The gradual
introduction of textures helps the infant transition toward family meals.
6. During a physical assessment of a 2-year-old, where should the nurse ideally start the
examination to gain the child’s cooperation?
A. Listening to the heart and lungs
B. Examining the ears and throat
C. Measuring blood pressure
D. Palpating the abdomen deeply
Answer: A
Rationale: When assessing a toddler, the nurse should begin with non-invasive and quiet
procedures, such as auscultating the heart and lungs, while the child is calm. Intrusive
procedures like examining the ears, throat, or measuring blood pressure should be saved
for the end of the exam. This ‘least to most invasive’ sequence helps build rapport and
reduces the child’s anxiety. Maintaining a calm and playful environment is essential for a
successful pediatric physical assessment.
NSG 434 Nursing Care of Children | Grand
Canyon University
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting up without support
B. Using a pincer grasp to pick up small objects
C. Rolling from back to abdomen
D. Walking while holding onto furniture
Answer: C
Rationale: By 6 months of age, most infants should be able to roll from their back to their
abdomen and vice versa. This period marks a significant transition in gross motor skills as
the infant gains core strength. Sitting without support typically occurs around 8 months,
while the pincer grasp and cruising develop closer to 9 to 10 months. Understanding these
milestones is critical for pediatric nurses to identify potential developmental delays early.
2. According to Erikson’s psychosocial theory, which developmental task is primary for a
toddler aged 1 to 3 years?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
,C. Trust vs. Mistrust
D. Industry vs. Inferiority
Answer: A
Rationale: The primary developmental task for a toddler is Autonomy vs. Shame and
Doubt, where children begin to assert their independence through ‘no’ and doing things
themselves. Successful navigation of this stage leads to self-confidence and self-control.
Trust vs. Mistrust applies to infancy, Initiative vs. Guilt to preschoolers, and Industry
vs. Inferiority to school-aged children. Nurses should encourage age-appropriate choices to
support the toddler’s sense of autonomy.
3. A nurse is preparing to administer an immunization to a 4-year-old child. Which approach
best demonstrates family-centered care and atraumatic principles?
A. Using a therapeutic hugging technique with the parent holding the child.
B. Allowing the child to play with the syringe and needle before the injection.
C. Asking the parents to leave the room so the child does not associate them with pain.
D. Telling the child that the injection will not hurt at all.
Answer: A
Rationale: Family-centered care emphasizes the importance of the parent’s presence as a
source of comfort and security during stressful procedures. Using a therapeutic hug allows
the parent to support the child safely while the nurse performs the task. Nurses should
,never lie to a child about pain, as it destroys trust. Providing a simple explanation and using
comfort measures aligns with the goal of atraumatic care.
4. Which type of play is most characteristic of a group of toddlers in a daycare setting?
A. Solitary play
B. Associative play
C. Parallel play
D. Cooperative play
Answer: C
Rationale: Toddlers typically engage in parallel play, where they play alongside other
children with similar toys but do not interact directly. This reflects their developing social
skills and transition from solitary play, which is common in infants. Associative play is
common in preschoolers who share materials but lack a formal plan. Cooperative play
involves organized activities and is seen in school-aged children.
5. A nurse is providing nutritional guidance to the mother of a 9-month-old infant. Which
food should the nurse recommend introducing next?
A. Whole cow’s milk
B. Honey as a natural sweetener
C. Finely mashed table foods or finger foods
D. Citrus fruits in large quantities
, Answer: C
Rationale: At 9 months, infants are developing the pincer grasp and can handle finely
mashed table foods or soft finger foods. Whole cow’s milk should not be introduced until
after 12 months because it is difficult to digest and lacks proper nutrients. Honey is strictly
contraindicated for infants under 12 months due to the risk of botulism. The gradual
introduction of textures helps the infant transition toward family meals.
6. During a physical assessment of a 2-year-old, where should the nurse ideally start the
examination to gain the child’s cooperation?
A. Listening to the heart and lungs
B. Examining the ears and throat
C. Measuring blood pressure
D. Palpating the abdomen deeply
Answer: A
Rationale: When assessing a toddler, the nurse should begin with non-invasive and quiet
procedures, such as auscultating the heart and lungs, while the child is calm. Intrusive
procedures like examining the ears, throat, or measuring blood pressure should be saved
for the end of the exam. This ‘least to most invasive’ sequence helps build rapport and
reduces the child’s anxiety. Maintaining a calm and playful environment is essential for a
successful pediatric physical assessment.
