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Santa Clara County Pediatric
Nurse Examination
Comprehensive Practice
Examination a well detailed one
written and graded
A+ upgraded
, 2
Examination Title: Santa Clara County Pediatric Nurse Certification Examination:
Comprehensive Assessment of Growth and Development, Acute and Chronic Disease
Management, and Evidence-Based Practice in Pediatric Nursing
Total Questions: 150 Multiple-Choice Questions
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Registered Nurses and Nurse Practitioners specializing in pediatric care
SECTION I: ASSESSMENT AND DIAGNOSITION (42%)
Growth and Development (Questions 1-15)
1. A 4-month-old infant is brought to the clinic for a well-child visit. The nurse expects which
developmental milestone to be present?
• A) Sitting without support
• B) Transferring objects from hand to hand
• C) Rolling from back to abdomen
• D) Pincer grasp development
-detailed answer 100% correct :- C
Rationale: By 4 months of age, most infants can roll from back to abdomen. Sitting without
support typically occurs at 6-7 months. Transferring objects hand-to-hand emerges around 7
months. Pincer grasp develops at approximately 9-10 months.
2. The nurse is assessing a 2-year-old child during a well-child examination. Which fine motor
skill should the nurse expect to observe?
• A) Building a tower of six to seven blocks
• B) Drawing a circle
• C) Using scissors to cut paper
• D) Copying a cross shape
-detailed answer 100% correct :- A
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Rationale: A 2-year-old can typically build a tower of six to seven blocks. Drawing a circle is
expected at 3 years. Using scissors develops around 4 years. Copying a cross shape is a 4- to 5-
year milestone.
3. According to Erikson's psychosocial stages, the primary developmental task for a preschool-
age child (3-5 years) is:
• A) Trust versus mistrust
• B) Autonomy versus shame and doubt
• C) Initiative versus guilt
• D) Industry versus inferiority
-detailed answer 100% correct :- C
Rationale: Initiative versus guilt is the psychosocial stage for preschool-age children (3-5 years).
Trust versus mistrust occurs in infancy, autonomy versus shame and doubt in toddlerhood, and
industry versus inferiority in school-age children.
4. A school-age child is hospitalized. According to Piaget's cognitive development theory, the
nurse should expect this child to be in which stage?
• A) Sensorimotor
• B) Preoperational
• C) Concrete operational
• D) Formal operational
-detailed answer 100% correct :- C
Rationale: School-age children (7-11 years) are in the concrete operational stage of Piaget's
cognitive development theory. Sensorimotor is infancy, preoperational is 2-7 years, and formal
operational begins at 11+ years.
5. The nurse is plotting growth parameters for a 6-month-old infant. Which finding would be
most concerning and warrant further investigation?
• A) Weight crossing two major percentile lines downward
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• B) Length at the 25th percentile
• C) Head circumference at the 50th percentile
• D) Weight at the 40th percentile
-detailed answer 100% correct :- A
Rationale: A downward crossing of two major percentile lines on a growth chart indicates
faltering growth and requires further investigation. Stable percentiles within normal ranges (B,
C, D) are expected findings.
6. The nurse is conducting a developmental screening on an 18-month-old toddler. Which
language milestone should the nurse expect?
• A) Speaking in two-word phrases
• B) Using 50 or more words
• C) Speaking in three- to four-word sentences
• D) Using pronouns correctly
-detailed answer 100% correct :- A
Rationale: At 18 months, toddlers typically speak in two-word phrases. Using 50 or more words
is expected at 24 months. Three- to four-word sentences emerge at 36 months. Correct
pronoun use develops at 3-4 years.
7. A 9-month-old infant is unable to sit without support. The nurse should:
• A) Document this as a normal finding
• B) Recommend further developmental evaluation
• C) Reassure the parents that all children develop at different rates
• D) Schedule a follow-up visit in 3 months
-detailed answer 100% correct :- B
Rationale: Sitting without support should be achieved by 8 months. Failure to achieve this
milestone by 9 months is a developmental red flag and warrants further evaluation.
Santa Clara County Pediatric
Nurse Examination
Comprehensive Practice
Examination a well detailed one
written and graded
A+ upgraded
, 2
Examination Title: Santa Clara County Pediatric Nurse Certification Examination:
Comprehensive Assessment of Growth and Development, Acute and Chronic Disease
Management, and Evidence-Based Practice in Pediatric Nursing
Total Questions: 150 Multiple-Choice Questions
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Registered Nurses and Nurse Practitioners specializing in pediatric care
SECTION I: ASSESSMENT AND DIAGNOSITION (42%)
Growth and Development (Questions 1-15)
1. A 4-month-old infant is brought to the clinic for a well-child visit. The nurse expects which
developmental milestone to be present?
• A) Sitting without support
• B) Transferring objects from hand to hand
• C) Rolling from back to abdomen
• D) Pincer grasp development
-detailed answer 100% correct :- C
Rationale: By 4 months of age, most infants can roll from back to abdomen. Sitting without
support typically occurs at 6-7 months. Transferring objects hand-to-hand emerges around 7
months. Pincer grasp develops at approximately 9-10 months.
2. The nurse is assessing a 2-year-old child during a well-child examination. Which fine motor
skill should the nurse expect to observe?
• A) Building a tower of six to seven blocks
• B) Drawing a circle
• C) Using scissors to cut paper
• D) Copying a cross shape
-detailed answer 100% correct :- A
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Rationale: A 2-year-old can typically build a tower of six to seven blocks. Drawing a circle is
expected at 3 years. Using scissors develops around 4 years. Copying a cross shape is a 4- to 5-
year milestone.
3. According to Erikson's psychosocial stages, the primary developmental task for a preschool-
age child (3-5 years) is:
• A) Trust versus mistrust
• B) Autonomy versus shame and doubt
• C) Initiative versus guilt
• D) Industry versus inferiority
-detailed answer 100% correct :- C
Rationale: Initiative versus guilt is the psychosocial stage for preschool-age children (3-5 years).
Trust versus mistrust occurs in infancy, autonomy versus shame and doubt in toddlerhood, and
industry versus inferiority in school-age children.
4. A school-age child is hospitalized. According to Piaget's cognitive development theory, the
nurse should expect this child to be in which stage?
• A) Sensorimotor
• B) Preoperational
• C) Concrete operational
• D) Formal operational
-detailed answer 100% correct :- C
Rationale: School-age children (7-11 years) are in the concrete operational stage of Piaget's
cognitive development theory. Sensorimotor is infancy, preoperational is 2-7 years, and formal
operational begins at 11+ years.
5. The nurse is plotting growth parameters for a 6-month-old infant. Which finding would be
most concerning and warrant further investigation?
• A) Weight crossing two major percentile lines downward
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• B) Length at the 25th percentile
• C) Head circumference at the 50th percentile
• D) Weight at the 40th percentile
-detailed answer 100% correct :- A
Rationale: A downward crossing of two major percentile lines on a growth chart indicates
faltering growth and requires further investigation. Stable percentiles within normal ranges (B,
C, D) are expected findings.
6. The nurse is conducting a developmental screening on an 18-month-old toddler. Which
language milestone should the nurse expect?
• A) Speaking in two-word phrases
• B) Using 50 or more words
• C) Speaking in three- to four-word sentences
• D) Using pronouns correctly
-detailed answer 100% correct :- A
Rationale: At 18 months, toddlers typically speak in two-word phrases. Using 50 or more words
is expected at 24 months. Three- to four-word sentences emerge at 36 months. Correct
pronoun use develops at 3-4 years.
7. A 9-month-old infant is unable to sit without support. The nurse should:
• A) Document this as a normal finding
• B) Recommend further developmental evaluation
• C) Reassure the parents that all children develop at different rates
• D) Schedule a follow-up visit in 3 months
-detailed answer 100% correct :- B
Rationale: Sitting without support should be achieved by 8 months. Failure to achieve this
milestone by 9 months is a developmental red flag and warrants further evaluation.
