,NSG 434 Exam 1 | Pediatric Nursing Advanced | Grand
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A 4-month-old infant is brought to the clinic for a well-child visit. The nurse notes that the infant has
good head control when pulled to a sitting position. Which developmental milestone is the nurse
assessing?
A) Gross motor development
B) Fine motor development
C) Language development
D) Social development
Correct Answer: Gross motor development
Rationale: Head control at 4 months is a gross motor milestone, as it involves the use of large muscle
groups to control the head and neck. Gross motor skills include rolling, sitting, and walking. Fine motor
skills include grasping and manipulating objects. Language and social development are separate
domains.
2. According to Erikson's theory of psychosocial development, a toddler (1–3 years) is in which stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: Autonomy vs. Shame and Doubt
Rationale: Erikson's stage for toddlers (1–3 years) is Autonomy vs. Shame and Doubt. During this stage,
children develop independence and self-control. Trust vs. Mistrust is infancy (birth–1 year), Initiative vs.
Guilt is preschool (3–6 years), and Industry vs. Inferiority is school-age (6–12 years).
3. A nurse is preparing to administer the first dose of the hepatitis B vaccine to a newborn. When should
this vaccine be administered?
,A) At 1 month of age
B) At 2 months of age
C) Within 12 hours of birth
D) Within 24 hours of birth
Correct Answer: Within 24 hours of birth
Rationale: The hepatitis B vaccine is typically administered within the first 24 hours of life, often in the
delivery room. The recommended schedule includes a total of 4 doses: at birth, 1 month, 2 months, and
6 months of age.
4. Which type of play is most developmentally appropriate for a 15-month-old toddler?
A) Playing a board game with dice
B) Building a tower of 2 blocks
C) Completing a 10-piece puzzle
D) Scribbling spontaneously with a crayon
Correct Answer: Building a tower of 2 blocks
Rationale: At 15 months, a child can typically build a tower of 2 blocks. Scribbling spontaneously occurs
around 18 months. Using a spoon without spilling occurs around 24 months. Board games and puzzles
with many pieces are not developmentally appropriate for a 15-month-old.
5. A nurse is assessing the anterior fontanel of a 6-month-old infant. The nurse expects the fontanel to
be:
A) Closed
B) Open and soft
C) Bulging
D) Depressed
, Correct Answer: Open and soft
Rationale: The anterior fontanel typically closes between 12 and 18 months of age. At 6 months, it
should be open and soft. A bulging fontanel indicates increased intracranial pressure, and a depressed
fontanel indicates dehydration.
6. The nurse is assessing a school-age child's blood pressure. Which cuff size should the nurse use to
obtain an accurate reading?
A) A cuff that covers 20% of the arm circumference
B) A cuff that covers 40% of the arm circumference
C) A cuff that covers 60% of the arm circumference
D) A cuff that covers 80% of the arm circumference
Correct Answer: A cuff that covers 40% of the arm circumference
Rationale: The correct blood pressure cuff size should cover approximately 40% of the arm
circumference. Using a cuff that is too small can result in falsely elevated readings, while a cuff that is
too large can result in falsely low readings.
7. A mother asks the nurse when her infant's posterior fontanel will close. What is the nurse's best
response?
A) 2 to 3 months
B) 6 to 8 months
C) 12 to 18 months
D) 24 months
Correct Answer: 2 to 3 months
Rationale: The posterior fontanel typically closes by 2 to 3 months of age. The anterior fontanel closes
later, between 12 and 18 months. The other options are incorrect timeframes for posterior fontanel
closure.
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A 4-month-old infant is brought to the clinic for a well-child visit. The nurse notes that the infant has
good head control when pulled to a sitting position. Which developmental milestone is the nurse
assessing?
A) Gross motor development
B) Fine motor development
C) Language development
D) Social development
Correct Answer: Gross motor development
Rationale: Head control at 4 months is a gross motor milestone, as it involves the use of large muscle
groups to control the head and neck. Gross motor skills include rolling, sitting, and walking. Fine motor
skills include grasping and manipulating objects. Language and social development are separate
domains.
2. According to Erikson's theory of psychosocial development, a toddler (1–3 years) is in which stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: Autonomy vs. Shame and Doubt
Rationale: Erikson's stage for toddlers (1–3 years) is Autonomy vs. Shame and Doubt. During this stage,
children develop independence and self-control. Trust vs. Mistrust is infancy (birth–1 year), Initiative vs.
Guilt is preschool (3–6 years), and Industry vs. Inferiority is school-age (6–12 years).
3. A nurse is preparing to administer the first dose of the hepatitis B vaccine to a newborn. When should
this vaccine be administered?
,A) At 1 month of age
B) At 2 months of age
C) Within 12 hours of birth
D) Within 24 hours of birth
Correct Answer: Within 24 hours of birth
Rationale: The hepatitis B vaccine is typically administered within the first 24 hours of life, often in the
delivery room. The recommended schedule includes a total of 4 doses: at birth, 1 month, 2 months, and
6 months of age.
4. Which type of play is most developmentally appropriate for a 15-month-old toddler?
A) Playing a board game with dice
B) Building a tower of 2 blocks
C) Completing a 10-piece puzzle
D) Scribbling spontaneously with a crayon
Correct Answer: Building a tower of 2 blocks
Rationale: At 15 months, a child can typically build a tower of 2 blocks. Scribbling spontaneously occurs
around 18 months. Using a spoon without spilling occurs around 24 months. Board games and puzzles
with many pieces are not developmentally appropriate for a 15-month-old.
5. A nurse is assessing the anterior fontanel of a 6-month-old infant. The nurse expects the fontanel to
be:
A) Closed
B) Open and soft
C) Bulging
D) Depressed
, Correct Answer: Open and soft
Rationale: The anterior fontanel typically closes between 12 and 18 months of age. At 6 months, it
should be open and soft. A bulging fontanel indicates increased intracranial pressure, and a depressed
fontanel indicates dehydration.
6. The nurse is assessing a school-age child's blood pressure. Which cuff size should the nurse use to
obtain an accurate reading?
A) A cuff that covers 20% of the arm circumference
B) A cuff that covers 40% of the arm circumference
C) A cuff that covers 60% of the arm circumference
D) A cuff that covers 80% of the arm circumference
Correct Answer: A cuff that covers 40% of the arm circumference
Rationale: The correct blood pressure cuff size should cover approximately 40% of the arm
circumference. Using a cuff that is too small can result in falsely elevated readings, while a cuff that is
too large can result in falsely low readings.
7. A mother asks the nurse when her infant's posterior fontanel will close. What is the nurse's best
response?
A) 2 to 3 months
B) 6 to 8 months
C) 12 to 18 months
D) 24 months
Correct Answer: 2 to 3 months
Rationale: The posterior fontanel typically closes by 2 to 3 months of age. The anterior fontanel closes
later, between 12 and 18 months. The other options are incorrect timeframes for posterior fontanel
closure.
