NUR 254 Exam 3 – Maternal & Pediatric Nursing
Practice Questions
**1. A nurse is assessing a 4-month-old infant during a well-child visit. The infant's mother asks when
her baby will be able to sit unsupported. What is the nurse's best response based on expected
developmental milestones?**
A) "Most infants can sit unsupported by 4 months of age."
B) "Infants typically begin to sit unsupported around 6 to 8 months of age."
C) "Sitting unsupported usually occurs around 10 to 12 months of age."
D) "Most infants do not sit unsupported until they are 15 months old."
**Answer: B**
*Rationale:* Infants typically begin to sit unsupported at approximately 6 to 8 months of age . At 4
months, the infant is just beginning to develop head control and trunk strength, but unsupported
sitting is not expected until later.
**2. The nurse is teaching a group of parents about expected developmental milestones for toddlers.
Which statement by a parent indicates correct understanding of toddler development?**
A) "My 24-month-old should be able to ride a tricycle and hop on one foot."
B) "My 18-month-old should be able to run well and engage in parallel play."
C) "At 24 months, my toddler should be able to run well and engage in parallel play."
D) "At 30 months, my toddler should be able to jump with both feet and start potty training."
**Answer: D**
*Rationale:* Toddlers at 30 months are expected to jump with both feet and begin potty training .
Running well and parallel play are expected at 24 months, while riding a tricycle is a preschool
milestone.
**3. The nurse is performing a developmental assessment on a 4-year-old child. Which milestone is
appropriate for a child of this age?**
A) Rides a tricycle, walks upstairs with alternate feet, and uses scissors
B) Skips and hops on one foot
C) Jumps with both feet and starts potty training
,D) Draws a person with 6 parts and ties shoelaces
**Answer: A**
*Rationale:* A 4-year-old preschooler should be able to ride a tricycle, walk upstairs with alternate
feet, and use scissors . Hopping on one foot is typically a 5-year-old milestone.
**4. The nurse is educating parents about the recommended schedule for lead poisoning screening in
children. At what ages should universal lead screening be performed according to current
recommendations?**
A) At birth and 6 months of age
B) At 1 year and 2 years of age
C) At 3 years and 4 years of age
D) Only if a child is at high risk
**Answer: B**
*Rationale:* Universal lead screening is recommended at 1 year and 2 years of age . This is a standard
preventive health measure for all children, regardless of risk factors.
**5. A nurse is assessing the fontanelles of a 12-month-old infant. Which finding would require
immediate notification of the healthcare provider?**
A) Anterior fontanelle that is slightly open
B) Posterior fontanelle that is open
C) Bulging fontanelle
D) Sunken anterior fontanelle
**Answer: C**
*Rationale:* A bulging fontanelle may indicate increased intracranial pressure and requires
immediate evaluation . While the posterior fontanelle typically closes by 2 months and the anterior by
18 months, a bulging fontanelle is a red flag regardless of age.
**6. The nurse is planning care for a hospitalized toddler. Which intervention best supports the
developmental needs of a toddler in Erikson's psychosocial stage of autonomy versus shame and
doubt?**
A) Allow the toddler to choose between two food options
B) Encourage the toddler to play with other children
,C) Provide a consistent daily schedule
D) Allow the toddler to watch educational videos
**Answer: A**
*Rationale:* Toddlers in the autonomy versus shame and doubt stage (1–3 years) need to develop
self-control and willpower . Offering choices supports their sense of autonomy. Too many choices can
be overwhelming, but providing limited choices is appropriate.
**7. The nurse is caring for a 6-year-old child who asks, "Why do I have to take this medicine?" What
is the best nursing response?**
A) "Because the doctor said so."
B) "It will help you get better and go back to school."
C) "The medication will help your body fight the infection."
D) "You just need to take it and not ask questions."
**Answer: C**
*Rationale:* School-age children (6–12 years) are in the industry versus inferiority stage and want
explanations for why things happen . They understand cause and effect, so providing a simple
explanation supports their developmental needs.
**8. A nurse is teaching parents about age-appropriate play activities for their child. Which play type
is most characteristic of the preschool-age child?**
A) Solitary play
B) Parallel play
C) Associative play
D) Cooperative play
**Answer: C**
*Rationale:* Associative play is common in preschool-age children (3–6 years) . In associative play,
children play together with no specific goal and may borrow or lend materials. Cooperative play
typically emerges in school-age children (6–12 years). Parallel play is characteristic of toddlers (1–3
years).
**9. The nurse is assessing an 8-month-old infant. Which finding is considered a developmental red
flag that should be reported to the healthcare provider?**
, A) Rolls from back to front
B) Sits with support
C) Does not babble
D) Responds to own name
**Answer: C**
*Rationale:* Infants should begin babbling by 9 months of age . An infant who is not babbling by this
time should be evaluated further. Rolling from back to front typically occurs around 4–6 months,
sitting with support is expected at 6 months.
**10. The nurse is caring for a toddler who is hospitalized. The parent states, "My child used to be
potty trained but now is having accidents." What is the nurse's best response?**
A) "Your child may have a urinary tract infection."
B) "This regression is common in hospitalized children and should resolve."
C) "We need to restart potty training immediately."
D) "You should punish your child for having accidents."
**Answer: B**
*Rationale:* Regression is a common response to hospitalization or stress in young children,
particularly in areas of development like potty training . This typically resolves once the child returns
to a normal routine and feels more secure.
**11. The nurse is preparing to examine the ears of a 2-year-old child. How should the nurse position
the pinna for this examination?**
A) Pull the pinna up and back
B) Pull the pinna down and back
C) Pull the pinna straight back
D) Pull the pinna forward
**Answer: B**
*Rationale:* For children under 3 years of age, the ear canal is angled differently, so the pinna should
be pulled down and back to straighten the ear canal . For children over 3 years, the pinna should be
pulled up and back.
**12. The nurse is performing a pain assessment on a 6-month-old infant. Which pain scale is most
appropriate for this infant?**
Practice Questions
**1. A nurse is assessing a 4-month-old infant during a well-child visit. The infant's mother asks when
her baby will be able to sit unsupported. What is the nurse's best response based on expected
developmental milestones?**
A) "Most infants can sit unsupported by 4 months of age."
B) "Infants typically begin to sit unsupported around 6 to 8 months of age."
C) "Sitting unsupported usually occurs around 10 to 12 months of age."
D) "Most infants do not sit unsupported until they are 15 months old."
**Answer: B**
*Rationale:* Infants typically begin to sit unsupported at approximately 6 to 8 months of age . At 4
months, the infant is just beginning to develop head control and trunk strength, but unsupported
sitting is not expected until later.
**2. The nurse is teaching a group of parents about expected developmental milestones for toddlers.
Which statement by a parent indicates correct understanding of toddler development?**
A) "My 24-month-old should be able to ride a tricycle and hop on one foot."
B) "My 18-month-old should be able to run well and engage in parallel play."
C) "At 24 months, my toddler should be able to run well and engage in parallel play."
D) "At 30 months, my toddler should be able to jump with both feet and start potty training."
**Answer: D**
*Rationale:* Toddlers at 30 months are expected to jump with both feet and begin potty training .
Running well and parallel play are expected at 24 months, while riding a tricycle is a preschool
milestone.
**3. The nurse is performing a developmental assessment on a 4-year-old child. Which milestone is
appropriate for a child of this age?**
A) Rides a tricycle, walks upstairs with alternate feet, and uses scissors
B) Skips and hops on one foot
C) Jumps with both feet and starts potty training
,D) Draws a person with 6 parts and ties shoelaces
**Answer: A**
*Rationale:* A 4-year-old preschooler should be able to ride a tricycle, walk upstairs with alternate
feet, and use scissors . Hopping on one foot is typically a 5-year-old milestone.
**4. The nurse is educating parents about the recommended schedule for lead poisoning screening in
children. At what ages should universal lead screening be performed according to current
recommendations?**
A) At birth and 6 months of age
B) At 1 year and 2 years of age
C) At 3 years and 4 years of age
D) Only if a child is at high risk
**Answer: B**
*Rationale:* Universal lead screening is recommended at 1 year and 2 years of age . This is a standard
preventive health measure for all children, regardless of risk factors.
**5. A nurse is assessing the fontanelles of a 12-month-old infant. Which finding would require
immediate notification of the healthcare provider?**
A) Anterior fontanelle that is slightly open
B) Posterior fontanelle that is open
C) Bulging fontanelle
D) Sunken anterior fontanelle
**Answer: C**
*Rationale:* A bulging fontanelle may indicate increased intracranial pressure and requires
immediate evaluation . While the posterior fontanelle typically closes by 2 months and the anterior by
18 months, a bulging fontanelle is a red flag regardless of age.
**6. The nurse is planning care for a hospitalized toddler. Which intervention best supports the
developmental needs of a toddler in Erikson's psychosocial stage of autonomy versus shame and
doubt?**
A) Allow the toddler to choose between two food options
B) Encourage the toddler to play with other children
,C) Provide a consistent daily schedule
D) Allow the toddler to watch educational videos
**Answer: A**
*Rationale:* Toddlers in the autonomy versus shame and doubt stage (1–3 years) need to develop
self-control and willpower . Offering choices supports their sense of autonomy. Too many choices can
be overwhelming, but providing limited choices is appropriate.
**7. The nurse is caring for a 6-year-old child who asks, "Why do I have to take this medicine?" What
is the best nursing response?**
A) "Because the doctor said so."
B) "It will help you get better and go back to school."
C) "The medication will help your body fight the infection."
D) "You just need to take it and not ask questions."
**Answer: C**
*Rationale:* School-age children (6–12 years) are in the industry versus inferiority stage and want
explanations for why things happen . They understand cause and effect, so providing a simple
explanation supports their developmental needs.
**8. A nurse is teaching parents about age-appropriate play activities for their child. Which play type
is most characteristic of the preschool-age child?**
A) Solitary play
B) Parallel play
C) Associative play
D) Cooperative play
**Answer: C**
*Rationale:* Associative play is common in preschool-age children (3–6 years) . In associative play,
children play together with no specific goal and may borrow or lend materials. Cooperative play
typically emerges in school-age children (6–12 years). Parallel play is characteristic of toddlers (1–3
years).
**9. The nurse is assessing an 8-month-old infant. Which finding is considered a developmental red
flag that should be reported to the healthcare provider?**
, A) Rolls from back to front
B) Sits with support
C) Does not babble
D) Responds to own name
**Answer: C**
*Rationale:* Infants should begin babbling by 9 months of age . An infant who is not babbling by this
time should be evaluated further. Rolling from back to front typically occurs around 4–6 months,
sitting with support is expected at 6 months.
**10. The nurse is caring for a toddler who is hospitalized. The parent states, "My child used to be
potty trained but now is having accidents." What is the nurse's best response?**
A) "Your child may have a urinary tract infection."
B) "This regression is common in hospitalized children and should resolve."
C) "We need to restart potty training immediately."
D) "You should punish your child for having accidents."
**Answer: B**
*Rationale:* Regression is a common response to hospitalization or stress in young children,
particularly in areas of development like potty training . This typically resolves once the child returns
to a normal routine and feels more secure.
**11. The nurse is preparing to examine the ears of a 2-year-old child. How should the nurse position
the pinna for this examination?**
A) Pull the pinna up and back
B) Pull the pinna down and back
C) Pull the pinna straight back
D) Pull the pinna forward
**Answer: B**
*Rationale:* For children under 3 years of age, the ear canal is angled differently, so the pinna should
be pulled down and back to straighten the ear canal . For children over 3 years, the pinna should be
pulled up and back.
**12. The nurse is performing a pain assessment on a 6-month-old infant. Which pain scale is most
appropriate for this infant?**
