NUR 106 – Module G2: Pediatric Growth &
Development, Nursing Independent Practice
Questions & Answers | Comprehensive Pediatric
Nursing Study Guide & Exam Preparation | Child
Growth & Development, Developmental Milestones,
Infant & Toddler Development, Preschool & School-
Age Development, Adolescent Development, Growth
Assessment, Nutrition, Safety, Health Promotion,
Developmental Screening, Family-Centered Care &
Detailed Rationales
Question 1: A 2-year-old child is brought to the clinic for a well-child visit. The
nurse notes that the child can walk up and down stairs by placing both feet on
each step and can build a tower of six blocks. According to Erikson's theory of
psychosocial development, which psychosocial crisis is this child primarily
navigating?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
CORRECT ANSWER: B. Autonomy vs. Shame and Doubt
Rationale: Erikson's second stage, Autonomy vs. Shame and Doubt, occurs during
toddlerhood (ages 1-3 years). During this stage, children develop a sense of personal
control and independence, characterized by behaviors like "doing it myself," which
aligns with the developmental milestones of a 2-year-old. Trust vs. Mistrust is for
infancy, Initiative vs. Guilt is for preschool, and Industry vs. Inferiority is for school-age
children.
Question 2: The mother of a 4-month-old infant reports that the baby is not
sleeping through the night and frequently wakes up crying. The infant was
born at 38 weeks gestation and has no health issues. The nurse should educate
the mother that this behavior is most likely due to which physiological factor?
A. The infant is experiencing night terrors.
B. The infant is teething and in pain.
C. The infant is in a period of rapid brain growth and has increased nutritional needs.
D. The infant has developed an attachment disorder.
CORRECT ANSWER: C. The infant is in a period of rapid brain growth and has
increased nutritional needs.
Rationale: At 4 months, infants often experience a growth spurt and a developmental
leap, leading to increased hunger and more frequent waking. While teething can cause
discomfort, it is not the most common reason for night waking at this specific age. Night
terrors are rare in infants, and attachment disorders manifest differently.
,Question 3: A nurse is assessing the fine motor skills of a 10-month-old infant.
Which finding indicates that the infant is achieving the expected
developmental milestone for this age?
A. The infant uses a pincer grasp to pick up a small piece of cereal.
B. The infant transfers a toy from one hand to the other.
C. The infant builds a tower of two cubes.
D. The infant holds a crayon and scribbles spontaneously.
CORRECT ANSWER: A. The infant uses a pincer grasp to pick up a small piece
of cereal.
Rationale: The pincer grasp, using the thumb and forefinger, typically develops between
9 and 10 months of age. Transferring objects occurs around 6-7 months, building a
tower of two cubes is a 15-month milestone, and scribbling spontaneously is seen
around 15-18 months.
Question 4: A mother expresses concern that her 3-year-old child is a "picky
eater" and only wants to eat the same three foods. Based on the principles of
pediatric nutrition, which nursing intervention would be most appropriate?
A. Advise the mother to restrict all snacks to ensure the child is hungry for meals.
B. Recommend the mother force the child to try at least one bite of a new food each
meal.
C. Educate the mother that this is a typical behavior for this age and to continue offering
a variety of foods without pressure.
D. Prescribe a daily multivitamin to compensate for any nutritional gaps.
CORRECT ANSWER: C. Educate the mother that this is a typical behavior for
this age and to continue offering a variety of foods without pressure.
Rationale: Food jags (limited food preferences) are common in toddlers and
preschoolers due to neophobia (fear of new things). The recommended approach is to
continue offering a variety of nutritious foods in a positive, non-coercive manner.
Forcing food can create a power struggle and worsen the behavior, while restricting
snacks may not address the root cause.
Question 5: In a health promotion class for parents of school-age children, the
nurse discusses the importance of physical activity. Which recommendation
aligns with current guidelines for this age group?
A. At least 30 minutes of moderate to vigorous physical activity daily.
B. At least 60 minutes of moderate to vigorous physical activity daily.
C. At least 90 minutes of vigorous physical activity three times a week.
D. Physical activity is not a priority as academic learning is more important.
CORRECT ANSWER: B. At least 60 minutes of moderate to vigorous physical
activity daily.
,Rationale: Current guidelines from the Centers for Disease Control and Prevention
(CDC) and the American Academy of Pediatrics (AAP) recommend that school-age
children and adolescents (6-17 years) get at least 60 minutes of moderate-to-vigorous
physical activity daily.
Question 6: The nurse is evaluating the development of an 8-month-old infant
during a well-child visit. Which gross motor skill is the nurse most likely to
observe?
A. The infant sits steadily without support.
B. The infant rolls from back to front and front to back.
C. The infant walks independently.
D. The infant stands on one foot.
CORRECT ANSWER: A. The infant sits steadily without support.
Rationale: Sitting without support is a typical gross motor milestone for an 8-month-old
infant. Rolling over occurs earlier, around 4-6 months. Walking independently typically
occurs around 12 months, and standing on one foot is a skill for older
toddlers/preschoolers.
Question 7: During a well-child visit for a 15-month-old toddler, the nurse
assesses the child's language development. Which finding would be considered
a potential delay requiring further evaluation?
A. The toddler says "mama" and "dada" specifically.
B. The toddler says three words other than "mama" and "dada."
C. The toddler points to a picture of a dog when asked to do so.
D. The toddler does not use any words other than "mama" and "dada."
CORRECT ANSWER: D. The toddler does not use any words other than
"mama" and "dada."
Rationale: By 15 months, a toddler should have a vocabulary of about 3-5 words other
than "mama" and "dada." A lack of any words by 15 months is a red flag. The other
options are expected or appropriate milestones.
Question 8: A nurse is providing anticipatory guidance to the parents of a 6-
month-old infant regarding sleep safety. Which statement indicates that the
parents understand the teaching?
A. "We will place the baby on his stomach to sleep so he doesn't choke if he spits up."
B. "We will put the baby to sleep on his back with a small blanket to keep him warm."
C. "We will remove all soft objects, toys, and loose bedding from the crib."
D. "We will place the baby in a crib with a soft bumper pad to prevent injury."
CORRECT ANSWER: C. "We will remove all soft objects, toys, and loose
bedding from the crib."
, Rationale: To reduce the risk of Sudden Infant Death Syndrome (SIDS), the American
Academy of Pediatrics recommends placing infants on their backs to sleep, on a firm
sleep surface, with no soft objects, loose bedding, or bumper pads. Stomach sleeping
and blanket use are risk factors.
Question 9: According to Piaget's theory of cognitive development, a 2-year-
old child is in the preoperational stage. Which characteristic is most
representative of this stage?
A. Object permanence
B. Egocentrism
C. Conservation of mass
D. Hypothetical deductive reasoning
CORRECT ANSWER: B. Egocentrism
Rationale: Egocentrism, the inability to see a situation from another person's point of
view, is a hallmark of the preoperational stage (2-7 years). Object permanence is a
sensorimotor stage accomplishment, conservation is a concrete operational skill, and
hypothetical deductive reasoning is characteristic of formal operations.
Question 10: A school nurse is assessing an 11-year-old child who is worried
about being "shorter than everyone else" in their class. The nurse notes that
the child has not yet exhibited any signs of puberty. Based on knowledge of
growth and development, what is the most appropriate response from the
nurse?
A. Reassure the child that growth is a normal process and that puberty begins at varying
ages, but schedule a pediatric endocrinology consult for growth hormone testing.
B. Inform the child that most girls have their growth spurt during this time, so they will
likely catch up soon.
C. Reassure the child that growth patterns can vary greatly and that they will likely have
their growth spurt as they progress through puberty.
D. Advise the child to begin a strength-training regimen to stimulate bone growth.
CORRECT ANSWER: C. Reassure the child that growth patterns can vary
greatly and that they will likely have their growth spurt as they progress
through puberty.
Rationale: Growth spurts are closely tied to puberty, which has a wide age range for
onset (8-13 for girls, 9-14 for boys). It is normal for an 11-year-old to not yet have begun
their growth spurt. Reassurance is the most appropriate first step, without implying
pathology or unnecessary referrals.
Question 11: The parent of a 7-year-old child tells the nurse that the child has
recently started complaining of stomachaches on Sunday evenings. The parent
is concerned about a possible physical illness. The nurse should first explore
which potential cause?
Development, Nursing Independent Practice
Questions & Answers | Comprehensive Pediatric
Nursing Study Guide & Exam Preparation | Child
Growth & Development, Developmental Milestones,
Infant & Toddler Development, Preschool & School-
Age Development, Adolescent Development, Growth
Assessment, Nutrition, Safety, Health Promotion,
Developmental Screening, Family-Centered Care &
Detailed Rationales
Question 1: A 2-year-old child is brought to the clinic for a well-child visit. The
nurse notes that the child can walk up and down stairs by placing both feet on
each step and can build a tower of six blocks. According to Erikson's theory of
psychosocial development, which psychosocial crisis is this child primarily
navigating?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
CORRECT ANSWER: B. Autonomy vs. Shame and Doubt
Rationale: Erikson's second stage, Autonomy vs. Shame and Doubt, occurs during
toddlerhood (ages 1-3 years). During this stage, children develop a sense of personal
control and independence, characterized by behaviors like "doing it myself," which
aligns with the developmental milestones of a 2-year-old. Trust vs. Mistrust is for
infancy, Initiative vs. Guilt is for preschool, and Industry vs. Inferiority is for school-age
children.
Question 2: The mother of a 4-month-old infant reports that the baby is not
sleeping through the night and frequently wakes up crying. The infant was
born at 38 weeks gestation and has no health issues. The nurse should educate
the mother that this behavior is most likely due to which physiological factor?
A. The infant is experiencing night terrors.
B. The infant is teething and in pain.
C. The infant is in a period of rapid brain growth and has increased nutritional needs.
D. The infant has developed an attachment disorder.
CORRECT ANSWER: C. The infant is in a period of rapid brain growth and has
increased nutritional needs.
Rationale: At 4 months, infants often experience a growth spurt and a developmental
leap, leading to increased hunger and more frequent waking. While teething can cause
discomfort, it is not the most common reason for night waking at this specific age. Night
terrors are rare in infants, and attachment disorders manifest differently.
,Question 3: A nurse is assessing the fine motor skills of a 10-month-old infant.
Which finding indicates that the infant is achieving the expected
developmental milestone for this age?
A. The infant uses a pincer grasp to pick up a small piece of cereal.
B. The infant transfers a toy from one hand to the other.
C. The infant builds a tower of two cubes.
D. The infant holds a crayon and scribbles spontaneously.
CORRECT ANSWER: A. The infant uses a pincer grasp to pick up a small piece
of cereal.
Rationale: The pincer grasp, using the thumb and forefinger, typically develops between
9 and 10 months of age. Transferring objects occurs around 6-7 months, building a
tower of two cubes is a 15-month milestone, and scribbling spontaneously is seen
around 15-18 months.
Question 4: A mother expresses concern that her 3-year-old child is a "picky
eater" and only wants to eat the same three foods. Based on the principles of
pediatric nutrition, which nursing intervention would be most appropriate?
A. Advise the mother to restrict all snacks to ensure the child is hungry for meals.
B. Recommend the mother force the child to try at least one bite of a new food each
meal.
C. Educate the mother that this is a typical behavior for this age and to continue offering
a variety of foods without pressure.
D. Prescribe a daily multivitamin to compensate for any nutritional gaps.
CORRECT ANSWER: C. Educate the mother that this is a typical behavior for
this age and to continue offering a variety of foods without pressure.
Rationale: Food jags (limited food preferences) are common in toddlers and
preschoolers due to neophobia (fear of new things). The recommended approach is to
continue offering a variety of nutritious foods in a positive, non-coercive manner.
Forcing food can create a power struggle and worsen the behavior, while restricting
snacks may not address the root cause.
Question 5: In a health promotion class for parents of school-age children, the
nurse discusses the importance of physical activity. Which recommendation
aligns with current guidelines for this age group?
A. At least 30 minutes of moderate to vigorous physical activity daily.
B. At least 60 minutes of moderate to vigorous physical activity daily.
C. At least 90 minutes of vigorous physical activity three times a week.
D. Physical activity is not a priority as academic learning is more important.
CORRECT ANSWER: B. At least 60 minutes of moderate to vigorous physical
activity daily.
,Rationale: Current guidelines from the Centers for Disease Control and Prevention
(CDC) and the American Academy of Pediatrics (AAP) recommend that school-age
children and adolescents (6-17 years) get at least 60 minutes of moderate-to-vigorous
physical activity daily.
Question 6: The nurse is evaluating the development of an 8-month-old infant
during a well-child visit. Which gross motor skill is the nurse most likely to
observe?
A. The infant sits steadily without support.
B. The infant rolls from back to front and front to back.
C. The infant walks independently.
D. The infant stands on one foot.
CORRECT ANSWER: A. The infant sits steadily without support.
Rationale: Sitting without support is a typical gross motor milestone for an 8-month-old
infant. Rolling over occurs earlier, around 4-6 months. Walking independently typically
occurs around 12 months, and standing on one foot is a skill for older
toddlers/preschoolers.
Question 7: During a well-child visit for a 15-month-old toddler, the nurse
assesses the child's language development. Which finding would be considered
a potential delay requiring further evaluation?
A. The toddler says "mama" and "dada" specifically.
B. The toddler says three words other than "mama" and "dada."
C. The toddler points to a picture of a dog when asked to do so.
D. The toddler does not use any words other than "mama" and "dada."
CORRECT ANSWER: D. The toddler does not use any words other than
"mama" and "dada."
Rationale: By 15 months, a toddler should have a vocabulary of about 3-5 words other
than "mama" and "dada." A lack of any words by 15 months is a red flag. The other
options are expected or appropriate milestones.
Question 8: A nurse is providing anticipatory guidance to the parents of a 6-
month-old infant regarding sleep safety. Which statement indicates that the
parents understand the teaching?
A. "We will place the baby on his stomach to sleep so he doesn't choke if he spits up."
B. "We will put the baby to sleep on his back with a small blanket to keep him warm."
C. "We will remove all soft objects, toys, and loose bedding from the crib."
D. "We will place the baby in a crib with a soft bumper pad to prevent injury."
CORRECT ANSWER: C. "We will remove all soft objects, toys, and loose
bedding from the crib."
, Rationale: To reduce the risk of Sudden Infant Death Syndrome (SIDS), the American
Academy of Pediatrics recommends placing infants on their backs to sleep, on a firm
sleep surface, with no soft objects, loose bedding, or bumper pads. Stomach sleeping
and blanket use are risk factors.
Question 9: According to Piaget's theory of cognitive development, a 2-year-
old child is in the preoperational stage. Which characteristic is most
representative of this stage?
A. Object permanence
B. Egocentrism
C. Conservation of mass
D. Hypothetical deductive reasoning
CORRECT ANSWER: B. Egocentrism
Rationale: Egocentrism, the inability to see a situation from another person's point of
view, is a hallmark of the preoperational stage (2-7 years). Object permanence is a
sensorimotor stage accomplishment, conservation is a concrete operational skill, and
hypothetical deductive reasoning is characteristic of formal operations.
Question 10: A school nurse is assessing an 11-year-old child who is worried
about being "shorter than everyone else" in their class. The nurse notes that
the child has not yet exhibited any signs of puberty. Based on knowledge of
growth and development, what is the most appropriate response from the
nurse?
A. Reassure the child that growth is a normal process and that puberty begins at varying
ages, but schedule a pediatric endocrinology consult for growth hormone testing.
B. Inform the child that most girls have their growth spurt during this time, so they will
likely catch up soon.
C. Reassure the child that growth patterns can vary greatly and that they will likely have
their growth spurt as they progress through puberty.
D. Advise the child to begin a strength-training regimen to stimulate bone growth.
CORRECT ANSWER: C. Reassure the child that growth patterns can vary
greatly and that they will likely have their growth spurt as they progress
through puberty.
Rationale: Growth spurts are closely tied to puberty, which has a wide age range for
onset (8-13 for girls, 9-14 for boys). It is normal for an 11-year-old to not yet have begun
their growth spurt. Reassurance is the most appropriate first step, without implying
pathology or unnecessary referrals.
Question 11: The parent of a 7-year-old child tells the nurse that the child has
recently started complaining of stomachaches on Sunday evenings. The parent
is concerned about a possible physical illness. The nurse should first explore
which potential cause?
