Pediatric Nursing Board Certification Exam Questions and
Answers with Verified Solutions Latest 2026/2027
Examination Title Pediatric Nursing Mastery Test Bank & Practice Exam
Guide
Specialty Coverage Growth & Development, Pediatric Cardiology,
Respiratory Disorders, Gastroenterology,
Neurological Emergencies
Passing Standard 75% Correct Responses
Edition Specification Latest 2026/2027 Master Review Edition
Module 1: Growth, Development & Health Promotion (Questions 1–15)
Question 1
A nurse assesses a 12-month-old infant during a routine well-child visit. Which developmental
milestone should the nurse expect the infant to exhibit?
• A) Building a tower of six cubes
• B) Walking while holding onto furniture (cruising) or taking first unassisted steps
• C) Speaking in complete four-word sentences
• D) Jumping in place with both feet leaving the ground
Correct Answer: B) Walking while holding onto furniture (cruising) or taking first unassisted steps
By 12 months, infants typically cruise along furniture or take independent steps. Building a six-cube tower is
expected around 24 months, and jumping in place occurs around 30 months.
Question 2
According to Erikson's theory of psychosocial development, which developmental crisis is
primary for a 4-year-old preschool child?
• A) Trust vs. Mistrust
• B) Autonomy vs. Shame and Doubt
• C) Initiative vs. Guilt
• D) Industry vs. Inferiority
Correct Answer: C) Initiative vs. Guilt
Preschoolers (ages 3–6) navigate Initiative vs. Guilt by exploring their environment and trying new activities.
Autonomy vs. Shame dominates toddlerhood (1–3 years), while Industry vs. Inferiority applies to school-age
children (6–12 years).
,Question 3
At what age does the anterior fontanelle typically close in a healthy infant?
• A) 2 to 3 months
• B) 6 to 8 months
• C) 12 to 18 months
• D) 24 to 30 months
Correct Answer: C) 12 to 18 months
The diamond-shaped anterior fontanelle closes between 12 and 18 months of age. The smaller posterior
fontanelle closes much earlier, between 2 and 3 months.
Question 4
Which type of play is characteristic of toddlers playing side-by-side in a sandbox with similar
toys without interacting directly?
• A) Solitary play
• B) Parallel play
• C) Associative play
• D) Cooperative play
Correct Answer: B) Parallel play
Parallel play is classic for toddlers (1–3 years), where children play alongside each other without direct
interaction. Preschoolers engage in associative play, and school-age children participate in cooperative play.
Question 5
Which pain assessment scale is most appropriate for evaluating pain intensity in a non-verbal 6-
month-old hospitalized infant?
• A) FLACC Scale (Face, Legs, Activity, Cry, Consolability)
• B) Wong-Baker FACES Scale
• C) Numeric Rating Scale (0–10)
• D) Visual Analog Scale
Correct Answer: A) FLACC Scale (Face, Legs, Activity, Cry, Consolability)
The FLACC scale is an observational tool validated for infants and young children aged 2 months to 7 years
who cannot self-report pain. Wong-Baker FACES requires self-reporting starting around age 3.
Question 6
Which intervention helps reduce procedural distress in a 2-year-old child undergoing a
venipuncture?
• A) Explaining the procedure in detail 3 days in advance
• B) Using distraction techniques such as blowing bubbles or a light-up spinner toy
• C) Asking the parents to leave the room during the procedure
• D) Restraining the child tightly without parental presence
Correct Answer: B) Using distraction techniques such as blowing bubbles or a light-up spinner toy
Active distraction engages the toddler's attention away from painful stimuli. Parents should remain present
as a comfort measure, and explanations should be brief and immediate rather than advance.
, Question 7
What safety recommendation should the nurse provide to parents regarding car seat installation
for an 8-month-old infant weighing 18 lbs?
• A) Rear-facing car seat in the back seat of the vehicle
• B) Forward-facing car seat in the front passenger seat
• C) Forward-facing car seat in the back seat
• D) Booster seat with a lap and shoulder belt
Correct Answer: A) Rear-facing car seat in the back seat of the vehicle
AAP guidelines recommend that infants and toddlers remain in a rear-facing car seat in the back seat until
they reach the maximum weight or height limit allowed by their seat (at least until age 2).
Question 8
A mother asks when she can safely introduce solid foods to her exclusively breastfed 3-month-
old infant. What is the nurse's best advice?
• A) Start cereal immediately to help the infant sleep through the night
• B) Wait until approximately 6 months of age when the tongue-extrusion reflex disappears
• C) Introduce whole cow's milk mixed with pureed meats at 4 months
• D) Begin solid foods as soon as the infant doubles their birth weight at 2 months
Correct Answer: B) Wait until approximately 6 months of age when the tongue-extrusion reflex disappears
Exclusive breastfeeding is recommended for the first 6 months. Solid foods are introduced around 6 months
when gastrointestinal maturation occurs and the infant loses the protective extrusion reflex.
Question 9
Which primitive reflex disappears around 4 months of age and is tested by turning the infant's
head to one side while supine, causing extension of the arm on that side and flexion of the
opposite arm?
• A) Tonic neck reflex (Fencer position)
• B) Babinski reflex
• C) Plantar grasp reflex
• D) Rooting reflex
Correct Answer: A) Tonic neck reflex (Fencer position)
The tonic neck reflex appears at birth and fades by 3–4 months. Persistence beyond 6 months indicates
potential central nervous system dysfunction or cerebral palsy.
Question 10
At what age should a child be able to stack a tower of four blocks, scribble spontaneously, and
use a spoon with minimal spilling?
• A) 12 months
• B) 18 months
• C) 36 months
• D) 48 months
Correct Answer: B) 18 months
At 18 months, fine motor skills advance to permit building a 3- to 4-block tower, spontaneous scribbling, and
independent spoon feeding with improving coordination.
Answers with Verified Solutions Latest 2026/2027
Examination Title Pediatric Nursing Mastery Test Bank & Practice Exam
Guide
Specialty Coverage Growth & Development, Pediatric Cardiology,
Respiratory Disorders, Gastroenterology,
Neurological Emergencies
Passing Standard 75% Correct Responses
Edition Specification Latest 2026/2027 Master Review Edition
Module 1: Growth, Development & Health Promotion (Questions 1–15)
Question 1
A nurse assesses a 12-month-old infant during a routine well-child visit. Which developmental
milestone should the nurse expect the infant to exhibit?
• A) Building a tower of six cubes
• B) Walking while holding onto furniture (cruising) or taking first unassisted steps
• C) Speaking in complete four-word sentences
• D) Jumping in place with both feet leaving the ground
Correct Answer: B) Walking while holding onto furniture (cruising) or taking first unassisted steps
By 12 months, infants typically cruise along furniture or take independent steps. Building a six-cube tower is
expected around 24 months, and jumping in place occurs around 30 months.
Question 2
According to Erikson's theory of psychosocial development, which developmental crisis is
primary for a 4-year-old preschool child?
• A) Trust vs. Mistrust
• B) Autonomy vs. Shame and Doubt
• C) Initiative vs. Guilt
• D) Industry vs. Inferiority
Correct Answer: C) Initiative vs. Guilt
Preschoolers (ages 3–6) navigate Initiative vs. Guilt by exploring their environment and trying new activities.
Autonomy vs. Shame dominates toddlerhood (1–3 years), while Industry vs. Inferiority applies to school-age
children (6–12 years).
,Question 3
At what age does the anterior fontanelle typically close in a healthy infant?
• A) 2 to 3 months
• B) 6 to 8 months
• C) 12 to 18 months
• D) 24 to 30 months
Correct Answer: C) 12 to 18 months
The diamond-shaped anterior fontanelle closes between 12 and 18 months of age. The smaller posterior
fontanelle closes much earlier, between 2 and 3 months.
Question 4
Which type of play is characteristic of toddlers playing side-by-side in a sandbox with similar
toys without interacting directly?
• A) Solitary play
• B) Parallel play
• C) Associative play
• D) Cooperative play
Correct Answer: B) Parallel play
Parallel play is classic for toddlers (1–3 years), where children play alongside each other without direct
interaction. Preschoolers engage in associative play, and school-age children participate in cooperative play.
Question 5
Which pain assessment scale is most appropriate for evaluating pain intensity in a non-verbal 6-
month-old hospitalized infant?
• A) FLACC Scale (Face, Legs, Activity, Cry, Consolability)
• B) Wong-Baker FACES Scale
• C) Numeric Rating Scale (0–10)
• D) Visual Analog Scale
Correct Answer: A) FLACC Scale (Face, Legs, Activity, Cry, Consolability)
The FLACC scale is an observational tool validated for infants and young children aged 2 months to 7 years
who cannot self-report pain. Wong-Baker FACES requires self-reporting starting around age 3.
Question 6
Which intervention helps reduce procedural distress in a 2-year-old child undergoing a
venipuncture?
• A) Explaining the procedure in detail 3 days in advance
• B) Using distraction techniques such as blowing bubbles or a light-up spinner toy
• C) Asking the parents to leave the room during the procedure
• D) Restraining the child tightly without parental presence
Correct Answer: B) Using distraction techniques such as blowing bubbles or a light-up spinner toy
Active distraction engages the toddler's attention away from painful stimuli. Parents should remain present
as a comfort measure, and explanations should be brief and immediate rather than advance.
, Question 7
What safety recommendation should the nurse provide to parents regarding car seat installation
for an 8-month-old infant weighing 18 lbs?
• A) Rear-facing car seat in the back seat of the vehicle
• B) Forward-facing car seat in the front passenger seat
• C) Forward-facing car seat in the back seat
• D) Booster seat with a lap and shoulder belt
Correct Answer: A) Rear-facing car seat in the back seat of the vehicle
AAP guidelines recommend that infants and toddlers remain in a rear-facing car seat in the back seat until
they reach the maximum weight or height limit allowed by their seat (at least until age 2).
Question 8
A mother asks when she can safely introduce solid foods to her exclusively breastfed 3-month-
old infant. What is the nurse's best advice?
• A) Start cereal immediately to help the infant sleep through the night
• B) Wait until approximately 6 months of age when the tongue-extrusion reflex disappears
• C) Introduce whole cow's milk mixed with pureed meats at 4 months
• D) Begin solid foods as soon as the infant doubles their birth weight at 2 months
Correct Answer: B) Wait until approximately 6 months of age when the tongue-extrusion reflex disappears
Exclusive breastfeeding is recommended for the first 6 months. Solid foods are introduced around 6 months
when gastrointestinal maturation occurs and the infant loses the protective extrusion reflex.
Question 9
Which primitive reflex disappears around 4 months of age and is tested by turning the infant's
head to one side while supine, causing extension of the arm on that side and flexion of the
opposite arm?
• A) Tonic neck reflex (Fencer position)
• B) Babinski reflex
• C) Plantar grasp reflex
• D) Rooting reflex
Correct Answer: A) Tonic neck reflex (Fencer position)
The tonic neck reflex appears at birth and fades by 3–4 months. Persistence beyond 6 months indicates
potential central nervous system dysfunction or cerebral palsy.
Question 10
At what age should a child be able to stack a tower of four blocks, scribble spontaneously, and
use a spoon with minimal spilling?
• A) 12 months
• B) 18 months
• C) 36 months
• D) 48 months
Correct Answer: B) 18 months
At 18 months, fine motor skills advance to permit building a 3- to 4-block tower, spontaneous scribbling, and
independent spoon feeding with improving coordination.
