RELIAS PEDIATRIC A v1
54 Questions & Answers • 2026/2027
Edition
Comprehensive Pediatric Assessment Examination
Aligned with Relias Pediatric Assessment Standards, Pediatric Nursing Core Competencies, and Evidence-Based
Pediatric Clinical Guidelines (2026/2027 Edition)
Total Questions 54 Cognitive Level 25% Recall / 50% Application / 25% Analysis
Sections 6 Question Style 75% Scenario-Based / 25% Direct Knowledge
Format Multiple Choice (4 options, single best
Special
answer)
Inclusions 10 Med Calc / 10 Developmental / 8 Emergency
Instructions: For each question, select the single best answer. Rationales are provided with each question and reflect Relias
assessment methodology and current pediatric clinical standards.
Section 1: Pediatric Growth & Development
Developmental theories (Erikson, Piaget, Freud, Kohlberg) and age-specific milestones across infant, toddler, preschool,
school-age, and adolescent stages.
Q1: A 4-month-old infant is hospitalized for bronchiolitis. The parents are unable to
stay overnight due to work obligations. Based on Erikson's psychosocial theory,
which developmental conflict is most at risk for being compromised by this
separation?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust *[CORRECT]*
D. Industry vs. Inferiority
Correct Answer: C
Rationale: Erikson's infancy stage (birth-1 year) centers on Trust vs. Mistrust, where consistent
caregiving and responsive feeding build security. Hospitalization disrupts consistent caregivers;
without reliable nurturing, the infant may develop mistrust. Autonomy (toddler), Initiative
(preschool), and Industry (school-age) belong to later developmental stages.
Relias Pediatric Assessment Standards | Evidence-Based Clinical Guidelines 2026/2027 Pediatric Nursing Core Competency Examination
,RELIAS PEDIATRIC A v1 | 54 Questions & Answers | 2026/2027 Edition Page 2
Q2: A 3-year-old believes the moon follows her home at night. According to Piaget's
cognitive theory, which characteristic of the preoperational stage does this thinking
reflect?
A. Conservation
B. Animism *[CORRECT]*
C. Abstract reasoning
D. Reversibility
Correct Answer: B
Rationale: Animism, a hallmark of Piaget's preoperational stage (ages 2-7), attributes lifelike
qualities to inanimate objects such as the moon 'following' the child. Conservation and
reversibility emerge during concrete operations (age 7-11), while abstract reasoning belongs to
formal operations (age 12+).
Q3: According to Freud's psychosexual theory, which developmental conflict is
characteristic of the preschool-age child (ages 3-6)?
A. Oral stage - gratification through feeding
B. Anal stage - toilet training conflict
C. Phallic stage - Oedipus/Electra complex *[CORRECT]*
D. Latency stage - sexual drives dormant
Correct Answer: C
Rationale: Freud's phallic stage (ages 3-6) involves unconscious sexual attachment to the
opposite-sex parent and rivalry with the same-sex parent (Oedipus/Electra complex). The oral
stage spans birth-1 year, the anal stage 1-3 years (toilet training), and the latency stage 6-12
years (sexual drives dormant).
Q4: A 9-year-old tells the nurse, 'I don't cheat on tests because the teacher will give
me detention.' According to Kohlberg's moral development theory, which stage of
moral reasoning does this statement reflect?
A. Preconventional - punishment and obedience orientation *[CORRECT]*
B. Conventional - law and order orientation
C. Postconventional - social contract orientation
D. Universal ethical principle orientation
Correct Answer: A
Rationale: Avoiding behavior solely to escape punishment reflects Kohlberg's preconventional
Stage 1 (punishment-obedience), typical in children ages 4-10. Conventional reasoning (Stage 4:
law and order) follows rules because they are societal laws. Postconventional Stages 5-6 involve
social contracts and universal ethics, emerging in adolescence or adulthood.
Relias Pediatric Assessment Standards | Evidence-Based Clinical Guidelines 2026/2027 Pediatric Nursing Core Competency Examination
, RELIAS PEDIATRIC A v1 | 54 Questions & Answers | 2026/2027 Edition Page 3
Q5: A 15-year-old with newly diagnosed type 1 diabetes tells the nurse, 'I'm not
going to take my insulin at school because my friends will think I'm weird.' Which
Erikson developmental conflict is this adolescent struggling with?
A. Identity vs. Role Confusion *[CORRECT]*
B. Intimacy vs. Isolation
C. Industry vs. Inferiority
D. Generativity vs. Stagnation
Correct Answer: A
Rationale: Adolescence (ages 12-18) is characterized by Identity vs. Role Confusion, where peer
acceptance and self-image dominate decisions. Refusing insulin to fit in reflects identity struggles
with chronic illness. Intimacy vs. Isolation is a young adult task, Industry is school-age, and
Generativity is middle adulthood.
Q6: During a well-child visit, the nurse observes a 6-month-old infant. Which gross
motor milestone should the nurse expect the infant to have achieved by this age?
A. Sits without support *[CORRECT]*
B. Walks independently
C. Crawls on hands and knees
D. Stands while holding onto furniture
Correct Answer: A
Rationale: Per CDC milestones, by 6 months most infants sit without support. Independent
walking typically occurs at 12-15 months, crawling emerges around 9 months, and standing while
holding furniture (cruising) develops around 9-12 months. The other milestones occur later in
infancy or early toddlerhood.
Q7: A parent expresses concern that their 2-year-old child speaks only in two-word
phrases. Which response by the nurse is most appropriate?
A. Your child may need a speech-language evaluation immediately.
B. We should screen for autism spectrum disorder.
C. Most 2-year-olds should be speaking in full sentences.
D. Two-word phrases are a normal milestone for a 2-year-old. *[CORRECT]*
Correct Answer: D
Rationale: By age 2, children typically use 2-word phrases and have a vocabulary of
approximately 50 words. Two-word combinations (e.g., 'want milk') are age-appropriate. Speech
evaluation is warranted only when milestones are significantly delayed (no words by 18 months).
Full sentences typically emerge around age 3.
Relias Pediatric Assessment Standards | Evidence-Based Clinical Guidelines 2026/2027 Pediatric Nursing Core Competency Examination
54 Questions & Answers • 2026/2027
Edition
Comprehensive Pediatric Assessment Examination
Aligned with Relias Pediatric Assessment Standards, Pediatric Nursing Core Competencies, and Evidence-Based
Pediatric Clinical Guidelines (2026/2027 Edition)
Total Questions 54 Cognitive Level 25% Recall / 50% Application / 25% Analysis
Sections 6 Question Style 75% Scenario-Based / 25% Direct Knowledge
Format Multiple Choice (4 options, single best
Special
answer)
Inclusions 10 Med Calc / 10 Developmental / 8 Emergency
Instructions: For each question, select the single best answer. Rationales are provided with each question and reflect Relias
assessment methodology and current pediatric clinical standards.
Section 1: Pediatric Growth & Development
Developmental theories (Erikson, Piaget, Freud, Kohlberg) and age-specific milestones across infant, toddler, preschool,
school-age, and adolescent stages.
Q1: A 4-month-old infant is hospitalized for bronchiolitis. The parents are unable to
stay overnight due to work obligations. Based on Erikson's psychosocial theory,
which developmental conflict is most at risk for being compromised by this
separation?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust *[CORRECT]*
D. Industry vs. Inferiority
Correct Answer: C
Rationale: Erikson's infancy stage (birth-1 year) centers on Trust vs. Mistrust, where consistent
caregiving and responsive feeding build security. Hospitalization disrupts consistent caregivers;
without reliable nurturing, the infant may develop mistrust. Autonomy (toddler), Initiative
(preschool), and Industry (school-age) belong to later developmental stages.
Relias Pediatric Assessment Standards | Evidence-Based Clinical Guidelines 2026/2027 Pediatric Nursing Core Competency Examination
,RELIAS PEDIATRIC A v1 | 54 Questions & Answers | 2026/2027 Edition Page 2
Q2: A 3-year-old believes the moon follows her home at night. According to Piaget's
cognitive theory, which characteristic of the preoperational stage does this thinking
reflect?
A. Conservation
B. Animism *[CORRECT]*
C. Abstract reasoning
D. Reversibility
Correct Answer: B
Rationale: Animism, a hallmark of Piaget's preoperational stage (ages 2-7), attributes lifelike
qualities to inanimate objects such as the moon 'following' the child. Conservation and
reversibility emerge during concrete operations (age 7-11), while abstract reasoning belongs to
formal operations (age 12+).
Q3: According to Freud's psychosexual theory, which developmental conflict is
characteristic of the preschool-age child (ages 3-6)?
A. Oral stage - gratification through feeding
B. Anal stage - toilet training conflict
C. Phallic stage - Oedipus/Electra complex *[CORRECT]*
D. Latency stage - sexual drives dormant
Correct Answer: C
Rationale: Freud's phallic stage (ages 3-6) involves unconscious sexual attachment to the
opposite-sex parent and rivalry with the same-sex parent (Oedipus/Electra complex). The oral
stage spans birth-1 year, the anal stage 1-3 years (toilet training), and the latency stage 6-12
years (sexual drives dormant).
Q4: A 9-year-old tells the nurse, 'I don't cheat on tests because the teacher will give
me detention.' According to Kohlberg's moral development theory, which stage of
moral reasoning does this statement reflect?
A. Preconventional - punishment and obedience orientation *[CORRECT]*
B. Conventional - law and order orientation
C. Postconventional - social contract orientation
D. Universal ethical principle orientation
Correct Answer: A
Rationale: Avoiding behavior solely to escape punishment reflects Kohlberg's preconventional
Stage 1 (punishment-obedience), typical in children ages 4-10. Conventional reasoning (Stage 4:
law and order) follows rules because they are societal laws. Postconventional Stages 5-6 involve
social contracts and universal ethics, emerging in adolescence or adulthood.
Relias Pediatric Assessment Standards | Evidence-Based Clinical Guidelines 2026/2027 Pediatric Nursing Core Competency Examination
, RELIAS PEDIATRIC A v1 | 54 Questions & Answers | 2026/2027 Edition Page 3
Q5: A 15-year-old with newly diagnosed type 1 diabetes tells the nurse, 'I'm not
going to take my insulin at school because my friends will think I'm weird.' Which
Erikson developmental conflict is this adolescent struggling with?
A. Identity vs. Role Confusion *[CORRECT]*
B. Intimacy vs. Isolation
C. Industry vs. Inferiority
D. Generativity vs. Stagnation
Correct Answer: A
Rationale: Adolescence (ages 12-18) is characterized by Identity vs. Role Confusion, where peer
acceptance and self-image dominate decisions. Refusing insulin to fit in reflects identity struggles
with chronic illness. Intimacy vs. Isolation is a young adult task, Industry is school-age, and
Generativity is middle adulthood.
Q6: During a well-child visit, the nurse observes a 6-month-old infant. Which gross
motor milestone should the nurse expect the infant to have achieved by this age?
A. Sits without support *[CORRECT]*
B. Walks independently
C. Crawls on hands and knees
D. Stands while holding onto furniture
Correct Answer: A
Rationale: Per CDC milestones, by 6 months most infants sit without support. Independent
walking typically occurs at 12-15 months, crawling emerges around 9 months, and standing while
holding furniture (cruising) develops around 9-12 months. The other milestones occur later in
infancy or early toddlerhood.
Q7: A parent expresses concern that their 2-year-old child speaks only in two-word
phrases. Which response by the nurse is most appropriate?
A. Your child may need a speech-language evaluation immediately.
B. We should screen for autism spectrum disorder.
C. Most 2-year-olds should be speaking in full sentences.
D. Two-word phrases are a normal milestone for a 2-year-old. *[CORRECT]*
Correct Answer: D
Rationale: By age 2, children typically use 2-word phrases and have a vocabulary of
approximately 50 words. Two-word combinations (e.g., 'want milk') are age-appropriate. Speech
evaluation is warranted only when milestones are significantly delayed (no words by 18 months).
Full sentences typically emerge around age 3.
Relias Pediatric Assessment Standards | Evidence-Based Clinical Guidelines 2026/2027 Pediatric Nursing Core Competency Examination
