Pediatric Nursing NCLEX Review 2026-2027 : 200 Exam-
Style Practice Questions with Correct Answers and
Detailed Rationales for Nursing Students, RN, LPN,
NCLEX-RN, and NCLEX-PN Success
About this resource:
Welcome to Pediatric Nursing NCLEX Review 2026, a comprehensive study guide designed to help
nursing students master the pediatric content tested on the NCLEX-RN and NCLEX-PN. This resource
contains 200 exam-style practice questions covering the full spectrum of pediatric nursing, including
growth and development, assessment and vital signs, common childhood illnesses, respiratory and
cardiac disorders, gastrointestinal and nutritional conditions, neurological and musculoskeletal
disorders, endocrine and metabolic disorders, hematologic and immunologic disorders, pharmacology,
immunizations, and safety.
SECTION 1: GROWTH & DEVELOPMENT (Questions 1–25)
1. A nurse is assessing a 4-month-old infant during a well-child visit. Which developmental milestone
should the nurse expect the infant to have achieved?
A. Sitting without support
B. Rolling from back to abdomen
C. Pincer grasp
D. Walking with assistance
Rationale: At 4 months, infants typically begin rolling from back to abdomen. Sitting without support
occurs around 6–8 months, pincer grasp develops around 9–10 months, and walking with assistance
occurs around 12–15 months.
2. A nurse is providing anticipatory guidance to the parents of a 12-month-old infant. Which fine
motor skill should the nurse expect the infant to have achieved?
A. Building a tower of four blocks
B. Using a neat pincer grasp
C. Holding a crayon with a mature grasp
D. Turning pages of a book one at a time
Rationale: By 12 months, infants typically develop a neat pincer grasp. Building towers, holding
crayons with a mature grasp, and turning pages one at a time develop later.
,3. A nurse is evaluating the psychosocial development of a 4-year-old child according to Erikson.
Which crisis is the child primarily facing?
A. Autonomy versus shame and doubt
B. Initiative versus guilt
C. Industry versus inferiority
D. Identity versus role confusion
Rationale: According to Erikson, preschoolers (3–5 years) face the crisis of initiative versus guilt.
Autonomy versus shame and doubt is typical of toddlers (1–3 years), industry versus inferiority of
school-age children (6–12 years), and identity versus role confusion of adolescents.
4. A nurse is assessing a 9-month-old infant during a well-child visit. Which gross motor skill should
the nurse expect the infant to be able to perform?
A. Sitting without support
B. Creeping on hands and knees
C. Walking independently
D. Standing on one foot
Rationale: By 9 months, infants typically creep on hands and knees. Sitting without support occurs
around 6–8 months, walking independently around 12–15 months, and standing on one foot much
later.
5. A nurse is assessing a 2-year-old toddler. Which finding would be of greatest concern?
A. The anterior fontanel is still open
B. The child has a vocabulary of 10 words
C. The child can walk up stairs with assistance
D. The child can scribble spontaneously
Rationale: By age 2, toddlers typically have a vocabulary of 50 or more words and can combine two
words. A vocabulary of only 10 words would be concerning for language delay. The anterior fontanel
typically closes by 12–18 months; if still open at 2 years, this would also be abnormal.
6. A nurse is evaluating the developmental progression of a 6-month-old infant. Which milestone is
typically expected?
A. Walking independently
B. Speaking two-word sentences
C. Rolling from back to front
D. Building a tower of three blocks
,Rationale: By 6 months of age, most infants can roll from their back to their stomach and vice versa.
Independent walking usually occurs around 12–15 months, two-word sentences emerge near 18–24
months, and stacking blocks develops after 12 months.
7. A nurse is assessing a 3-year-old child. Which fine motor skill should the nurse expect?
A. Tying shoelaces
B. Copying a circle
C. Writing their first name
D. Using a fork independently
Rationale: A 3–4-year-old preschooler can ride a tricycle, copy a circle, use scissors, and dress with
assistance. Tying shoelaces and writing their first name are 5–6 year milestones.
8. The parent of a 15-month-old toddler asks the nurse about expected language development. Which
response by the nurse is correct?
A. The toddler should be able to speak in complete sentences
B. The toddler should have a vocabulary of about 4–6 words
C. The toddler should be able to name all body parts
D. The toddler should be able to recite the alphabet
Rationale: At 15 months, toddlers typically have a vocabulary of 4–6 words. Complete sentences
develop around 2–3 years. Naming body parts develops around 18–24 months.
9. A nurse is providing anticipatory guidance to the parents of a 7-year-old child. According to Erikson,
which developmental task is most appropriate for this child?
A. Developing trust
B. Developing autonomy
C. Developing a sense of industry
D. Developing identity
Rationale: School-age children (6–12 years) are in Erikson's stage of industry versus inferiority, where
they develop a sense of competence and achievement. Trust is developed in infancy, autonomy in
toddlerhood, and identity in adolescence.
10. A nurse is assessing a 4-year-old child's cognitive development according to Piaget. Which thinking
characteristic is typical of this age?
A. Abstract reasoning
B. Egocentrism
C. Hypothetical thinking
D. Formal operational thought
, Rationale: Preschoolers (2–7 years) are in Piaget's preoperational stage, characterized by
egocentrism, magical thinking, and inability to conserve. Abstract reasoning and hypothetical thinking
develop in the formal operational stage (adolescence).
11. A nurse is assessing a newborn's reflexes. Which reflex should disappear by 4 months of age?
A. Moro reflex
B. Babinski reflex
C. Grasp reflex
D. Rooting reflex
Rationale: The Moro (startle) reflex typically disappears by 4 months. The Babinski reflex may persist
up to 12 months. The grasp reflex disappears around 3–4 months, and the rooting reflex disappears
around 3–4 months as well.
12. A nurse is assessing a 10-month-old infant. Which developmental milestone should the nurse
expect?
A. Walking independently
B. Pulling to stand
C. Using a spoon
D. Saying "mama" and "dada" specifically
Rationale: By 10 months, infants typically pull to stand. Independent walking occurs around 12–15
months. Using a spoon develops around 12–18 months. Saying "mama" and "dada" specifically
typically occurs around 10–12 months, but pulling to stand is the more definitive milestone.
13. A nurse is providing education to parents of a 2-week-old infant about expected growth. What is
the expected pattern of weight gain in the first 6 months?
A. Birth weight doubles by 6 months
B. Birth weight triples by 6 months
C. Birth weight quadruples by 6 months
D. Birth weight remains the same
Rationale: Birth weight typically doubles by 6 months and triples by 12 months. This is an important
growth parameter for nurses to monitor.
14. A nurse is assessing an 18-month-old toddler. Which gross motor skill should the nurse expect?
A. Running
B. Walking up stairs with one hand held
C. Jumping with both feet
D. Standing on tiptoes
Style Practice Questions with Correct Answers and
Detailed Rationales for Nursing Students, RN, LPN,
NCLEX-RN, and NCLEX-PN Success
About this resource:
Welcome to Pediatric Nursing NCLEX Review 2026, a comprehensive study guide designed to help
nursing students master the pediatric content tested on the NCLEX-RN and NCLEX-PN. This resource
contains 200 exam-style practice questions covering the full spectrum of pediatric nursing, including
growth and development, assessment and vital signs, common childhood illnesses, respiratory and
cardiac disorders, gastrointestinal and nutritional conditions, neurological and musculoskeletal
disorders, endocrine and metabolic disorders, hematologic and immunologic disorders, pharmacology,
immunizations, and safety.
SECTION 1: GROWTH & DEVELOPMENT (Questions 1–25)
1. A nurse is assessing a 4-month-old infant during a well-child visit. Which developmental milestone
should the nurse expect the infant to have achieved?
A. Sitting without support
B. Rolling from back to abdomen
C. Pincer grasp
D. Walking with assistance
Rationale: At 4 months, infants typically begin rolling from back to abdomen. Sitting without support
occurs around 6–8 months, pincer grasp develops around 9–10 months, and walking with assistance
occurs around 12–15 months.
2. A nurse is providing anticipatory guidance to the parents of a 12-month-old infant. Which fine
motor skill should the nurse expect the infant to have achieved?
A. Building a tower of four blocks
B. Using a neat pincer grasp
C. Holding a crayon with a mature grasp
D. Turning pages of a book one at a time
Rationale: By 12 months, infants typically develop a neat pincer grasp. Building towers, holding
crayons with a mature grasp, and turning pages one at a time develop later.
,3. A nurse is evaluating the psychosocial development of a 4-year-old child according to Erikson.
Which crisis is the child primarily facing?
A. Autonomy versus shame and doubt
B. Initiative versus guilt
C. Industry versus inferiority
D. Identity versus role confusion
Rationale: According to Erikson, preschoolers (3–5 years) face the crisis of initiative versus guilt.
Autonomy versus shame and doubt is typical of toddlers (1–3 years), industry versus inferiority of
school-age children (6–12 years), and identity versus role confusion of adolescents.
4. A nurse is assessing a 9-month-old infant during a well-child visit. Which gross motor skill should
the nurse expect the infant to be able to perform?
A. Sitting without support
B. Creeping on hands and knees
C. Walking independently
D. Standing on one foot
Rationale: By 9 months, infants typically creep on hands and knees. Sitting without support occurs
around 6–8 months, walking independently around 12–15 months, and standing on one foot much
later.
5. A nurse is assessing a 2-year-old toddler. Which finding would be of greatest concern?
A. The anterior fontanel is still open
B. The child has a vocabulary of 10 words
C. The child can walk up stairs with assistance
D. The child can scribble spontaneously
Rationale: By age 2, toddlers typically have a vocabulary of 50 or more words and can combine two
words. A vocabulary of only 10 words would be concerning for language delay. The anterior fontanel
typically closes by 12–18 months; if still open at 2 years, this would also be abnormal.
6. A nurse is evaluating the developmental progression of a 6-month-old infant. Which milestone is
typically expected?
A. Walking independently
B. Speaking two-word sentences
C. Rolling from back to front
D. Building a tower of three blocks
,Rationale: By 6 months of age, most infants can roll from their back to their stomach and vice versa.
Independent walking usually occurs around 12–15 months, two-word sentences emerge near 18–24
months, and stacking blocks develops after 12 months.
7. A nurse is assessing a 3-year-old child. Which fine motor skill should the nurse expect?
A. Tying shoelaces
B. Copying a circle
C. Writing their first name
D. Using a fork independently
Rationale: A 3–4-year-old preschooler can ride a tricycle, copy a circle, use scissors, and dress with
assistance. Tying shoelaces and writing their first name are 5–6 year milestones.
8. The parent of a 15-month-old toddler asks the nurse about expected language development. Which
response by the nurse is correct?
A. The toddler should be able to speak in complete sentences
B. The toddler should have a vocabulary of about 4–6 words
C. The toddler should be able to name all body parts
D. The toddler should be able to recite the alphabet
Rationale: At 15 months, toddlers typically have a vocabulary of 4–6 words. Complete sentences
develop around 2–3 years. Naming body parts develops around 18–24 months.
9. A nurse is providing anticipatory guidance to the parents of a 7-year-old child. According to Erikson,
which developmental task is most appropriate for this child?
A. Developing trust
B. Developing autonomy
C. Developing a sense of industry
D. Developing identity
Rationale: School-age children (6–12 years) are in Erikson's stage of industry versus inferiority, where
they develop a sense of competence and achievement. Trust is developed in infancy, autonomy in
toddlerhood, and identity in adolescence.
10. A nurse is assessing a 4-year-old child's cognitive development according to Piaget. Which thinking
characteristic is typical of this age?
A. Abstract reasoning
B. Egocentrism
C. Hypothetical thinking
D. Formal operational thought
, Rationale: Preschoolers (2–7 years) are in Piaget's preoperational stage, characterized by
egocentrism, magical thinking, and inability to conserve. Abstract reasoning and hypothetical thinking
develop in the formal operational stage (adolescence).
11. A nurse is assessing a newborn's reflexes. Which reflex should disappear by 4 months of age?
A. Moro reflex
B. Babinski reflex
C. Grasp reflex
D. Rooting reflex
Rationale: The Moro (startle) reflex typically disappears by 4 months. The Babinski reflex may persist
up to 12 months. The grasp reflex disappears around 3–4 months, and the rooting reflex disappears
around 3–4 months as well.
12. A nurse is assessing a 10-month-old infant. Which developmental milestone should the nurse
expect?
A. Walking independently
B. Pulling to stand
C. Using a spoon
D. Saying "mama" and "dada" specifically
Rationale: By 10 months, infants typically pull to stand. Independent walking occurs around 12–15
months. Using a spoon develops around 12–18 months. Saying "mama" and "dada" specifically
typically occurs around 10–12 months, but pulling to stand is the more definitive milestone.
13. A nurse is providing education to parents of a 2-week-old infant about expected growth. What is
the expected pattern of weight gain in the first 6 months?
A. Birth weight doubles by 6 months
B. Birth weight triples by 6 months
C. Birth weight quadruples by 6 months
D. Birth weight remains the same
Rationale: Birth weight typically doubles by 6 months and triples by 12 months. This is an important
growth parameter for nurses to monitor.
14. A nurse is assessing an 18-month-old toddler. Which gross motor skill should the nurse expect?
A. Running
B. Walking up stairs with one hand held
C. Jumping with both feet
D. Standing on tiptoes
