Galen College of Nursing NUR 230 Exam 4:
Comprehensive Pediatric Nursing Review
(140 High-Yield Questions with Answers &
Rationales) – Growth & Development,
Respiratory, Cardiovascular, Gastrointestinal,
Renal, Endocrine, Hematologic, Oncologic
SECTION 1: GROWTH & DEVELOPMENT
1. A nurse is assessing a 6-month-old infant. Which developmental milestone
should the nurse expect the infant to demonstrate?
A. Rolling from stomach to back
B. Sitting without support
C. Transferring objects hand to hand
D. Pulling to a standing position
Answer: A
Rationale: Rolling from stomach to back is typically achieved by 4–6 months.
Sitting without support occurs at 8 months (B). Transferring objects hand to hand
occurs at 7 months (C). Pulling to stand occurs at 9–10 months (D).
2. A nurse is teaching parents about expected growth patterns. At what age
does an infant typically double their birth weight?
A. 3 months
B. 5 months
C. 6 months
D. 12 months
Answer: B
Rationale: Infants typically double their birth weight by 5 months (B). Tripling
occurs by 12 months (D). 3 months (A) is too early for doubling. 6 months (C) is
,when birth weight has typically doubled or slightly exceeded it, but 5 months is
the standard expected age.
3. A nurse is assessing a 2-year-old toddler. Which behavior indicates the
toddler is in Erikson's stage of autonomy vs. shame and doubt?
A. Crying when separated from parent
B. Saying "no" frequently and wanting to do things independently
C. Sharing toys with other children
D. Following simple two-step commands
Answer: B
Rationale: Autonomy vs. shame and doubt (1–3 years) is characterized by the
child asserting independence and saying "no" (B). Separation anxiety (A) is more
related to trust vs. mistrust. Sharing (C) is more characteristic of initiative vs. guilt
(preschool). Following commands (D) is a cognitive milestone, not psychosocial.
4. A nurse is calculating the expected weight of a 3-year-old child who weighed
7 lbs at birth. What is the expected weight?
A. 21 lbs
B. 28 lbs
C. 35 lbs
D. 42 lbs
Answer: B
Rationale: A child typically quadruples birth weight by 2–3 years. 7 lbs × 4 = 28 lbs
(B). 21 lbs (A) is triple birth weight (1 year). 35 lbs (C) is quintuple. 42 lbs (D) is
sextuple.
5. A nurse is assessing a 4-month-old infant's fine motor skills. Which finding
should the nurse expect?
A. Grasping a rattle voluntarily
B. Using a pincer grasp
,C. Scribbling with a crayon
D. Stacking two blocks
Answer: A
Rationale: Voluntary grasping of a rattle is expected at 3–4 months (A). Pincer
grasp (B) develops at 9–10 months. Scribbling (C) occurs at 12–15 months.
Stacking blocks (D) occurs at 15–18 months.
6. A nurse is evaluating a 5-year-old child's language development. Which
statement by the child indicates normal development?
A. "I goed to the park yesterday."
B. "Me want cookie."
C. "I don't know nothing."
D. "I sawed a big dog."
Answer: A
Rationale: Overgeneralization of grammar rules (e.g., "goed") is normal at 4–5
years (A). "Me want cookie" (B) is typical of a 2-year-old. Double negatives (C)
may persist but are less expected at 5. "Sawed" (D) is also overgeneralization, but
"goed" is more classic for this age. Both A and D are technically correct, but A is
the best answer as it is the most commonly tested.
7. A nurse is providing anticipatory guidance to parents of a 9-month-old infant.
Which safety instruction is priority?
A. "Place the infant in a forward-facing car seat."
B. "Remove small objects from the floor."
C. "Begin toilet training."
D. "Introduce whole milk."
Answer: B
Rationale: At 9 months, infants are crawling and putting objects in their mouths,
so removing small objects prevents choking (B). Forward-facing car seats (A) are
recommended at 2 years or when the child outgrows rear-facing. Toilet training
, (C) is not expected until 18–24 months. Whole milk (D) is introduced at 12
months.
8. A nurse is assessing a 12-month-old infant. Which finding requires further
evaluation?
A. Birth weight tripled
B. Uses a pincer grasp
C. Says 10–15 words
D. Walks independently
Answer: C
Rationale: A 12-month-old typically says 2–3 words with meaning, not 10–15 (C).
Tripled birth weight (A), pincer grasp (B), and walking independently (D) are all
expected at 12 months.
9. A nurse is teaching a parent about Piaget's cognitive development. Which
behavior indicates the sensorimotor stage?
A. Object permanence
B. Conservation
C. Egocentrism
D. Abstract thinking
Answer: A
Rationale: Object permanence is achieved during the sensorimotor stage (0–2
years) (A). Conservation (B) and egocentrism (C) are preoperational (2–7 years).
Abstract thinking (D) is formal operational (12+ years).
10. A nurse is assessing a 3-year-old child. Which gross motor skill should the
nurse expect?
A. Hopping on one foot
B. Riding a tricycle
Comprehensive Pediatric Nursing Review
(140 High-Yield Questions with Answers &
Rationales) – Growth & Development,
Respiratory, Cardiovascular, Gastrointestinal,
Renal, Endocrine, Hematologic, Oncologic
SECTION 1: GROWTH & DEVELOPMENT
1. A nurse is assessing a 6-month-old infant. Which developmental milestone
should the nurse expect the infant to demonstrate?
A. Rolling from stomach to back
B. Sitting without support
C. Transferring objects hand to hand
D. Pulling to a standing position
Answer: A
Rationale: Rolling from stomach to back is typically achieved by 4–6 months.
Sitting without support occurs at 8 months (B). Transferring objects hand to hand
occurs at 7 months (C). Pulling to stand occurs at 9–10 months (D).
2. A nurse is teaching parents about expected growth patterns. At what age
does an infant typically double their birth weight?
A. 3 months
B. 5 months
C. 6 months
D. 12 months
Answer: B
Rationale: Infants typically double their birth weight by 5 months (B). Tripling
occurs by 12 months (D). 3 months (A) is too early for doubling. 6 months (C) is
,when birth weight has typically doubled or slightly exceeded it, but 5 months is
the standard expected age.
3. A nurse is assessing a 2-year-old toddler. Which behavior indicates the
toddler is in Erikson's stage of autonomy vs. shame and doubt?
A. Crying when separated from parent
B. Saying "no" frequently and wanting to do things independently
C. Sharing toys with other children
D. Following simple two-step commands
Answer: B
Rationale: Autonomy vs. shame and doubt (1–3 years) is characterized by the
child asserting independence and saying "no" (B). Separation anxiety (A) is more
related to trust vs. mistrust. Sharing (C) is more characteristic of initiative vs. guilt
(preschool). Following commands (D) is a cognitive milestone, not psychosocial.
4. A nurse is calculating the expected weight of a 3-year-old child who weighed
7 lbs at birth. What is the expected weight?
A. 21 lbs
B. 28 lbs
C. 35 lbs
D. 42 lbs
Answer: B
Rationale: A child typically quadruples birth weight by 2–3 years. 7 lbs × 4 = 28 lbs
(B). 21 lbs (A) is triple birth weight (1 year). 35 lbs (C) is quintuple. 42 lbs (D) is
sextuple.
5. A nurse is assessing a 4-month-old infant's fine motor skills. Which finding
should the nurse expect?
A. Grasping a rattle voluntarily
B. Using a pincer grasp
,C. Scribbling with a crayon
D. Stacking two blocks
Answer: A
Rationale: Voluntary grasping of a rattle is expected at 3–4 months (A). Pincer
grasp (B) develops at 9–10 months. Scribbling (C) occurs at 12–15 months.
Stacking blocks (D) occurs at 15–18 months.
6. A nurse is evaluating a 5-year-old child's language development. Which
statement by the child indicates normal development?
A. "I goed to the park yesterday."
B. "Me want cookie."
C. "I don't know nothing."
D. "I sawed a big dog."
Answer: A
Rationale: Overgeneralization of grammar rules (e.g., "goed") is normal at 4–5
years (A). "Me want cookie" (B) is typical of a 2-year-old. Double negatives (C)
may persist but are less expected at 5. "Sawed" (D) is also overgeneralization, but
"goed" is more classic for this age. Both A and D are technically correct, but A is
the best answer as it is the most commonly tested.
7. A nurse is providing anticipatory guidance to parents of a 9-month-old infant.
Which safety instruction is priority?
A. "Place the infant in a forward-facing car seat."
B. "Remove small objects from the floor."
C. "Begin toilet training."
D. "Introduce whole milk."
Answer: B
Rationale: At 9 months, infants are crawling and putting objects in their mouths,
so removing small objects prevents choking (B). Forward-facing car seats (A) are
recommended at 2 years or when the child outgrows rear-facing. Toilet training
, (C) is not expected until 18–24 months. Whole milk (D) is introduced at 12
months.
8. A nurse is assessing a 12-month-old infant. Which finding requires further
evaluation?
A. Birth weight tripled
B. Uses a pincer grasp
C. Says 10–15 words
D. Walks independently
Answer: C
Rationale: A 12-month-old typically says 2–3 words with meaning, not 10–15 (C).
Tripled birth weight (A), pincer grasp (B), and walking independently (D) are all
expected at 12 months.
9. A nurse is teaching a parent about Piaget's cognitive development. Which
behavior indicates the sensorimotor stage?
A. Object permanence
B. Conservation
C. Egocentrism
D. Abstract thinking
Answer: A
Rationale: Object permanence is achieved during the sensorimotor stage (0–2
years) (A). Conservation (B) and egocentrism (C) are preoperational (2–7 years).
Abstract thinking (D) is formal operational (12+ years).
10. A nurse is assessing a 3-year-old child. Which gross motor skill should the
nurse expect?
A. Hopping on one foot
B. Riding a tricycle
