NACE Care of the Child Exam
120 Multiple-Choice Questions with Answers and Rationales
1. A nurse assesses a 6-month-old infant. Which developmental milestone
is expected at this age?
A. Walks while holding furniture
B. Says "mama" with meaning
C. Uses a neat pincer grasp
D. Rolls from back to abdomen and abdomen to back
Answer: D. Rolls from back to abdomen and abdomen to back
Rationale: By about 6 months infants roll in both directions. Cruising, meaningful
words and the pincer grasp appear at roughly 9 to 12 months.
2. Which finding best indicates that a 5-month-old infant is ready to begin
solid foods?
A. Extrusion reflex has diminished and the infant sits with support
B. Infant is able to drink from a cup
C. Infant has cut the first tooth
D. Infant sleeps through the night
Answer: A. Extrusion reflex has diminished and the infant sits with support
Rationale: Readiness for solids includes loss of the tongue-extrusion reflex, head
control and sitting with support. Cup drinking, teeth and sleep patterns are not
readiness cues.
Page 1
,3. A 9-month-old looks for a toy that was hidden under a blanket. This
behavior demonstrates which Piaget concept?
A. Egocentrism
B. Conservation
C. Object permanence
D. Magical thinking
Answer: C. Object permanence
Rationale: Object permanence, the understanding that objects exist when out of
sight, develops late in the sensorimotor stage (about 8 to 12 months).
4. A 2-year-old repeatedly says "no" and insists on dressing himself. Which
response by the nurse is best?
A. Insist that the parent dress him quickly
B. Offer limited choices, such as which shirt to wear
C. Ignore the behavior until he stops
D. Punish the refusal with a time-out each time
Answer: B. Offer limited choices, such as which shirt to wear
Rationale: Toddlers are in Erikson's autonomy versus shame and doubt stage.
Offering limited choices supports independence while keeping the child safe and
cooperative.
5. A hospitalized 4-year-old says, "I am sick because I was bad." What is the
nurse's best response?
A. "You are right, so you need to behave better."
B. "Do not say that. It is silly."
C. "Let's talk about this when you are older."
D. "Being sick is not a punishment. Nothing you did or thought made you sick."
Answer: D. "Being sick is not a punishment. Nothing you did or thought
made you sick."
Rationale: Preschoolers use magical thinking and may believe illness is
punishment. The nurse corrects the misconception with simple, reassuring words.
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,6. Which activity is most appropriate for a hospitalized 8-year-old to
support the developmental task of industry?
A. Rocking and cuddling with a soft toy
B. Playing alone with a rattle
C. Watching television all day
D. Building a model and completing a craft project
Answer: D. Building a model and completing a craft project
Rationale: School-age children (industry versus inferiority) benefit from tasks that
give a sense of accomplishment, such as crafts, models and games with rules.
7. A hospitalized 15-year-old refuses to take part in care and asks to be left
alone. Which nursing action is most appropriate?
A. Tell the teen that parents will make all decisions
B. Provide privacy, explain procedures and involve the teen in decisions
C. Schedule all care without discussion
D. Place the teen in a room with young children
Answer: B. Provide privacy, explain procedures and involve the teen in
decisions
Rationale: Adolescents value privacy, autonomy and peer identity. Involving
them in decisions improves cooperation.
8. A toddler admitted for several days stays withdrawn, cries quietly and
shows little interest in play. Which stage of separation anxiety is this?
A. Protest
B. Detachment
C. Adaptation
D. Despair
Answer: D. Despair
Rationale: The despair stage is marked by sadness, withdrawal and apathy.
Protest involves loud crying and searching, and detachment appears as apparent
calm with loss of attachment.
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, 9. At what age is a mature pincer grasp expected?
A. 2 to 3 months
B. 4 to 5 months
C. 15 to 18 months
D. 10 to 12 months
Answer: D. 10 to 12 months
Rationale: The neat pincer grasp (thumb and index finger) develops at about 9 to
12 months.
10. The nurse expects the anterior fontanel of an infant to close by what
age?
A. 12 to 18 months
B. 2 to 3 months
C. 4 to 6 months
D. 24 to 30 months
Answer: A. 12 to 18 months
Rationale: The anterior fontanel normally closes between 12 and 18 months,
while the posterior fontanel closes by about 2 to 3 months.
11. At what age does the posterior fontanel typically close?
A. 9 months
B. 2 to 3 months
C. 12 months
D. 18 months
Answer: B. 2 to 3 months
Rationale: The posterior fontanel is small and triangular and closes by 2 to 3
months of age.
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120 Multiple-Choice Questions with Answers and Rationales
1. A nurse assesses a 6-month-old infant. Which developmental milestone
is expected at this age?
A. Walks while holding furniture
B. Says "mama" with meaning
C. Uses a neat pincer grasp
D. Rolls from back to abdomen and abdomen to back
Answer: D. Rolls from back to abdomen and abdomen to back
Rationale: By about 6 months infants roll in both directions. Cruising, meaningful
words and the pincer grasp appear at roughly 9 to 12 months.
2. Which finding best indicates that a 5-month-old infant is ready to begin
solid foods?
A. Extrusion reflex has diminished and the infant sits with support
B. Infant is able to drink from a cup
C. Infant has cut the first tooth
D. Infant sleeps through the night
Answer: A. Extrusion reflex has diminished and the infant sits with support
Rationale: Readiness for solids includes loss of the tongue-extrusion reflex, head
control and sitting with support. Cup drinking, teeth and sleep patterns are not
readiness cues.
Page 1
,3. A 9-month-old looks for a toy that was hidden under a blanket. This
behavior demonstrates which Piaget concept?
A. Egocentrism
B. Conservation
C. Object permanence
D. Magical thinking
Answer: C. Object permanence
Rationale: Object permanence, the understanding that objects exist when out of
sight, develops late in the sensorimotor stage (about 8 to 12 months).
4. A 2-year-old repeatedly says "no" and insists on dressing himself. Which
response by the nurse is best?
A. Insist that the parent dress him quickly
B. Offer limited choices, such as which shirt to wear
C. Ignore the behavior until he stops
D. Punish the refusal with a time-out each time
Answer: B. Offer limited choices, such as which shirt to wear
Rationale: Toddlers are in Erikson's autonomy versus shame and doubt stage.
Offering limited choices supports independence while keeping the child safe and
cooperative.
5. A hospitalized 4-year-old says, "I am sick because I was bad." What is the
nurse's best response?
A. "You are right, so you need to behave better."
B. "Do not say that. It is silly."
C. "Let's talk about this when you are older."
D. "Being sick is not a punishment. Nothing you did or thought made you sick."
Answer: D. "Being sick is not a punishment. Nothing you did or thought
made you sick."
Rationale: Preschoolers use magical thinking and may believe illness is
punishment. The nurse corrects the misconception with simple, reassuring words.
Page 2
,6. Which activity is most appropriate for a hospitalized 8-year-old to
support the developmental task of industry?
A. Rocking and cuddling with a soft toy
B. Playing alone with a rattle
C. Watching television all day
D. Building a model and completing a craft project
Answer: D. Building a model and completing a craft project
Rationale: School-age children (industry versus inferiority) benefit from tasks that
give a sense of accomplishment, such as crafts, models and games with rules.
7. A hospitalized 15-year-old refuses to take part in care and asks to be left
alone. Which nursing action is most appropriate?
A. Tell the teen that parents will make all decisions
B. Provide privacy, explain procedures and involve the teen in decisions
C. Schedule all care without discussion
D. Place the teen in a room with young children
Answer: B. Provide privacy, explain procedures and involve the teen in
decisions
Rationale: Adolescents value privacy, autonomy and peer identity. Involving
them in decisions improves cooperation.
8. A toddler admitted for several days stays withdrawn, cries quietly and
shows little interest in play. Which stage of separation anxiety is this?
A. Protest
B. Detachment
C. Adaptation
D. Despair
Answer: D. Despair
Rationale: The despair stage is marked by sadness, withdrawal and apathy.
Protest involves loud crying and searching, and detachment appears as apparent
calm with loss of attachment.
Page 3
, 9. At what age is a mature pincer grasp expected?
A. 2 to 3 months
B. 4 to 5 months
C. 15 to 18 months
D. 10 to 12 months
Answer: D. 10 to 12 months
Rationale: The neat pincer grasp (thumb and index finger) develops at about 9 to
12 months.
10. The nurse expects the anterior fontanel of an infant to close by what
age?
A. 12 to 18 months
B. 2 to 3 months
C. 4 to 6 months
D. 24 to 30 months
Answer: A. 12 to 18 months
Rationale: The anterior fontanel normally closes between 12 and 18 months,
while the posterior fontanel closes by about 2 to 3 months.
11. At what age does the posterior fontanel typically close?
A. 9 months
B. 2 to 3 months
C. 12 months
D. 18 months
Answer: B. 2 to 3 months
Rationale: The posterior fontanel is small and triangular and closes by 2 to 3
months of age.
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