Pediatrics Final Practice Exam
1. The nurse is examining a 10-month-old boy who was born 10 weeks early. Which
finding is cause for concern?
A) The child has doubled his birth weight.
B) The child exhibits plantar grasp reflex.
C) The child's head circumference is 49.53 cm.
D) No primary teeth have erupted yet. ANS C
The child's head size is large for his adjusted age (7.5 months), which would be cause
for concern. The average head circumference of the full-term newborn is 35 cm (13.5
in). Head circumference increases about 10 cm from birth to 1 year (Levine, 2019).
Birth weight doubles by about 4 months of age. Plantar grasp reflex does not
disappear until 9 months adjusted age. Primary teeth may not erupt until 8 months
adjusted age.
2.The nurse is teaching a new mother about the drastic growth and developmental
changes her infant will experience in the first year of life. Which statement describes
a developmental milestone occurring in infancy?
A) By 6 months of age, the infant's brain weighs half that of the adult brain; at
age 12 months, the brain weighs 2.5 times what it did at birth.
B) Most infants triple their birth weight by 4 to 6 months of age and quadruple
their birth weight by the time they are 1 year old.
C) The head circumference increases rapidly during the first 6 months: the
average increase is about 1 in per month.
D) The heart triples in size over the first year of life; the average pulse rate
,decreases from 120 to 140 in the newborn to about 100 in the 1-year-old. ANS A
Feedback:
By 6 months of age, the infant's brain weighs half that of the adult brain; at age 12
months, the brain weighs 2.5 times what it did at birth. Most infants double their birth
weight by 4 to 6 months of age and triple their birth weight by the time they are 1
year old. The head circumference increases rapidly during the first 6 months: the
average increase is about 0.6 in (1.5 cm) per month. The heart doubles in size over
the first year of life. As the cardiovascular system matures, the average pulse rate
decreases from 120 to 140 in the newborn to about 100 in the 1-year-old.
3.The nurse is assessing the respiratory system of a newborn. Which anatomic
differences place the infant at risk for respiratory compromise? Select all that apply.
A) The nasal passages are narrower.
B) The trachea and chest wall are less compliant.
C) The bronchi and bronchioles are shorter and wider.
D) The larynx is more funnel shaped.
E) The tongue is smaller.
F) There are significantly fewer alveoli. ANS A, D, F
Feedback:
In comparison with the adult, in the infant, the nasal passages are narrower, the
trachea and chest wall are more compliant, the bronchi and bronchioles are shorter
and narrower, the larynx is more funnel shaped, the tongue is larger, and there are
significantly fewer alveoli. These anatomic differences place the infant at higher risk
for respiratory compromise. The respiratory system does not reach adult levels of
maturity until about 7 years of age.
,4.A new mother shows the nurse that her baby grasps her finger when she touches
the baby's palm. How might the nurse respond to this information?
A) "This is a primitive reflex known as the plantar grasp."
B) "This is a primitive reflex known as the palmar grasp."
C) "This is a protective reflex known as rooting."
D) "This is a protective reflex known as the Moro reflex." ANS B
Feedback:
Primitive reflexes are subcortical and involve a whole-body response. Selected
primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck,
plantar and palmar grasp, step, and Babinski. During the palmar grasp, the infant
reflexively grasps when the palm is touched. The plantar grasp occurs when the
infant reflexively grasps with the bottom of the foot when pressure is applied to the
plantar surface. The root reflex occurs when the infant's cheek is stroked and the
infant turns to that side, searching with mouth. The Moro reflex is displayed when
with sudden extension of the head, the arms abduct and move upward and the hands
form a "C."
5.Which reflex, if found in a 4-month-old infant, would cause the nurse to be
concerned?
A) Plantar grasp
B) Step
C) Babinski
D) Neck righting ANS B
Feedback:
, Appropriate appearance and disappearance of primitive reflexes, along with the
development of protective reflexes, indicates a healthy neurologic system. The step
reflex is a primitive reflex that appears at birth and disappears at 4 to 8 weeks of age.
The plantar grasp reflex is a primitive reflex that appears at birth and disappears at
about the age of 9 months. The Babinski reflex is a primitive reflex that appears at
birth and disappears around the age of 12 months. The neck righting reflex is a
protective reflex that appears around the age of 4 to 6 months and persists.
6.A new mother expresses concern to the nurse that her baby is crying and grunting
when passing stool. What is the nurse's best response to this observation?
A) "This is normal behavior for infants unless the stool passed is hard and dry."
B) "This is normal behavior for infants due to the immaturity of the
gastrointestinal system."
C) "This indicates a blockage in the intestine and must be reported to the
health care provider."
D) "This is normal behavior for infants unless the stool passed is black or
green." ANS A
Feedback:
Due to the immaturity of the gastrointestinal system, newborns and young infants
often grunt, strain, or cry while attempting to have a bowel movement. This is not of
concern unless the stool is hard and dry. Stool color and texture may change
depending on the foods that the infant is ingesting. Iron supplements may cause the
stool to appear black or very dark green.
7.The neonatal nurse assesses newborns for iron deficiency anemia. Which newborn
1. The nurse is examining a 10-month-old boy who was born 10 weeks early. Which
finding is cause for concern?
A) The child has doubled his birth weight.
B) The child exhibits plantar grasp reflex.
C) The child's head circumference is 49.53 cm.
D) No primary teeth have erupted yet. ANS C
The child's head size is large for his adjusted age (7.5 months), which would be cause
for concern. The average head circumference of the full-term newborn is 35 cm (13.5
in). Head circumference increases about 10 cm from birth to 1 year (Levine, 2019).
Birth weight doubles by about 4 months of age. Plantar grasp reflex does not
disappear until 9 months adjusted age. Primary teeth may not erupt until 8 months
adjusted age.
2.The nurse is teaching a new mother about the drastic growth and developmental
changes her infant will experience in the first year of life. Which statement describes
a developmental milestone occurring in infancy?
A) By 6 months of age, the infant's brain weighs half that of the adult brain; at
age 12 months, the brain weighs 2.5 times what it did at birth.
B) Most infants triple their birth weight by 4 to 6 months of age and quadruple
their birth weight by the time they are 1 year old.
C) The head circumference increases rapidly during the first 6 months: the
average increase is about 1 in per month.
D) The heart triples in size over the first year of life; the average pulse rate
,decreases from 120 to 140 in the newborn to about 100 in the 1-year-old. ANS A
Feedback:
By 6 months of age, the infant's brain weighs half that of the adult brain; at age 12
months, the brain weighs 2.5 times what it did at birth. Most infants double their birth
weight by 4 to 6 months of age and triple their birth weight by the time they are 1
year old. The head circumference increases rapidly during the first 6 months: the
average increase is about 0.6 in (1.5 cm) per month. The heart doubles in size over
the first year of life. As the cardiovascular system matures, the average pulse rate
decreases from 120 to 140 in the newborn to about 100 in the 1-year-old.
3.The nurse is assessing the respiratory system of a newborn. Which anatomic
differences place the infant at risk for respiratory compromise? Select all that apply.
A) The nasal passages are narrower.
B) The trachea and chest wall are less compliant.
C) The bronchi and bronchioles are shorter and wider.
D) The larynx is more funnel shaped.
E) The tongue is smaller.
F) There are significantly fewer alveoli. ANS A, D, F
Feedback:
In comparison with the adult, in the infant, the nasal passages are narrower, the
trachea and chest wall are more compliant, the bronchi and bronchioles are shorter
and narrower, the larynx is more funnel shaped, the tongue is larger, and there are
significantly fewer alveoli. These anatomic differences place the infant at higher risk
for respiratory compromise. The respiratory system does not reach adult levels of
maturity until about 7 years of age.
,4.A new mother shows the nurse that her baby grasps her finger when she touches
the baby's palm. How might the nurse respond to this information?
A) "This is a primitive reflex known as the plantar grasp."
B) "This is a primitive reflex known as the palmar grasp."
C) "This is a protective reflex known as rooting."
D) "This is a protective reflex known as the Moro reflex." ANS B
Feedback:
Primitive reflexes are subcortical and involve a whole-body response. Selected
primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck,
plantar and palmar grasp, step, and Babinski. During the palmar grasp, the infant
reflexively grasps when the palm is touched. The plantar grasp occurs when the
infant reflexively grasps with the bottom of the foot when pressure is applied to the
plantar surface. The root reflex occurs when the infant's cheek is stroked and the
infant turns to that side, searching with mouth. The Moro reflex is displayed when
with sudden extension of the head, the arms abduct and move upward and the hands
form a "C."
5.Which reflex, if found in a 4-month-old infant, would cause the nurse to be
concerned?
A) Plantar grasp
B) Step
C) Babinski
D) Neck righting ANS B
Feedback:
, Appropriate appearance and disappearance of primitive reflexes, along with the
development of protective reflexes, indicates a healthy neurologic system. The step
reflex is a primitive reflex that appears at birth and disappears at 4 to 8 weeks of age.
The plantar grasp reflex is a primitive reflex that appears at birth and disappears at
about the age of 9 months. The Babinski reflex is a primitive reflex that appears at
birth and disappears around the age of 12 months. The neck righting reflex is a
protective reflex that appears around the age of 4 to 6 months and persists.
6.A new mother expresses concern to the nurse that her baby is crying and grunting
when passing stool. What is the nurse's best response to this observation?
A) "This is normal behavior for infants unless the stool passed is hard and dry."
B) "This is normal behavior for infants due to the immaturity of the
gastrointestinal system."
C) "This indicates a blockage in the intestine and must be reported to the
health care provider."
D) "This is normal behavior for infants unless the stool passed is black or
green." ANS A
Feedback:
Due to the immaturity of the gastrointestinal system, newborns and young infants
often grunt, strain, or cry while attempting to have a bowel movement. This is not of
concern unless the stool is hard and dry. Stool color and texture may change
depending on the foods that the infant is ingesting. Iron supplements may cause the
stool to appear black or very dark green.
7.The neonatal nurse assesses newborns for iron deficiency anemia. Which newborn
