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NCLEX RN Exam Bank on Pediatric Growth
Monitoring and Immunization Protocols
Table of Contents
Subtopic 1: Pediatric Growth Parameters and Developmental Norms (Birth–Adolescence) 2
Subtopic 2: Pediatric Immunization Schedule (CDC Guidelines & Special Situations) ...... 10
Subtopic 3: Vaccine Storage, Handling, and Administration Guidelines ........................... 19
Subtopic 4: Adverse Events, Contraindications & Precautions in Pediatric Vaccination .... 27
Subtopic 5: Vaccine Storage, Handling, and Cold Chain Maintenance............................. 36
Subtopic 6: Live vs. Inactivated Vaccines—Storage, Administration & Contraindications
(Q101–Q120) .............................................................................................................. 44
Subtopic 7: Adverse Vaccine Reactions and Nursing Management ................................. 53
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Subtopic 1: Pediatric Growth Parameters and
Developmental Norms (Birth–Adolescence)
Question 1
A nurse is assessing the growth of a 6-month-old infant. Which of the following findings
indicates appropriate weight gain since birth?
A. Tripled birth weight
B. Doubled birth weight
C. Gained 10 pounds
D. Weighs 20 pounds
Correct Answer: B. Doubled birth weight
Rationale: Infants are expected to double their birth weight by 5–6 months and triple it by
12 months.
Question 2
Which of the following growth measurements is the most accurate indicator of chronic
malnutrition in children?
A. Weight-for-age
B. Weight-for-height
C. Height-for-age
D. BMI percentile
Correct Answer: C. Height-for-age
Rationale: Height-for-age reflects long-term nutritional status and can indicate chronic
malnutrition.
Question 3
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A 3-year-old child’s head circumference is being measured. At what age should head
circumference stop being routinely measured?
A. 6 years
B. 2 years
C. 4 years
D. 18 months
Correct Answer: B. 2 years
Rationale: Head circumference is routinely measured until 2 years old to monitor brain
growth and development.
Question 4
Which percentile range is considered normal on the pediatric growth chart?
A. 20th–50th percentile
B. 75th–100th percentile
C. 10th–90th percentile
D. 5th–95th percentile
Correct Answer: D. 5th–95th percentile
Rationale: Growth within the 5th to 95th percentile is generally considered normal for
children.
Question 5
A mother is concerned her 15-month-old son is not walking yet. What is the nurse’s best
response?
A. “You should contact a neurologist immediately.”
B. “Most children walk between 12–15 months; let's reassess at 18 months.”
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C. “Walking should start by 12 months, this is delayed.”
D. “It’s too early to expect walking.”
Correct Answer: B. “Most children walk between 12–15 months; let's reassess at 18
months.”
Rationale: Walking usually begins between 12–15 months; delay is assessed after 18
months.
Question 6
At what age should a child have a full set of 20 primary teeth?
A. 12 months
B. 30 months
C. 18 months
D. 3 years
Correct Answer: B. 30 months
Rationale: Most children have a complete set of 20 deciduous teeth by around 2.5 years (30
months).
Question 7
Which milestone is expected by 9 months of age?
A. Using a spoon
B. Sitting without support
C. Walking independently
D. Saying two-word sentences
Correct Answer: B. Sitting without support
NCLEX RN Exam Bank on Pediatric Growth
Monitoring and Immunization Protocols
Table of Contents
Subtopic 1: Pediatric Growth Parameters and Developmental Norms (Birth–Adolescence) 2
Subtopic 2: Pediatric Immunization Schedule (CDC Guidelines & Special Situations) ...... 10
Subtopic 3: Vaccine Storage, Handling, and Administration Guidelines ........................... 19
Subtopic 4: Adverse Events, Contraindications & Precautions in Pediatric Vaccination .... 27
Subtopic 5: Vaccine Storage, Handling, and Cold Chain Maintenance............................. 36
Subtopic 6: Live vs. Inactivated Vaccines—Storage, Administration & Contraindications
(Q101–Q120) .............................................................................................................. 44
Subtopic 7: Adverse Vaccine Reactions and Nursing Management ................................. 53
, 2
Subtopic 1: Pediatric Growth Parameters and
Developmental Norms (Birth–Adolescence)
Question 1
A nurse is assessing the growth of a 6-month-old infant. Which of the following findings
indicates appropriate weight gain since birth?
A. Tripled birth weight
B. Doubled birth weight
C. Gained 10 pounds
D. Weighs 20 pounds
Correct Answer: B. Doubled birth weight
Rationale: Infants are expected to double their birth weight by 5–6 months and triple it by
12 months.
Question 2
Which of the following growth measurements is the most accurate indicator of chronic
malnutrition in children?
A. Weight-for-age
B. Weight-for-height
C. Height-for-age
D. BMI percentile
Correct Answer: C. Height-for-age
Rationale: Height-for-age reflects long-term nutritional status and can indicate chronic
malnutrition.
Question 3
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A 3-year-old child’s head circumference is being measured. At what age should head
circumference stop being routinely measured?
A. 6 years
B. 2 years
C. 4 years
D. 18 months
Correct Answer: B. 2 years
Rationale: Head circumference is routinely measured until 2 years old to monitor brain
growth and development.
Question 4
Which percentile range is considered normal on the pediatric growth chart?
A. 20th–50th percentile
B. 75th–100th percentile
C. 10th–90th percentile
D. 5th–95th percentile
Correct Answer: D. 5th–95th percentile
Rationale: Growth within the 5th to 95th percentile is generally considered normal for
children.
Question 5
A mother is concerned her 15-month-old son is not walking yet. What is the nurse’s best
response?
A. “You should contact a neurologist immediately.”
B. “Most children walk between 12–15 months; let's reassess at 18 months.”
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C. “Walking should start by 12 months, this is delayed.”
D. “It’s too early to expect walking.”
Correct Answer: B. “Most children walk between 12–15 months; let's reassess at 18
months.”
Rationale: Walking usually begins between 12–15 months; delay is assessed after 18
months.
Question 6
At what age should a child have a full set of 20 primary teeth?
A. 12 months
B. 30 months
C. 18 months
D. 3 years
Correct Answer: B. 30 months
Rationale: Most children have a complete set of 20 deciduous teeth by around 2.5 years (30
months).
Question 7
Which milestone is expected by 9 months of age?
A. Using a spoon
B. Sitting without support
C. Walking independently
D. Saying two-word sentences
Correct Answer: B. Sitting without support
