Wong’s Nursing Care of Infants and Children, 12th Edition —
Chapter 1: Perspectives of Pediatric Nursing.
1 — Chapter 1 • Health Care for Children (Health Promotion)
Stem: A 4-year-old arrives for a well visit. The nurse’s priority
health promotion question is which of the following to assess
the child’s developmental trajectory? (≤65 words)
A. Current snack preferences
B. Ability to hop on one foot
C. Immunization history
D. Number of hours child watches screens daily
Correct Answer: B
Rationales:
• Correct (B): Gross motor skills like hopping on one foot are
age-appropriate developmental milestones to screen
developmental trajectory. (Wong, Ch. 1 — Health
Promotion & Development).
• A: Snack preferences inform nutrition, not primary
developmental screening.
• C: Immunizations are essential for prevention but not a
direct developmental milestone.
• D: Screen time is relevant to health promotion, but not as
direct a developmental cue as observed motor skill.
Teaching Point: Use age-based milestones to screen
development quickly.
,2 — Chapter 1 • Development (Clinical Judgment)
Stem: A 9-month-old infant shows persistent head lag when
pulled to sit. The nurse recognizes this may indicate:
A. Normal development for 9 months
B. Possible delay in motor development
C. Early signs of dental eruption problems
D. Nutritional iron overload
Correct Answer: B
Rationales:
• Correct (B): Head control typically stabilizes before 6
months; head lag at 9 months suggests motor delay
requiring further evaluation. (Wong, Ch. 1 —
Development).
• A: Head lag is not normal at 9 months.
• C: Dental eruption is unrelated to head control.
• D: Iron overload does not present as isolated head lag.
Teaching Point: Persistent head lag beyond 6 months warrants
developmental evaluation.
3 — Chapter 1 • Nutrition (Infant Nutrition)
Stem: A breastfeeding mother asks when to introduce solid
foods to her 5-month-old. The nurse’s best evidence-based
,reply is:
A. Start solids immediately; infant looks hungry.
B. Begin at about 6 months, when developmental readiness
appears.
C. Introduce solids only after first tooth erupts.
D. Delay solids until 9 months to prevent allergies.
Correct Answer: B
Rationales:
• Correct (B): Complementary solids are generally
recommended at ~6 months when the infant shows
readiness (sits with support, loss of tongue-thrust). (Wong,
Ch. 1 — Nutrition).
• A: Starting too early can increase aspiration/allergy risks.
• C: Tooth eruption is not the primary readiness cue.
• D: Delaying to 9 months lacks evidence and may impair
iron intake.
Teaching Point: Introduce solids around 6 months when
developmental cues appear.
4 — Chapter 1 • Oral Health (Prevention)
Stem: A nurse counseling parents about infant oral health
should emphasize:
A. Begin toothbrushing with fluoridated toothpaste at tooth
eruption.
, B. Wait until child can spit to use toothpaste.
C. Avoid fluoride until age 5.
D. Bottle propping is acceptable for sleep.
Correct Answer: A
Rationales:
• Correct (A): Start brushing with a smear of fluoridated
toothpaste at first tooth eruption to prevent early
childhood caries. (Wong, Ch. 1 — Oral Health).
• B: Waiting until spitting delays beneficial fluoride exposure.
• C: Avoiding fluoride until age 5 contradicts caries
prevention recommendations.
• D: Bottle propping increases risk of caries and aspiration; it
is unsafe.
Teaching Point: Begin early oral hygiene at first tooth eruption
with appropriate fluoride.
5 — Chapter 1 • Obesity & Type 2 Diabetes (Health
Promotion)
Stem: A school nurse identifies a 12-year-old with BMI at 98th
percentile and acanthosis nigricans. Priority nursing action:
A. Recommend immediate low-calorie diet without provider
follow-up
B. Screen for insulin resistance and coordinate primary care
referral
Chapter 1: Perspectives of Pediatric Nursing.
1 — Chapter 1 • Health Care for Children (Health Promotion)
Stem: A 4-year-old arrives for a well visit. The nurse’s priority
health promotion question is which of the following to assess
the child’s developmental trajectory? (≤65 words)
A. Current snack preferences
B. Ability to hop on one foot
C. Immunization history
D. Number of hours child watches screens daily
Correct Answer: B
Rationales:
• Correct (B): Gross motor skills like hopping on one foot are
age-appropriate developmental milestones to screen
developmental trajectory. (Wong, Ch. 1 — Health
Promotion & Development).
• A: Snack preferences inform nutrition, not primary
developmental screening.
• C: Immunizations are essential for prevention but not a
direct developmental milestone.
• D: Screen time is relevant to health promotion, but not as
direct a developmental cue as observed motor skill.
Teaching Point: Use age-based milestones to screen
development quickly.
,2 — Chapter 1 • Development (Clinical Judgment)
Stem: A 9-month-old infant shows persistent head lag when
pulled to sit. The nurse recognizes this may indicate:
A. Normal development for 9 months
B. Possible delay in motor development
C. Early signs of dental eruption problems
D. Nutritional iron overload
Correct Answer: B
Rationales:
• Correct (B): Head control typically stabilizes before 6
months; head lag at 9 months suggests motor delay
requiring further evaluation. (Wong, Ch. 1 —
Development).
• A: Head lag is not normal at 9 months.
• C: Dental eruption is unrelated to head control.
• D: Iron overload does not present as isolated head lag.
Teaching Point: Persistent head lag beyond 6 months warrants
developmental evaluation.
3 — Chapter 1 • Nutrition (Infant Nutrition)
Stem: A breastfeeding mother asks when to introduce solid
foods to her 5-month-old. The nurse’s best evidence-based
,reply is:
A. Start solids immediately; infant looks hungry.
B. Begin at about 6 months, when developmental readiness
appears.
C. Introduce solids only after first tooth erupts.
D. Delay solids until 9 months to prevent allergies.
Correct Answer: B
Rationales:
• Correct (B): Complementary solids are generally
recommended at ~6 months when the infant shows
readiness (sits with support, loss of tongue-thrust). (Wong,
Ch. 1 — Nutrition).
• A: Starting too early can increase aspiration/allergy risks.
• C: Tooth eruption is not the primary readiness cue.
• D: Delaying to 9 months lacks evidence and may impair
iron intake.
Teaching Point: Introduce solids around 6 months when
developmental cues appear.
4 — Chapter 1 • Oral Health (Prevention)
Stem: A nurse counseling parents about infant oral health
should emphasize:
A. Begin toothbrushing with fluoridated toothpaste at tooth
eruption.
, B. Wait until child can spit to use toothpaste.
C. Avoid fluoride until age 5.
D. Bottle propping is acceptable for sleep.
Correct Answer: A
Rationales:
• Correct (A): Start brushing with a smear of fluoridated
toothpaste at first tooth eruption to prevent early
childhood caries. (Wong, Ch. 1 — Oral Health).
• B: Waiting until spitting delays beneficial fluoride exposure.
• C: Avoiding fluoride until age 5 contradicts caries
prevention recommendations.
• D: Bottle propping increases risk of caries and aspiration; it
is unsafe.
Teaching Point: Begin early oral hygiene at first tooth eruption
with appropriate fluoride.
5 — Chapter 1 • Obesity & Type 2 Diabetes (Health
Promotion)
Stem: A school nurse identifies a 12-year-old with BMI at 98th
percentile and acanthosis nigricans. Priority nursing action:
A. Recommend immediate low-calorie diet without provider
follow-up
B. Screen for insulin resistance and coordinate primary care
referral
