SAUNDERS COMPREHENSIVE REVIEW FOR THE NCLEX-
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1) (Single-best-answer — Growth & Development)
A 9-month-old infant is brought to the clinic for a well-child
check. Which milestone finding is most appropriate for this
age?
A. Uses a spoon without help and says two to three words.
B. Stands alone briefly and uses a crude pincer grasp.
C. Balances on one foot for 2–3 seconds and copies a circle.
D. Walks up and down stairs alternating feet and skips.
Correct answer: B
Rationale:
• B (Correct): At 9 months infants typically pull to stand, may
stand briefly unsupported, and begin using a crude pincer
grasp (index finger and thumb approximating). This
matches expected gross and fine motor skills.
, • A (Incorrect): Independent spoon use and saying 2–3 clear
words is more consistent with 18–24 months (language)
and 15–18 months (self-feed).
• C (Incorrect): Balancing on one foot and copying a circle
are preschool/school-age skills (around 4 years for circle
copying).
• D (Incorrect): Alternating feet on stairs and skipping are
advanced gross motor skills (preschool to early school age)
and not expected at 9 months.
2) (Single-best-answer — Communication with Family)
A toddler’s mother is tearful and expresses guilt after her child’s
hospitalization for bronchiolitis. What is the nurse’s best initial
response?
A. “You mustn’t blame yourself; respiratory infections happen.”
B. “Tell me what happened and what you’re feeling right now.”
C. “I’ll call the physician to explain what caused the illness.”
D. “You should stop researching on the internet; it often makes
things worse.”
Correct answer: B
Rationale:
• B (Correct): Encourages the mother to express emotions
and provides a therapeutic listening opportunity. Open-
, ended, empathic, and developmentally appropriate for
family support.
• A (Incorrect): Although meant to reassure, it minimizes
feelings and blocks expression.
• C (Incorrect): Involving the physician may be appropriate
later for clinical questions, but it does not address the
mother’s immediate need for emotional support.
• D (Incorrect): Judgmental and not therapeutic; it dismisses
the family’s coping strategies.
3) (Case/NGN — Respiratory: Asthma, Prioritization)
A 7-year-old with moderate persistent asthma arrives at the ED
with increasing shortness of breath, audible wheezes,
respiratory rate 32/min, pulse 120, O₂ sat 92% on room air.
Which intervention should the nurse implement first?
A. Administer nebulized albuterol and ipratropium.
B. Begin IV corticosteroid therapy.
C. Obtain a peak expiratory flow rate (PEFR).
D. Provide high-flow oxygen via face mask.
Correct answer: A
Rationale:
• A (Correct): Rapid bronchodilation with nebulized short-
acting β₂ agonist (albuterol) is the immediate priority to
relieve bronchospasm and improve ventilation. Combining
, ipratropium may be appropriate for moderate–severe
exacerbations.
• B (Incorrect): Corticosteroids are important early but have
delayed onset—not the first immediate action for acute
bronchospasm.
• C (Incorrect): PEFR is useful for assessment but should not
delay treatment.
• D (Incorrect): Oxygen is indicated if hypoxemia is severe;
O₂ sat 92% is borderline but priority remains
bronchodilator therapy to correct ventilation-perfusion
mismatch. Supplemental O₂ may accompany
bronchodilator therapy if saturations drop.
4) (Calculation — Pediatric Dosage)
An infant weighs 12 kg. The physician orders amoxicillin 90
mg/kg/day PO divided q12h for otitis media. The suspension
available is 250 mg per 5 mL. What volume (mL) should the
nurse administer per dose? (Round to one decimal place.)
A. 5.4 mL
B. 10.8 mL
C. 21.6 mL
D. 43.2 mL
Correct answer: B
Rationale / Calculation:
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1) (Single-best-answer — Growth & Development)
A 9-month-old infant is brought to the clinic for a well-child
check. Which milestone finding is most appropriate for this
age?
A. Uses a spoon without help and says two to three words.
B. Stands alone briefly and uses a crude pincer grasp.
C. Balances on one foot for 2–3 seconds and copies a circle.
D. Walks up and down stairs alternating feet and skips.
Correct answer: B
Rationale:
• B (Correct): At 9 months infants typically pull to stand, may
stand briefly unsupported, and begin using a crude pincer
grasp (index finger and thumb approximating). This
matches expected gross and fine motor skills.
, • A (Incorrect): Independent spoon use and saying 2–3 clear
words is more consistent with 18–24 months (language)
and 15–18 months (self-feed).
• C (Incorrect): Balancing on one foot and copying a circle
are preschool/school-age skills (around 4 years for circle
copying).
• D (Incorrect): Alternating feet on stairs and skipping are
advanced gross motor skills (preschool to early school age)
and not expected at 9 months.
2) (Single-best-answer — Communication with Family)
A toddler’s mother is tearful and expresses guilt after her child’s
hospitalization for bronchiolitis. What is the nurse’s best initial
response?
A. “You mustn’t blame yourself; respiratory infections happen.”
B. “Tell me what happened and what you’re feeling right now.”
C. “I’ll call the physician to explain what caused the illness.”
D. “You should stop researching on the internet; it often makes
things worse.”
Correct answer: B
Rationale:
• B (Correct): Encourages the mother to express emotions
and provides a therapeutic listening opportunity. Open-
, ended, empathic, and developmentally appropriate for
family support.
• A (Incorrect): Although meant to reassure, it minimizes
feelings and blocks expression.
• C (Incorrect): Involving the physician may be appropriate
later for clinical questions, but it does not address the
mother’s immediate need for emotional support.
• D (Incorrect): Judgmental and not therapeutic; it dismisses
the family’s coping strategies.
3) (Case/NGN — Respiratory: Asthma, Prioritization)
A 7-year-old with moderate persistent asthma arrives at the ED
with increasing shortness of breath, audible wheezes,
respiratory rate 32/min, pulse 120, O₂ sat 92% on room air.
Which intervention should the nurse implement first?
A. Administer nebulized albuterol and ipratropium.
B. Begin IV corticosteroid therapy.
C. Obtain a peak expiratory flow rate (PEFR).
D. Provide high-flow oxygen via face mask.
Correct answer: A
Rationale:
• A (Correct): Rapid bronchodilation with nebulized short-
acting β₂ agonist (albuterol) is the immediate priority to
relieve bronchospasm and improve ventilation. Combining
, ipratropium may be appropriate for moderate–severe
exacerbations.
• B (Incorrect): Corticosteroids are important early but have
delayed onset—not the first immediate action for acute
bronchospasm.
• C (Incorrect): PEFR is useful for assessment but should not
delay treatment.
• D (Incorrect): Oxygen is indicated if hypoxemia is severe;
O₂ sat 92% is borderline but priority remains
bronchodilator therapy to correct ventilation-perfusion
mismatch. Supplemental O₂ may accompany
bronchodilator therapy if saturations drop.
4) (Calculation — Pediatric Dosage)
An infant weighs 12 kg. The physician orders amoxicillin 90
mg/kg/day PO divided q12h for otitis media. The suspension
available is 250 mg per 5 mL. What volume (mL) should the
nurse administer per dose? (Round to one decimal place.)
A. 5.4 mL
B. 10.8 mL
C. 21.6 mL
D. 43.2 mL
Correct answer: B
Rationale / Calculation:
