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 — Growth & Development (2 months)
A 2-month-old infant is brought to the clinic for well-child care.
Which milestone would the nurse expect to observe for a
healthy 2-month-old?
A. Sits unsupported for several seconds
B. Begins to babble (cooing), follows objects past midline, and
lifts head briefly when prone
C. Uses pincer grasp to pick up small objects
D. Uses two-word phrases
Correct answer: B
Rationale — Correct (B): At 2 months infants typically show
early social and motor milestones: cooing/babbling (vocalizes),
visually tracks past midline, and momentarily lifts head when
,prone. This reflects early gross motor and
social/communication development appropriate for 6–8 weeks.
Rationale — Incorrect:
• A: Sits unsupported occurs around 6 months — incorrect
age.
• C: Pincer grasp develops around 9–12 months.
• D: Two-word phrases occur in toddler/preschool years (≈2
years), not at 2 months.
Safety/development tie: Recognizing expected milestones
allows early identification of delays and timely referral
(developmental surveillance).
2 — Growth & Development (9 months)
Which skill indicates a 9-month-old is developing normally?
A. Cruises along furniture and says “mama/dada” specifically to
parents
B. Runs steadily and skips
C. Rides a tricycle independently
D. Copies simple drawings
Correct answer: A
Rationale — Correct (A): By 9 months many infants pull to
stand, cruise along furniture, and use specific mama/dada as
intentional words — appropriate for late infancy.
,Rationale — Incorrect:
• B: Running and skipping are preschool to early school-age
skills (≈3–5 years).
• C: Tricycle riding is ~3 years.
• D: Copying drawings is typically 3–4 years and later.
Safety/development tie: Encouraging safe exploration
(childproofing) is crucial as mobility increases.
3 — Respiratory (Bronchiolitis)
A 6-month-old with bronchiolitis is admitted with tachypnea,
retractions, and poor feeding. Which nursing action has highest
priority?
A. Encourage parents to hold infant to soothe
B. Offer oral liquids every 30 minutes
C. Monitor oxygen saturation and provide supplemental oxygen
to maintain age-appropriate SpO₂
D. Teach parents about RSV prevention for future seasons
Correct answer: C
Rationale — Correct (C): For bronchiolitis with respiratory
distress, maintaining adequate oxygenation is top priority.
Monitor SpO₂ and provide supplemental oxygen when below
the facility/age target (commonly <90–92% depending on
protocol). This supports tissue oxygenation and prevents
deterioration.
, Rationale — Incorrect:
• A: Soothing is appropriate but secondary to
airway/oxygenation needs.
• B: Poor feeding with tachypnea increases aspiration risk;
priority is airway/oxygenation stabilization — oral intake
may need modification (small frequent feeds, NG if
necessary).
• D: Education is important but not immediate priority when
infant is in respiratory distress.
Safety tie: Airway/oxygenation is always prioritized (ABCs) in
pediatric respiratory illness.
4 — Respiratory (Asthma): NGN-style case
Case: A 7-year-old with moderate persistent asthma arrives
with increased wheeze and audible expiratory wheezing;
respiratory rate 36, SpO₂ 94% on room air. Child is using
accessory muscles. Which action should the nurse implement
first?
A. Administer prescribed short-acting beta₂ agonist (albuterol)
via a spacer with mask
B. Start oral corticosteroid and schedule for later administration
C. Teach family about long-term control medications
D. Obtain a chest x-ray
Correct answer: A
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1 — Growth & Development (2 months)
A 2-month-old infant is brought to the clinic for well-child care.
Which milestone would the nurse expect to observe for a
healthy 2-month-old?
A. Sits unsupported for several seconds
B. Begins to babble (cooing), follows objects past midline, and
lifts head briefly when prone
C. Uses pincer grasp to pick up small objects
D. Uses two-word phrases
Correct answer: B
Rationale — Correct (B): At 2 months infants typically show
early social and motor milestones: cooing/babbling (vocalizes),
visually tracks past midline, and momentarily lifts head when
,prone. This reflects early gross motor and
social/communication development appropriate for 6–8 weeks.
Rationale — Incorrect:
• A: Sits unsupported occurs around 6 months — incorrect
age.
• C: Pincer grasp develops around 9–12 months.
• D: Two-word phrases occur in toddler/preschool years (≈2
years), not at 2 months.
Safety/development tie: Recognizing expected milestones
allows early identification of delays and timely referral
(developmental surveillance).
2 — Growth & Development (9 months)
Which skill indicates a 9-month-old is developing normally?
A. Cruises along furniture and says “mama/dada” specifically to
parents
B. Runs steadily and skips
C. Rides a tricycle independently
D. Copies simple drawings
Correct answer: A
Rationale — Correct (A): By 9 months many infants pull to
stand, cruise along furniture, and use specific mama/dada as
intentional words — appropriate for late infancy.
,Rationale — Incorrect:
• B: Running and skipping are preschool to early school-age
skills (≈3–5 years).
• C: Tricycle riding is ~3 years.
• D: Copying drawings is typically 3–4 years and later.
Safety/development tie: Encouraging safe exploration
(childproofing) is crucial as mobility increases.
3 — Respiratory (Bronchiolitis)
A 6-month-old with bronchiolitis is admitted with tachypnea,
retractions, and poor feeding. Which nursing action has highest
priority?
A. Encourage parents to hold infant to soothe
B. Offer oral liquids every 30 minutes
C. Monitor oxygen saturation and provide supplemental oxygen
to maintain age-appropriate SpO₂
D. Teach parents about RSV prevention for future seasons
Correct answer: C
Rationale — Correct (C): For bronchiolitis with respiratory
distress, maintaining adequate oxygenation is top priority.
Monitor SpO₂ and provide supplemental oxygen when below
the facility/age target (commonly <90–92% depending on
protocol). This supports tissue oxygenation and prevents
deterioration.
, Rationale — Incorrect:
• A: Soothing is appropriate but secondary to
airway/oxygenation needs.
• B: Poor feeding with tachypnea increases aspiration risk;
priority is airway/oxygenation stabilization — oral intake
may need modification (small frequent feeds, NG if
necessary).
• D: Education is important but not immediate priority when
infant is in respiratory distress.
Safety tie: Airway/oxygenation is always prioritized (ABCs) in
pediatric respiratory illness.
4 — Respiratory (Asthma): NGN-style case
Case: A 7-year-old with moderate persistent asthma arrives
with increased wheeze and audible expiratory wheezing;
respiratory rate 36, SpO₂ 94% on room air. Child is using
accessory muscles. Which action should the nurse implement
first?
A. Administer prescribed short-acting beta₂ agonist (albuterol)
via a spacer with mask
B. Start oral corticosteroid and schedule for later administration
C. Teach family about long-term control medications
D. Obtain a chest x-ray
Correct answer: A
