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.
A 9-month-old infant is brought to the clinic. The parent reports
the infant began pulling to stand and using a pincer grasp over
the previous two weeks. Which additional developmental
milestone would you expect for this age?
A. Says two-word phrases (e.g., “more milk”)
B. Cruises around furniture and may say “mama/dada”
nonspecifically
C. Throws a ball overhand and pedals a tricycle
D. Copies a cross when shown
Answer: B
Rationale — Correct (B): At ~9 months infants commonly pull to
stand, cruise (move holding furniture), and say “mama/dada”
nonspecifically. These are appropriate gross motor and early
,language milestones for this age. Safety concept: expect
increased mobility → caregiver education about fall/aspiration
prevention.
Why A is incorrect: Two-word phrases typically emerge around
18–24 months.
Why C is incorrect: Overhand throwing and tricycle pedaling are
school-age/preschool skills (~3–5 years).
Why D is incorrect: Copying a cross is a later fine motor/visual-
motor skill (~4–5 years).
2.
A 3-year-old child is hospitalized after a febrile seizure. Which
nursing action best supports the child’s cognitive and
psychosocial development while hospitalized?
A. Encourage independent dressing and provide simple choices
(e.g., blue or red cup)
B. Provide detailed explanations of procedures using medical
terminology
C. Allow unrestricted access to electronic screens for distraction
D. Place the child in isolation to prevent stimulation
Answer: A
Rationale — Correct (A): Three-year-olds benefit from choices
and opportunities for independence; offering simple, concrete
choices supports autonomy and self-concept. This aligns with
,developmental needs (initiative vs guilt). Safety: supports
cooperation and reduces anxiety.
Why B is incorrect: Preschoolers need simple, concrete
explanations, not complex medical jargon.
Why C is incorrect: Unlimited screen time is not therapeutic
and can impede interaction; brief, age-appropriate activities are
better.
Why D is incorrect: Unnecessary isolation may increase fear;
isolation only if infection control requires it.
3.
A 4-year-old is admitted with asthma exacerbation. Which
observation best indicates the child is improving?
A. Respiratory rate increases from 28 to 36 breaths/minute
B. Use of accessory muscles decreases and wheezing is less
audible
C. Pulse oximetry stays at 88% on room air
D. The child’s speech becomes more labored and one-word
answers are given
Answer: B
Rationale — Correct (B): Decreased accessory muscle use and
decreased wheezing indicate lower work of breathing and
improved airway airflow. This reflects effective treatment
(bronchodilators/oxygen) and improved respiratory status.
, Why A is incorrect: RR increasing suggests worsening
respiratory distress in a child whose normal RR for 4 years is
lower; increased RR is not improvement.
Why C is incorrect: SpO₂ of 88% is hypoxemia; improvement
would show SpO₂ > 92% (depending on guidelines).
Why D is incorrect: More labored speech and one-word
answers indicate increased respiratory distress.
4.
A 2-month-old infant is seen for a well visit. Which milestone is
most appropriate to expect at this visit?
A. Sits unsupported for short periods
B. Begins to babble and social smile present
C. Walks with assistance
D. Uses a mature pincer grasp
Answer: B
Rationale — Correct (B): By 2 months infants typically display a
social smile and cooing/babbling begins. Developmental safety
teaching includes tummy time and immunization counseling.
Why A is incorrect: Sits unsupported usually occurs around 6
months.
Why C is incorrect: Walking with assistance is around 9–12
months.
Why D is incorrect: Mature pincer grasp emerges closer to 9–12
months.
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1.
A 9-month-old infant is brought to the clinic. The parent reports
the infant began pulling to stand and using a pincer grasp over
the previous two weeks. Which additional developmental
milestone would you expect for this age?
A. Says two-word phrases (e.g., “more milk”)
B. Cruises around furniture and may say “mama/dada”
nonspecifically
C. Throws a ball overhand and pedals a tricycle
D. Copies a cross when shown
Answer: B
Rationale — Correct (B): At ~9 months infants commonly pull to
stand, cruise (move holding furniture), and say “mama/dada”
nonspecifically. These are appropriate gross motor and early
,language milestones for this age. Safety concept: expect
increased mobility → caregiver education about fall/aspiration
prevention.
Why A is incorrect: Two-word phrases typically emerge around
18–24 months.
Why C is incorrect: Overhand throwing and tricycle pedaling are
school-age/preschool skills (~3–5 years).
Why D is incorrect: Copying a cross is a later fine motor/visual-
motor skill (~4–5 years).
2.
A 3-year-old child is hospitalized after a febrile seizure. Which
nursing action best supports the child’s cognitive and
psychosocial development while hospitalized?
A. Encourage independent dressing and provide simple choices
(e.g., blue or red cup)
B. Provide detailed explanations of procedures using medical
terminology
C. Allow unrestricted access to electronic screens for distraction
D. Place the child in isolation to prevent stimulation
Answer: A
Rationale — Correct (A): Three-year-olds benefit from choices
and opportunities for independence; offering simple, concrete
choices supports autonomy and self-concept. This aligns with
,developmental needs (initiative vs guilt). Safety: supports
cooperation and reduces anxiety.
Why B is incorrect: Preschoolers need simple, concrete
explanations, not complex medical jargon.
Why C is incorrect: Unlimited screen time is not therapeutic
and can impede interaction; brief, age-appropriate activities are
better.
Why D is incorrect: Unnecessary isolation may increase fear;
isolation only if infection control requires it.
3.
A 4-year-old is admitted with asthma exacerbation. Which
observation best indicates the child is improving?
A. Respiratory rate increases from 28 to 36 breaths/minute
B. Use of accessory muscles decreases and wheezing is less
audible
C. Pulse oximetry stays at 88% on room air
D. The child’s speech becomes more labored and one-word
answers are given
Answer: B
Rationale — Correct (B): Decreased accessory muscle use and
decreased wheezing indicate lower work of breathing and
improved airway airflow. This reflects effective treatment
(bronchodilators/oxygen) and improved respiratory status.
, Why A is incorrect: RR increasing suggests worsening
respiratory distress in a child whose normal RR for 4 years is
lower; increased RR is not improvement.
Why C is incorrect: SpO₂ of 88% is hypoxemia; improvement
would show SpO₂ > 92% (depending on guidelines).
Why D is incorrect: More labored speech and one-word
answers indicate increased respiratory distress.
4.
A 2-month-old infant is seen for a well visit. Which milestone is
most appropriate to expect at this visit?
A. Sits unsupported for short periods
B. Begins to babble and social smile present
C. Walks with assistance
D. Uses a mature pincer grasp
Answer: B
Rationale — Correct (B): By 2 months infants typically display a
social smile and cooing/babbling begins. Developmental safety
teaching includes tummy time and immunization counseling.
Why A is incorrect: Sits unsupported usually occurs around 6
months.
Why C is incorrect: Walking with assistance is around 9–12
months.
Why D is incorrect: Mature pincer grasp emerges closer to 9–12
months.
