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 (6 months)
Stem: A 6-month-old infant is brought to the well-child clinic.
Which developmental behavior would the nurse expect to
observe at this age?
A. Uses a pincer grasp to pick up small objects.
B. Sits unsupported and transfers objects hand to hand.
C. Says 2–3 word phrases and follows one-step commands.
D. Walks independently and stacks two blocks.
Correct Answer: B
Rationale (correct): By about 6 months infants typically sit
unsupported and begin transferring objects hand to hand — key
sensorimotor milestones (improved trunk control and bilateral
,coordination). This reflects motor and cognitive development
(exploration via grasp and transfer).
Rationale (incorrect):
A — Pincer grasp emerges later, around 9–12 months, not
reliably by 6 months.
C — Two-word phrases and consistent following of one-step
verbal commands are typically seen in toddlers (≈24 months for
2-word phrases; receptive language earlier).
D — Walking independently and block stacking are usually
around 12+ months (walking) and 15–18 months (stacking
simple towers), not at 6 months.
Test plan focus: Growth & development; Health Promotion and
Maintenance.
2 — Growth & Development (2 years)
Stem: A parent asks what to expect from their 2-year-old.
Which is an appropriate developmental milestone for a healthy
2-year-old?
A. Builds a tower of 6–8 blocks and knows colors.
B. Uses 2- to 3-word phrases, runs, and begins parallel play.
C. Skips on one foot and ties shoes.
D. Writes simple letters and reads simple words.
Correct Answer: B
Rationale (correct): At 2 years children typically use 2- to 3-
word phrases, can run, and engage in parallel play (play beside,
,not yet with, peers). These reflect language, gross motor, and
social development for this age.
Rationale (incorrect):
A — Building a tower of 6–8 blocks and reliable color
recognition is more consistent with preschool ages (3–4 years).
C — Skipping and shoe-tying are later preschool/early school-
age skills (≈4–6 years).
D — Letter writing/reading emerges in preschool to early school
age (4–6 years).
Test plan focus: Growth & development; Health Promotion and
Maintenance.
3 — Growth & Development (4 years)
Stem: During a 4-year well visit the nurse assesses motor skills.
Which task, if performed by the child, indicates an expected 4-
year milestone?
A. Hop on one foot and use scissors to cut out a simple shape.
B. Walk up stairs one foot per step and pincer grasp.
C. Ride a two-wheeled bike without training wheels.
D. Tie shoelaces independently and count to 20.
Correct Answer: A
Rationale (correct): At about 4 years, children typically can hop
on one foot and use scissors to cut simple shapes, reflecting
improved balance and fine motor coordination.
, Rationale (incorrect):
B — Walking up stairs with alternating feet typically occurs
around 2–3 years; pincer grasp is earlier (≈9–12 months).
C — Riding a two-wheeled bike is generally mastered later (≈5–
7 years) after balance skills develop.
D — Independent shoelace tying and counting to 20 happen at
later preschool/early school age.
Test plan focus: Growth & development.
4 — Asthma (acute)
Stem: A 7-year-old with asthma arrives to the ED with increased
work of breathing, audibly wheezing, and O₂ saturation 90% on
room air. Which intervention should the nurse anticipate as
highest priority?
A. Administer oral corticosteroid and discharge with follow-up.
B. Begin nebulized short-acting beta-2 agonist (albuterol)
treatments and give supplemental oxygen.
C. Teach use of peak flow meter and action plan before any
medications.
D. Request chest x-ray to rule out pneumonia prior to
treatment.
Correct Answer: B
Rationale (correct): In acute asthma exacerbation, rapid
bronchodilation (nebulized short-acting beta-2 agonist) and
oxygen to correct hypoxia are immediate priorities to relieve
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1 — Growth & Development (6 months)
Stem: A 6-month-old infant is brought to the well-child clinic.
Which developmental behavior would the nurse expect to
observe at this age?
A. Uses a pincer grasp to pick up small objects.
B. Sits unsupported and transfers objects hand to hand.
C. Says 2–3 word phrases and follows one-step commands.
D. Walks independently and stacks two blocks.
Correct Answer: B
Rationale (correct): By about 6 months infants typically sit
unsupported and begin transferring objects hand to hand — key
sensorimotor milestones (improved trunk control and bilateral
,coordination). This reflects motor and cognitive development
(exploration via grasp and transfer).
Rationale (incorrect):
A — Pincer grasp emerges later, around 9–12 months, not
reliably by 6 months.
C — Two-word phrases and consistent following of one-step
verbal commands are typically seen in toddlers (≈24 months for
2-word phrases; receptive language earlier).
D — Walking independently and block stacking are usually
around 12+ months (walking) and 15–18 months (stacking
simple towers), not at 6 months.
Test plan focus: Growth & development; Health Promotion and
Maintenance.
2 — Growth & Development (2 years)
Stem: A parent asks what to expect from their 2-year-old.
Which is an appropriate developmental milestone for a healthy
2-year-old?
A. Builds a tower of 6–8 blocks and knows colors.
B. Uses 2- to 3-word phrases, runs, and begins parallel play.
C. Skips on one foot and ties shoes.
D. Writes simple letters and reads simple words.
Correct Answer: B
Rationale (correct): At 2 years children typically use 2- to 3-
word phrases, can run, and engage in parallel play (play beside,
,not yet with, peers). These reflect language, gross motor, and
social development for this age.
Rationale (incorrect):
A — Building a tower of 6–8 blocks and reliable color
recognition is more consistent with preschool ages (3–4 years).
C — Skipping and shoe-tying are later preschool/early school-
age skills (≈4–6 years).
D — Letter writing/reading emerges in preschool to early school
age (4–6 years).
Test plan focus: Growth & development; Health Promotion and
Maintenance.
3 — Growth & Development (4 years)
Stem: During a 4-year well visit the nurse assesses motor skills.
Which task, if performed by the child, indicates an expected 4-
year milestone?
A. Hop on one foot and use scissors to cut out a simple shape.
B. Walk up stairs one foot per step and pincer grasp.
C. Ride a two-wheeled bike without training wheels.
D. Tie shoelaces independently and count to 20.
Correct Answer: A
Rationale (correct): At about 4 years, children typically can hop
on one foot and use scissors to cut simple shapes, reflecting
improved balance and fine motor coordination.
, Rationale (incorrect):
B — Walking up stairs with alternating feet typically occurs
around 2–3 years; pincer grasp is earlier (≈9–12 months).
C — Riding a two-wheeled bike is generally mastered later (≈5–
7 years) after balance skills develop.
D — Independent shoelace tying and counting to 20 happen at
later preschool/early school age.
Test plan focus: Growth & development.
4 — Asthma (acute)
Stem: A 7-year-old with asthma arrives to the ED with increased
work of breathing, audibly wheezing, and O₂ saturation 90% on
room air. Which intervention should the nurse anticipate as
highest priority?
A. Administer oral corticosteroid and discharge with follow-up.
B. Begin nebulized short-acting beta-2 agonist (albuterol)
treatments and give supplemental oxygen.
C. Teach use of peak flow meter and action plan before any
medications.
D. Request chest x-ray to rule out pneumonia prior to
treatment.
Correct Answer: B
Rationale (correct): In acute asthma exacerbation, rapid
bronchodilation (nebulized short-acting beta-2 agonist) and
oxygen to correct hypoxia are immediate priorities to relieve
