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 — Milestones)
A 9-month-old infant is seen for a well-child visit. Which
developmental behavior is most appropriate for this age?
A. Uses a spoon to feed self without help.
B. Pulls to stand and may cruise along furniture.
C. Speaks in three-word sentences.
D. Rides a tricycle.
Correct answer: B
Rationale — Correct (B): Pulling to stand and cruising (walking
while holding furniture) is an expected gross motor milestone
around 9 months. This reflects increasing lower-extremity
,strength, balance, and object permanence development that
supports independent mobility soon after.
Rationale — Incorrect:
• A: Using a spoon independently is more typical of toddlers
(≈15–24 months); at 9 months infants may attempt self-
feeding but need assistance.
• C: Three-word sentences occur much later (around 2–3
years). At 9 months, babbling and simple approximations
of words occur.
• D: Riding a tricycle is a gross motor skill expected at about
3 years.
2. (Respiratory — Asthma: acute management)
A 7-year-old with moderate persistent asthma presents with
increased wheezing and dyspnea. The nurse administers
albuterol via nebulizer as ordered. Which outcome indicates
effective short-term bronchodilator therapy?
A. Decreased respiratory rate and improved air movement on
auscultation.
B. Lowered blood glucose level.
C. Decreased heart rate to baseline.
D. New coarse crackles in the lungs.
Correct answer: A
,Rationale — Correct (A): Effective bronchodilation from short-
acting beta-agonists typically decreases bronchospasm,
improving air movement and often reducing respiratory rate as
the child breathes easier. Assessment should focus on work of
breathing and lung sounds.
Rationale — Incorrect:
• B: Albuterol can cause hyperglycemia (not hypoglycemia)
due to beta-agonist effects on glycogenolysis; this is not a
desired therapeutic outcome.
• C: Albuterol often increases heart rate (tachycardia) as a
side effect; a decreased heart rate is not expected.
• D: Coarse crackles suggest fluid or alveolar consolidation,
not bronchodilation; they are not an expected sign of
effective therapy.
3. (Respiratory — Bronchiolitis/RSV)
A 6-month-old infant admitted with bronchiolitis is in the
emergency department. Which nursing action is highest
priority?
A. Encourage oral fluids.
B. Provide suctioning of the nares as needed.
C. Administer acetaminophen for fever.
D. Teach parents about RSV prevention.
Correct answer: B
, Rationale — Correct (B): Infants with bronchiolitis have small
airways and prominent nasal obstruction — they are obligate
nose breathers. Suctioning to maintain a patent airway and
adequate oxygenation is the immediate priority for respiratory
distress and feeding ability.
Rationale — Incorrect:
• A: Oral fluids are important but cannot be given safely if
airway patency is compromised.
• C: Treating fever is supportive but less urgent than
maintaining airway and oxygenation.
• D: Parent teaching is important but secondary to
immediate nursing interventions to preserve airway and
oxygenation.
4. (Cardiac — Congenital Heart Disease)
A 3-month-old infant with a large ventricular septal defect
(VSD) is on the cardiac unit. Which sign indicates that
congestive heart failure (CHF) may be developing?
A. Weight gain and increased urine output.
B. Poor feeding, tachypnea, and hepatomegaly.
C. Decreased respiratory rate and improved activity tolerance.
D. Decreased heart rate and flushed skin.
Correct answer: B
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1. (Growth & Development — Milestones)
A 9-month-old infant is seen for a well-child visit. Which
developmental behavior is most appropriate for this age?
A. Uses a spoon to feed self without help.
B. Pulls to stand and may cruise along furniture.
C. Speaks in three-word sentences.
D. Rides a tricycle.
Correct answer: B
Rationale — Correct (B): Pulling to stand and cruising (walking
while holding furniture) is an expected gross motor milestone
around 9 months. This reflects increasing lower-extremity
,strength, balance, and object permanence development that
supports independent mobility soon after.
Rationale — Incorrect:
• A: Using a spoon independently is more typical of toddlers
(≈15–24 months); at 9 months infants may attempt self-
feeding but need assistance.
• C: Three-word sentences occur much later (around 2–3
years). At 9 months, babbling and simple approximations
of words occur.
• D: Riding a tricycle is a gross motor skill expected at about
3 years.
2. (Respiratory — Asthma: acute management)
A 7-year-old with moderate persistent asthma presents with
increased wheezing and dyspnea. The nurse administers
albuterol via nebulizer as ordered. Which outcome indicates
effective short-term bronchodilator therapy?
A. Decreased respiratory rate and improved air movement on
auscultation.
B. Lowered blood glucose level.
C. Decreased heart rate to baseline.
D. New coarse crackles in the lungs.
Correct answer: A
,Rationale — Correct (A): Effective bronchodilation from short-
acting beta-agonists typically decreases bronchospasm,
improving air movement and often reducing respiratory rate as
the child breathes easier. Assessment should focus on work of
breathing and lung sounds.
Rationale — Incorrect:
• B: Albuterol can cause hyperglycemia (not hypoglycemia)
due to beta-agonist effects on glycogenolysis; this is not a
desired therapeutic outcome.
• C: Albuterol often increases heart rate (tachycardia) as a
side effect; a decreased heart rate is not expected.
• D: Coarse crackles suggest fluid or alveolar consolidation,
not bronchodilation; they are not an expected sign of
effective therapy.
3. (Respiratory — Bronchiolitis/RSV)
A 6-month-old infant admitted with bronchiolitis is in the
emergency department. Which nursing action is highest
priority?
A. Encourage oral fluids.
B. Provide suctioning of the nares as needed.
C. Administer acetaminophen for fever.
D. Teach parents about RSV prevention.
Correct answer: B
, Rationale — Correct (B): Infants with bronchiolitis have small
airways and prominent nasal obstruction — they are obligate
nose breathers. Suctioning to maintain a patent airway and
adequate oxygenation is the immediate priority for respiratory
distress and feeding ability.
Rationale — Incorrect:
• A: Oral fluids are important but cannot be given safely if
airway patency is compromised.
• C: Treating fever is supportive but less urgent than
maintaining airway and oxygenation.
• D: Parent teaching is important but secondary to
immediate nursing interventions to preserve airway and
oxygenation.
4. (Cardiac — Congenital Heart Disease)
A 3-month-old infant with a large ventricular septal defect
(VSD) is on the cardiac unit. Which sign indicates that
congestive heart failure (CHF) may be developing?
A. Weight gain and increased urine output.
B. Poor feeding, tachypnea, and hepatomegaly.
C. Decreased respiratory rate and improved activity tolerance.
D. Decreased heart rate and flushed skin.
Correct answer: B
