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
20 NCLEX/NGN Pediatric Questions (Professional test-bank
style)
1. (Growth & Development — Infant gross motor)
A 6-month-old infant is brought for a well visit. Which of the
following observed behaviors indicates age-appropriate gross
motor development at 6 months?
A. Sits unsupported for several seconds.
B. Pulls to stand and cruises along furniture.
C. Walks independently a few steps.
D. Copies a vertical line with a crayon.
Answer: A. Sits unsupported for several seconds.
Rationale — Correct (A): By 6 months infants commonly sit
with little or no support; this is an expected gross motor
,milestone and signals appropriate neuromuscular development
(CDC/AAP milestone guidance). Sitting unsupported is a safety
cue for caregivers (reduce fall risk, supervise). CDC+1
Rationale — Incorrect:
B (pulls to stand/cruises) is expected around 9–12 months; C
(walks independently) is typically ~12 months; D (copies a
vertical line) is a fine motor/graphic skill expected at preschool
age (~3–4 years). Choosing a later milestone would
overestimate the infant’s abilities and risk unsafe expectations.
2. (Growth & Development — Language)
A 15-month-old toddler is assessed in clinic. Which language
behavior is most consistent with age-expected development?
A. Uses 10–20 words and says single words to request items.
B. Uses three- to four-word sentences and asks “why?”
frequently.
C. Produces most speech sounds clearly for strangers to
understand.
D. Talks in complete paragraphs about imaginary events.
Answer: A. Uses 10–20 words and says single words to request
items.
Rationale — Correct (A): At ~15 months toddlers typically have
an expanding vocabulary and use single words to label or
request. This aligns with CDC/AAP milestones for 12–18
,months. Safety: recognizing typical language helps identify
communication deficits early. CDC+1
Rationale — Incorrect: B corresponds to preschool age (~3–4
years); C (speech clarity to strangers) occurs later (around age
3–4); D describes advanced narrative skills not expected at 15
months.
3. (Respiratory — Asthma rescue plan & caregiver teaching)
A 5-year-old with moderate persistent asthma is brought to the
ED for wheezing. After treatment with nebulized albuterol and
systemic corticosteroids, the child’s respiratory rate improves
but the caregiver asks about long-term daily medication. Which
explanation is best?
A. “Daily inhaled corticosteroids reduce airway inflammation
and prevent symptoms; use as prescribed even when symptoms
improve.”
B. “You only need daily medicines when the child is wheezing.”
C. “Daily oral steroids are safest for prevention.”
D. “Stopping all medicines once symptoms resolve reduces
medication side effects.”
Answer: A. “Daily inhaled corticosteroids reduce airway
inflammation and prevent symptoms; use as prescribed even
when symptoms improve.”
Rationale — Correct (A): Inhaled corticosteroids are first-line
controller therapy for persistent asthma; caregiver education
, should emphasize daily adherence to reduce inflammation,
exacerbations, and hospitalization risk. Safety: preventing
underuse reduces risk of severe exacerbations.
Rationale — Incorrect: B is incorrect — controller therapy is
preventive, not only during wheeze. C is unsafe — long-term
oral steroids carry systemic risks and are not routine for
maintenance. D risks relapse/exacerbation; abrupt
discontinuation of controllers without provider guidance is
unsafe.
4. (Respiratory — Bronchiolitis prioritization NGN style)
A 6-month-old with RSV bronchiolitis is admitted. Which
nursing assessment finding requires the highest priority
immediate intervention?
A. Respiratory rate 58/min with moderate intercostal
retractions.
B. Oxygen saturation (SpO₂) 88% on room air.
C. Nasal flaring with mild feeding intolerance.
D. A cough causing occasional emesis.
Answer: B. Oxygen saturation (SpO₂) 88% on room air.
Rationale — Correct (B): Hypoxemia (SpO₂ <90%) is an
immediate safety issue requiring prompt oxygen support—
highest priority per airway/oxygenation assessment. In infants
with bronchiolitis, maintaining adequate oxygenation prevents
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
20 NCLEX/NGN Pediatric Questions (Professional test-bank
style)
1. (Growth & Development — Infant gross motor)
A 6-month-old infant is brought for a well visit. Which of the
following observed behaviors indicates age-appropriate gross
motor development at 6 months?
A. Sits unsupported for several seconds.
B. Pulls to stand and cruises along furniture.
C. Walks independently a few steps.
D. Copies a vertical line with a crayon.
Answer: A. Sits unsupported for several seconds.
Rationale — Correct (A): By 6 months infants commonly sit
with little or no support; this is an expected gross motor
,milestone and signals appropriate neuromuscular development
(CDC/AAP milestone guidance). Sitting unsupported is a safety
cue for caregivers (reduce fall risk, supervise). CDC+1
Rationale — Incorrect:
B (pulls to stand/cruises) is expected around 9–12 months; C
(walks independently) is typically ~12 months; D (copies a
vertical line) is a fine motor/graphic skill expected at preschool
age (~3–4 years). Choosing a later milestone would
overestimate the infant’s abilities and risk unsafe expectations.
2. (Growth & Development — Language)
A 15-month-old toddler is assessed in clinic. Which language
behavior is most consistent with age-expected development?
A. Uses 10–20 words and says single words to request items.
B. Uses three- to four-word sentences and asks “why?”
frequently.
C. Produces most speech sounds clearly for strangers to
understand.
D. Talks in complete paragraphs about imaginary events.
Answer: A. Uses 10–20 words and says single words to request
items.
Rationale — Correct (A): At ~15 months toddlers typically have
an expanding vocabulary and use single words to label or
request. This aligns with CDC/AAP milestones for 12–18
,months. Safety: recognizing typical language helps identify
communication deficits early. CDC+1
Rationale — Incorrect: B corresponds to preschool age (~3–4
years); C (speech clarity to strangers) occurs later (around age
3–4); D describes advanced narrative skills not expected at 15
months.
3. (Respiratory — Asthma rescue plan & caregiver teaching)
A 5-year-old with moderate persistent asthma is brought to the
ED for wheezing. After treatment with nebulized albuterol and
systemic corticosteroids, the child’s respiratory rate improves
but the caregiver asks about long-term daily medication. Which
explanation is best?
A. “Daily inhaled corticosteroids reduce airway inflammation
and prevent symptoms; use as prescribed even when symptoms
improve.”
B. “You only need daily medicines when the child is wheezing.”
C. “Daily oral steroids are safest for prevention.”
D. “Stopping all medicines once symptoms resolve reduces
medication side effects.”
Answer: A. “Daily inhaled corticosteroids reduce airway
inflammation and prevent symptoms; use as prescribed even
when symptoms improve.”
Rationale — Correct (A): Inhaled corticosteroids are first-line
controller therapy for persistent asthma; caregiver education
, should emphasize daily adherence to reduce inflammation,
exacerbations, and hospitalization risk. Safety: preventing
underuse reduces risk of severe exacerbations.
Rationale — Incorrect: B is incorrect — controller therapy is
preventive, not only during wheeze. C is unsafe — long-term
oral steroids carry systemic risks and are not routine for
maintenance. D risks relapse/exacerbation; abrupt
discontinuation of controllers without provider guidance is
unsafe.
4. (Respiratory — Bronchiolitis prioritization NGN style)
A 6-month-old with RSV bronchiolitis is admitted. Which
nursing assessment finding requires the highest priority
immediate intervention?
A. Respiratory rate 58/min with moderate intercostal
retractions.
B. Oxygen saturation (SpO₂) 88% on room air.
C. Nasal flaring with mild feeding intolerance.
D. A cough causing occasional emesis.
Answer: B. Oxygen saturation (SpO₂) 88% on room air.
Rationale — Correct (B): Hypoxemia (SpO₂ <90%) is an
immediate safety issue requiring prompt oxygen support—
highest priority per airway/oxygenation assessment. In infants
with bronchiolitis, maintaining adequate oxygenation prevents
