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
Question 1 — Growth & Development (Infant)
A 6-month-old infant is brought to the clinic for a well-child
check. Which milestone is developmentally expected at this
age?
A. Uses a mature pincer grasp to feed self finger foods.
B. Sits unsupported and transfers objects hand-to-hand.
C. Walks independently several steps.
D. Speaks two-word phrases (e.g., “more milk”).
Correct answer: B
Rationale:
B is correct. At about 6 months infants typically sit unsupported
and can transfer objects from hand to hand — standard gross-
and fine-motor milestones.
A is incorrect because a mature pincer grasp generally appears
,around 9–12 months (early pincer may begin ~8–9 months). C is
incorrect — independent walking usually occurs ~12 months. D
is incorrect — two-word phrases are characteristic of about 2
years of age.
Question 2 — Growth & Development (Toddler)
Which behavior from a 2-year-old is most consistent with
expected psychosocial and language development?
A. Plays cooperatively in sustained group play and tells stories.
B. Uses two-to-three word phrases and demonstrates parallel
play.
C. Dresses self completely and shows concern for peers’
feelings.
D. Ties shoelaces and rides a tricycle.
Correct answer: B
Rationale:
B is correct. At 2 years toddlers typically use two-to-three word
phrases and engage primarily in parallel play (playing alongside
but not with peers).
A is incorrect because sustained cooperative group play and
storytelling come later (preschool age). C is incorrect —
dressing skills and peer empathy are more advanced (3–4
years). D is incorrect — tying shoelaces and riding a tricycle are
usually seen around 4–5 years (tricycle ~3 years; laces ~5 years).
,Question 3 — Respiratory (Asthma) — Multiple Choice
A 7-year-old with known moderate persistent asthma presents
with increased coughing at night and peak expiratory flow rate
(PEFR) decreased to 60% of personal best. Which immediate
nursing action is highest priority?
A. Administer scheduled inhaled corticosteroid at home dose.
B. Give quick-relief short-acting beta-agonist (SABA) via
metered-dose inhaler with spacer.
C. Begin oral prednisone at home and observe for 24 hours.
D. Encourage the child to lie flat and take slow deep breaths.
Correct answer: B
Rationale:
B is correct. A PEFR of 60% and nocturnal cough indicate
bronchoconstriction needing immediate bronchodilation with a
SABA (e.g., albuterol) via MDI + spacer, which provides rapid
symptom relief and is the standard initial action for acute
exacerbation.
A is incorrect — inhaled corticosteroids are controller
medications and do not provide rapid relief. C is incorrect as
first action — systemic steroids may be indicated but not before
acute bronchodilation; they are adjuncts to reduce
inflammation. D is incorrect and unsafe — lying flat can worsen
dyspnea; position of comfort (upright) and prompt
bronchodilator therapy are indicated.
, Question 4 — Respiratory (Bronchiolitis) — Select All That
Apply (SATA)
A 3-month-old infant is diagnosed with bronchiolitis (likely RSV).
Which nursing interventions are appropriate? (Select all that
apply.)
A. Provide suctioning of nasal secretions to maintain airway.
B. Administer oral cough suppressants to stop the cough.
C. Monitor oxygen saturation and give supplemental oxygen if
hypoxemic.
D. Encourage routine outpatient care—no need for hydration
monitoring.
E. Educate caregivers about signs of respiratory distress to seek
immediate care.
Correct answers: A, C, E
Rationale:
A is correct — infants are obligate nose breathers; nasal
suctioning relieves obstruction and improves feeding/airway.
C is correct — continuous monitoring of oxygen saturation and
supplemental oxygen for hypoxemia are appropriate.
E is correct — caregiver education about increased work of
breathing, poor feeding, dehydration, apnea is essential.
B is incorrect — oral cough suppressants are not recommended
for infants and may be harmful. D is incorrect — hydration
monitoring is critical (risk for dehydration due to poor feeding
and tachypnea).
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
Question 1 — Growth & Development (Infant)
A 6-month-old infant is brought to the clinic for a well-child
check. Which milestone is developmentally expected at this
age?
A. Uses a mature pincer grasp to feed self finger foods.
B. Sits unsupported and transfers objects hand-to-hand.
C. Walks independently several steps.
D. Speaks two-word phrases (e.g., “more milk”).
Correct answer: B
Rationale:
B is correct. At about 6 months infants typically sit unsupported
and can transfer objects from hand to hand — standard gross-
and fine-motor milestones.
A is incorrect because a mature pincer grasp generally appears
,around 9–12 months (early pincer may begin ~8–9 months). C is
incorrect — independent walking usually occurs ~12 months. D
is incorrect — two-word phrases are characteristic of about 2
years of age.
Question 2 — Growth & Development (Toddler)
Which behavior from a 2-year-old is most consistent with
expected psychosocial and language development?
A. Plays cooperatively in sustained group play and tells stories.
B. Uses two-to-three word phrases and demonstrates parallel
play.
C. Dresses self completely and shows concern for peers’
feelings.
D. Ties shoelaces and rides a tricycle.
Correct answer: B
Rationale:
B is correct. At 2 years toddlers typically use two-to-three word
phrases and engage primarily in parallel play (playing alongside
but not with peers).
A is incorrect because sustained cooperative group play and
storytelling come later (preschool age). C is incorrect —
dressing skills and peer empathy are more advanced (3–4
years). D is incorrect — tying shoelaces and riding a tricycle are
usually seen around 4–5 years (tricycle ~3 years; laces ~5 years).
,Question 3 — Respiratory (Asthma) — Multiple Choice
A 7-year-old with known moderate persistent asthma presents
with increased coughing at night and peak expiratory flow rate
(PEFR) decreased to 60% of personal best. Which immediate
nursing action is highest priority?
A. Administer scheduled inhaled corticosteroid at home dose.
B. Give quick-relief short-acting beta-agonist (SABA) via
metered-dose inhaler with spacer.
C. Begin oral prednisone at home and observe for 24 hours.
D. Encourage the child to lie flat and take slow deep breaths.
Correct answer: B
Rationale:
B is correct. A PEFR of 60% and nocturnal cough indicate
bronchoconstriction needing immediate bronchodilation with a
SABA (e.g., albuterol) via MDI + spacer, which provides rapid
symptom relief and is the standard initial action for acute
exacerbation.
A is incorrect — inhaled corticosteroids are controller
medications and do not provide rapid relief. C is incorrect as
first action — systemic steroids may be indicated but not before
acute bronchodilation; they are adjuncts to reduce
inflammation. D is incorrect and unsafe — lying flat can worsen
dyspnea; position of comfort (upright) and prompt
bronchodilator therapy are indicated.
, Question 4 — Respiratory (Bronchiolitis) — Select All That
Apply (SATA)
A 3-month-old infant is diagnosed with bronchiolitis (likely RSV).
Which nursing interventions are appropriate? (Select all that
apply.)
A. Provide suctioning of nasal secretions to maintain airway.
B. Administer oral cough suppressants to stop the cough.
C. Monitor oxygen saturation and give supplemental oxygen if
hypoxemic.
D. Encourage routine outpatient care—no need for hydration
monitoring.
E. Educate caregivers about signs of respiratory distress to seek
immediate care.
Correct answers: A, C, E
Rationale:
A is correct — infants are obligate nose breathers; nasal
suctioning relieves obstruction and improves feeding/airway.
C is correct — continuous monitoring of oxygen saturation and
supplemental oxygen for hypoxemia are appropriate.
E is correct — caregiver education about increased work of
breathing, poor feeding, dehydration, apnea is essential.
B is incorrect — oral cough suppressants are not recommended
for infants and may be harmful. D is incorrect — hydration
monitoring is critical (risk for dehydration due to poor feeding
and tachypnea).
