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1. A nurse is assessing a 12monthold infant during a wellchild visit. Which finding requires further
evaluation?
A. Birth weight has tripled.
B. Anterior fontanel is still open.
C. The infant can say “mama” and “dada” specifically.
D. The infant can pull to stand.
Correct Answer: B
Explanation: The anterior fontanel typically closes between 12 and 18 months of age. It should be closed
or nearly closed by 12 months in most infants; a persistently open fontanel may indicate hydrocephalus,
hypothyroidism, or nutritional issues.
2. A nurse is providing anticipatory guidance to the parents of a 4monthold infant. Which statement by
the parent indicates understanding of injury prevention?
A. “I can put the crib near a window for fresh air.”
B. “I will set the water heater temperature to 120°F.”
C. “I can place soft toys in the crib for comfort.”
D. “I will start feeding honey to help with sleep.”
Correct Answer: B
Explanation: Water heater temperature should be set at or below 120°F (49°C) to prevent scalding
burns. Cribs should be away from windows (fall hazard) and free of soft objects (SIDS risk). Honey is not
recommended under 12 months due to botulism risk.
3. A nurse is assessing a 2yearold child. Which gross motor skill should the child be expected to
perform?
A. Ride a tricycle
B. Walk up and down stairs with alternate feet
C. Kick a ball forward
D. Stand on one foot for 10 seconds
,Correct Answer: C
Explanation: A 2yearold can run, kick a ball, and walk up stairs with both feet on each step (not
alternate). Tricycle riding (3 years), alternate footing on stairs (34 years), and standing on one foot (4+
years) come later.
4. A nurse is calculating the maintenance fluid requirement for a child weighing 22 kg. Using the
HollidaySegar method, what is the hourly rate?
A. 45 mL/hr
B. 55 mL/hr
C. 65 mL/hr
D. 75 mL/hr
Correct Answer: C
Explanation: HollidaySegar: first 10 kg = 100 mL/kg/day (40 mL/hr), next 10 kg = 50 mL/kg/day (20
mL/hr), remaining kg = 20 mL/kg/day. For 22 kg: 10 kg (40) + 10 kg (20) + 2 kg (20 mL/kg/day = 40
mL/day ÷24 = 1.67 mL/hr, total ~61.67 mL/hr. Rounding to 65 mL/hr is typical. Exact:
1000+500+40=1540 mL/day ÷24 = 64.16 mL/hr.
5. A nurse is caring for a child with suspected appendicitis. Which finding is most indicative of
perforation?
A. Sudden relief of pain followed by rebound tenderness
B. Fever and vomiting
C. Right lower quadrant pain
D. Anorexia
Correct Answer: A
Explanation: Sudden pain relief may indicate appendix rupture and decompression, followed by
peritonitis with rebound tenderness. This is a surgical emergency.
6. A nurse is educating the parents of a child with newly diagnosed celiac disease. Which food should be
avoided?
A. Rice cakes
B. Corn tortillas
C. Whole wheat bread
,D. Potato chips
Correct Answer: C
Explanation: Celiac disease requires lifelong avoidance of gluten (wheat, barley, rye). Whole wheat
bread contains gluten. Rice, corn, and potatoes are glutenfree.
7. A nurse is assessing a 6monthold infant. Which developmental milestone should the nurse expect?
A. Sitting without support
B. Transferring objects from hand to hand
C. Babbling with consonantvowel combinations (“baba”)
D. Playing patacake
Correct Answer: C
Explanation: Babbling (consonantvowel) emerges around 6 months. Sitting without support occurs at 78
months; transfer handtohand at 7 months; patacake at 912 months.
8. A nurse is preparing to administer immunizations to a 2monthold infant. Which vaccines are typically
given at this age?
A. DTaP, IPV, Hib, PCV13, Rotavirus
B. MMR, Varicella, Hepatitis A
C. Tdap, HPV, MenACWY
D. DTaP only
Correct Answer: A
Explanation: At 2 months, routine vaccines include DTaP (diphtheria, tetanus, pertussis), IPV (polio), Hib
(Haemophilus influenzae type b), PCV13 (pneumococcal), and rotavirus (oral). MMR and varicella are
given at 1215 months.
9. A nurse is caring for a child with a diagnosis of Kawasaki disease. Which finding is most characteristic?
A. Polyarthritis
B. Strawberry tongue and conjunctival injection
C. Vesicular rash
D. Hepatosplenomegaly
, Correct Answer: B
Explanation: Kawasaki disease presents with fever >5 days, bilateral conjunctival injection, oral mucosal
changes (strawberry tongue, cracked lips), polymorphous rash, cervical lymphadenopathy, and changes
in extremities.
10. A nurse is calculating the dosage of acetaminophen for a child weighing 12 kg. The safe dose range is
1015 mg/kg/dose. What is the maximum single dose in mg?
A. 120 mg
B. 150 mg
C. 180 mg
D. 200 mg
Correct Answer: C
Explanation: 15 mg/kg × 12 kg = 180 mg. Do not exceed 15 mg/kg/dose (or 75 mg/kg/day).
Acetaminophen is given every 46 hours.
11. A nurse is assessing a 3yearold child for signs of developmental delay. Which finding is concerning?
A. Stuttering when excited
B. Unable to ride a tricycle
C. Unable to copy a circle
D. Speaks in 34 word sentences
Correct Answer: C
Explanation: By age 3, a child should be able to copy a circle. Stuttering can be normal in preschoolers.
Tricycle riding is expected at age 3, but not all achieve exactly at 3; speaking sentences is normal.
12. A nurse is teaching a parent about fever management in a 6monthold. Which statement indicates
correct understanding?
A. “I will give aspirin to reduce fever.”
B. “I will alternate acetaminophen and ibuprofen every 2 hours.”
C. “I can give acetaminophen for fever over 100.4°F (38°C) if the baby is uncomfortable.”
D. “I will bundle the baby in blankets to sweat out the fever.”
Correct Answer: C