NSG 434 Exams 1 (2026) – Nursing Care of
Children:Actual Questions & Answers with
Rationales | Grand Canyon University
Section 1: Growth & Development (Questions 1–35)
1. Which of the following best describes the purpose of a family-centered
approach in pediatric nursing?
A) Focusing exclusively on the child's physical health needs
B) Ensuring the healthcare team makes all decisions for the child
C) Recognizing the family as the constant in the child's life and collaborating with
them in care
D) Limiting family involvement to visiting hours only
Correct Answer: C
Rationale: Family-centered care is built on the philosophy that the family is the
primary source of strength and support for the child. It emphasizes partnership,
respect, and collaboration between the healthcare team and the family, recognizing
that the family knows the child best.
2. A nurse is preparing to perform a physical assessment on a 3-year-old child.
Which approach is most developmentally appropriate?
A) Perform the assessment in a head-to-toe order starting with the head
B) Ask the child to remain completely still throughout the exam
C) Allow the child to play with the equipment before starting and use distraction
techniques
D) Perform the most invasive procedures first to get them over with
,Correct Answer: C
Rationale: For a preschool-age child, the nurse should allow the child to handle
equipment, use simple explanations, and incorporate play and distraction. The
assessment should begin with less invasive procedures and proceed to more invasive
ones. Toddlers and preschoolers are egocentric, and their cooperation is enhanced
when they feel some control over the situation.
3. According to Erikson's theory of psychosocial development, which
developmental task is a 2-year-old toddler attempting to master?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: B
Rationale: Erikson's psychosocial development theory for toddlers (1-3 years)
focuses on autonomy versus shame and doubt. Toddlers are working to establish
independence and control over their bodies and environment, often through tasks
like toilet training and feeding themselves. Trust vs. Mistrust is the infant stage.
4. A nurse is assessing a 4-year-old child's cognitive development. According to
Piaget's theory, this child is in which stage of cognitive development?
A) Sensorimotor
B) Preoperational
C) Concrete operational
D) Formal operational
Correct Answer: B
Rationale: Piaget's preoperational stage spans from ages 2 to 7 years. Children in this
stage use symbols and language but are egocentric and have magical thinking. The
,sensorimotor stage is from birth to 2 years, concrete operational is 7-11 years, and
formal operational is 11 years and beyond.
5. A nurse is providing anticipatory guidance to the parents of a 1-month-old
infant. Which safety topic is the priority for this age group?
A) Water safety
B) Car seat safety
C) Poison prevention
D) Firearm safety
Correct Answer: B
Rationale: At 1 month of age, car seat safety is the priority, as infants must always ride
in a rear-facing car seat. This is a critical safety measure from birth. Water safety
becomes more relevant as the child ages, and poison prevention is more relevant
once the child becomes mobile.
6. A 4-month-old infant is brought for a well-child visit. Which milestone would
the nurse expect to observe?
A) Sitting without support
B) Rolling from front to back
C) Pincer grasp
D) Walking with assistance
Correct Answer: B
Rationale: Rolling front to back typically appears by 4 months. Sitting without support
is ~6-8 months, pincer grasp ~9 months, walking with assistance ~10-12 months.
7. According to Erikson, the primary psychosocial task of a toddler (1-3 years) is to
develop:
, A) Trust
B) Autonomy
C) Initiative
D) Industry
Correct Answer: B
Rationale: Autonomy vs. shame/doubt is the toddler stage. Trust is infancy, initiative is
preschool, industry is school-age.
8. The nurse is assessing a 2-year-old. Which behavior is consistent with Piaget's
preoperational stage?
A) Object permanence
B) Magical thinking
C) Abstract reasoning
D) Conservation of mass
Correct Answer: B
Rationale: Magical thinking is typical in preoperational stage (2-7 years). Object
permanence develops in sensorimotor stage; abstract reasoning and conservation
come later.
9. A mother asks why her 9-month-old cries when she leaves the room. The nurse
explains this as:
A) Separation anxiety
B) Stranger fear
C) Colic
D) Egocentrism
Correct Answer: A
Rationale: Separation anxiety peaks around 9 months. Stranger fear is related but
different; colic is earlier; egocentrism is preschool.
Children:Actual Questions & Answers with
Rationales | Grand Canyon University
Section 1: Growth & Development (Questions 1–35)
1. Which of the following best describes the purpose of a family-centered
approach in pediatric nursing?
A) Focusing exclusively on the child's physical health needs
B) Ensuring the healthcare team makes all decisions for the child
C) Recognizing the family as the constant in the child's life and collaborating with
them in care
D) Limiting family involvement to visiting hours only
Correct Answer: C
Rationale: Family-centered care is built on the philosophy that the family is the
primary source of strength and support for the child. It emphasizes partnership,
respect, and collaboration between the healthcare team and the family, recognizing
that the family knows the child best.
2. A nurse is preparing to perform a physical assessment on a 3-year-old child.
Which approach is most developmentally appropriate?
A) Perform the assessment in a head-to-toe order starting with the head
B) Ask the child to remain completely still throughout the exam
C) Allow the child to play with the equipment before starting and use distraction
techniques
D) Perform the most invasive procedures first to get them over with
,Correct Answer: C
Rationale: For a preschool-age child, the nurse should allow the child to handle
equipment, use simple explanations, and incorporate play and distraction. The
assessment should begin with less invasive procedures and proceed to more invasive
ones. Toddlers and preschoolers are egocentric, and their cooperation is enhanced
when they feel some control over the situation.
3. According to Erikson's theory of psychosocial development, which
developmental task is a 2-year-old toddler attempting to master?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: B
Rationale: Erikson's psychosocial development theory for toddlers (1-3 years)
focuses on autonomy versus shame and doubt. Toddlers are working to establish
independence and control over their bodies and environment, often through tasks
like toilet training and feeding themselves. Trust vs. Mistrust is the infant stage.
4. A nurse is assessing a 4-year-old child's cognitive development. According to
Piaget's theory, this child is in which stage of cognitive development?
A) Sensorimotor
B) Preoperational
C) Concrete operational
D) Formal operational
Correct Answer: B
Rationale: Piaget's preoperational stage spans from ages 2 to 7 years. Children in this
stage use symbols and language but are egocentric and have magical thinking. The
,sensorimotor stage is from birth to 2 years, concrete operational is 7-11 years, and
formal operational is 11 years and beyond.
5. A nurse is providing anticipatory guidance to the parents of a 1-month-old
infant. Which safety topic is the priority for this age group?
A) Water safety
B) Car seat safety
C) Poison prevention
D) Firearm safety
Correct Answer: B
Rationale: At 1 month of age, car seat safety is the priority, as infants must always ride
in a rear-facing car seat. This is a critical safety measure from birth. Water safety
becomes more relevant as the child ages, and poison prevention is more relevant
once the child becomes mobile.
6. A 4-month-old infant is brought for a well-child visit. Which milestone would
the nurse expect to observe?
A) Sitting without support
B) Rolling from front to back
C) Pincer grasp
D) Walking with assistance
Correct Answer: B
Rationale: Rolling front to back typically appears by 4 months. Sitting without support
is ~6-8 months, pincer grasp ~9 months, walking with assistance ~10-12 months.
7. According to Erikson, the primary psychosocial task of a toddler (1-3 years) is to
develop:
, A) Trust
B) Autonomy
C) Initiative
D) Industry
Correct Answer: B
Rationale: Autonomy vs. shame/doubt is the toddler stage. Trust is infancy, initiative is
preschool, industry is school-age.
8. The nurse is assessing a 2-year-old. Which behavior is consistent with Piaget's
preoperational stage?
A) Object permanence
B) Magical thinking
C) Abstract reasoning
D) Conservation of mass
Correct Answer: B
Rationale: Magical thinking is typical in preoperational stage (2-7 years). Object
permanence develops in sensorimotor stage; abstract reasoning and conservation
come later.
9. A mother asks why her 9-month-old cries when she leaves the room. The nurse
explains this as:
A) Separation anxiety
B) Stranger fear
C) Colic
D) Egocentrism
Correct Answer: A
Rationale: Separation anxiety peaks around 9 months. Stranger fear is related but
different; colic is earlier; egocentrism is preschool.
