NSG 3600 Exam 2 Pediatric Nursing | Latest Update
2026/2027 | 200 Practice Questions & Detailed Answers
| Galen College | A+ Graded
SECTION 1: Growth & Development Milestones (Questions 1–20)
1. A nurse is assessing a 6monthold infant during a wellchild visit. Which developmental milestone
should the nurse expect the infant to demonstrate?
A) Walking independently
B) Saying twoword phrases
C) Rolling from back to abdomen
D) Building a tower of four blocks
Answer: C) Rolling from back to abdomen
Rationale: By 6 months of age, infants typically can roll from back to abdomen and vice versa. Walking
independently usually occurs around 12–15 months, twoword phrases emerge around 18–24 months,
and building a tower of blocks is a skill seen in toddlers around 18–24 months .
2. A nurse observes a 2yearold child build a tower of six blocks, kick a ball forward, and use twoword
phrases. These findings indicate:
A) Delayed fine motor skills requiring occupational therapy referral
B) Ageappropriate gross motor, fine motor, and language development
C) Advanced language development with potential giftedness
D) Regression in gross motor abilities from the 18month level
Answer: B) Ageappropriate gross motor, fine motor, and language development
Rationale: By age 2, children typically build towers of 4–6 blocks, kick balls, and use twoword phrases
(telegraphic speech). These are all ageappropriate milestones with no evidence of delay or advanced
skills .
,3. A nurse measures the head circumference of a 4monthold infant and notes it has increased by 2 cm
since birth. The parents express concern about the rapid growth. The nurse should explain that this rate
of head growth is expected because:
A) The brain grows faster than any other organ during the first year of life
B) Cranial sutures fuse prematurely in early infancy
C) Fontanelles typically close completely by 3 months of age
D) Head circumference should equal chest circumference at 4 months
Answer: A) The brain grows faster than any other organ during the first year of life
Rationale: Brain growth is most rapid in the first year, with head circumference increasing approximately
1.5–2 cm per month during the first 6 months. Cranial sutures do not fuse prematurely, fontanelles close
later (anterior by 12–18 months), and head equals chest circumference at approximately 1–2 years .
4. A nurse is teaching a parent about appropriate toys for a 9monthold infant. Which toy would best
support the infant's current developmental needs?
A) A set of nesting cups that the infant can bang together and explore
B) A complex puzzle with small interlocking pieces
C) A board game that requires turntaking with siblings
D) A detailed coloring book with finetip markers
Answer: A) A set of nesting cups that the infant can bang together and explore
Rationale: At 9 months, infants engage in tertiary circular reactions and enjoy exploring object
properties. Nesting cups support this developmental need. Small puzzle pieces pose a choking hazard,
board games require skills beyond this age, and coloring books are appropriate for older preschoolers .
5. A nurse is assessing a 6monthold infant. The mother reports the baby can sit with support but cannot
yet transfer objects from one hand to the other. The nurse recognizes this milestone is consistent with
which theorist's framework?
A) Piaget's sensorimotor stage, substage 3
B) Erikson's autonomy versus shame and doubt
C) Freud's anal stage of psychosexual development
D) Kohlberg's preconventional level of moral reasoning
,Answer: A) Piaget's sensorimotor stage, substage 3
Rationale: Piaget's sensorimotor stage substage 3 (4–8 months) involves secondary circular reactions
and early object manipulation. Sitting with support and beginning hand transfer align with this. Erikson's
autonomy stage occurs at 1–3 years, Freud's anal stage at 1–3 years, and Kohlberg's theory applies to
older children .
6. A school nurse is evaluating a 5yearold child who frequently sucks their thumb and carries a security
blanket. Based on developmental theory, the nurse should advise the teacher that:
A) These comfort behaviors are typical for this age and usually resolve spontaneously
B) Thumb sucking at this age indicates severe anxiety requiring immediate intervention
C) The child is regressing to an earlier developmental stage due to trauma
D) Security objects should be confiscated to promote independence
Answer: A) These comfort behaviors are typical for this age and usually resolve spontaneously
Rationale: Thumb sucking and transitional objects are common in preschoolers and typically diminish as
the child develops coping skills. These behaviors do not indicate severe anxiety or regression unless
accompanied by other concerning signs. Removing security objects abruptly can increase anxiety .
7. The difference between cephalocaudal and proximodistal development is:
A) Cephalocaudal proceeds from center outward; proximodistal proceeds head to toe
B) Cephalocaudal proceeds head to toe; proximodistal proceeds center outward
C) Both proceed from head to toe
D) Both proceed from center outward
Answer: B) Cephalocaudal proceeds head to toe; proximodistal proceeds center outward
Rationale: Cephalocaudal development proceeds from head to toe (head control precedes walking),
whereas proximodistal development proceeds from the center outward (trunk control precedes fine
motor control of fingers) .
8. A healthy infant usually doubles birth weight by about:
A) 1 month of age
, B) 4–6 months of age
C) 12 months of age
D) 2 years of age
Answer: B) 4–6 months of age
Rationale: Infants typically double their birth weight by 4–6 months and triple it by 12 months. This
reflects normal growth and nutritional adequacy.
9. Failure to thrive in an infant is best described as:
A) Normal small size in a child of short parents
B) Rapid weight gain
C) Inadequate weight gain or growth for age
D) A temporary decrease in appetite
Answer: C) Inadequate weight gain or growth for age
Rationale: Failure to thrive is defined as inadequate physical growth during infancy and early childhood,
often related to inadequate nutrition, underlying disease, or psychosocial factors.
10. A nurse is assessing a 12yearold child who recently entered puberty and expresses embarrassment
about physical changes. The nurse should prioritize which intervention?
A) Provide private, ageappropriate education about normal pubertal changes
B) Require mandatory gym class participation without exception
C) Schedule a psychiatric evaluation for social anxiety disorder
D) Inform the child's parents about the refusal to participate immediately
Answer: A) Provide private, ageappropriate education about normal pubertal changes
Rationale: Adolescents experiencing puberty often feel selfconscious about body changes. Providing
private, factual education normalizes the experience and builds confidence. Mandating participation
without addressing concerns or pathologizing normal behavior are inappropriate .
2026/2027 | 200 Practice Questions & Detailed Answers
| Galen College | A+ Graded
SECTION 1: Growth & Development Milestones (Questions 1–20)
1. A nurse is assessing a 6monthold infant during a wellchild visit. Which developmental milestone
should the nurse expect the infant to demonstrate?
A) Walking independently
B) Saying twoword phrases
C) Rolling from back to abdomen
D) Building a tower of four blocks
Answer: C) Rolling from back to abdomen
Rationale: By 6 months of age, infants typically can roll from back to abdomen and vice versa. Walking
independently usually occurs around 12–15 months, twoword phrases emerge around 18–24 months,
and building a tower of blocks is a skill seen in toddlers around 18–24 months .
2. A nurse observes a 2yearold child build a tower of six blocks, kick a ball forward, and use twoword
phrases. These findings indicate:
A) Delayed fine motor skills requiring occupational therapy referral
B) Ageappropriate gross motor, fine motor, and language development
C) Advanced language development with potential giftedness
D) Regression in gross motor abilities from the 18month level
Answer: B) Ageappropriate gross motor, fine motor, and language development
Rationale: By age 2, children typically build towers of 4–6 blocks, kick balls, and use twoword phrases
(telegraphic speech). These are all ageappropriate milestones with no evidence of delay or advanced
skills .
,3. A nurse measures the head circumference of a 4monthold infant and notes it has increased by 2 cm
since birth. The parents express concern about the rapid growth. The nurse should explain that this rate
of head growth is expected because:
A) The brain grows faster than any other organ during the first year of life
B) Cranial sutures fuse prematurely in early infancy
C) Fontanelles typically close completely by 3 months of age
D) Head circumference should equal chest circumference at 4 months
Answer: A) The brain grows faster than any other organ during the first year of life
Rationale: Brain growth is most rapid in the first year, with head circumference increasing approximately
1.5–2 cm per month during the first 6 months. Cranial sutures do not fuse prematurely, fontanelles close
later (anterior by 12–18 months), and head equals chest circumference at approximately 1–2 years .
4. A nurse is teaching a parent about appropriate toys for a 9monthold infant. Which toy would best
support the infant's current developmental needs?
A) A set of nesting cups that the infant can bang together and explore
B) A complex puzzle with small interlocking pieces
C) A board game that requires turntaking with siblings
D) A detailed coloring book with finetip markers
Answer: A) A set of nesting cups that the infant can bang together and explore
Rationale: At 9 months, infants engage in tertiary circular reactions and enjoy exploring object
properties. Nesting cups support this developmental need. Small puzzle pieces pose a choking hazard,
board games require skills beyond this age, and coloring books are appropriate for older preschoolers .
5. A nurse is assessing a 6monthold infant. The mother reports the baby can sit with support but cannot
yet transfer objects from one hand to the other. The nurse recognizes this milestone is consistent with
which theorist's framework?
A) Piaget's sensorimotor stage, substage 3
B) Erikson's autonomy versus shame and doubt
C) Freud's anal stage of psychosexual development
D) Kohlberg's preconventional level of moral reasoning
,Answer: A) Piaget's sensorimotor stage, substage 3
Rationale: Piaget's sensorimotor stage substage 3 (4–8 months) involves secondary circular reactions
and early object manipulation. Sitting with support and beginning hand transfer align with this. Erikson's
autonomy stage occurs at 1–3 years, Freud's anal stage at 1–3 years, and Kohlberg's theory applies to
older children .
6. A school nurse is evaluating a 5yearold child who frequently sucks their thumb and carries a security
blanket. Based on developmental theory, the nurse should advise the teacher that:
A) These comfort behaviors are typical for this age and usually resolve spontaneously
B) Thumb sucking at this age indicates severe anxiety requiring immediate intervention
C) The child is regressing to an earlier developmental stage due to trauma
D) Security objects should be confiscated to promote independence
Answer: A) These comfort behaviors are typical for this age and usually resolve spontaneously
Rationale: Thumb sucking and transitional objects are common in preschoolers and typically diminish as
the child develops coping skills. These behaviors do not indicate severe anxiety or regression unless
accompanied by other concerning signs. Removing security objects abruptly can increase anxiety .
7. The difference between cephalocaudal and proximodistal development is:
A) Cephalocaudal proceeds from center outward; proximodistal proceeds head to toe
B) Cephalocaudal proceeds head to toe; proximodistal proceeds center outward
C) Both proceed from head to toe
D) Both proceed from center outward
Answer: B) Cephalocaudal proceeds head to toe; proximodistal proceeds center outward
Rationale: Cephalocaudal development proceeds from head to toe (head control precedes walking),
whereas proximodistal development proceeds from the center outward (trunk control precedes fine
motor control of fingers) .
8. A healthy infant usually doubles birth weight by about:
A) 1 month of age
, B) 4–6 months of age
C) 12 months of age
D) 2 years of age
Answer: B) 4–6 months of age
Rationale: Infants typically double their birth weight by 4–6 months and triple it by 12 months. This
reflects normal growth and nutritional adequacy.
9. Failure to thrive in an infant is best described as:
A) Normal small size in a child of short parents
B) Rapid weight gain
C) Inadequate weight gain or growth for age
D) A temporary decrease in appetite
Answer: C) Inadequate weight gain or growth for age
Rationale: Failure to thrive is defined as inadequate physical growth during infancy and early childhood,
often related to inadequate nutrition, underlying disease, or psychosocial factors.
10. A nurse is assessing a 12yearold child who recently entered puberty and expresses embarrassment
about physical changes. The nurse should prioritize which intervention?
A) Provide private, ageappropriate education about normal pubertal changes
B) Require mandatory gym class participation without exception
C) Schedule a psychiatric evaluation for social anxiety disorder
D) Inform the child's parents about the refusal to participate immediately
Answer: A) Provide private, ageappropriate education about normal pubertal changes
Rationale: Adolescents experiencing puberty often feel selfconscious about body changes. Providing
private, factual education normalizes the experience and builds confidence. Mandating participation
without addressing concerns or pathologizing normal behavior are inappropriate .
