Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1
A 9-month-old infant is brought to the clinic for well-child
care. Which developmental behavior is most appropriate to
expect at 9 months?
A. Says two to three words besides “mama/dada.”
B. Pulls to stand and may cruise along furniture.
C. Rides a tricycle independently.
D. Copies a circle when drawing.
Correct answer: B
Rationale:
B is correct — by about 9 months infants commonly pull to
stand and may begin cruising (walking while holding
furniture). This reflects gross motor development typical for
that age.
Why others are incorrect:
A — Saying two to three distinct words usually occurs later
,(around 12–18 months). At 9 months infants may say
“mama/dada” and babble but not multiple clear words.
C — Riding a tricycle is a complex gross motor skill expected
around age 3 years.
D — Copying a circle is a fine motor/visual-motor skill usually
expected around 3–4 years.
2
A 4-year-old with asthma is having increased wheezing and
shortness of breath at night. The child’s prescribed short-
acting bronchodilator (albuterol) is scheduled every 4 hours
PRN. The parent reports giving the medication every 2 hours
because symptoms seem worse. The nurse’s best immediate
action is to:
A. Instruct the parent to stop giving the medication and call
the provider tomorrow.
B. Ask the parent to bring the child to the emergency
department now for evaluation.
C. Reassure the parent that more dosing is fine until
symptoms improve.
D. Encourage the parent to give an oral antihistamine instead.
Correct answer: B
Rationale:
B is correct — receiving short-acting beta2 agonists more
frequently than prescribed (every 2 hours when ordered
,every 4 hours PRN) indicates unstable asthma and potential
for deterioration; immediate evaluation in ED is warranted
for possible respiratory distress or need for additional
therapy (e.g., systemic steroids, continuous nebulization).
Safety and escalation of care are priorities.
Why others are incorrect:
A — Stopping the medication and delaying contact risks
worsening respiratory distress.
C — Reassuring that more dosing is fine is unsafe; more
frequent dosing may indicate severe symptoms and could
lead to adverse effects (tachycardia, hypokalemia) or mask
deterioration.
D — An oral antihistamine is not appropriate for acute
asthma exacerbation and could delay necessary treatment.
3
A parent asks how to give an oral liquid antibiotic to a 14-
month-old toddler. Which instruction is best?
A. “Place the syringe at the back of the tongue and squirt
quickly so the toddler swallows it.”
B. “Mix the medicine with a full bottle of formula so the
toddler cannot taste it.”
C. “Give the medication slowly toward the inside of the cheek
while the toddler is sitting upright.”
D. “Add the medication to a bite of fruit and let the toddler
play with it as they eat.”
, Correct answer: C
Rationale:
C is correct — giving medication slowly toward the inside of
the cheek (buccal area) while the child is upright reduces risk
of aspiration and promotes swallowing. Using an oral syringe
and slow, small amounts is evidence-based best practice for
toddlers.
Why others are incorrect:
A — Placing the syringe at the back of the tongue and
squirting quickly increases choking/aspiration risk.
B — Mixing medicine into a full bottle risks the child not
finishing the bottle and receiving incomplete dose; if mixing
is used, it should be a small, known amount of a tolerable
food and the child must finish it (and only if medication
instructions allow). Many antibiotics advise against mixing or
recommend specific foods — always follow label.
D — Letting the toddler play with medicated food risks
uneven dosing and loss of dose; also not developmentally
appropriate for ensuring full ingestion.
4
A 7-year-old child with type 1 diabetes is admitted with
vomiting and abdominal pain. The nurse notes Kussmaul
respirations and a serum glucose of 540 mg/dL. Which action
has the highest priority?
Examination
9th Edition
Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1
A 9-month-old infant is brought to the clinic for well-child
care. Which developmental behavior is most appropriate to
expect at 9 months?
A. Says two to three words besides “mama/dada.”
B. Pulls to stand and may cruise along furniture.
C. Rides a tricycle independently.
D. Copies a circle when drawing.
Correct answer: B
Rationale:
B is correct — by about 9 months infants commonly pull to
stand and may begin cruising (walking while holding
furniture). This reflects gross motor development typical for
that age.
Why others are incorrect:
A — Saying two to three distinct words usually occurs later
,(around 12–18 months). At 9 months infants may say
“mama/dada” and babble but not multiple clear words.
C — Riding a tricycle is a complex gross motor skill expected
around age 3 years.
D — Copying a circle is a fine motor/visual-motor skill usually
expected around 3–4 years.
2
A 4-year-old with asthma is having increased wheezing and
shortness of breath at night. The child’s prescribed short-
acting bronchodilator (albuterol) is scheduled every 4 hours
PRN. The parent reports giving the medication every 2 hours
because symptoms seem worse. The nurse’s best immediate
action is to:
A. Instruct the parent to stop giving the medication and call
the provider tomorrow.
B. Ask the parent to bring the child to the emergency
department now for evaluation.
C. Reassure the parent that more dosing is fine until
symptoms improve.
D. Encourage the parent to give an oral antihistamine instead.
Correct answer: B
Rationale:
B is correct — receiving short-acting beta2 agonists more
frequently than prescribed (every 2 hours when ordered
,every 4 hours PRN) indicates unstable asthma and potential
for deterioration; immediate evaluation in ED is warranted
for possible respiratory distress or need for additional
therapy (e.g., systemic steroids, continuous nebulization).
Safety and escalation of care are priorities.
Why others are incorrect:
A — Stopping the medication and delaying contact risks
worsening respiratory distress.
C — Reassuring that more dosing is fine is unsafe; more
frequent dosing may indicate severe symptoms and could
lead to adverse effects (tachycardia, hypokalemia) or mask
deterioration.
D — An oral antihistamine is not appropriate for acute
asthma exacerbation and could delay necessary treatment.
3
A parent asks how to give an oral liquid antibiotic to a 14-
month-old toddler. Which instruction is best?
A. “Place the syringe at the back of the tongue and squirt
quickly so the toddler swallows it.”
B. “Mix the medicine with a full bottle of formula so the
toddler cannot taste it.”
C. “Give the medication slowly toward the inside of the cheek
while the toddler is sitting upright.”
D. “Add the medication to a bite of fruit and let the toddler
play with it as they eat.”
, Correct answer: C
Rationale:
C is correct — giving medication slowly toward the inside of
the cheek (buccal area) while the child is upright reduces risk
of aspiration and promotes swallowing. Using an oral syringe
and slow, small amounts is evidence-based best practice for
toddlers.
Why others are incorrect:
A — Placing the syringe at the back of the tongue and
squirting quickly increases choking/aspiration risk.
B — Mixing medicine into a full bottle risks the child not
finishing the bottle and receiving incomplete dose; if mixing
is used, it should be a small, known amount of a tolerable
food and the child must finish it (and only if medication
instructions allow). Many antibiotics advise against mixing or
recommend specific foods — always follow label.
D — Letting the toddler play with medicated food risks
uneven dosing and loss of dose; also not developmentally
appropriate for ensuring full ingestion.
4
A 7-year-old child with type 1 diabetes is admitted with
vomiting and abdominal pain. The nurse notes Kussmaul
respirations and a serum glucose of 540 mg/dL. Which action
has the highest priority?
