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
1
A 9-month-old infant is brought to the clinic for a well-child
visit. Which milestone is developmentally appropriate for a 9-
month-old?
A. Uses a spoon independently without spilling.
B. Says "mama" and "dada" specifically to the correct parent.
C. Walks independently several steps.
D. Copies a circle when given a crayon.
Correct answer: B
Rationale:
• B (Correct): By about 9 months infants usually say “mama”
and “dada” and often attach the words to the appropriate
, parent (specificity emerges). This reflects progressing
expressive language and social recognition.
• A (Incorrect): Independent spoon use without spilling is
more typical around 15–18 months; at 9 months infants
may attempt finger feeding and show emerging pincer
grasp.
• C (Incorrect): Independent walking generally appears
around 12 months (9 months may cruise or pull to stand
but not yet walk well).
• D (Incorrect): Copying a circle is a preschool skill (about 3–
4 years), not an infant skill.
2
A 4-year-old is brought in after a fall. The child is clingy, cries
when separated from the parent, and wants the parent to stay
in the room during the exam. Which statement best explains
this behavior to the parent?
A. "This child is overly dependent and should be corrected."
B. "At this age separation anxiety is common; your presence
helps the child feel safe."
C. "The child will get worse unless you leave and encourage
independence."
D. "Clinging is unusual at age 4; consider behavior therapy."
Correct answer: B
,Rationale:
• B (Correct): Preschoolers (3–5 years) often show
separation concerns after stress or illness; having a
caregiver present reduces anxiety and is developmentally
appropriate. Teaching caregivers supportive strategies is
appropriate.
• A (Incorrect): Labeling the child as "overly dependent" is
judgmental and inaccurate; separation concerns can be
situational.
• C (Incorrect): Forcing separation acutely during a stressful
event can increase distress and reduce cooperation;
gradual techniques are better after stabilization.
• D (Incorrect): Clinging in context of trauma or illness at age
4 is not unusual and does not automatically indicate need
for therapy.
3
A 3-year-old with asthma is prescribed a metered-dose inhaler
(MDI) with spacer. Which caregiver teaching point is most
important for effective medication delivery?
A. Have the child hold the spacer above the head while inhaling
quickly.
B. Shake the MDI, place the spacer in the child’s mouth, press
the canister once, and have the child take slow, deep breaths or
use tidal breathing for young children.
, C. Remove the spacer if the child refuses it; direct MDI use is
equivalent.
D. Only use the spacer for rescue inhalers, not daily controllers.
Correct answer: B
Rationale:
• B (Correct): Proper technique—shaking the MDI, attaching
spacer, actuating once per inhalation, and using slow deep
breaths (or 4–6 tidal breaths for young children)—
maximizes lung deposition and safety. Spacers are
recommended for children.
• A (Incorrect): Holding spacer above the head and inhaling
quickly wastes medication; proper positioning is mouth
placement and slow inhalation.
• C (Incorrect): Direct MDI use without a spacer reduces
drug delivery and increases oropharyngeal deposition; if
the child refuses, use caregiver modeling and distraction,
not removal.
• D (Incorrect): Spacers are appropriate with MDIs for both
rescue and some controller inhalers (as per formulation) to
improve delivery, depending on medication.
4
A 6-month-old infant with bronchiolitis (likely RSV) has
tachypnea but oxygen saturation 94% on room air and is
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1
A 9-month-old infant is brought to the clinic for a well-child
visit. Which milestone is developmentally appropriate for a 9-
month-old?
A. Uses a spoon independently without spilling.
B. Says "mama" and "dada" specifically to the correct parent.
C. Walks independently several steps.
D. Copies a circle when given a crayon.
Correct answer: B
Rationale:
• B (Correct): By about 9 months infants usually say “mama”
and “dada” and often attach the words to the appropriate
, parent (specificity emerges). This reflects progressing
expressive language and social recognition.
• A (Incorrect): Independent spoon use without spilling is
more typical around 15–18 months; at 9 months infants
may attempt finger feeding and show emerging pincer
grasp.
• C (Incorrect): Independent walking generally appears
around 12 months (9 months may cruise or pull to stand
but not yet walk well).
• D (Incorrect): Copying a circle is a preschool skill (about 3–
4 years), not an infant skill.
2
A 4-year-old is brought in after a fall. The child is clingy, cries
when separated from the parent, and wants the parent to stay
in the room during the exam. Which statement best explains
this behavior to the parent?
A. "This child is overly dependent and should be corrected."
B. "At this age separation anxiety is common; your presence
helps the child feel safe."
C. "The child will get worse unless you leave and encourage
independence."
D. "Clinging is unusual at age 4; consider behavior therapy."
Correct answer: B
,Rationale:
• B (Correct): Preschoolers (3–5 years) often show
separation concerns after stress or illness; having a
caregiver present reduces anxiety and is developmentally
appropriate. Teaching caregivers supportive strategies is
appropriate.
• A (Incorrect): Labeling the child as "overly dependent" is
judgmental and inaccurate; separation concerns can be
situational.
• C (Incorrect): Forcing separation acutely during a stressful
event can increase distress and reduce cooperation;
gradual techniques are better after stabilization.
• D (Incorrect): Clinging in context of trauma or illness at age
4 is not unusual and does not automatically indicate need
for therapy.
3
A 3-year-old with asthma is prescribed a metered-dose inhaler
(MDI) with spacer. Which caregiver teaching point is most
important for effective medication delivery?
A. Have the child hold the spacer above the head while inhaling
quickly.
B. Shake the MDI, place the spacer in the child’s mouth, press
the canister once, and have the child take slow, deep breaths or
use tidal breathing for young children.
, C. Remove the spacer if the child refuses it; direct MDI use is
equivalent.
D. Only use the spacer for rescue inhalers, not daily controllers.
Correct answer: B
Rationale:
• B (Correct): Proper technique—shaking the MDI, attaching
spacer, actuating once per inhalation, and using slow deep
breaths (or 4–6 tidal breaths for young children)—
maximizes lung deposition and safety. Spacers are
recommended for children.
• A (Incorrect): Holding spacer above the head and inhaling
quickly wastes medication; proper positioning is mouth
placement and slow inhalation.
• C (Incorrect): Direct MDI use without a spacer reduces
drug delivery and increases oropharyngeal deposition; if
the child refuses, use caregiver modeling and distraction,
not removal.
• D (Incorrect): Spacers are appropriate with MDIs for both
rescue and some controller inhalers (as per formulation) to
improve delivery, depending on medication.
4
A 6-month-old infant with bronchiolitis (likely RSV) has
tachypnea but oxygen saturation 94% on room air and is
