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) (Growth & Development — Infant)
A 6-month-old infant is brought to the clinic for well-baby care.
Which milestone is most appropriate for a 6-month-old?
A. Says 2–3 single words (e.g., "mama," "dada") with meaning.
B. Sits unsupported and begins to pass objects from one hand
to the other.
C. Walks independently five to six steps.
D. Copies a vertical line on paper with a crayon.
Correct answer: B
Rationale:
• B (Correct): At 6 months infants typically sit unsupported
and can transfer objects hand to hand — gross and fine
motor milestones appropriate for this age. Developmental
, expectations are the basis for anticipatory guidance and
safety (e.g., fall risk when sitting unsupported).
• A (Incorrect): Intentional use of 2–3 meaningful words
usually occurs closer to 9–12 months. At 6 months,
babbling (e.g., "ba-ba") is expected, not purposeful words.
• C (Incorrect): Independent walking usually begins around
12–15 months. Selecting this would overestimate gross
motor development and could lead to missed referral for
delay.
• D (Incorrect): Copying lines is a preschool fine motor skill
(approx. 3–4 years). Expecting it at 6 months is
inappropriate.
2) (Growth & Development — Toddler)
A 2-year-old toddler is admitted for dehydration. Which
behavior by the child indicates typical psychosocial
development for this age?
A. Plays cooperatively with several other children for long
periods.
B. Uses one-word or two-word phrases and states “mine”
frequently.
C. Demonstrates dependable toileting and can brush teeth
without assistance.
D. Shows interest in reading quietly alone for 30 minutes.
Correct answer: B
,Rationale:
• B (Correct): At 2 years, toddlers use two-word phrases and
strongly assert autonomy (possessive language like
“mine”) — Erikson’s autonomy vs. shame/doubt.
Recognizing this helps tailor family communication and
safety instructions (e.g., choking risk, supervision).
• A (Incorrect): Cooperative play is more typical of
preschoolers (3–5 years); 2-year-olds engage in parallel
play (play beside, not with, others).
• C (Incorrect): Independent toileting and toothbrushing
without assistance typically occur later (toilet training
usually by 2.5–3 years; brushing needs supervision).
• D (Incorrect): Sustained independent quiet reading is not
developmentally expected for a 2-year-old.
3) (Respiratory — Asthma: Acute Care Prioritization, NGN
style)
A 7-year-old child with known moderate persistent asthma
arrives to the ED wheezing, speaking in short phrases,
respiratory rate 36/min, pulse 132/min, O₂ saturation 89% on
room air. Which action is highest priority?
A. Administer nebulized albuterol and ipratropium immediately.
B. Obtain a chest x-ray to rule out pneumonia.
C. Begin oral corticosteroids and discharge home with follow-
, up.
D. Start a heliox mask to improve oxygenation.
Correct answer: A
Rationale:
• A (Correct): Priority is to relieve bronchoconstriction and
improve ventilation—administering rapid-acting
bronchodilator (nebulized albuterol) ± ipratropium is
immediate, life-saving treatment. Low oxygen saturation
(89%) and increased work of breathing require rapid
bronchodilation and supplemental oxygen. This aligns with
airway/breathing first in NGN priority decisions.
• B (Incorrect): Chest x-ray is not the immediate priority and
should not delay bronchodilator therapy in an acute
exacerbation. Imaging may be considered after
stabilization.
• C (Incorrect): Oral corticosteroids are appropriate but are
not the single highest priority and do not replace
immediate bronchodilator treatment; discharge is unsafe
with current hypoxia and tachycardia.
• D (Incorrect): Heliox is not first-line and is rarely indicated;
high-priority bronchodilation and oxygen therapy are
indicated first.
4) (Bronchiolitis — Pediatric Infectious Respiratory)
PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
PEDIATRIC NURSING (CHILD HEALTH & DEVELOPMENTAL
DISORDERS) TEST BANK
1) (Growth & Development — Infant)
A 6-month-old infant is brought to the clinic for well-baby care.
Which milestone is most appropriate for a 6-month-old?
A. Says 2–3 single words (e.g., "mama," "dada") with meaning.
B. Sits unsupported and begins to pass objects from one hand
to the other.
C. Walks independently five to six steps.
D. Copies a vertical line on paper with a crayon.
Correct answer: B
Rationale:
• B (Correct): At 6 months infants typically sit unsupported
and can transfer objects hand to hand — gross and fine
motor milestones appropriate for this age. Developmental
, expectations are the basis for anticipatory guidance and
safety (e.g., fall risk when sitting unsupported).
• A (Incorrect): Intentional use of 2–3 meaningful words
usually occurs closer to 9–12 months. At 6 months,
babbling (e.g., "ba-ba") is expected, not purposeful words.
• C (Incorrect): Independent walking usually begins around
12–15 months. Selecting this would overestimate gross
motor development and could lead to missed referral for
delay.
• D (Incorrect): Copying lines is a preschool fine motor skill
(approx. 3–4 years). Expecting it at 6 months is
inappropriate.
2) (Growth & Development — Toddler)
A 2-year-old toddler is admitted for dehydration. Which
behavior by the child indicates typical psychosocial
development for this age?
A. Plays cooperatively with several other children for long
periods.
B. Uses one-word or two-word phrases and states “mine”
frequently.
C. Demonstrates dependable toileting and can brush teeth
without assistance.
D. Shows interest in reading quietly alone for 30 minutes.
Correct answer: B
,Rationale:
• B (Correct): At 2 years, toddlers use two-word phrases and
strongly assert autonomy (possessive language like
“mine”) — Erikson’s autonomy vs. shame/doubt.
Recognizing this helps tailor family communication and
safety instructions (e.g., choking risk, supervision).
• A (Incorrect): Cooperative play is more typical of
preschoolers (3–5 years); 2-year-olds engage in parallel
play (play beside, not with, others).
• C (Incorrect): Independent toileting and toothbrushing
without assistance typically occur later (toilet training
usually by 2.5–3 years; brushing needs supervision).
• D (Incorrect): Sustained independent quiet reading is not
developmentally expected for a 2-year-old.
3) (Respiratory — Asthma: Acute Care Prioritization, NGN
style)
A 7-year-old child with known moderate persistent asthma
arrives to the ED wheezing, speaking in short phrases,
respiratory rate 36/min, pulse 132/min, O₂ saturation 89% on
room air. Which action is highest priority?
A. Administer nebulized albuterol and ipratropium immediately.
B. Obtain a chest x-ray to rule out pneumonia.
C. Begin oral corticosteroids and discharge home with follow-
, up.
D. Start a heliox mask to improve oxygenation.
Correct answer: A
Rationale:
• A (Correct): Priority is to relieve bronchoconstriction and
improve ventilation—administering rapid-acting
bronchodilator (nebulized albuterol) ± ipratropium is
immediate, life-saving treatment. Low oxygen saturation
(89%) and increased work of breathing require rapid
bronchodilation and supplemental oxygen. This aligns with
airway/breathing first in NGN priority decisions.
• B (Incorrect): Chest x-ray is not the immediate priority and
should not delay bronchodilator therapy in an acute
exacerbation. Imaging may be considered after
stabilization.
• C (Incorrect): Oral corticosteroids are appropriate but are
not the single highest priority and do not replace
immediate bronchodilator treatment; discharge is unsafe
with current hypoxia and tachycardia.
• D (Incorrect): Heliox is not first-line and is rarely indicated;
high-priority bronchodilation and oxygen therapy are
indicated first.
4) (Bronchiolitis — Pediatric Infectious Respiratory)
