NCLEX Pediatric Nursing: Growth and Development

Question 1

A nurse is assessing a 2-year-old child. Which developmental milestone would the nurse expect to find?

Accepted Answer

Using 50+ words and combining 2-word phrases

Answer

Speaking in complete 5–6 word sentences

Answer

Walking up stairs with alternating feet

Answer

Drawing a circle and copying simple shapes

Question 2

A parent asks when their infant should receive the first dose of the hepatitis B vaccine. The nurse should respond:

Accepted Answer

Within 24 hours of birth

Answer

At 2 months of age at the first well-baby visit

Answer

At 6 months when the immune system matures

Answer

Only if the mother tests positive for hepatitis B

Question 3

A nurse is caring for a child with epiglottitis. Which intervention should the nurse avoid?

Accepted Answer

Examining the throat with a tongue depressor to visualize the epiglottis

Answer

Administering humidified oxygen

Answer

Placing the child in a position of comfort (usually upright/sitting)

Answer

Preparing for possible emergency airway management

Question 4

A nurse is caring for a child with croup (laryngotracheobronchitis). The child has a 'barky' cough and inspiratory stridor at rest. Which treatment is most appropriate?

Accepted Answer

Administer nebulized racemic epinephrine and oral/IM dexamethasone

Answer

Initiate immediate IV antibiotics for bacterial infection

Answer

Perform a throat culture to identify the pathogen

Answer

Perform immediate intubation to secure the airway

Question 5

The nurse is performing a developmental assessment on a 4-month-old infant. Which finding would be cause for concern?

Accepted Answer

No social smile in response to caregiver

Answer

Does not yet pull to stand

Answer

Cannot walk with support

Answer

Cannot hold a rattle

Question 6

A nurse is educating parents about preventing sudden infant death syndrome (SIDS). Which recommendation is most important?

Accepted Answer

Place the infant in a supine (back) position on a firm mattress in their own sleep space

Answer

Place the infant in the prone (tummy) position for sleep

Answer

Co-sleep with the infant to monitor their breathing

Answer

Use a soft mattress and bumper pads for the crib

Question 7

A school-age child (8 years old) is admitted for an appendectomy. According to Erikson's theory of psychosocial development, which stage is this child in?

Accepted Answer

Industry vs. Inferiority

Answer

Trust vs. Mistrust

Answer

Initiative vs. Guilt

Answer

Identity vs. Role Confusion

Question 8

A nurse is assessing a 6-month-old infant for dehydration. Which clinical sign is the most reliable indicator of dehydration in infants?

Accepted Answer

Skin turgor — tenting when pinched and slow return (>2 seconds)

Answer

Dry lips and mouth

Answer

Absence of tears when crying

Answer

Sunken anterior fontanel

Question 9

A child with sickle cell disease presents to the emergency department with severe bone pain, fever, and swelling in the hands and feet. What condition does this most likely represent?

Accepted Answer

Vaso-occlusive (pain) crisis

Answer

Splenic sequestration crisis

Answer

Aplastic crisis due to parvovirus B19

Answer

Hyperhemolytic crisis

Question 10

A nurse is educating parents of a child diagnosed with type 1 diabetes about sick day management. Which instruction is most important?

Accepted Answer

Continue insulin, check blood glucose every 1–2 hours, and check urine/blood ketones

Answer

Hold insulin if the child is not eating to prevent hypoglycemia

Answer

Give only half the usual insulin dose during illness

Answer

Only administer insulin if blood glucose exceeds 400 mg/dL