NSG 3600 Exam 1 Pediatric
Nursing Comprehensive
Examination 2026
1. A 5-year-old child is experiencing bed-wetting. According to Erikson's psychosocial development
theory, this child is in which stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
ANSWER: B) Autonomy vs. Shame and Doubt
Rationale: The 5-year-old child is in the preschool stage of development according to Erikson, which is
characterized by Autonomy vs. Shame and Doubt. During this stage, children are developing a sense of
personal control over physical skills and independence. Bed-wetting may create feelings of shame and
doubt if not handled appropriately. Trust vs. Mistrust occurs during infancy (birth to 18 months).
Initiative vs. Guilt occurs in preschool years but focuses more on initiating activities. Industry vs.
Inferiority occurs during school-age years (6-12 years), where children develop competence and skills.
2. A 7-year-old child who is struggling with school performance and feeling incompetent is likely
experiencing which Erikson stage conflict?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
,C) Initiative vs. Guilt
D) Industry vs. Inferiority
ANSWER: D) Industry vs. Inferiority
Rationale: The 7-year-old child is in the school-age developmental stage according to Erikson,
characterized by Industry vs. Inferiority. During this stage, children develop a sense of competence and
achievement through learning new skills. When children struggle with school performance, they may
develop feelings of inferiority. Trust vs. Mistrust occurs in infancy. Autonomy vs. Shame and Doubt
occurs in toddlerhood. Initiative vs. Guilt occurs in preschool years.
3. A 14-year-old adolescent is demonstrating the ability to think about abstract concepts and
hypothetical situations. This cognitive ability is characteristic of which Piaget stage?
A) Sensorimotor Stage
B) Preoperational Stage
C) Concrete Operational Stage
D) Formal Operational Stage
ANSWER: D) Formal Operational Stage
Rationale: The Formal Operational Stage, according to Piaget, begins around age 11 and continues into
adulthood. During this stage, individuals develop the ability to think abstractly, logically, and use
deductive reasoning. They can consider hypothetical situations and think about possibilities. The
Sensorimotor Stage (birth to 2 years) involves learning through senses. The Preoperational Stage (2-7
years) involves symbolic thinking but lacks logic. The Concrete Operational Stage (7-11 years) involves
logical thinking about concrete events but limited abstract thinking.
4. A college-bound student is required to receive the meningococcal vaccine. Which of the following is
the most important consideration regarding this vaccine?
A) It is only required for students living in dormitories
B) It provides lifelong immunity after one dose
,C) It should be administered at least 2-4 weeks before college entry
D) It is contraindicated in students with egg allergies
ANSWER: C) It should be administered at least 2-4 weeks before college entry
Rationale: The meningococcal vaccine should be administered at least 2-4 weeks before college entry to
ensure adequate immunity development. The vaccine is recommended for all college students, not just
those in dormitories, as the risk increases in young adults. The vaccine does not provide lifelong
immunity; a booster is recommended at age 16. The meningococcal vaccine is not contraindicated in egg
allergies as it is not egg-based; influenza and yellow fever vaccines may have egg-related
contraindications.
5. A nurse is caring for a patient diagnosed with MRSA. Which transmission-based precautions should
the nurse implement?
A) Standard precautions only
B) Contact precautions only
C) Droplet precautions only
D) Contact and Droplet precautions
ANSWER: D) Contact and Droplet precautions
Rationale: MRSA (Methicillin-resistant Staphylococcus aureus) requires Contact precautions, which
include wearing gloves and a gown when entering the room. If the patient has MRSA pneumonia or
respiratory symptoms, Droplet precautions may also be required. Standard precautions alone are
insufficient for MRSA. Contact precautions are the primary requirement, but when respiratory
symptoms are present, droplet precautions are added. Droplet precautions alone are not sufficient for
MRSA; gloves and gown are required for contact.
6. The nurse is assessing a patient and notes a positive Babinski sign. This finding is considered normal in
which population?
A) Adults
, B) Older adults
C) Infants under 12 months
D) School-age children
ANSWER: C) Infants under 12 months
Rationale: A positive Babinski sign (dorsiflexion of the great toe and fanning of the other toes) is a
normal finding in infants up to 12 months of age due to immature neurological development. After 12
months, a positive Babinski sign is abnormal and may indicate upper motor neuron damage. A positive
Babinski sign is never normal in adults or older adults and requires further neurological evaluation. In
school-age children, a positive Babinski sign is abnormal and warrants investigation.
7. The mother of a 6-month-old infant asks about expected developmental milestones. Which of the
following is an appropriate milestone for this age?
A) Walking independently
B) Saying first words
C) Cooing
D) Sitting without support
ANSWER: C) Cooing
Rationale: Cooing is an expected milestone for a 6-month-old infant. Cooing typically begins around 2-3
months and continues through 6 months. Walking independently typically occurs around 12-15 months.
Saying first words typically occurs around 12 months. Sitting without support typically occurs around 6-8
months, but cooing is more consistently observed at 6 months.
8. A postoperative patient reports redness and warmth to the extremity. The nurse should be most
concerned about which of the following?
A) Normal healing process
B) Deep vein thrombosis
Nursing Comprehensive
Examination 2026
1. A 5-year-old child is experiencing bed-wetting. According to Erikson's psychosocial development
theory, this child is in which stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
ANSWER: B) Autonomy vs. Shame and Doubt
Rationale: The 5-year-old child is in the preschool stage of development according to Erikson, which is
characterized by Autonomy vs. Shame and Doubt. During this stage, children are developing a sense of
personal control over physical skills and independence. Bed-wetting may create feelings of shame and
doubt if not handled appropriately. Trust vs. Mistrust occurs during infancy (birth to 18 months).
Initiative vs. Guilt occurs in preschool years but focuses more on initiating activities. Industry vs.
Inferiority occurs during school-age years (6-12 years), where children develop competence and skills.
2. A 7-year-old child who is struggling with school performance and feeling incompetent is likely
experiencing which Erikson stage conflict?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
,C) Initiative vs. Guilt
D) Industry vs. Inferiority
ANSWER: D) Industry vs. Inferiority
Rationale: The 7-year-old child is in the school-age developmental stage according to Erikson,
characterized by Industry vs. Inferiority. During this stage, children develop a sense of competence and
achievement through learning new skills. When children struggle with school performance, they may
develop feelings of inferiority. Trust vs. Mistrust occurs in infancy. Autonomy vs. Shame and Doubt
occurs in toddlerhood. Initiative vs. Guilt occurs in preschool years.
3. A 14-year-old adolescent is demonstrating the ability to think about abstract concepts and
hypothetical situations. This cognitive ability is characteristic of which Piaget stage?
A) Sensorimotor Stage
B) Preoperational Stage
C) Concrete Operational Stage
D) Formal Operational Stage
ANSWER: D) Formal Operational Stage
Rationale: The Formal Operational Stage, according to Piaget, begins around age 11 and continues into
adulthood. During this stage, individuals develop the ability to think abstractly, logically, and use
deductive reasoning. They can consider hypothetical situations and think about possibilities. The
Sensorimotor Stage (birth to 2 years) involves learning through senses. The Preoperational Stage (2-7
years) involves symbolic thinking but lacks logic. The Concrete Operational Stage (7-11 years) involves
logical thinking about concrete events but limited abstract thinking.
4. A college-bound student is required to receive the meningococcal vaccine. Which of the following is
the most important consideration regarding this vaccine?
A) It is only required for students living in dormitories
B) It provides lifelong immunity after one dose
,C) It should be administered at least 2-4 weeks before college entry
D) It is contraindicated in students with egg allergies
ANSWER: C) It should be administered at least 2-4 weeks before college entry
Rationale: The meningococcal vaccine should be administered at least 2-4 weeks before college entry to
ensure adequate immunity development. The vaccine is recommended for all college students, not just
those in dormitories, as the risk increases in young adults. The vaccine does not provide lifelong
immunity; a booster is recommended at age 16. The meningococcal vaccine is not contraindicated in egg
allergies as it is not egg-based; influenza and yellow fever vaccines may have egg-related
contraindications.
5. A nurse is caring for a patient diagnosed with MRSA. Which transmission-based precautions should
the nurse implement?
A) Standard precautions only
B) Contact precautions only
C) Droplet precautions only
D) Contact and Droplet precautions
ANSWER: D) Contact and Droplet precautions
Rationale: MRSA (Methicillin-resistant Staphylococcus aureus) requires Contact precautions, which
include wearing gloves and a gown when entering the room. If the patient has MRSA pneumonia or
respiratory symptoms, Droplet precautions may also be required. Standard precautions alone are
insufficient for MRSA. Contact precautions are the primary requirement, but when respiratory
symptoms are present, droplet precautions are added. Droplet precautions alone are not sufficient for
MRSA; gloves and gown are required for contact.
6. The nurse is assessing a patient and notes a positive Babinski sign. This finding is considered normal in
which population?
A) Adults
, B) Older adults
C) Infants under 12 months
D) School-age children
ANSWER: C) Infants under 12 months
Rationale: A positive Babinski sign (dorsiflexion of the great toe and fanning of the other toes) is a
normal finding in infants up to 12 months of age due to immature neurological development. After 12
months, a positive Babinski sign is abnormal and may indicate upper motor neuron damage. A positive
Babinski sign is never normal in adults or older adults and requires further neurological evaluation. In
school-age children, a positive Babinski sign is abnormal and warrants investigation.
7. The mother of a 6-month-old infant asks about expected developmental milestones. Which of the
following is an appropriate milestone for this age?
A) Walking independently
B) Saying first words
C) Cooing
D) Sitting without support
ANSWER: C) Cooing
Rationale: Cooing is an expected milestone for a 6-month-old infant. Cooing typically begins around 2-3
months and continues through 6 months. Walking independently typically occurs around 12-15 months.
Saying first words typically occurs around 12 months. Sitting without support typically occurs around 6-8
months, but cooing is more consistently observed at 6 months.
8. A postoperative patient reports redness and warmth to the extremity. The nurse should be most
concerned about which of the following?
A) Normal healing process
B) Deep vein thrombosis
