Peds Exam 1 NCLEX style questions
To establish a good interview relationship with an adolescent, which strategy is most appropriate?
1. Asking personal questions unrelated to the situation
2. Writing down everything the teen says
3. Asking open-ended questions
4. Discussing the nurse's own thoughts and feelings about the situation - ANSWER3. Asking open-ended
questions
RATIONALE: Open-ended questions allow the adolescent to share information and feelings. Asking
personal questions not related to the situation jeopardizes the trust that must be established because
the adolescent may feel as though he's being interrogated with unnecessary questions. Writing
everything down during the interview can be a distraction and doesn't allow the nurse to observe how
the adolescent behaves. Discussing the nurse's thoughts and feelings may bias the assessment and is
inappropriate when interviewing any client
A chronically ill school-age child is most vulnerable to which stressor?
1. Mutilation anxiety
2. Anticipatory grief
3. Anxiety over school absences
4. Fear of hospital procedures - ANSWER3. Anxiety over school absences
RATIONALE: The school-age child is becoming industrious and attempts to master school-related
activities. Therefore, school absences are likely to cause extreme anxiety for a school-age child who's
chronically ill. Mutilation anxiety is more common in adolescents. Anticipatory grief is rare in a school-
age child. Fear of hospital procedures is most pronounced in preschool-age children.
When developing a care plan for an adolescent, the nurse considers the child's psychosocial needs.
During adolescence, psychosocial development focuses on:
,1. becoming industrious.
2. establishing an identity.
3. achieving intimacy.
4. developing initiative. - ANSWER2. establishing an identity.
RATIONALE: According to Erikson, the primary psychosocial task during adolescence is to establish a
personal identity while overcoming role or identity confusion. The adolescent attempts to establish a
group identity by seeking acceptance and approval from peers, and strives to attain a personal identity
by becoming more independent from his family. Becoming industrious is the developmental task of the
school-age child; achieving intimacy is the task of the young adult; and developing initiative is the task of
the preschooler.
A nurse notes that an infant develops arm movement before fine-motor finger skills and interprets this
as an example of which pattern of development?
1. Cephalocaudal
2. Proximodistal
3. Differentiation
4. Mass-to-specific - ANSWER2. Proximodistal
RATIONALE: Proximodistal development progresses from the center of the body to the extremities, such
as from the arm to the fingers. Cephalocaudal development occurs along the body's long axis; for
example, the infant develops control over the head, mouth, and eye movements before the upper body,
torso, and legs. Mass-to-specific development, sometimes called differentiation, occurs as the child
masters’ simple operations before complex functions and moves from broad, general patterns of
behavior to more refined ones.
A teenage mother brings her 1-year-old child to the pediatrician's office for a well-baby checkup. She
says that her infant can't sit alone or roll over. An appropriate response by the nurse would be:
1. "This is very abnormal. Your child must be sick."
2. "Let's see about further developmental testing."
3. "Don't worry, this is normal for her age."
, 4. "Maybe you just haven't seen her do it." - ANSWER. "Let's see about further developmental testing."
RATIONALE: Stating that further developmental testing is necessary is appropriate because at age 12
months a child should be sitting up and rolling over. Therefore, this child may have developmental
problems. Saying the infant's behavior is abnormal or suggesting that the mother hasn't seen her infant
do these milestones isn't therapeutic and can cut off communication with the mother. Telling the mother
that the infant's behavior is normal misleads the mother with false reassurance.
The mother of an 11-month-old infant reports to the nurse that her infant sleeps much less than other
children. The mother asks the nurse whether her infant is getting sufficient sleep. What should be the
nurse's initial response?
1. Reassure the mother that each infant's sleep needs are individual.
2. Ask the mother for more information about the infant's sleep patterns.
3. Instruct the mother to decrease the infant's daytime sleep to increase his nighttime sleep.
4. Inform the mother that her infant's growth and development are appropriate for his age, so sleep isn't
a concern. - ANSWER2. Ask the mother for more information about the infant's sleep patterns.
RATIONALE: The nurse needs more information about the infant's sleep patterns to rule out potential
problems before determining whether the infant is getting enough sleep. The nurse shouldn't offer
advice or reassurance without knowing more about the infant's specific sleep habits.
A nurse observes a 2½-year-old child playing with another child of the same age in the playroom on the
pediatric unit. What type of play should the nurse expect the children to engage in?
1. Associative play
2. Parallel play
3. Cooperative play
4. Therapeutic play - ANSWER2. Parallel play
RATIONALE: Two-year-olds engage in parallel play, in which they play side by side but rarely interact.
Associative play is characteristic of preschoolers, in which they are all engaged in a similar activity but
there is little organization. School-age children engage in cooperative play, which is organized and goal-
To establish a good interview relationship with an adolescent, which strategy is most appropriate?
1. Asking personal questions unrelated to the situation
2. Writing down everything the teen says
3. Asking open-ended questions
4. Discussing the nurse's own thoughts and feelings about the situation - ANSWER3. Asking open-ended
questions
RATIONALE: Open-ended questions allow the adolescent to share information and feelings. Asking
personal questions not related to the situation jeopardizes the trust that must be established because
the adolescent may feel as though he's being interrogated with unnecessary questions. Writing
everything down during the interview can be a distraction and doesn't allow the nurse to observe how
the adolescent behaves. Discussing the nurse's thoughts and feelings may bias the assessment and is
inappropriate when interviewing any client
A chronically ill school-age child is most vulnerable to which stressor?
1. Mutilation anxiety
2. Anticipatory grief
3. Anxiety over school absences
4. Fear of hospital procedures - ANSWER3. Anxiety over school absences
RATIONALE: The school-age child is becoming industrious and attempts to master school-related
activities. Therefore, school absences are likely to cause extreme anxiety for a school-age child who's
chronically ill. Mutilation anxiety is more common in adolescents. Anticipatory grief is rare in a school-
age child. Fear of hospital procedures is most pronounced in preschool-age children.
When developing a care plan for an adolescent, the nurse considers the child's psychosocial needs.
During adolescence, psychosocial development focuses on:
,1. becoming industrious.
2. establishing an identity.
3. achieving intimacy.
4. developing initiative. - ANSWER2. establishing an identity.
RATIONALE: According to Erikson, the primary psychosocial task during adolescence is to establish a
personal identity while overcoming role or identity confusion. The adolescent attempts to establish a
group identity by seeking acceptance and approval from peers, and strives to attain a personal identity
by becoming more independent from his family. Becoming industrious is the developmental task of the
school-age child; achieving intimacy is the task of the young adult; and developing initiative is the task of
the preschooler.
A nurse notes that an infant develops arm movement before fine-motor finger skills and interprets this
as an example of which pattern of development?
1. Cephalocaudal
2. Proximodistal
3. Differentiation
4. Mass-to-specific - ANSWER2. Proximodistal
RATIONALE: Proximodistal development progresses from the center of the body to the extremities, such
as from the arm to the fingers. Cephalocaudal development occurs along the body's long axis; for
example, the infant develops control over the head, mouth, and eye movements before the upper body,
torso, and legs. Mass-to-specific development, sometimes called differentiation, occurs as the child
masters’ simple operations before complex functions and moves from broad, general patterns of
behavior to more refined ones.
A teenage mother brings her 1-year-old child to the pediatrician's office for a well-baby checkup. She
says that her infant can't sit alone or roll over. An appropriate response by the nurse would be:
1. "This is very abnormal. Your child must be sick."
2. "Let's see about further developmental testing."
3. "Don't worry, this is normal for her age."
, 4. "Maybe you just haven't seen her do it." - ANSWER. "Let's see about further developmental testing."
RATIONALE: Stating that further developmental testing is necessary is appropriate because at age 12
months a child should be sitting up and rolling over. Therefore, this child may have developmental
problems. Saying the infant's behavior is abnormal or suggesting that the mother hasn't seen her infant
do these milestones isn't therapeutic and can cut off communication with the mother. Telling the mother
that the infant's behavior is normal misleads the mother with false reassurance.
The mother of an 11-month-old infant reports to the nurse that her infant sleeps much less than other
children. The mother asks the nurse whether her infant is getting sufficient sleep. What should be the
nurse's initial response?
1. Reassure the mother that each infant's sleep needs are individual.
2. Ask the mother for more information about the infant's sleep patterns.
3. Instruct the mother to decrease the infant's daytime sleep to increase his nighttime sleep.
4. Inform the mother that her infant's growth and development are appropriate for his age, so sleep isn't
a concern. - ANSWER2. Ask the mother for more information about the infant's sleep patterns.
RATIONALE: The nurse needs more information about the infant's sleep patterns to rule out potential
problems before determining whether the infant is getting enough sleep. The nurse shouldn't offer
advice or reassurance without knowing more about the infant's specific sleep habits.
A nurse observes a 2½-year-old child playing with another child of the same age in the playroom on the
pediatric unit. What type of play should the nurse expect the children to engage in?
1. Associative play
2. Parallel play
3. Cooperative play
4. Therapeutic play - ANSWER2. Parallel play
RATIONALE: Two-year-olds engage in parallel play, in which they play side by side but rarely interact.
Associative play is characteristic of preschoolers, in which they are all engaged in a similar activity but
there is little organization. School-age children engage in cooperative play, which is organized and goal-
