NACE Care of the Child Exam ACTUAL EXAM
2026/2027 | Pediatric Nursing | Verified Q&A |
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Section 1: Growth & Development (15 Questions)
Q1: A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental milestone
would the nurse expect to observe?
A. The infant walks while holding onto furniture
B. The infant uses a pincer grasp to pick up small objects
C. The infant rolls from prone to supine and sits with support. [CORRECT]
D. The infant says "mama" and "dada" with specific meaning
Correct Answer: C
Rationale: At 6 months, infants typically roll from prone to supine (and vice versa) and can sit with
support. This reflects normal gross motor development progression. Option A (cruising) occurs around
9-10 months; Option B (pincer grasp) develops at 9-12 months; Option D (meaningful "mama/dada")
occurs around 10-12 months when infants begin attaching meaning to sounds.
Q2: A school nurse is evaluating a 5-year-old child's cognitive development. Which behavior
demonstrates appropriate cognitive functioning for this age?
A. The child understands that a ball of clay maintains its mass when flattened
B. The child believes that dreams are caused by external events
C. The child can classify objects by multiple characteristics simultaneously
D. The child engages in magical thinking and believes inanimate objects have lifelike qualities.
[CORRECT]
Correct Answer: D
Rationale: According to Piaget, 5-year-olds are in the preoperational stage (2-7 years), characterized by
magical thinking, animism (believing objects are alive), and egocentrism. They cannot yet understand
conservation (Option A - concrete operational stage, 7+ years), distinguish internal from external events
(Option B), or perform concrete logical operations (Option C - concrete operational stage).
,Q3: During a routine check-up, a nurse notes that a 12-month-old child is not yet pulling to stand. The
child can sit independently and crawl. What is the most appropriate nursing action?
A. Document this as a normal variation and schedule routine follow-up
B. Refer the child for immediate developmental evaluation
C. Assess the child's birth history and current muscle tone, then determine if referral is needed.
[CORRECT]
D. Reassure parents that some children skip the standing milestone entirely
Correct Answer: C
Rationale: Pulling to stand is expected by 12 months, but a comprehensive assessment including birth
history (prematurity, complications), muscle tone, and overall developmental trajectory is essential
before determining if this represents a delay requiring intervention. While some variation exists, gross
motor delays warrant systematic evaluation per AAP guidelines. Option A is premature without
assessment; Option B is excessive without context; Option D provides false reassurance.
Q4: A nurse is counseling parents of a 15-year-old about adolescent brain development. Which
statement accurately describes the adolescent brain?
A. "The brain is fully mature by age 15, so your teen should have complete impulse control"
B. "The prefrontal cortex, responsible for decision-making and impulse control, continues developing
until approximately age 25. [CORRECT]"
C. "Adolescents process emotions in the prefrontal cortex, making them less reactive than adults"
D. "Brain development is complete by puberty, around age 12-13"
Correct Answer: B
Rationale: Neuroscience research confirms the prefrontal cortex (executive function, impulse control,
risk assessment) continues maturing into the mid-20s, while the limbic system (emotions, rewards) is
more active during adolescence. This developmental asynchrony explains increased risk-taking behavior.
Options A and D are factually incorrect; Option C is reversed—adolescents process emotions primarily
through the amygdala (limbic system), not the prefrontal cortex.
Q5: A pediatric nurse is assessing language development in a 2-year-old. Which finding indicates normal
expressive language development?
A. The child uses 50+ words and combines two words into phrases. [CORRECT]
B. The child speaks in complete sentences with proper grammar
,C. The child understands complex instructions but speaks in single words only
D. The child has a vocabulary of 200+ words and asks "why" questions constantly
Correct Answer: A
Rationale: By age 2, normal expressive language includes a vocabulary of 50+ words and the ability to
combine two words (telegraphic speech). Option B (complete sentences) is typical of 3-4 years; Option C
suggests expressive language delay despite receptive language being intact; Option D (200+ words,
"why" questions) describes 3-year-old language development.
Q6: During a developmental screening, a nurse notes a 9-month-old infant does not babble consonant
sounds (e.g., "ba," "da"). The infant coos and makes vowel sounds. What is the priority nursing
intervention?
A. Reassure parents that babbling develops between 9-12 months and recheck at 12 months
B. Refer immediately to speech-language pathology for evaluation
C. Assess hearing status and refer for audiological evaluation if indicated. [CORRECT]
D. Document as normal and provide language stimulation techniques only
Correct Answer: C
Rationale: Canonical babbling (repeated consonant-vowel combinations) should emerge by 6-10
months. Absence of babbling by 9 months warrants hearing assessment, as hearing impairment is a
primary cause of speech/language delays. Early identification is critical for intervention. Option A delays
necessary evaluation; Option B is premature without ruling out hearing issues; Option D misses a red
flag requiring systematic assessment.
Q7: A nurse is teaching parents about fine motor development in their 4-year-old. Which activity would
the nurse recommend to support appropriate developmental progression?
A. Building complex 3D structures with small interlocking blocks
B. Drawing a person with 6+ body parts and writing letters
C. Using scissors to cut along a curved line and drawing simple shapes. [CORRECT]
D. Tying shoelaces with a double knot and copying a triangle
Correct Answer: C
Rationale: By age 4, children develop the fine motor skills to cut along curved lines and draw simple
shapes (circles, squares). Option A describes 5-6 year skills; Option B (detailed person, writing) is typical
of 5+ years; Option D (shoelace tying, complex shapes) is expected by 5-6 years. The nurse should
recommend age-appropriate activities to build skills progressively without frustration.
, Q8: A pediatric nurse is assessing a 3-year-old's psychosocial development. The child plays alongside
other children but does not interact with them directly. How should the nurse interpret this behavior?
A. The child is demonstrating delayed social development requiring intervention
B. This is parallel play, which is normal for children aged 2-3 years. [CORRECT]
C. The child is showing early signs of autism spectrum disorder
D. This represents associative play typical of 4-5 year olds
Correct Answer: B
Rationale: Parallel play (playing near but not with others) is the characteristic play pattern for toddlers
aged 2-3 years per Parten's stages of play. It represents normal social development, not delay (Option A)
or autism (Option C). Associative play (Option D) involves interaction and sharing, emerging around 3-4
years. The nurse should reassure parents this is developmentally appropriate.
Q9: A nurse is evaluating a 7-year-old's cognitive development using Piaget's theory. Which behavior
demonstrates concrete operational thinking?
A. The child can think abstractly about justice and fairness
B. The child understands that 8 ounces of water in a tall glass equals 8 ounces in a wide bowl. [CORRECT]
C. The child believes the moon follows them when they walk
D. The child engages in pretend play with imaginary friends
Correct Answer: B
Rationale: Conservation (understanding quantity remains constant despite changes in appearance) is
the hallmark of concrete operational thought (ages 7-11). Option A describes formal operational
thinking (12+ years); Option C (egocentrism/animism) and Option D (pretend play) are preoperational
stage characteristics (2-7 years). The 7-year-old has transitioned to logical, concrete reasoning.
Q10: During a routine assessment, a nurse notes that an 18-month-old child has lost previously acquired
skills, including the ability to say 10 words and walk independently. The child now crawls and uses only 2
words. What is the priority action?
A. Reassure parents that developmental regression is common during illness
B. Refer immediately for comprehensive developmental and neurological evaluation. [CORRECT]
C. Schedule routine follow-up in 3 months to monitor progress
D. Suggest speech therapy and physical therapy without medical evaluation
Correct Answer: B
2026/2027 | Pediatric Nursing | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1: Growth & Development (15 Questions)
Q1: A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental milestone
would the nurse expect to observe?
A. The infant walks while holding onto furniture
B. The infant uses a pincer grasp to pick up small objects
C. The infant rolls from prone to supine and sits with support. [CORRECT]
D. The infant says "mama" and "dada" with specific meaning
Correct Answer: C
Rationale: At 6 months, infants typically roll from prone to supine (and vice versa) and can sit with
support. This reflects normal gross motor development progression. Option A (cruising) occurs around
9-10 months; Option B (pincer grasp) develops at 9-12 months; Option D (meaningful "mama/dada")
occurs around 10-12 months when infants begin attaching meaning to sounds.
Q2: A school nurse is evaluating a 5-year-old child's cognitive development. Which behavior
demonstrates appropriate cognitive functioning for this age?
A. The child understands that a ball of clay maintains its mass when flattened
B. The child believes that dreams are caused by external events
C. The child can classify objects by multiple characteristics simultaneously
D. The child engages in magical thinking and believes inanimate objects have lifelike qualities.
[CORRECT]
Correct Answer: D
Rationale: According to Piaget, 5-year-olds are in the preoperational stage (2-7 years), characterized by
magical thinking, animism (believing objects are alive), and egocentrism. They cannot yet understand
conservation (Option A - concrete operational stage, 7+ years), distinguish internal from external events
(Option B), or perform concrete logical operations (Option C - concrete operational stage).
,Q3: During a routine check-up, a nurse notes that a 12-month-old child is not yet pulling to stand. The
child can sit independently and crawl. What is the most appropriate nursing action?
A. Document this as a normal variation and schedule routine follow-up
B. Refer the child for immediate developmental evaluation
C. Assess the child's birth history and current muscle tone, then determine if referral is needed.
[CORRECT]
D. Reassure parents that some children skip the standing milestone entirely
Correct Answer: C
Rationale: Pulling to stand is expected by 12 months, but a comprehensive assessment including birth
history (prematurity, complications), muscle tone, and overall developmental trajectory is essential
before determining if this represents a delay requiring intervention. While some variation exists, gross
motor delays warrant systematic evaluation per AAP guidelines. Option A is premature without
assessment; Option B is excessive without context; Option D provides false reassurance.
Q4: A nurse is counseling parents of a 15-year-old about adolescent brain development. Which
statement accurately describes the adolescent brain?
A. "The brain is fully mature by age 15, so your teen should have complete impulse control"
B. "The prefrontal cortex, responsible for decision-making and impulse control, continues developing
until approximately age 25. [CORRECT]"
C. "Adolescents process emotions in the prefrontal cortex, making them less reactive than adults"
D. "Brain development is complete by puberty, around age 12-13"
Correct Answer: B
Rationale: Neuroscience research confirms the prefrontal cortex (executive function, impulse control,
risk assessment) continues maturing into the mid-20s, while the limbic system (emotions, rewards) is
more active during adolescence. This developmental asynchrony explains increased risk-taking behavior.
Options A and D are factually incorrect; Option C is reversed—adolescents process emotions primarily
through the amygdala (limbic system), not the prefrontal cortex.
Q5: A pediatric nurse is assessing language development in a 2-year-old. Which finding indicates normal
expressive language development?
A. The child uses 50+ words and combines two words into phrases. [CORRECT]
B. The child speaks in complete sentences with proper grammar
,C. The child understands complex instructions but speaks in single words only
D. The child has a vocabulary of 200+ words and asks "why" questions constantly
Correct Answer: A
Rationale: By age 2, normal expressive language includes a vocabulary of 50+ words and the ability to
combine two words (telegraphic speech). Option B (complete sentences) is typical of 3-4 years; Option C
suggests expressive language delay despite receptive language being intact; Option D (200+ words,
"why" questions) describes 3-year-old language development.
Q6: During a developmental screening, a nurse notes a 9-month-old infant does not babble consonant
sounds (e.g., "ba," "da"). The infant coos and makes vowel sounds. What is the priority nursing
intervention?
A. Reassure parents that babbling develops between 9-12 months and recheck at 12 months
B. Refer immediately to speech-language pathology for evaluation
C. Assess hearing status and refer for audiological evaluation if indicated. [CORRECT]
D. Document as normal and provide language stimulation techniques only
Correct Answer: C
Rationale: Canonical babbling (repeated consonant-vowel combinations) should emerge by 6-10
months. Absence of babbling by 9 months warrants hearing assessment, as hearing impairment is a
primary cause of speech/language delays. Early identification is critical for intervention. Option A delays
necessary evaluation; Option B is premature without ruling out hearing issues; Option D misses a red
flag requiring systematic assessment.
Q7: A nurse is teaching parents about fine motor development in their 4-year-old. Which activity would
the nurse recommend to support appropriate developmental progression?
A. Building complex 3D structures with small interlocking blocks
B. Drawing a person with 6+ body parts and writing letters
C. Using scissors to cut along a curved line and drawing simple shapes. [CORRECT]
D. Tying shoelaces with a double knot and copying a triangle
Correct Answer: C
Rationale: By age 4, children develop the fine motor skills to cut along curved lines and draw simple
shapes (circles, squares). Option A describes 5-6 year skills; Option B (detailed person, writing) is typical
of 5+ years; Option D (shoelace tying, complex shapes) is expected by 5-6 years. The nurse should
recommend age-appropriate activities to build skills progressively without frustration.
, Q8: A pediatric nurse is assessing a 3-year-old's psychosocial development. The child plays alongside
other children but does not interact with them directly. How should the nurse interpret this behavior?
A. The child is demonstrating delayed social development requiring intervention
B. This is parallel play, which is normal for children aged 2-3 years. [CORRECT]
C. The child is showing early signs of autism spectrum disorder
D. This represents associative play typical of 4-5 year olds
Correct Answer: B
Rationale: Parallel play (playing near but not with others) is the characteristic play pattern for toddlers
aged 2-3 years per Parten's stages of play. It represents normal social development, not delay (Option A)
or autism (Option C). Associative play (Option D) involves interaction and sharing, emerging around 3-4
years. The nurse should reassure parents this is developmentally appropriate.
Q9: A nurse is evaluating a 7-year-old's cognitive development using Piaget's theory. Which behavior
demonstrates concrete operational thinking?
A. The child can think abstractly about justice and fairness
B. The child understands that 8 ounces of water in a tall glass equals 8 ounces in a wide bowl. [CORRECT]
C. The child believes the moon follows them when they walk
D. The child engages in pretend play with imaginary friends
Correct Answer: B
Rationale: Conservation (understanding quantity remains constant despite changes in appearance) is
the hallmark of concrete operational thought (ages 7-11). Option A describes formal operational
thinking (12+ years); Option C (egocentrism/animism) and Option D (pretend play) are preoperational
stage characteristics (2-7 years). The 7-year-old has transitioned to logical, concrete reasoning.
Q10: During a routine assessment, a nurse notes that an 18-month-old child has lost previously acquired
skills, including the ability to say 10 words and walk independently. The child now crawls and uses only 2
words. What is the priority action?
A. Reassure parents that developmental regression is common during illness
B. Refer immediately for comprehensive developmental and neurological evaluation. [CORRECT]
C. Schedule routine follow-up in 3 months to monitor progress
D. Suggest speech therapy and physical therapy without medical evaluation
Correct Answer: B
