Growth and Development and Immunizations Test Bank

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Sample questions from Growth and Development and Immunizations Test Bank

This material has 45 questions with answers and rationales. Here are the first 5.

1. 1.A 2-month-old infant is seen for a well-child visit. The infant feeds well, gains weight appropriately, and has normal vital signs. Which observation best supports age-appropriate development?

   • A.Smiles in response to the caregiver's face and voice
   • B.Sits without support for several minutes
   • C.Transfers a toy from one hand to the other
   • D.Uses a thumb-and-finger grasp to pick up cereal

   Rationale: A social smile is an expected developmental finding around 2 months. Independent sitting and transferring objects between hands develop later in infancy. A refined thumb-and-finger grasp also emerges later, typically near the end of the first year. Match developmental expectations to the infant's age rather than selecting the most advanced skill.

2. 2.A 6-month-old infant born at term is evaluated in a pediatric clinic. The infant smiles, reaches for toys, and responds to sounds but has persistent head lag and cannot hold the head steady when supported upright. Which action should the nurse take?

   • A.Reassure the caregiver that this is expected until 9 months
   • B.Recommend a seated infant walker to strengthen the neck
   • C.Notify the provider and arrange further developmental assessment
   • D.Teach the caregiver to start solid foods before reassessment

   Rationale: Persistent poor head control at 6 months warrants prompt developmental evaluation. Waiting until 9 months may delay early intervention. Infant walkers do not treat motor delays and increase injury risk, while starting solids does not address the finding and may be unsafe with poor head control. A significant missed motor milestone requires assessment rather than reassurance alone.

3. 3.A 9-month-old infant at a clinic visit cries when the nurse approaches but quiets when held by the parent. The infant is afebrile, alert, and interactive with the parent. Which nursing approach is best?

   • A.Ask the parent to leave so the infant can establish trust with the nurse
   • B.Begin the assessment while the infant sits on the parent's lap
   • C.Document the behavior as evidence of insecure attachment
   • D.Complete the most uncomfortable procedures first

   Rationale: Stranger anxiety is common in later infancy, and using the parent's lap supports security during assessment. Removing the parent often intensifies distress. This isolated behavior does not indicate insecure attachment, and uncomfortable procedures are usually saved for last when feasible. Incorporate normal developmental responses into the examination approach.

4. 4.A 12-month-old child is seen at a health supervision visit. The child pulls to stand, waves goodbye, and picks up small objects with the thumb and index finger. The parent asks which snack is safest while practicing self-feeding. Which recommendation should the nurse give?

   • A.Whole grapes cut from the stem
   • B.A spoonful of thick peanut butter
   • C.Raw carrot coins
   • D.Small pieces of soft, ripe banana

   Answer and rationale are in the full material.

5. 5.An 18-month-old child at a primary care visit uses no meaningful words, rarely points to share interest, and inconsistently responds to their name. The child has normal vital signs and no acute illness. What is the nurse's best response?

   • A.Initiate developmental and autism screening and facilitate hearing and early-intervention referrals
   • B.Reassure the parent that children commonly remain nonverbal until age 3
   • C.Recommend additional educational screen time before obtaining referrals
   • D.Explain that these findings establish a diagnosis of autism spectrum disorder

   Answer and rationale are in the full material.