Growth and Development and Vaccines

Free preview · Original latest version

Sample questions from Growth and Development and Vaccines

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 2-month-old infant is brought to a primary care clinic for a well-child visit. The infant's weight is increasing appropriately, temperature is 36.8 C (98.2 F), and the parent reports that the infant startles at loud noises. Which additional finding best supports expected development?

   • A.Smiles when the parent talks to the infant
   • B.Sits unsupported for several minutes
   • C.Transfers a toy from one hand to the other
   • D.Uses a thumb-and-index-finger grasp to pick up cereal

   Rationale: A responsive social smile is an expected finding around 2 months. Unsupported sitting and transferring objects between hands develop later in infancy. A precise pincer grasp is generally a late-infancy skill, not a 2-month milestone. The exam takeaway is to distinguish early social interaction from later gross and fine motor achievements.

2. 2.A 4-month-old infant is assessed in a pediatric clinic. The infant tracks a toy and coos but has marked head lag when gently pulled toward sitting and cannot hold the head steady while supported upright. Vital signs are normal. Which action should the nurse take?

   • A.Explain that steady head control usually develops after 9 months
   • B.Notify the primary care provider and facilitate developmental evaluation
   • C.Recommend a seated infant walker to strengthen the neck
   • D.Delay reassessment until the infant begins crawling

   Rationale: Persistent marked head lag and poor supported head control at 4 months warrant further assessment. Reassuring the parent that head control normally develops after 9 months misrepresents expected development. Infant walkers do not treat developmental delay and introduce injury risk, while waiting for crawling delays intervention. The exam takeaway is to act on concerning motor findings rather than use a wait-and-see approach.

3. 3.A 6-month-old infant is seen at a community clinic. The infant has good head control, sits with support, and reaches for food during family meals. The parent asks how to begin complementary feeding while continuing breast milk. Which instruction is best?

   • A.Replace most breast milk feedings with diluted fruit juice
   • B.Delay all peanut-containing foods until the third birthday
   • C.Offer developmentally appropriate iron-rich foods while continuing breast milk
   • D.Add honey to cereal to improve acceptance of new foods

   Rationale: Around 6 months, a developmentally ready infant should begin complementary foods that include iron-rich choices while continuing breast milk or iron-fortified formula. Juice should not replace nutrient-dense milk feedings, and routine delay of peanut introduction until age 3 is not recommended. Honey is avoided before 12 months because of infant botulism risk. The exam takeaway is to combine developmental readiness with nutritional adequacy and safe food selection.

4. 4.A 9-month-old infant in an outpatient clinic cries when the parent steps away and reaches toward the parent when an unfamiliar nurse approaches. The infant plays comfortably when seated on the parent's lap and has normal vital signs. Which nursing approach is most appropriate?

   • A.Ask the parent to leave so the infant can become independent
   • B.Restrain the infant before beginning the assessment
   • C.Refer the infant for evaluation of impaired attachment
   • D.Begin the assessment while the infant remains on the parent's lap

   Answer and rationale are in the full material.

5. 5.A 12-month-old child is evaluated at a well-child visit. The child pulls to stand and picks up small food pieces but does not respond to the child's name, use gestures such as waving, or babble. The parent reports no recent illness. Which action has the highest priority?

   • A.Arrange hearing and developmental evaluation through the provider
   • B.Reassure the parent because motor development is normal
   • C.Recommend educational videos before pursuing evaluation
   • D.Wait until age 2 years to determine whether language develops

   Answer and rationale are in the full material.