Growth & development NCLEX-RN Practice Questions

Growth & development NCLEX-RN Practice Questions help you assess key pediatric milestones, anticipatory guidance, and age-appropriate interventions central to Health Promotion & Maintenance on the NCLEX-RN. This topic-wise set focuses on normal and atypical patterns from infancy through adolescence—covering motor and language milestones, psychosocial tasks (Erikson), cognitive development (Piaget), nutrition, immunization timing, screening, and safety. Questions emphasize clinical judgment, red flags, and patient-family education, with scenarios mirroring exam style. Whether you are reinforcing fundamentals or integrating nuanced details like reflex integration, car seat recommendations, or puberty staging, these practice items are designed to sharpen prioritization and evidence-based decision-making for pediatric care.

Q1. A 9-month-old infant is brought for a well visit. Which behavior is most consistent with expected development at this age?

• Pulls to stand and uses a pincer grasp to pick up small objects
• Walks independently and stacks two blocks
• Sits without support and says three clear words
• Rolls front to back and babbles consonant sounds only

Correct Answer: Pulls to stand and uses a pincer grasp to pick up small objects

Q2. The nurse evaluates growth in a 12-month-old. Which finding indicates normal physical development?

• Birth weight has doubled and length increased by 25%
• Birth weight has tripled and length increased by 50%
• Birth weight has quadrupled and head circumference decreased
• Birth weight unchanged and head circumference equals chest circumference

Correct Answer: Birth weight has tripled and length increased by 50%

Q3. A 2-month-old exhibits a strong Moro reflex. The parent asks when it will disappear. The nurse’s best response is:

• “Typically by 1 month of age.”
• “Usually by 4 to 6 months of age.”
• “Around 9 months when cruising begins.”
• “Not until the child can walk independently.”

Correct Answer: “Usually by 4 to 6 months of age.”

Q4. A nurse counsels a breastfeeding mother about vitamin D. Which recommendation is evidence-based?

• Begin 400 IU/day vitamin D supplementation within the first few days of life
• Delay vitamin D until solid foods begin at 6 months
• Supplement only if the infant is premature
• Supplement only if the infant has rickets on X-ray

Correct Answer: Begin 400 IU/day vitamin D supplementation within the first few days of life

Q5. A 15-month-old is seen for a well visit. Which gross motor skill is expected?

• Hops on one foot
• Walks independently
• Rides a tricycle
• Alternate feet down stairs

Correct Answer: Walks independently

Q6. A nurse assesses an infant for fontanel closure. Which is the typical timeframe for anterior fontanel closure?

• 2 to 3 months
• 6 to 9 months
• 12 to 18 months
• 24 to 36 months

Correct Answer: 12 to 18 months

Q7. During a 3-year-old’s visit, which language milestone should the nurse expect?

• Two-word phrases with a 50-word vocabulary
• Three-word sentences and speech ~75% intelligible
• Four-word sentences and fully intelligible speech
• One to three words used nonspecifically

Correct Answer: Three-word sentences and speech ~75% intelligible

Q8. A nurse provides anticipatory guidance to the parents of a 7-month-old. Which behavior is most typical at this age?

• Separation anxiety peaks and cooperative play begins
• Object permanence emerges and stranger anxiety can start
• Parallel play and toilet training readiness
• Initiative in play with imaginary friends

Correct Answer: Object permanence emerges and stranger anxiety can start

Q9. According to Erikson, which psychosocial task is the priority focus for a toddler (1–3 years)?

• Trust vs. Mistrust
• Autonomy vs. Shame and Doubt
• Initiative vs. Guilt
• Industry vs. Inferiority

Correct Answer: Autonomy vs. Shame and Doubt

Q10. A nurse teaches parents of a preschooler about play. Which description fits this age best?

• Solitary play
• Parallel play
• Associative and imaginative play
• Competitive team play

Correct Answer: Associative and imaginative play

Q11. A 10-year-old is evaluated for school performance. Which Piaget stage best describes expected cognitive function at this age?

• Sensorimotor
• Preoperational
• Concrete operational
• Formal operational

Correct Answer: Concrete operational

Q12. An adolescent female presents for a physical. Which is typically the first sign of pubertal development?

• Menarche
• Growth spurt
• Thelarche (breast budding)
• Pubic hair development

Correct Answer: Thelarche (breast budding)

Q13. A 6-year-old is due for a car seat upgrade. Which recommendation aligns with safety guidelines?

• Remain rear-facing until age 6 regardless of size
• Use a forward-facing seat with harness until reaching seat limits, then booster until 4’9”
• Transition to regular seat belt at age 6
• Front seat is safe with airbag off

Correct Answer: Use a forward-facing seat with harness until reaching seat limits, then booster until 4’9”

Q14. A 4-month-old is exclusively breastfed. What iron recommendation is appropriate?

• No iron needed in the first year
• Begin 1 mg/kg/day elemental iron at 4 months
• Start iron at 12 months with cow’s milk
• Iron only if hemoglobin is below 8 g/dL

Correct Answer: Begin 1 mg/kg/day elemental iron at 4 months

Q15. The parent of a 2-year-old asks about toilet training. Which sign indicates readiness?

• No interest in the toilet but dry diaper overnight
• Imitates adults, follows simple commands, stays dry for at least 2 hours
• Fear of the toilet but verbalizes desire to use it
• Speaks in complete sentences and can hop on one foot

Correct Answer: Imitates adults, follows simple commands, stays dry for at least 2 hours

Q16. A nurse evaluates pain in a pre-verbal toddler post-op. Which pain assessment tool is most appropriate?

• Numeric Rating Scale (0–10)
• Wong-Baker FACES for ages 1–2 months
• FLACC behavioral scale
• McGill Pain Questionnaire

Correct Answer: FLACC behavioral scale

Q17. A 5-year-old at a well visit should be able to perform which fine motor task?

• Build a 2-block tower
• Copy a triangle
• Copy a circle only
• Tie shoelaces consistently

Correct Answer: Copy a triangle

Q18. Parents of a 10-month-old ask about preventing dental caries. Which advice is best?

• Put the infant to bed with a bottle of juice to soothe
• Brush teeth twice daily with a smear (rice-grain) of fluoride toothpaste
• Delay dental visits until age 3
• Use only bottled water to avoid fluoride exposure

Correct Answer: Brush teeth twice daily with a smear (rice-grain) of fluoride toothpaste

Q19. Which is the best example of age-appropriate play for a toddler (18–24 months)?

• Organized team sports
• Parallel play with push-pull toys
• Complex board games
• Cooperative group projects

Correct Answer: Parallel play with push-pull toys

Q20. A nurse screens a 12-month-old for lead exposure. Which blood lead level requires action per current reference value?

• 1.0 µg/dL
• 3.5 µg/dL or higher
• 5.5 µg/dL or higher only if symptomatic
• 10 µg/dL is acceptable

Correct Answer: 3.5 µg/dL or higher

Q21. At what age should an infant typically roll from front to back?

• 2 months
• 4 months
• 7 months
• 10 months

Correct Answer: 4 months

Q22. A 7-year-old is due for dental eruption of the first permanent tooth. Which is most likely?

• First permanent molars erupt around age 6–7 years
• First permanent tooth is always a central incisor at 4 years
• All primary teeth are lost by age 5
• Permanent teeth begin erupting at puberty only

Correct Answer: First permanent molars erupt around age 6–7 years

Q23. A 4-year-old’s speech is assessed. What level of understandability is expected (rule of fours)?

• 25% of speech understood by strangers
• 50% of speech understood by strangers
• 75% of speech understood by strangers
• Nearly 100% of speech understood by strangers

Correct Answer: Nearly 100% of speech understood by strangers

Q24. A parent of a 6-week-old asks about tummy time. The nurse explains its purpose primarily is to promote:

• Early walking
• Head control and prevention of positional plagiocephaly
• Faster language acquisition
• Earlier pincer grasp

Correct Answer: Head control and prevention of positional plagiocephaly

Q25. An 11-year-old is in which Erikson stage, guiding anticipatory guidance about school and activities?

• Trust vs. Mistrust
• Initiative vs. Guilt
• Industry vs. Inferiority
• Identity vs. Role Confusion

Correct Answer: Industry vs. Inferiority

Q26. A 3-month-old still has a strong head lag when pulled to sit. What is the best initial action?

• Reassure as normal at this age and recheck at 4 months
• Immediate neurology referral for cerebral palsy
• Advise increased prone play and reassess soon
• Order brain MRI urgently

Correct Answer: Advise increased prone play and reassess soon

Q27. A 13-year-old male presents for puberty counseling. What is typically the first sign of puberty in boys?

• Facial hair growth
• Testicular enlargement
• Voice deepening
• Peak height velocity

Correct Answer: Testicular enlargement

Q28. A 2-year-old drinks whole cow’s milk excessively (36 oz/day) and eats poorly. Which growth risk is the priority?

• Hypercalcemia causing seizures
• Iron-deficiency anemia and failure to thrive
• Protein toxicity
• Vitamin D toxicity

Correct Answer: Iron-deficiency anemia and failure to thrive

Q29. A 5-year-old is ready to start kindergarten. Which motor skill supports this developmental transition?

• Skipping and tying shoelaces consistently
• Hopping on one foot and copying a square
• Alternating feet downstairs and riding a tricycle
• Standing on one foot for 2 seconds and stacking 4 blocks

Correct Answer: Hopping on one foot and copying a square

Q30. During a 18-month visit, which red flag warrants further developmental evaluation?

• Vocabulary of 10–15 words
• Not yet able to run steadily
• No attempt to use a spoon and persistent loss of previously acquired words
• Enjoys parallel play but resists sharing

Correct Answer: No attempt to use a spoon and persistent loss of previously acquired words

Download