An 8-year-old admitted for a fracture asks for his school books and a model kit he wants to finish. Supporting this request helps him master which developmental task?

Autonomy versus shame and doubt

While observing a breastfeed, which finding indicates that the baby is well attached to the breast?

More areola is seen above the mouth than below it

The chin is held well away from the breast

The baby's cheeks are drawn in with each suck

The baby's lower lip is turned inward

During a well-baby visit, a 9-month-old girl cannot sit without support, though she rolls over. What is the nurse's most appropriate conclusion?

Gross motor delay that needs a developmental referral

Fine motor delay to recheck at 18 months

Normal variation that needs no follow-up

Expected delay in a baby who is breastfed

According to Erikson, the psychosocial task of the toddler (1-3 years) is:

Autonomy versus shame and doubt

Growth, development and milestones

20 AIIMS NORCET (Nursing Officer) practice questions on Growth, development and milestones, part of Paediatric Nursing. The first 20 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
During screening, a child rides a tricycle, copies a circle, builds a tower of 9 cubes, and can tell her own age and sex. These milestones together best match an age of:
1. A3 years
2. B18 months
3. C4 years
4. D2 years
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Answer: A · 3 years
Riding a tricycle, copying a circle, a tower of about 9-10 cubes and knowing one's age and sex are classic 3-year milestones. A 2-year-old builds a tower of about 6-7 cubes, runs and makes simple two-word phrases, but cannot copy a circle. A 4-year-old copies a cross or a square and hops on one foot. At 18 months the tower is about 3-4 cubes and the child scribbles.
- B: An 18-month-old builds 3-4 cubes and only scribbles.
- C: A 4-year-old already copies a cross or a square and hops.
- D: A 2-year-old cannot yet copy a circle or ride a tricycle.
Question 2 · Medium
An 8-year-old admitted for a fracture asks for his school books and a model kit he wants to finish. Supporting this request helps him master which developmental task?
1. AInitiative versus guilt
2. BAutonomy versus shame and doubt
3. CIndustry versus inferiority
4. DIdentity versus role confusion
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Answer: C · Industry versus inferiority
School-age children (6-12 years) work on industry versus inferiority: they gain self-esteem by finishing tasks and gaining skills. Allowing schoolwork and projects in hospital supports a sense of achievement and keeps the child in touch with peers. Being kept idle or failing at tasks leads to feelings of inferiority. Hospital teachers and play programmes serve this need.
- A: Initiative versus guilt is the preschool task.
- B: Autonomy versus shame and doubt is the toddler task.
- D: Identity versus role confusion is the adolescent task.
Question 3 · Medium
While observing a breastfeed, which finding indicates that the baby is well attached to the breast?
1. AThe chin is held well away from the breast
2. BThe baby's cheeks are drawn in with each suck
3. CThe baby's lower lip is turned inward
4. DMore areola is seen above the mouth than below it
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Answer: D · More areola is seen above the mouth than below it
Signs of good attachment are a wide open mouth, the lower lip turned outward, the chin touching the breast, and more areola visible above than below the mouth. With good attachment the baby takes slow, deep sucks, sometimes pausing. Cheeks that are drawn in, an inverted lower lip or a chin away from the breast suggest poor attachment. Poor attachment causes sore nipples and poor milk transfer.
- A: In good attachment the chin touches the breast.
- B: Drawn-in cheeks show the baby is sucking only on the nipple.
- C: A well-attached baby's lower lip is turned outward.
Question 4 · Medium
During a well-baby visit, a 9-month-old girl cannot sit without support, though she rolls over. What is the nurse's most appropriate conclusion?
1. AGross motor delay that needs a developmental referral
2. BFine motor delay to recheck at 18 months
3. CNormal variation that needs no follow-up
4. DExpected delay in a baby who is breastfed
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Answer: A · Gross motor delay that needs a developmental referral
Most infants sit with support at about 5-6 months and sit steadily without support by 7-8 months. A 9-month-old who still cannot sit alone has a gross motor delay. She should be referred for a full developmental assessment, including tone, vision and nutrition. Early referral allows early stimulation and treatment of any cause.
- B: Sitting is a gross motor skill, and waiting until 18 months loses valuable time.
- C: Sitting alone by 9 months is a key milestone, so its absence is not a normal variant.
- D: Breastfeeding does not delay motor development.
Question 5 · Easy
According to Erikson, the psychosocial task of the toddler (1-3 years) is:
1. AInitiative versus guilt
2. BAutonomy versus shame and doubt
3. CIndustry versus inferiority
4. DTrust versus mistrust
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Answer: B · Autonomy versus shame and doubt
Erikson describes the toddler's task as autonomy versus shame and doubt. Toddlers want to do things for themselves, such as feeding, dressing and toilet training. Nurses support this by offering simple choices and allowing safe self-care in hospital. Over-control or shaming over accidents leads to doubt in one's own abilities.
- A: Initiative versus guilt belongs to the preschool child (3-6 years).
- C: Industry versus inferiority is the task of the school-age child.
- D: Trust versus mistrust is the task of infancy (birth to 1 year).
Question 6 · Medium
At birth the head circumference is larger than the chest circumference. The two measurements usually become equal at about:
1. A1 year
2. B3 years
3. C6 months
4. D3 months
Answer and explanation in LearnFree account
Question 7 · Easy
WHO and the Indian IYCF guidelines recommend exclusive breastfeeding for:
1. AThe first 6 months of life
2. BThe first 12 months of life
3. CThe first 3 months of life
4. DThe first 4 months of life
Answer and explanation in LearnFree account
Question 8 · Easy
A responsive social smile first appears in a normal infant at about:
1. A6-8 weeks
2. B6 months
3. C2 weeks
4. D4 months
Answer and explanation in LearnFree account
Question 9 · Medium
A 2-year-old in the ward throws himself on the floor, screaming, when told it is time for his bath. He is in no danger. What is the nurse's most appropriate response?
1. AGive him a sweet so that he stops crying
2. BCancel the bath and let him choose the time
3. CScold him firmly and send him to his bed
4. DIgnore the outburst while keeping him safe, then proceed
Answer and explanation in LearnFree account
Question 10 · Medium
The mother of a 5-month-old asks when her baby will be able to pick up a small object such as a pea between the thumb and index finger. The nurse explains that this pincer grasp usually develops at about:
1. A15-18 months
2. B4-5 months
3. C6-7 months
4. D9-10 months
Answer and explanation in LearnFree account
Question 11 · Easy
The anterior fontanelle of a normal infant usually closes by the age of:
1. A3-4 months
2. B12-18 months
3. C6-8 weeks
4. D24-30 months
Answer and explanation in LearnFree account
Question 12 · Easy
Two toddlers sit side by side, each building with blocks, without sharing or playing together. This type of play is called:
1. AParallel play
2. BSolitary play
3. CCooperative play
4. DAssociative play
Answer and explanation in LearnFree account
Question 13 · Medium
A child measured 50 cm at birth. By the usual growth rule, the child will reach about 100 cm in height at the age of:
1. A4 years
2. B6 years
3. C2 years
4. D1 year
Answer and explanation in LearnFree account
Question 14 · Medium
A 10-month-old watches a nurse hide a rattle under a towel and at once pulls the towel away to find it. According to Piaget, this shows that the infant has developed:
1. AObject permanence
2. BEgocentric thinking
3. CConservation of mass
4. DSymbolic play
Answer and explanation in LearnFree account
Question 15 · Medium
A mother of a 10-day-old exclusively breastfed baby worries that she does not have enough milk. Which finding best reassures the nurse that intake is adequate?
1. AThe mother's breasts feel soft after feeds
2. BThe baby passes urine six or more times in 24 hours
3. CThe baby cries for a short time after each feed
4. DThe baby feeds no more often than every four hours
Answer and explanation in LearnFree account
Question 16 · Hard
A baby girl was born at term weighing 2.8 kg. At her first birthday she weighs 7.0 kg and has no illness now. Applying the usual rule for weight gain in infancy, what should the nurse conclude?
1. AExpected about 5.6 kg, so her weight is above target
2. BExpected about 7.0 kg, so her growth is normal
3. CExpected about 8.4 kg, so this is growth faltering
4. DExpected about 11.2 kg, so she is severely wasted
Answer and explanation in LearnFree account
Question 17 · Hard
Using the usual formula for children aged 1-6 years, weight (kg) = (age in years x 2) + 8, what is the expected weight of a 4-year-old boy?
1. A12 kg
2. B16 kg
3. C20 kg
4. D14 kg
Answer and explanation in LearnFree account
Question 18 · Hard
A 15 kg child is kept nil by mouth before surgery. By the Holliday-Segar method, what is the maintenance fluid requirement for 24 hours?
1. A1100 mL
2. B1000 mL
3. C1250 mL
4. D1500 mL
Answer and explanation in LearnFree account
Question 19 · Easy
A healthy term infant is expected to triple the birth weight by about the age of:
1. A9 months
2. B2 years
3. C5 months
4. D1 year
Answer and explanation in LearnFree account
Question 20 · Medium
A mother of a thriving, exclusively breastfed 6-month-old asks what to give as her baby's first food. Which advice is most appropriate?
1. ADiluted cow's milk in a bottle, stopping breastfeeds
2. BFruit juice only for the first month of weaning
3. CThin rice water and dal water given by bottle
4. DThick mashed cereal-pulse porridge, continuing breastfeeds
Answer and explanation in LearnFree account

Growth, development and milestones

During screening, a child rides a tricycle, copies a circle, builds a tower of 9 cubes, and can tell her own age and sex. These milestones together best match an age of:

An 8-year-old admitted for a fracture asks for his school books and a model kit he wants to finish. Supporting this request helps him master which developmental task?

While observing a breastfeed, which finding indicates that the baby is well attached to the breast?

During a well-baby visit, a 9-month-old girl cannot sit without support, though she rolls over. What is the nurse's most appropriate conclusion?

According to Erikson, the psychosocial task of the toddler (1-3 years) is:

At birth the head circumference is larger than the chest circumference. The two measurements usually become equal at about:

WHO and the Indian IYCF guidelines recommend exclusive breastfeeding for:

A responsive social smile first appears in a normal infant at about:

A 2-year-old in the ward throws himself on the floor, screaming, when told it is time for his bath. He is in no danger. What is the nurse's most appropriate response?

The mother of a 5-month-old asks when her baby will be able to pick up a small object such as a pea between the thumb and index finger. The nurse explains that this pincer grasp usually develops at about:

The anterior fontanelle of a normal infant usually closes by the age of:

Two toddlers sit side by side, each building with blocks, without sharing or playing together. This type of play is called:

A child measured 50 cm at birth. By the usual growth rule, the child will reach about 100 cm in height at the age of:

A 10-month-old watches a nurse hide a rattle under a towel and at once pulls the towel away to find it. According to Piaget, this shows that the infant has developed:

A mother of a 10-day-old exclusively breastfed baby worries that she does not have enough milk. Which finding best reassures the nurse that intake is adequate?

A baby girl was born at term weighing 2.8 kg. At her first birthday she weighs 7.0 kg and has no illness now. Applying the usual rule for weight gain in infancy, what should the nurse conclude?

Using the usual formula for children aged 1-6 years, weight (kg) = (age in years x 2) + 8, what is the expected weight of a 4-year-old boy?

A 15 kg child is kept nil by mouth before surgery. By the Holliday-Segar method, what is the maintenance fluid requirement for 24 hours?

A healthy term infant is expected to triple the birth weight by about the age of:

A mother of a thriving, exclusively breastfed 6-month-old asks what to give as her baby's first food. Which advice is most appropriate?