NCLEX Pediatric: Growth and Development Questions
Pediatric: Growth and Development NCLEX Practice Questions
Question 1.
The nurse in the clinic is assessing communication patterns of a 5- month-old female patient. The nurse has determined the highest level of developing has been achieved if the child:
(a) Uses simple words like “dada”
(b) Uses monosyllabic babbling
(c) Links syllables together
(d) Coos when comforted
Answer:
(b) Uses monosyllabic babbling
Explanation:
Monosyllabic babbling is expected to occur between the ages of 3 and 6 months.
Rationale:
(a) is incorrect because simple words like “dada” is expected to occur between the ages of 9 and 12 months.
(c) is incorrect because linking of syllables is expected to occur between the ages of 6 and 9 months.
(d) is incorrect because cooing starts at birth and continues until approximately 2 months.
Question 2.
The nurse in the clinic is speaking with the mother of an 8-year-old girl who is 4 feet tall. The nurse tells the mother the best car safety device for her daughter is which of the following?
(a) Front-facing convertible seat with a harness
(b) Rear-facing convertible seat
(c) Regular seat in the car with the seat belt firmly across the body, from one shoulder down to the opposite hip
(d) Booster seat with belt-positioning belt
Answer:
(d) Booster seat with belt-positioning belt
Explanation:
The American Academy of Pediatrics (AAP) recommends a booster seat with a belt-positioning belt is to be used for children between the ages of 8 and 12 years old and until they have reached at least 4 feet, 9 inches tall. The belt should lie across the middle of the chest, not near the neck or face.
Rationale:
(a) is incorrect because a front-facing convertible seats with a harness is used until age 5 or when the upper weight or height limit of the convertible seat has been reached.
(b) is incorrect because the AAP recommends that toddlers are kept in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat.
(c) is incorrect because the regular seat belt should not be used until the child is 4 feet, 9 inches tall.
Question 3.
The student nurse is learning about pediatric growth and development. The student nurse learns which developmental stage is unstable and challenging regarding personal identity development?
(a) Adolescence
(b) Toddlerhood
(c) School-age
(d) Infancy
Answer:
(a) Adolescence
Explanation:
Adolescence (age 12 to 20) is an unstable, challenging time for developing personal identity as many things are occurring, including life choices, physical changes, cognitive changes, and social changes. Erikson coined this identity crisis as identity versus role confusion” as it is a turning point in the life of the individual and is a critical part of development. The positive outcome for this stage is developing a coherent sense of self with plans for future work or education. If the adolescent demonstrates an inability to develop a personal and vocational identity, this is the negative outcome for this stage.
Rationale:
(b) is incorrect because toddlers (age 1 to 3) have not developed personal identity yet. The developmental task at this stage is “autonomy vs. shame and doubt.” The positive outcome for the child is exercising self-control and having the ability to control her environment directly.
(c) is incorrect because the school-age child (age 6 to 12) is characterized by simple, observable personal identity (boy, girl, child, good, etc.). The developmental task is “industry versus inferiority.” The positive outcome is developing a sense of confidence and using creativity to influence the environment.
(d) is incorrect because infancy is characterized by identifying faces of, mother, father, etc. The task is “trust versus mistrust.”
Question 4.
A 15-year-old boy has been admitted to the hospital for acute appendicitis and is recovering from appendectomy. Which nursing intervention is most appropriate regarding facilitation of normal growth and development?
(a) Allow the family to bring the boy his favorite computer games
(b) Encourage the parents to sleep in the room with the boy
(c) Encourage the boy to read, rest, and make his own food choices
(d) Allow the boy to participate in group activities with other same-age individuals when medically stable
Answer:
(d) Allow the boy to participate in group activities with other same-age individuals when medically stable
Explanation:
Adolescents seek autonomy and independence and are sometimes unsure about spending time with their parents when hospitalized. Peer group is important, and separation from their friends can cause anxiety. Allowing the child time to spend with others of a similar age can be beneficial for facilitating normal development.
Rationale:
(a) is incorrect because, although electronics may be enjoyable to the boy, this may isolate the teen from his peer group. Promoting social interaction is a greater priority than encouraging use of favorite toys and games.
(b) is incorrect because having the parents sleep in the room does not promote interaction with peers and may not be the boy’s desire. The nurse should talk with the boy first to determine if he wants his parents to stay in the room, and then talk with the parents to help develop a plan that both the boy and the parents are comfortable with.
(c) is incorrect because encouraging rest and solitary activities, such as reading, may isolate the teen from their peer group. Allowing the boy to make his own food choices may not meet dietary needs for normal growth.
Question 5.
The nurse in the clinic is evaluating a 24-month boy’s developmental level. Which observation does the nurse expect?
(a) Copies a circle
(b) Uses a cup when drinking
(c) Skips and hops on one foot
(d) Walks alone, throws objects, has a 10-word vocabulary
Answer:
(b) Uses a cup when drinking
Explanation:
By the age of 24 months, a child should be able to use a spoon and drink from a cup, although some spilling may occur. Other milestones common for a 24-month-old include building a 5 to 6 block tower, having a 300- word vocabulary, and obeying easy commands.
Rationale:
(a) is incorrect because the ability to copy a circle occurs at age 3 years.
(c) is incorrect because a child is not expected to skip and hop on one foot until the age of 4 years.
(d) is incorrect because these are expectations for a child between the ages of 15 and 18 months.
Question 6.
The nurse in the clinic is interviewing a mother who expresses concern regarding her 3-year-old daughter demanding a bottle of milk in her bed at naptime and bedtime. What is the most appropriate suggestion the nurse should give?
(a) “Try giving your daughter milk in a sippy-cup before the nap, „ instead of a bottle in the bed.”
(b) “Give your daughter the bottle of milk at naptime but not bedtime.”
(c) “You can give your daughter the bottle if it contains 50 percent juice and 50 percent water inside.”
(d) “You can give your daughter the bottle if it has water in it.”
Answer:
(a) “Try giving your daughter milk in a sippy-cup before the nap, „ instead of a bottle in the bed.”
Explanation:
The American Academy of Pediatrics (AAP) recommends weaning a baby from the bottle by 18 months of age. Toddlers should not be given bottles or cups to fall asleep with if they contain milk, juice, or any other sweetened beverage, as it increases risk of dental caries. The best way to help wean this child from the bottle at age 3 is to offer the desired beverage in a sippy-cup, before laying her down.
Rationale:
(b) is incorrect because the AAP recommends weaning the bedtime bottle last, because it’s usually the hardest for the child to give up.
(c) is incorrect because watered-down juice can cause dental caries.
(d) is incorrect because, although water is safer for the teeth than milk or juice, a 3-year-old should transition to the sippy-cup instead of the bottle.
Question 7.
A 5-year-old boy with a fractured femur is on the pediatric orthopedic unit in traction. When planning the boy’s care, which of the following activities does the nurse include?
(a) Large picture books
(b) A radio
(c) Crayons and coloring book
(d) Sports videos
Answer:
(c) Crayons and coloring book
Explanation:
The preschooler engages in simple and imaginative play including coloring books and crayons, felt and magnetic boards, puppets, and Play- Doh. While in traction, the nurse should encourage activities that hold the child’s interest and encourage imagination and creativity. The child must be reminded not to turn to either side while in traction, so the coloring supplies should be placed within easy reach on the over-bed table.
Rationale:
(a) is incorrect because infants and toddlers enjoy large picture books.
(b) is incorrect because a 5-year-old may not know how to operate a radio. This is more appropriate for an adolescent.
(d) is incorrect because sports videos are appropriate for an adolescent, not a school-age child.
Question 8.
The nurse in the clinic works with children of all ages regularly. Which of the following age groups does the nurse know has a tendency to have eating disorders?
(a) Adolescents
(b) Toddlers
(c) School-age children
(d) Infants
Answer:
(a) Adolescents
Explanation:
Eating disorders include anorexia nervosa, bulimia, and binge eating. Adolescents (age 12-20) are undergoing many changes, including mental, physical, cognitive, and social. They are highly impressionable and easily affected by the thoughts and feelings of others, while exerting their independence from parents. Body image becomes more important , during adolescence than previously in life. Pressure may be felt by the adolescent with all the changes around them, and eating disorders are an attempt at gaining control.
Rationale:
(b) is incorrect because toddlers (age l to 3) do not exhibit eating disorders.
(c) is incorrect because school-age children (6 to 12) rarely exhibit eating disorders. Older school-age girls do tend to develop body image concerns, but eating disorders are more common after the age of 12 than before.
(d) is incorrect because infants (birth to 12 months) do not exhibit eating disorders.
Question 9.
The mother of a 3-year-old girl tells the nurse in the family practice clinic that her daughter is rebellious and throws temper tantrums. Which response by the nurse is most appropriate?
(a) “Punish the child for saying “no” in order to change her behavior.”
(b) “In order to reduce your stress, you should allow this behavior because it is normal for this age. She will grow out of it.”
(c) “We can talk about how to set limits on your daughter’s behavior.”
(d) “Ignore your daughter completely when she acts in this manner. When she sees that she is not gaining your attention, she will stop.”
Answer:
(c) “We can talk about how to set limits on your daughter’s behavior.”
Explanation:
Children’s focus is on independence from ages 1 to 3 years, according to Erikson. This often means rebelling against parent wishes and saying “no” as well as throwing temper tantrums. The parents must be consistent in setting limits that allow the child to have some independence and control over their environment, while learning self-control.
Rationale:
(a) is incorrect because saying “no” is normal behavior at this age. It is more appropriate for the nurse to teach the mother how to set limits in order to effectively control her child’s behavior.
(b) is incorrect because although this behavior is normal, this statement is dismissive and does not teach the parent how to deal with the behavior or to set limits.
(d) is incorrect because ignoring the child during rebellious activity or temper tantrums is not safe for the child.
Question 10.
The nurse in the clinic works with patients of all ages. The nurse knows the age group that demonstrates regression when experiencing sickness is which of the following?
(a) Adolescent
(b) Young adult
(c) Toddler
(d) Infant
Answer:
(c) Toddler
Explanation:
Regression is backtracking to a previous milestone or earlier level of functioning. Toddlers are beginning to demonstrate independence from parents, and when ill, the toddler may be unable to do certain things on their own. Regression is seen as the toddler tending to depend more on the parents and perform at earlier developmental levels (toilet training, sleeping, etc.) until the illness is resolved.
Rationale:
(a) is incorrect because adolescents do not typically demonstrate regression with illness.
(b) is incorrect because young adults do not typically demonstrate regression with illness.
(d) is incorrect because infants do not typically demonstrate regression with illness.
Question 11.
A 2-year-old was admitted for illness 6 days ago, and the parents visited the child briefly every evening. For the first 2 days, the child cried and was inconsolable. During the next 3 days, the child became quiet and withdrawn. Today, the child is in the hospital playroom when her parents come to visit. The child does not run to her parents when they arrive but continues to play with building blocks with the hospital volunteer. How does the nurse interpret this behavior?
(a) The child is still withdrawn
(b) The child is self-centered
(c) The child is experiencing despair
(d) The child is behaving as expected
Answer:
(d) The child is behaving as expected
Explanation:
Young children progress through several stages of separation anxiety when separated from their parents. These phases are protest, despair, and denial/detachment. This child is behaving normally for the detachment phase, showing interest in the environment and hospital staff. These stages occur as a result of lack of physical connection between the child and the parents.
Rationale:
(a) is incorrect because the child is playing, which is not a sign of withdrawal. A child who acts withdrawn is in the despair stage of separation anxiety.
(b) is incorrect because self-centeredness is not a stage of separation anxiety.
(c) is incorrect because the child was in despair during days 3 to 5 of the hospital stay. A child in the despair stage of separation anxiety appears subdued, apathetic, picks at food, and is uninterested in the surrounding environment.
Question 12.
A 16-year-old boy is admitted for an illness. According to Erikson, which intervention does the nurse implement?
(a) Encourage the boy to invite his friends to visit
(b) Encourage the parents to help the boy keep up with material being covered at school
(c) Offer the boy a visit from pastoral care
(d) Discourage the use of electronics
Answer:
(a) Encourage the boy to invite his friends to visit
Explanation:
Erikson developed the theory of psychosocial development consisting of eight stages beginning at infancy and progressing to adulthood. Erikson’s theory states that during adolescence (age 12 to 20) the developmental task is “identity versus role confusion.” The most important people in this age group are the boy’s peers. Encouraging the friends to visit will help keep the boy from becoming withdrawn and socially isolated.
Rationale:
(b) is incorrect because physical and social interaction with peers is more important than schoolwork for the ill adolescent. If his needs for interaction with his peer group are met, he will be more likely to keep up with his schoolwork.
(c) is incorrect because social groups are generally more important to adolescents than spiritual matters.
(d) is incorrect because, although electronic devices can cause isolation, „ they can also be a source of connecting with the peer group through social media. Per hospital policy and with the parents’ permission, the nurse should allow the boy to use electronics and also encourage social interaction with visitors.
Question 13.
The nurse on the maternity unit is providing discharge instructions to the mother of an infant regarding physical and psychosocial development. Which of the following instructions is appropriate for the nurse to give?
(a) Allow the infant to signal needs
(b) The baby’s birth weight should be doubled by 12 months of age
(c) Allow the infant to cry for 3 to 5 minutes before intervening
(d) Expect teething to begin around 3 to 4 months
Answer:
(a) Allow the infant to signal needs
Explanation:
Erikson developed the theory of psychosocial development consisting of eight stages beginning at infancy and progressing to adulthood. Erikson’s theory of psychosocial development states the newborn must be allowed to signal needs in order to learn how to control the environment. Some common infant signals include rubbing the eyes while tired, turning the head away when the baby needs a break from eye contact, and crying when tired or when needing to have a bowel movement.
Rationale:
(b) is incorrect because an infant’s birth weight should double by 5 months old and triple by 12 months of age.
(c) is incorrect because the developmental task in infancy (birth to 12 months) is trust versus mistrust. Delayed response by the caregiver when the infant cries leads to mistrust.
(d) is incorrect because, although some babies start teething earlier, the mother should not expect the beginning of teething until about 6 months of age.
Question 14.
The nurse is teaching a childcare and parenting class to expecting parents. When one of the expectant parents asks the nurse about Sudden Infant Death Syndrome (SIDS), what the most appropriate response by the nurse?
(a) “Using a pacifier while sleeping increases the risk for SIDS.”
(b) “Child abuse in the form of intentional suffocation is often misdiagnosed as SIDS and may make up nearly 50 percent of reported SIDS cases.”
(c) “Overheating and exposure to tobacco smoke are known to increase the risk for SIDS, which is the leading cause of death between 1 and 12 months.”
(d) “The most effective way to prevent SIDS is to put all babies to sleep on their backs when under the age of 6 months.”
Answer:
(c) “Overheating and exposure to tobacco smoke are known to increase the risk for SIDS, which is the leading cause of death between 1 and 12 months.”
Explanation:
SIDS is the most common cause of death in infancy, while the cause is not always known. Expecting mothers should be taught not to smoke or be exposed to tobacco smoke during pregnancy. Parents of infants must be taught to place the child on the back to sleep, not to use heavy blankets or covers and not to place the infant in the bed with them in order to decrease the risk of SIDS.
Rationale:
(a) is incorrect because use of a pacifier decreases the risk for SIDS.
(b) is incorrect because these misdiagnosed child abuse cases only make up about 5 percent of SIDS cases.
(d) is incorrect because babies should be laid on their back to sleep for the .first 12 months of life to prevent SIDS.
Question 15.
The nurse on the pediatric unit is observing children in the playroom. The nurse would expect to see 5-year-old children playing in which of the following manners?
(a) Board games with school-age children
(b) With their toys alongside other children, without interacting much
(c) Playing with push-pull toys and stuffed animals
(d) Cooperatively with other preschoolers
Answer:
(d) Cooperatively with other preschoolers
Explanation:
Preschoolers (age 3 to 6 years) typically play cooperatively with others of the same age group. Interactive play generally starts around the age of 5 years. Preschoolers typically enjoy playground toys, tricycles (with helmet), coloring activities, matching games, and housekeeping toys that allow them to imitate adult professions and activities.
Rationale:
(a) is incorrect because competitive play is typical seen with older children, not preschoolers.
(b) is incorrect because this describes parallel play, which is typical of toddlers (age 1 to 3 years).
(c) is incorrect because this describes play characteristic of toddlers (age 1 to 3 years).
Question 16.
The nurse is providing education to the parents of a 13-year-old boy. Which of the following statements is the most important for the nurse to make?
(a) “Motor vehicle accidents are the most common cause of death among adolescents, so teach him to wear his seatbelt while driving.”
(b) “The sexual education that children receive in school may not be sufficient. Discussions should continue at home regarding sexual abstinence, safe sex, and sexually transmitted infections (STIs).”
(c) “It is important to be aware of the signs of marijuana use because use has increased among middle-schoolers in the last five years.”
(d) “It is important to have your child screened by a cardiologist because heart disease is on the rise amongst teenagers.”
Answer:
(b) “The sexual education that children receive in school may not be sufficient. Discussions should continue at home regarding sexual abstinence, safe sex, and sexually transmitted infections (STIs).”
Explanation:
Children often begin to learn about sex in school in the fifth grade. Discussions should continue throughout adolescence to help children develop their knowledge about the anatomy and physiology of the human body as well as the potential consequences of teenage sexual experiences (peer pressure, unwanted pregnancies, difficult relationships, STIs.) The pediatric nurse should make themselves available to discuss these issues with the parents and/or the child.
Rationale:
(a) is incorrect because although accidents (unintentional injuries) are the leading cause of death among adolescents, this child is only 13 years old and will not be driving for several years. (Note: motor vehicle accidents account for one-third of all deaths to teenagers.)
(c) is incorrect because marijuana use among middle-school children has actually decreased recently, despite changes in laws.
(d) is incorrect because unless specific symptoms are assessed, a 13-year- old boy does not need to be screened by a cardiologist.
Question 17.
The nurse on the pediatric unit is caring for an adolescent admitted for , pneumonia. The nurse knows the major threat experienced by the adolescent who is hospitalized is which of the following?
(a) Pain management
(b) Restricted physical activity
(c) Altered body image
(d) Separation from family
Answer:
(c) Altered body image
Explanation:
Body image is very important to the adolescent. Hospitalization, especially if it requires IVs and specialized equipment, or weight loss from prolonged illness, can be traumatic to the individual.
Rationale:
(a) is incorrect because pain management is important to the adolescent but not as concerning as body image.
(b) is incorrect because restricted physical activity affects the adolescent, but body image and their peer group are often the greater concerns.
(d) is incorrect because separation from family affects the adolescent but is not the major threat. Adolescents are often even more tied to their peer group than they are to their family.
Question 18.
The pediatric nurse is caring for a 5-month-old infant in the family practice clinic. At birth, the baby weighed 6 lbs. 11 oz. What does the nurse expect the baby’s weight to be now?
(a) It depends on whether the baby is breastfed or formula-fed.
(b) 15 lbs. 8oz.
(c) 20lbs. 1oz.
(d) 13 lbs. 6oz.
Answer:
(d) 13 lbs. 6oz.
Explanation:
An infant’s birth weight should double by the age of 5 months.
Rationale:
(a) is incorrect because regardless of whether the baby is fed formula or breastmilk, the weight should double by 5 months of age.
(b) is incorrect because 15 lbs. 8 oz. is more than double the birthweight, which is not expected at this time.
(c) is incorrect because 20 lbs. 1 oz. represents triple the birth weight, which should be reached by 12 months of age.
Question 19.
A nurse is working with children and adolescents on the pediatric ward of the hospital. The nurse knows the individual’s development of distinguishing right and wrong and developing ethical values on which to base actions is which of the following?
(a) Moral development
(b) Cognitive development
(c) Psychosocial development
(d) Psychoanalytic development
Answer:
(a) Moral development
Explanation:
Moral development is learning to distinguish right and wrong as well as acquiring ethical values to base actions on.
Rationale:
(b) is incorrect because cognitive development is knowledge and learning.
(c) is incorrect because psychosocial development is learning one’s role in society.
(d) is incorrect because psychoanalytic development is development of personality.
Question 20.
The nurse is developing a care plan for an adolescent girl admitted for pneumonia. Which statement regarding normal growth and development is effective nursing care is based on?
(a) Growth occurs at same rates for individuals in the same stage
(b) Development progresses from complex to simple tasks
(c) Individuals have unique growth patterns and development that are difficult to predict
(d) Success in each phase of growth and development affects ability to successfully complete subsequent phases
Answer:
(d) Success in each phase of growth and development affects ability to successfully complete subsequent phases
Explanation:
Developmental failures can result in deficiencies in later developmental stages. The nurse must be alert to developmental stages in order to understand patient growth and development.
Rationale:
(a) is incorrect because growth patterns vary between individuals in the same stage.
(b) is incorrect because development progresses from simple to complex tasks.
(c) is incorrect because growth and development patterns vary from one individual to another but are predictable within a normal range for age and gender.
Question 21.
The nurse in the clinic is caring for school-age children. The nurse knows physical growth involves which of the following?
(a) Skill level changes
(b) Skeletal structure strengthening
(c) Improved intellectual task performance
(d) Learning appropriate responses to social situations
Answer:
(b) Skeletal structure strengthening
Explanation:
Physical growth includes height, weight, bones, and teeth changes and is objective and measurable.
Rationale:
(a) is incorrect because skill level changes describe physical and intellectual development, not growth.
(c) is incorrect because improved intellectual task performance describes cognitive development.
(d) is incorrect because responses to social situations describes psychosocial development.
Question 22.
The nursing student on the pediatric ward is learning about development. Which of the following does the student identify as development?
(a) 7-month-old pulls up to standing position
(b) 8-month-old develops two lower teeth
(c) Infant birth weight doubles by 6 months
(d) Young child uses words to make needs known instead of crying
Answer:
(a) 7-month-old pulls up to standing position
Explanation:
An infant pulling up to standing position demonstrates change in function and skill, which is development and occurs predictably (i.e., infant sits up, pulls up, then stands).
Rationale:
(b) is incorrect because development of teeth is demonstrative of growth.
(c) is incorrect because doubling of infant birth weight is demonstrative of growth.
(d) is incorrect because developing communication skills to express needs demonstrates maturation.
Question 23.
A mother and father are in the clinic speaking with the nurse about their 2-year-old son. The child is very independent and rejects authority of the parents. The nurse should respond based on which of the following?
(a) The parents must tighten control on their child
(b) The need for autonomy is usually apparent by puberty
(c) Punishment and limiting the child’s choices will restore trust
(d) Independence demonstrated by their child is normal and part of maturation
Answer:
(d) Independence demonstrated by their child is normal and part of maturation
Explanation:
Children in this developmental stage learn self-care and develop autonomy. The toddler years mark the beginning of establishing independence. Parents should be encouraged to set limits and allow the child to make simple choices to gain a feeling of control over their environment. (“What shirt would you like to wear today? Do you want bananas or peas with your lunch?”)
Rationale:
(a) is incorrect because children at this stage need supervision and opportunities to make choices for themselves, not strict control.
(b) is incorrect because the need for autonomy appears between ages l and 3 years, long before puberty.
(c) is incorrect because punishment and limiting the child’s choices can create shame and doubt in the child.
Question 24.
The nurse on the pediatric medical-surgical unit is caring for an adolescent admitted for fractures. The nurse knows this adolescent’s developmental needs are best met by which of the following interventions?
(a) Providing word puzzles and other diversional activities
(b) Providing privacy when the adolescent’s significant other comes to visit
(c) Encouraging parents to stay with the adolescent all the time
(d) Explaining procedures and including the adolescent in the decision making process
Answer:
(d) Explaining procedures and including the adolescent in the decision making process
Explanation:
Meeting an adolescent’s developmental needs includes allowing participation in decisions regarding care. Adolescents need to understand issues regarding their treatment and tend to cooperate and cope better if they are involved in the decision-making process.
Rationale:
(a) is incorrect because diversional activities are appropriate for school- aged children.
(b) is incorrect because privacy during the significant other’s visits is appropriate for the young adult.
(c) is incorrect because adolescents need parental presence as well as independence and separation. It is important for the nurse to talk with both the patient and the parents to determine how much time of parental visitation is desired and to help balance the child’s desires with the parent’s wishes.
Question 25.
The nursing student in the family clinic is learning about Piaget’s theory of cognitive development. The student learns that the school age child, age 7 to 11 years, demonstrates concrete operations when which of the following is demonstrated?
(a) Begins to think abstractly
(b) Participates in parallel play
(c) Can communicate with others at a simple level
(d) Recognizes others perceive things differently
Answer:
(d) Recognizes others perceive things differently
Explanation:
Piaget developed the theory of cognitive development, which describes the child’s mental model of how they see the world. Age 7 to 11 years, or concrete operations stage, according to Piaget, is characterized by the ability to think through processes without performing them and mentally understanding others’ viewpoints if different from their own.
Rationale:
(a) is incorrect because abstract thought is apparent in an older child, age 11 years on.
(b) is incorrect because parallel play is demonstrated by younger children, 2 to 5 years.
(c) is incorrect because simple level communication is demonstrated up to age 7 years.