PEDIATRICS FINAL EXAMINATION LATEST 2026/2027 |
Graded A with Frequently Tested Questions | 100% Solved
with Detailed Rationales | Pediatric Nursing Exam Prep | Pass
Guaranteed
Domain 1: Growth and Development (18 Questions)
Q1
An 18-month-old child is brought for a well-child visit. The parents report that the child
can walk independently, says "mama" and "dada" specifically, points to indicate wants,
and scribbles with a crayon. However, the child cannot stack 6 cubes, jump with both
feet, or use 2-word phrases. Which developmental domain shows a potential delay?
A. Gross motor development
B. Fine motor development
C. Language development
D. Social development
Correct Answer: C
Rationale: According to CDC/AAP developmental milestones (2022 updated guidelines),
by 18 months children should demonstrate: gross motor (walking independently,
climbing stairs with help, beginning to run—this child is appropriate); fine motor
,(scribbling, stacking 2-4 cubes—this child is appropriate with scribbling); language
(using 3-6 words besides mama/dada, using 2-word phrases—this child shows delay
using only 2 specific words and no 2-word phrases); and social (pointing, showing
affection, playing simple pretend—this child is appropriate). The language delay is the
key finding. Option A is incorrect because walking independently is an 12-15 month
milestone, and this 18-month-old has achieved it. Option B is incorrect because
scribbling is an 18-month milestone and stacking 6 cubes is actually a 24-month
milestone, so this child is not delayed. Option D is incorrect because pointing is a
critical 18-month social-communication milestone that this child has achieved.
Test-taking strategy: Know that 18 months is a critical language surveillance point;
absence of 2-word phrases warrants evaluation. High-yield pearl: The 18-month visit is
specifically designated by AAP for autism screening (M-CHAT-R/F) due to the
importance of language and social milestones at this age.
Q2
A mother brings her 6-month-old infant for a routine check-up. Which developmental
milestones would be expected at this age according to current AAP guidelines?
A. Rolls front to back, sits without support, transfers objects hand-to-hand, babbles
consonants [CORRECT]
B. Walks holding furniture, says 3 words, feeds self with fingers, waves bye-bye
C. Rolls back to front only, sits with support, reaches for objects, coos
D. Stands independently, uses spoon, points to objects, follows 2-step commands
Correct Answer: A
,Rationale: Six-month milestones per CDC/AAP 2022 guidelines include: gross motor
(rolls front to back and back to front, sits with support and begins sitting without
support, bears weight on legs); fine motor (transfers objects between hands, reaches
and grasps); language (babbles with consonants [ba, da, ma], makes squealing sounds);
and social (recognizes familiar faces, laughs, looks at self in mirror). Option A correctly
identifies these 6-month milestones. Option B describes 12-month milestones (walking
with support, first words, self-feeding, waving). Option C describes 4-month milestones
(back to front rolling develops 4-6 months, sitting with support is 4-6 months, reaching
is 4 months, cooing is 2-4 months)—these are too immature for 6 months. Option D
describes 15-18 month milestones (independent standing, utensil use, pointing,
following commands). Common error: Students often confuse rolling
milestones—front-to-back typically precedes back-to-front by 1-2 months. High-yield
pearl: The 6-month visit is critical for detecting cerebral palsy (abnormal muscle tone,
asymmetric movements) and vision problems (strabismus assessment).
Q3
During a school physical examination, a 13-year-old female is noted to have breast buds
(areolar elevation) and a few straight pubic hairs. Her height has increased from the
50th to the 75th percentile over the past year. According to Tanner staging, what stage
of sexual maturity has she reached?
A. Tanner Stage 1 (Prepubertal)
B. Tanner Stage 2 [CORRECT]
C. Tanner Stage 3
D. Tanner Stage 4
, Correct Answer: B
Rationale: Tanner Stage 2 (thelarche/pubarche onset) is characterized by: breast
development—breast bud stage with elevation of breast and papilla as small mound,
enlargement of areolar diameter; pubic hair—sparse, lightly pigmented, straight, medial
border of labia; and growth velocity—beginning of height acceleration (peak height
velocity occurs in Tanner 3-4 for girls). This 13-year-old female with breast buds,
straight sparse pubic hair, and accelerated growth matches Tanner Stage 2. Option A
(Stage 1) shows no breast development, no pubic hair, and pre-pubertal growth velocity.
Option C (Stage 3) shows breast enlargement and elevation of contour beyond areola,
darker/coarser/curled pubic hair spreading to mons pubis, and continued height
acceleration. Option D (Stage 4) shows areola and papilla forming secondary mound,
adult-type pubic hair but limited area, and decelerating growth. Common error: Students
confuse the breast bud stage (Tanner 2) with more developed breast tissue. High-yield
pearl: Average age of menarche is 12.5 years in US; it typically occurs in Tanner Stage
3-4, about 2-2.5 years after thelarche. Early menarche (<10 years) or delayed menarche
(>15 years or >3 years after thelarche) requires evaluation.
Q4
A 4-year-old child is evaluated for suspected developmental delay. Which combination
of milestones would be MOST concerning for a significant developmental disorder?
A. Speaks in 4-word sentences, rides tricycle, hops on one foot, knows some colors
B. Speaks in 2-word phrases only, cannot jump with both feet, cannot stack 6 cubes,
cannot draw a circle [CORRECT]
Graded A with Frequently Tested Questions | 100% Solved
with Detailed Rationales | Pediatric Nursing Exam Prep | Pass
Guaranteed
Domain 1: Growth and Development (18 Questions)
Q1
An 18-month-old child is brought for a well-child visit. The parents report that the child
can walk independently, says "mama" and "dada" specifically, points to indicate wants,
and scribbles with a crayon. However, the child cannot stack 6 cubes, jump with both
feet, or use 2-word phrases. Which developmental domain shows a potential delay?
A. Gross motor development
B. Fine motor development
C. Language development
D. Social development
Correct Answer: C
Rationale: According to CDC/AAP developmental milestones (2022 updated guidelines),
by 18 months children should demonstrate: gross motor (walking independently,
climbing stairs with help, beginning to run—this child is appropriate); fine motor
,(scribbling, stacking 2-4 cubes—this child is appropriate with scribbling); language
(using 3-6 words besides mama/dada, using 2-word phrases—this child shows delay
using only 2 specific words and no 2-word phrases); and social (pointing, showing
affection, playing simple pretend—this child is appropriate). The language delay is the
key finding. Option A is incorrect because walking independently is an 12-15 month
milestone, and this 18-month-old has achieved it. Option B is incorrect because
scribbling is an 18-month milestone and stacking 6 cubes is actually a 24-month
milestone, so this child is not delayed. Option D is incorrect because pointing is a
critical 18-month social-communication milestone that this child has achieved.
Test-taking strategy: Know that 18 months is a critical language surveillance point;
absence of 2-word phrases warrants evaluation. High-yield pearl: The 18-month visit is
specifically designated by AAP for autism screening (M-CHAT-R/F) due to the
importance of language and social milestones at this age.
Q2
A mother brings her 6-month-old infant for a routine check-up. Which developmental
milestones would be expected at this age according to current AAP guidelines?
A. Rolls front to back, sits without support, transfers objects hand-to-hand, babbles
consonants [CORRECT]
B. Walks holding furniture, says 3 words, feeds self with fingers, waves bye-bye
C. Rolls back to front only, sits with support, reaches for objects, coos
D. Stands independently, uses spoon, points to objects, follows 2-step commands
Correct Answer: A
,Rationale: Six-month milestones per CDC/AAP 2022 guidelines include: gross motor
(rolls front to back and back to front, sits with support and begins sitting without
support, bears weight on legs); fine motor (transfers objects between hands, reaches
and grasps); language (babbles with consonants [ba, da, ma], makes squealing sounds);
and social (recognizes familiar faces, laughs, looks at self in mirror). Option A correctly
identifies these 6-month milestones. Option B describes 12-month milestones (walking
with support, first words, self-feeding, waving). Option C describes 4-month milestones
(back to front rolling develops 4-6 months, sitting with support is 4-6 months, reaching
is 4 months, cooing is 2-4 months)—these are too immature for 6 months. Option D
describes 15-18 month milestones (independent standing, utensil use, pointing,
following commands). Common error: Students often confuse rolling
milestones—front-to-back typically precedes back-to-front by 1-2 months. High-yield
pearl: The 6-month visit is critical for detecting cerebral palsy (abnormal muscle tone,
asymmetric movements) and vision problems (strabismus assessment).
Q3
During a school physical examination, a 13-year-old female is noted to have breast buds
(areolar elevation) and a few straight pubic hairs. Her height has increased from the
50th to the 75th percentile over the past year. According to Tanner staging, what stage
of sexual maturity has she reached?
A. Tanner Stage 1 (Prepubertal)
B. Tanner Stage 2 [CORRECT]
C. Tanner Stage 3
D. Tanner Stage 4
, Correct Answer: B
Rationale: Tanner Stage 2 (thelarche/pubarche onset) is characterized by: breast
development—breast bud stage with elevation of breast and papilla as small mound,
enlargement of areolar diameter; pubic hair—sparse, lightly pigmented, straight, medial
border of labia; and growth velocity—beginning of height acceleration (peak height
velocity occurs in Tanner 3-4 for girls). This 13-year-old female with breast buds,
straight sparse pubic hair, and accelerated growth matches Tanner Stage 2. Option A
(Stage 1) shows no breast development, no pubic hair, and pre-pubertal growth velocity.
Option C (Stage 3) shows breast enlargement and elevation of contour beyond areola,
darker/coarser/curled pubic hair spreading to mons pubis, and continued height
acceleration. Option D (Stage 4) shows areola and papilla forming secondary mound,
adult-type pubic hair but limited area, and decelerating growth. Common error: Students
confuse the breast bud stage (Tanner 2) with more developed breast tissue. High-yield
pearl: Average age of menarche is 12.5 years in US; it typically occurs in Tanner Stage
3-4, about 2-2.5 years after thelarche. Early menarche (<10 years) or delayed menarche
(>15 years or >3 years after thelarche) requires evaluation.
Q4
A 4-year-old child is evaluated for suspected developmental delay. Which combination
of milestones would be MOST concerning for a significant developmental disorder?
A. Speaks in 4-word sentences, rides tricycle, hops on one foot, knows some colors
B. Speaks in 2-word phrases only, cannot jump with both feet, cannot stack 6 cubes,
cannot draw a circle [CORRECT]
