PEDIATRIC PRIMARY CARE PRACTICE EXAM
(80 QUESTIONS) QUESTIONS AND
ANSWERS WITH RATIONALES/ GRADED
A+/2026 UPDATE /100%CORRECT
Section 1: Developmental Milestones & Screening (Questions 1–10)
1. A 4-month-old infant is brought for a well-child visit. Which developmental milestone would the
practitioner expect to observe?
A) Sits without support
B) Transfers objects hand to hand
C) Rolls from back to side
D) Pulls to stand
Answer: C) Rolls from back to side
Rationale: By 4 months, infants typically roll from back to side. Sitting without support occurs around 6–
8 months, transferring objects around 6–7 months, and pulling to stand around 9–12 months.
2. During a 12-month well-child visit, the parent expresses concern that the child is not yet walking.
What is the most appropriate response?
A) Refer immediately to early intervention
B) Reassure that independent walking by 15 months is within normal limits
C) Order a developmental assessment
D) Recommend physical therapy
,Answer: B) Reassure that independent walking by 15 months is within normal limits
Rationale: Gross motor milestones: most children walk independently by 12–15 months. Reassurance is
appropriate unless other red flags are present.
3. Which screening tool is specifically designed for autism spectrum disorder (ASD) in toddlers?
A) Denver II
B) M-CHAT-R/F
C) PEDS
D) ASQ-3
Answer: B) M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up)
Rationale: M-CHAT-R/F is a validated screening tool for ASD in children 16–30 months. PEDS and ASQ-3
are general developmental screens; Denver II is a developmental assessment tool.
4. A 2-year-old child speaks in 2- to 3-word phrases, follows simple commands, and points to body
parts. This language development is consistent with which age?
A) 12 months
B) 18 months
C) 24 months
D) 30 months
Answer: C) 24 months
Rationale: By 24 months, children typically use 2- to 3-word phrases, have a 50+ word vocabulary,
follow two-step commands, and point to named body parts.
5. At which age does the anterior fontanelle typically close?
A) 2–4 months
B) 4–8 months
C) 9–18 months
, D) 18–24 months
Answer: C) 9–18 months
Rationale: The anterior fontanelle closes between 9 and 18 months. Delayed closure may indicate
hypothyroidism, rickets, or increased intracranial pressure.
6. Which finding during a 9-month-old’s examination warrants further evaluation?
A) Babbling
B) Stranger anxiety
C) Absence of pincer grasp
D) Pulling to stand
Answer: C) Absence of pincer grasp
Rationale: Pincer grasp typically develops by 9–10 months. Its absence may indicate fine motor delay
warranting further evaluation.
7. A mother reports her 3-year-old has begun stuttering. What is the most appropriate guidance?
A) Refer to speech therapy immediately
B) Advise the mother to correct each stuttered word
C) Reassure that dysfluency is common during language explosion and usually resolves
spontaneously
D) Recommend a hearing evaluation
Answer: C) Reassure that dysfluency is common during language explosion and usually resolves
spontaneously
Rationale: Developmental stuttering (dysfluency) is common between ages 2–5 and typically resolves
without intervention unless it persists >6 months or is accompanied by secondary behaviors.
8. A 5-year-old is unable to hop on one foot or draw a triangle. The practitioner should:
A) Diagnose a developmental delay
B) Refer for occupational therapy
(80 QUESTIONS) QUESTIONS AND
ANSWERS WITH RATIONALES/ GRADED
A+/2026 UPDATE /100%CORRECT
Section 1: Developmental Milestones & Screening (Questions 1–10)
1. A 4-month-old infant is brought for a well-child visit. Which developmental milestone would the
practitioner expect to observe?
A) Sits without support
B) Transfers objects hand to hand
C) Rolls from back to side
D) Pulls to stand
Answer: C) Rolls from back to side
Rationale: By 4 months, infants typically roll from back to side. Sitting without support occurs around 6–
8 months, transferring objects around 6–7 months, and pulling to stand around 9–12 months.
2. During a 12-month well-child visit, the parent expresses concern that the child is not yet walking.
What is the most appropriate response?
A) Refer immediately to early intervention
B) Reassure that independent walking by 15 months is within normal limits
C) Order a developmental assessment
D) Recommend physical therapy
,Answer: B) Reassure that independent walking by 15 months is within normal limits
Rationale: Gross motor milestones: most children walk independently by 12–15 months. Reassurance is
appropriate unless other red flags are present.
3. Which screening tool is specifically designed for autism spectrum disorder (ASD) in toddlers?
A) Denver II
B) M-CHAT-R/F
C) PEDS
D) ASQ-3
Answer: B) M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up)
Rationale: M-CHAT-R/F is a validated screening tool for ASD in children 16–30 months. PEDS and ASQ-3
are general developmental screens; Denver II is a developmental assessment tool.
4. A 2-year-old child speaks in 2- to 3-word phrases, follows simple commands, and points to body
parts. This language development is consistent with which age?
A) 12 months
B) 18 months
C) 24 months
D) 30 months
Answer: C) 24 months
Rationale: By 24 months, children typically use 2- to 3-word phrases, have a 50+ word vocabulary,
follow two-step commands, and point to named body parts.
5. At which age does the anterior fontanelle typically close?
A) 2–4 months
B) 4–8 months
C) 9–18 months
, D) 18–24 months
Answer: C) 9–18 months
Rationale: The anterior fontanelle closes between 9 and 18 months. Delayed closure may indicate
hypothyroidism, rickets, or increased intracranial pressure.
6. Which finding during a 9-month-old’s examination warrants further evaluation?
A) Babbling
B) Stranger anxiety
C) Absence of pincer grasp
D) Pulling to stand
Answer: C) Absence of pincer grasp
Rationale: Pincer grasp typically develops by 9–10 months. Its absence may indicate fine motor delay
warranting further evaluation.
7. A mother reports her 3-year-old has begun stuttering. What is the most appropriate guidance?
A) Refer to speech therapy immediately
B) Advise the mother to correct each stuttered word
C) Reassure that dysfluency is common during language explosion and usually resolves
spontaneously
D) Recommend a hearing evaluation
Answer: C) Reassure that dysfluency is common during language explosion and usually resolves
spontaneously
Rationale: Developmental stuttering (dysfluency) is common between ages 2–5 and typically resolves
without intervention unless it persists >6 months or is accompanied by secondary behaviors.
8. A 5-year-old is unable to hop on one foot or draw a triangle. The practitioner should:
A) Diagnose a developmental delay
B) Refer for occupational therapy
