PEDIATRIC FINAL EXAM – VERSION A
SECTION 1: Growth & Development (Questions 1–20)
1. A 4-month-old infant should be able to perform which of the following milestones?
A) Sit without support
B) Roll from abdomen to back
C) Walk with assistance
D) Say "mama" specifically
Correct Answer: B
Rationale: By 4 months, most infants can roll from abdomen to back. Sitting without support
occurs around 6–8 months, walking with assistance around 9–12 months, and specific
"mama" around 10–12 months.
2. Which immunization is typically given at birth?
A) DTaP
B) MMR
C) Hepatitis B
D) Varicella
Correct Answer: C
Rationale: Hepatitis B vaccine is given within 24 hours of birth. DTaP starts at 2 months,
MMR at 12–15 months, varicella at 12–15 months.
3. A 2-year-old child exhibits negativism, says "no" frequently, and has temper tantrums. This
behavior is most consistent with:
A) Autism spectrum disorder
B) Normal developmental stage
C) Oppositional defiant disorder
D) Separation anxiety disorder
Correct Answer: B
Rationale: Negativism and temper tantrums are typical for Erikson's stage of autonomy vs.
shame/doubt (ages 1–3). It is developmentally normal, not pathological.
4. By what age should a child be able to draw a circle?
A) 2 years
B) 3 years
C) 4 years
D) 5 years
,Correct Answer: B
Rationale: At 3 years, a child can copy a circle. At 4 years, they can draw a cross; at 5 years, a
square.
5. The anterior fontanelle typically closes by:
A) 2 months
B) 6 months
C) 12–18 months
D) 24 months
Correct Answer: C
Rationale: Anterior fontanelle closes between 12–18 months. Posterior fontanelle closes by
2–3 months.
6. A 9-month-old is brought to the clinic. Which finding would require further evaluation?
A) Pincer grasp present
B) Stranger anxiety present
C) Unable to sit without support
D) Says "mama" and "dada" nonspecifically
Correct Answer: C
Rationale: By 9 months, most infants sit without support. Absence of this milestone
warrants developmental screening.
7. According to Piaget, a 6-month-old is in which stage of cognitive development?
A) Preoperational
B) Sensorimotor
C) Concrete operational
D) Formal operational
Correct Answer: B
Rationale: Sensorimotor stage is from birth to 2 years. Preoperational is 2–7 years, concrete
operational is 7–11 years, formal operational is 11+ years.
8. A mother asks when she can introduce cow's milk to her infant. Your best response is:
A) 4 months
B) 6 months
C) 9 months
D) 12 months
Correct Answer: D
,Rationale: Whole cow's milk should not be introduced before 12 months due to risk of iron
deficiency anemia and renal solute load.
9. Which gross motor milestone is expected at 12 months?
A) Runs
B) Stands alone
C) Jumps in place
D) Walks up stairs
Correct Answer: B
Rationale: By 12 months, most children stand alone briefly. Running occurs around 18
months, jumping around 24 months, walking up stairs around 18–24 months.
10. A 15-month-old's weight is now triple the birth weight. This is:
A) Underweight
B) Normal
C) Overweight
D) Failure to thrive
Correct Answer: B
Rationale: Birth weight triples by 12 months, so triple at 15 months is within normal range.
11. Which fine motor skill is expected at 18 months?
A) Builds a tower of 2 cubes
B) Builds a tower of 3–4 cubes
C) Builds a tower of 6 cubes
D) Builds a tower of 8 cubes
Correct Answer: B
Rationale: At 18 months, a child builds a tower of 3–4 cubes. Two cubes at 15 months, six
cubes at 2 years.
12. Separation anxiety typically peaks at:
A) 4–6 months
B) 6–8 months
C) 10–18 months
D) 24–30 months
Correct Answer: C
Rationale: Separation anxiety peaks between 10–18 months and usually resolves by age 2–3
years.
, 13. A 3-year-old child is hospitalized. Which behavior is developmentally expected?
A) Fear of bodily harm
B) Regression to thumb-sucking
C) Loss of bladder control
D) All of the above
Correct Answer: D
Rationale: Hospitalization can cause regression in young children, including thumb-sucking,
enuresis, and fear of bodily harm.
14. Which is a characteristic of parallel play?
A) Playing with others with shared goals
B) Playing alongside but not with others
C) Playing alone
D) Playing rule-based games
Correct Answer: B
Rationale: Parallel play (age 2–3) is playing near but not interacting with others. Solitary play
is common in infants, associative/cooperative play in older preschoolers.
15. The pincer grasp is usually fully developed by:
A) 6 months
B) 9 months
C) 12 months
D) 15 months
Correct Answer: B
Rationale: The pincer grasp (using thumb and forefinger) develops around 9–10 months.
16. A 5-year-old child's vocabulary typically includes approximately how many words?
A) 500
B) 1,000
C) 2,000
D) 5,000
Correct Answer: C
Rationale: By age 5, most children have a vocabulary of about 2,000 words and can speak in
complete sentences.
17. Which sleep pattern is normal for a 2-month-old?
A) Sleeping through the night
B) Waking every 2–4 hours for feeds
C) Needing only one nap daily
D) Sleeping 12 hours uninterrupted
SECTION 1: Growth & Development (Questions 1–20)
1. A 4-month-old infant should be able to perform which of the following milestones?
A) Sit without support
B) Roll from abdomen to back
C) Walk with assistance
D) Say "mama" specifically
Correct Answer: B
Rationale: By 4 months, most infants can roll from abdomen to back. Sitting without support
occurs around 6–8 months, walking with assistance around 9–12 months, and specific
"mama" around 10–12 months.
2. Which immunization is typically given at birth?
A) DTaP
B) MMR
C) Hepatitis B
D) Varicella
Correct Answer: C
Rationale: Hepatitis B vaccine is given within 24 hours of birth. DTaP starts at 2 months,
MMR at 12–15 months, varicella at 12–15 months.
3. A 2-year-old child exhibits negativism, says "no" frequently, and has temper tantrums. This
behavior is most consistent with:
A) Autism spectrum disorder
B) Normal developmental stage
C) Oppositional defiant disorder
D) Separation anxiety disorder
Correct Answer: B
Rationale: Negativism and temper tantrums are typical for Erikson's stage of autonomy vs.
shame/doubt (ages 1–3). It is developmentally normal, not pathological.
4. By what age should a child be able to draw a circle?
A) 2 years
B) 3 years
C) 4 years
D) 5 years
,Correct Answer: B
Rationale: At 3 years, a child can copy a circle. At 4 years, they can draw a cross; at 5 years, a
square.
5. The anterior fontanelle typically closes by:
A) 2 months
B) 6 months
C) 12–18 months
D) 24 months
Correct Answer: C
Rationale: Anterior fontanelle closes between 12–18 months. Posterior fontanelle closes by
2–3 months.
6. A 9-month-old is brought to the clinic. Which finding would require further evaluation?
A) Pincer grasp present
B) Stranger anxiety present
C) Unable to sit without support
D) Says "mama" and "dada" nonspecifically
Correct Answer: C
Rationale: By 9 months, most infants sit without support. Absence of this milestone
warrants developmental screening.
7. According to Piaget, a 6-month-old is in which stage of cognitive development?
A) Preoperational
B) Sensorimotor
C) Concrete operational
D) Formal operational
Correct Answer: B
Rationale: Sensorimotor stage is from birth to 2 years. Preoperational is 2–7 years, concrete
operational is 7–11 years, formal operational is 11+ years.
8. A mother asks when she can introduce cow's milk to her infant. Your best response is:
A) 4 months
B) 6 months
C) 9 months
D) 12 months
Correct Answer: D
,Rationale: Whole cow's milk should not be introduced before 12 months due to risk of iron
deficiency anemia and renal solute load.
9. Which gross motor milestone is expected at 12 months?
A) Runs
B) Stands alone
C) Jumps in place
D) Walks up stairs
Correct Answer: B
Rationale: By 12 months, most children stand alone briefly. Running occurs around 18
months, jumping around 24 months, walking up stairs around 18–24 months.
10. A 15-month-old's weight is now triple the birth weight. This is:
A) Underweight
B) Normal
C) Overweight
D) Failure to thrive
Correct Answer: B
Rationale: Birth weight triples by 12 months, so triple at 15 months is within normal range.
11. Which fine motor skill is expected at 18 months?
A) Builds a tower of 2 cubes
B) Builds a tower of 3–4 cubes
C) Builds a tower of 6 cubes
D) Builds a tower of 8 cubes
Correct Answer: B
Rationale: At 18 months, a child builds a tower of 3–4 cubes. Two cubes at 15 months, six
cubes at 2 years.
12. Separation anxiety typically peaks at:
A) 4–6 months
B) 6–8 months
C) 10–18 months
D) 24–30 months
Correct Answer: C
Rationale: Separation anxiety peaks between 10–18 months and usually resolves by age 2–3
years.
, 13. A 3-year-old child is hospitalized. Which behavior is developmentally expected?
A) Fear of bodily harm
B) Regression to thumb-sucking
C) Loss of bladder control
D) All of the above
Correct Answer: D
Rationale: Hospitalization can cause regression in young children, including thumb-sucking,
enuresis, and fear of bodily harm.
14. Which is a characteristic of parallel play?
A) Playing with others with shared goals
B) Playing alongside but not with others
C) Playing alone
D) Playing rule-based games
Correct Answer: B
Rationale: Parallel play (age 2–3) is playing near but not interacting with others. Solitary play
is common in infants, associative/cooperative play in older preschoolers.
15. The pincer grasp is usually fully developed by:
A) 6 months
B) 9 months
C) 12 months
D) 15 months
Correct Answer: B
Rationale: The pincer grasp (using thumb and forefinger) develops around 9–10 months.
16. A 5-year-old child's vocabulary typically includes approximately how many words?
A) 500
B) 1,000
C) 2,000
D) 5,000
Correct Answer: C
Rationale: By age 5, most children have a vocabulary of about 2,000 words and can speak in
complete sentences.
17. Which sleep pattern is normal for a 2-month-old?
A) Sleeping through the night
B) Waking every 2–4 hours for feeds
C) Needing only one nap daily
D) Sleeping 12 hours uninterrupted
