,NRNP 6541 Midterm Exam | Primary Care of
Adolescents & Children (2026) Q&A | Walden University
1. According to the American Academy of Pediatrics, developmental screening
using a validated tool is recommended at which set of ages?
A) 6, 12, and 24 months
B) 9, 18, and 30 months
C) 12, 24, and 36 months
D) 4, 12, and 24 months
Correct Answer: 9, 18, and 30 months
Rationale: The AAP recommends developmental screening at the 9-, 18-, and
30-month well-child visits using a standardized tool. These ages align with
critical periods for early identification of delays. Screening at 6 months is too
early for many domains, and 36 months is after the recommended 30-month
screen. Early detection facilitates timely intervention.
2. A 15-month-old child is brought for a well visit. Which milestone would the
provider expect the child to have achieved?
A) Walks up stairs with alternating feet
B) Speaks in two-word phrases
C) Stoops and recovers to standing
D) Copies a circle
Correct Answer: Stoops and recovers to standing
,Rationale: At 15 months, a child typically stoops and recovers to standing
without support. Walking up stairs alternating feet and speaking two-word
phrases are 2-year milestones. Copying a circle is a 3-year fine motor milestone.
Knowing age-appropriate gross motor skills is essential for well-child
surveillance.
3. Head circumference measurement is routinely performed at each well-child
visit until what age?
A) 12 months
B) 18 months
C) 2 years
D) 3 years
Correct Answer: 2 years
Rationale: The CDC and AAP recommend measuring head circumference at
every well-child visit through 24 months of age to monitor brain growth. After
age 2, head growth slows, and routine measurement is no longer necessary
unless there is a concern such as hydrocephalus or microcephaly.
4. A parent asks why the 4-month-old infant needs so many vaccines at one
visit. Which response by the nurse is most accurate?
A) Splitting vaccines increases the risk of fever
B) Combination vaccines reduce the number of injections needed
C) Giving multiple vaccines at once can overload the immune system
D) The schedule is flexible and can be spread out over several months
, Correct Answer: Combination vaccines reduce the number of injections needed
Rationale: Combination vaccines (e.g., DTaP-IPV-Hib) allow multiple antigens to
be given in a single injection, decreasing the total number of shots. The infant
immune system can handle many antigens; there is no evidence that
simultaneous vaccination overloads it. Delaying vaccines leaves the child
unprotected, and splitting doses is not recommended.
5. A 12-month-old child is due for which set of immunizations according to the
CDC schedule?
A) DTaP, IPV, Hib, PCV, RV
B) MMR, varicella, hepatitis A
C) Tdap, MCV, HPV
D) MMR, varicella, hepatitis B, DTaP
Correct Answer: MMR, varicella, hepatitis A
Rationale: At the 12- to 15-month visit, the CDC recommends the first dose of
MMR and varicella, and the hepatitis A series can begin. DTaP, IPV, Hib, PCV,
and RV are given at 2, 4, and 6 months. Tdap, MCV, and HPV are adolescent
vaccines. Hepatitis B is given at birth, 1-2 months, and 6-18 months.
6. Which immunization is indicated for an 11-year-old during a routine health
maintenance visit?
A) DTaP, Hib, PCV13
B) Tdap, MCV4, HPV
C) MMR, varicella, hepatitis A
Adolescents & Children (2026) Q&A | Walden University
1. According to the American Academy of Pediatrics, developmental screening
using a validated tool is recommended at which set of ages?
A) 6, 12, and 24 months
B) 9, 18, and 30 months
C) 12, 24, and 36 months
D) 4, 12, and 24 months
Correct Answer: 9, 18, and 30 months
Rationale: The AAP recommends developmental screening at the 9-, 18-, and
30-month well-child visits using a standardized tool. These ages align with
critical periods for early identification of delays. Screening at 6 months is too
early for many domains, and 36 months is after the recommended 30-month
screen. Early detection facilitates timely intervention.
2. A 15-month-old child is brought for a well visit. Which milestone would the
provider expect the child to have achieved?
A) Walks up stairs with alternating feet
B) Speaks in two-word phrases
C) Stoops and recovers to standing
D) Copies a circle
Correct Answer: Stoops and recovers to standing
,Rationale: At 15 months, a child typically stoops and recovers to standing
without support. Walking up stairs alternating feet and speaking two-word
phrases are 2-year milestones. Copying a circle is a 3-year fine motor milestone.
Knowing age-appropriate gross motor skills is essential for well-child
surveillance.
3. Head circumference measurement is routinely performed at each well-child
visit until what age?
A) 12 months
B) 18 months
C) 2 years
D) 3 years
Correct Answer: 2 years
Rationale: The CDC and AAP recommend measuring head circumference at
every well-child visit through 24 months of age to monitor brain growth. After
age 2, head growth slows, and routine measurement is no longer necessary
unless there is a concern such as hydrocephalus or microcephaly.
4. A parent asks why the 4-month-old infant needs so many vaccines at one
visit. Which response by the nurse is most accurate?
A) Splitting vaccines increases the risk of fever
B) Combination vaccines reduce the number of injections needed
C) Giving multiple vaccines at once can overload the immune system
D) The schedule is flexible and can be spread out over several months
, Correct Answer: Combination vaccines reduce the number of injections needed
Rationale: Combination vaccines (e.g., DTaP-IPV-Hib) allow multiple antigens to
be given in a single injection, decreasing the total number of shots. The infant
immune system can handle many antigens; there is no evidence that
simultaneous vaccination overloads it. Delaying vaccines leaves the child
unprotected, and splitting doses is not recommended.
5. A 12-month-old child is due for which set of immunizations according to the
CDC schedule?
A) DTaP, IPV, Hib, PCV, RV
B) MMR, varicella, hepatitis A
C) Tdap, MCV, HPV
D) MMR, varicella, hepatitis B, DTaP
Correct Answer: MMR, varicella, hepatitis A
Rationale: At the 12- to 15-month visit, the CDC recommends the first dose of
MMR and varicella, and the hepatitis A series can begin. DTaP, IPV, Hib, PCV,
and RV are given at 2, 4, and 6 months. Tdap, MCV, and HPV are adolescent
vaccines. Hepatitis B is given at birth, 1-2 months, and 6-18 months.
6. Which immunization is indicated for an 11-year-old during a routine health
maintenance visit?
A) DTaP, Hib, PCV13
B) Tdap, MCV4, HPV
C) MMR, varicella, hepatitis A
