Sentinel U APS Pediatric Wellness
Simulation – Alonzo Harwood Case |
100% Score | Advanced Practice Series
2026.
SECTION 1: FOUNDATIONAL PEDIATRIC KNOWLEDGE &
DEVELOPMENTAL MILESTONES
Question 1
A 4-year-old child like Alonzo should be able to accomplish which fine motor skill?
A) Tying shoelaces
B) Drawing a circle
C) Using safety scissors
D) Writing first name
Correct Answer: B
Rationale: Drawing a circle is an age-appropriate fine motor milestone for a 4-year-old.
Tying shoelaces typically emerges at age 6, using scissors at age 5, and writing a first
name at age 5-6 .
,Question 2
Which developmental screening tool is most appropriate for a wellness visit in a 4-year-
old?
A) M-CHAT
B) Denver II
C) PHQ-9
D) CAGE questionnaire
Correct Answer: B
Rationale: The Denver II screens personal-social, fine motor-adaptive, language, and
gross motor domains. M-CHAT is for toddlers (16-30 months). PHQ-9 and CAGE are for
mental health/substance use in older patients .
Question 3
Alonzo speaks in 4-5 word sentences and asks "why" questions constantly. This
language development is typical for which age?
A) 2 years
B) 3 years
C) 4 years
D) 5 years
Correct Answer: C
Rationale: Four-year-olds typically use 4-5 word sentences, ask many questions
(especially "why"), and can tell simple stories. Two-year-olds use 2-3 word phrases; 3-
year-olds use 3-4 word sentences .
,Question 4
Which gross motor milestone is expected in a typically developing 4-year-old?
A) Hopping on one foot
B) Skipping
C) Walking backward
D) Standing on tiptoes
Correct Answer: A
Rationale: Hopping on one foot emerges at age 4. Skipping develops at age 5. Walking
backward is a 3-year-old skill. Standing on tiptoes is a 2-3 year skill .
Question 5
Red flags for developmental delay at age 4 include all EXCEPT:
A) Unable to copy a circle
B) Does not use "me" and "you" correctly
C) Can brush teeth with help
D) No interest in interactive games
Correct Answer: C
Rationale: Brushing teeth with help is appropriate for age 4. The other options
represent developmental red flags requiring further evaluation .
Question 6
A 4-year-old's play behavior is typically described as:
, A) Solitary
B) Parallel
C) Associative/cooperative with peers
D) Competitive with strict rules
Correct Answer: C
Rationale: Associative and cooperative play with peers emerges around age 4. Solitary
play is typical for infants and toddlers. Parallel play is seen around age 2-3. Competitive
play with strict rules emerges around age 6-7 .
Question 7
According to Erikson, a 4-year-old is in which psychosocial stage of development?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: C
Rationale: Initiative vs. Guilt (ages 3-6) is when children begin to assert power and
control over their environment. Trust vs. Mistrust is infancy; Autonomy vs. Shame/Doubt
is toddler; Industry vs. Inferiority is school-age .
Question 8
A 4-year-old's typical weight gain per year is approximately:
Simulation – Alonzo Harwood Case |
100% Score | Advanced Practice Series
2026.
SECTION 1: FOUNDATIONAL PEDIATRIC KNOWLEDGE &
DEVELOPMENTAL MILESTONES
Question 1
A 4-year-old child like Alonzo should be able to accomplish which fine motor skill?
A) Tying shoelaces
B) Drawing a circle
C) Using safety scissors
D) Writing first name
Correct Answer: B
Rationale: Drawing a circle is an age-appropriate fine motor milestone for a 4-year-old.
Tying shoelaces typically emerges at age 6, using scissors at age 5, and writing a first
name at age 5-6 .
,Question 2
Which developmental screening tool is most appropriate for a wellness visit in a 4-year-
old?
A) M-CHAT
B) Denver II
C) PHQ-9
D) CAGE questionnaire
Correct Answer: B
Rationale: The Denver II screens personal-social, fine motor-adaptive, language, and
gross motor domains. M-CHAT is for toddlers (16-30 months). PHQ-9 and CAGE are for
mental health/substance use in older patients .
Question 3
Alonzo speaks in 4-5 word sentences and asks "why" questions constantly. This
language development is typical for which age?
A) 2 years
B) 3 years
C) 4 years
D) 5 years
Correct Answer: C
Rationale: Four-year-olds typically use 4-5 word sentences, ask many questions
(especially "why"), and can tell simple stories. Two-year-olds use 2-3 word phrases; 3-
year-olds use 3-4 word sentences .
,Question 4
Which gross motor milestone is expected in a typically developing 4-year-old?
A) Hopping on one foot
B) Skipping
C) Walking backward
D) Standing on tiptoes
Correct Answer: A
Rationale: Hopping on one foot emerges at age 4. Skipping develops at age 5. Walking
backward is a 3-year-old skill. Standing on tiptoes is a 2-3 year skill .
Question 5
Red flags for developmental delay at age 4 include all EXCEPT:
A) Unable to copy a circle
B) Does not use "me" and "you" correctly
C) Can brush teeth with help
D) No interest in interactive games
Correct Answer: C
Rationale: Brushing teeth with help is appropriate for age 4. The other options
represent developmental red flags requiring further evaluation .
Question 6
A 4-year-old's play behavior is typically described as:
, A) Solitary
B) Parallel
C) Associative/cooperative with peers
D) Competitive with strict rules
Correct Answer: C
Rationale: Associative and cooperative play with peers emerges around age 4. Solitary
play is typical for infants and toddlers. Parallel play is seen around age 2-3. Competitive
play with strict rules emerges around age 6-7 .
Question 7
According to Erikson, a 4-year-old is in which psychosocial stage of development?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: C
Rationale: Initiative vs. Guilt (ages 3-6) is when children begin to assert power and
control over their environment. Trust vs. Mistrust is infancy; Autonomy vs. Shame/Doubt
is toddler; Industry vs. Inferiority is school-age .
Question 8
A 4-year-old's typical weight gain per year is approximately:
