Sentinel U APS Pediatric Wellness Simulation
Alonzo Harwood Case | Practice Exam & Clinical Competency Analysis
100 Questions | Activity Report Format | Northern Kentucky University - 2026/2027 Update
About this study guide: This 100-question practice exam aligns with the Sentinel U APS Pediatric Wellness Simulation (Alonzo
Harwood case) and Northern Kentucky University nursing program competencies for the 2026-2027 academic year. The exam
reflects a 100% score activity report standard, with 75% scenario-based and 25% direct-recall items. Cognitive mix: ~30% recall,
~50% application, ~20% analysis. Each rationale doubles as study content and links clinical reasoning to Sentinel U simulation
competencies (assessment, communication, EBI, clinical decision-making, safety, professionalism).
Section Questions Count
Pediatric Growth and Development Q1–Q12 12
Pediatric Health History and Physical Assessment Q13–Q26 14
Pediatric Wellness and Health Promotion Q27–Q40 14
Pediatric Pharmacology and Medication Safety Q41–Q53 13
Common Pediatric Conditions and Management Q54–Q67 14
Family-Centered Care and Communication Q68–Q80 13
Clinical Decision-Making and Documentation Q81–Q92 12
Sentinel U Simulation Competencies and Debriefing Q93–Q100 8
Section 1: Pediatric Growth and Development
Competencies covered: Developmental milestones (infant through adolescent), growth chart interpretation, BMI, head circumference,
Denver II, ASQ, M-CHAT
Q1: Alonzo Harwood is a 4-year-old boy presenting for his well-child visit. Which of the following gross
motor milestones should he have achieved by this age?
A. Sits without support
B. Walks independently
C. Hops on one foot and climbs stairs alternating feet [CORRECT]
D. Rides a two-wheel bicycle without training wheels
Correct Answer: C
Rationale: By age 4, a child should hop on one foot (briefly), climb stairs with alternating feet, and run
with control. Sitting without support (A) is achieved by ~6-8 months and walking (B) by ~12-15 months.
Riding a two-wheel bicycle without training wheels (D) is typical of school-age children (~6-8 years). In
Sentinel U, correct milestone identification is a 100% score competency under the Pediatric
Assessment domain.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 1
, Q2: When assessing Alonzo's language development at age 4, which finding is consistent with normal
milestones?
A. Uses 2-word phrases only
B. Tells a short story and uses future tense; strangers understand him most of the time [CORRECT]
C. Speaks only in single words; difficult for strangers to understand
D. Uses no consonant sounds yet
Correct Answer: B
Rationale: By age 4, a child uses sentences of 4-5 words, tells stories, uses future tense, and is
intelligible to strangers most of the time. Two-word phrases are typical at age 2; single words and
stranger unintelligibility warrant evaluation. Consonant sounds develop by 12-18 months. Sentinel U
competency scoring rewards accurate milestone identification and red-flag recognition.
Q3: Alonzo's weight is plotted at the 75th percentile for age on the CDC growth chart. Which
interpretation is correct?
A. Alonzo weighs 75% of the ideal weight for his age
B. Alonzo weighs more than 75% of boys his age and less than 25% of boys his age [CORRECT]
C. Alonzo is overweight because he is above the 50th percentile
D. Alonzo is in the 75th weight category for adults
Correct Answer: B
Rationale: A percentile indicates the child's rank relative to same-age, same-sex peers. The 75th
percentile means Alonzo weighs more than ~75% of 4-year-old boys. Being above the 50th percentile
is normal and does not indicate overweight, which is instead defined by BMI percentile (>=85th).
Misinterpreting percentile as a percentage of ideal weight is a common Sentinel U distractor.
Q4: Alonzo's BMI is 16.2, which plots at the 55th percentile for age and sex. How should the nurse
classify his weight status?
A. Underweight (less than 5th percentile)
B. Healthy weight (5th to less than 85th percentile) [CORRECT]
C. Overweight (85th to less than 95th percentile)
D. Obese (95th percentile or greater)
Correct Answer: B
Rationale: Pediatric BMI is plotted on sex-specific CDC growth charts (ages 2-20). Healthy weight =
5th to <85th percentile; overweight = 85th to <95th; obese = >=95th; underweight = <5th. Alonzo at the
55th percentile is healthy. Adult BMI cutoffs (25, 30) do NOT apply to children. This is a 100% score
competency in Sentinel U.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 2
, Q5: Which statement correctly distinguishes growth from development?
A. They are interchangeable terms describing the same process
B. Growth refers to measurable physical changes (height, weight); development refers to functional
skill acquisition (motor, language, social) [CORRECT]
C. Growth refers to language skills; development refers to physical changes
D. Growth refers to social skills only
Correct Answer: B
Rationale: Growth is the measurable increase in physical size (e.g., height, weight, head
circumference). Development is the progressive acquisition of skills and function across motor,
language, cognitive, and social-emotional domains. Confusing the two is a commonly tested concept
pair. Sentinel U evaluates recognition of both domains.
Q6: Alonzo's mother Maria mentions his 6-month-old cousin is also coming for a visit. Which fine
motor milestone should the 6-month-old infant demonstrate?
A. Pincer grasp (thumb and forefinger)
B. Transfers objects from hand to hand and rakes with a palmar grasp [CORRECT]
C. Builds a tower of two cubes
D. Draws a circle
Correct Answer: B
Rationale: By 6 months, infants transfer objects hand-to-hand and use a palmar/raking grasp. Pincer
grasp matures around 9-12 months; building a 2-cube tower at ~15-18 months; drawing a circle at ~3
years. Sentinel U expects nurses to recognize age-appropriate milestones across infancy.
Q7: Which of the following is a validated developmental screening tool recommended by the AAP at
the 4-year well-child visit?
A. Braden Scale
B. Ages and Stages Questionnaire (ASQ-3) and/or Denver II [CORRECT]
C. Glasgow Coma Scale
D. APGAR score
Correct Answer: B
Rationale: The AAP recommends structured developmental screening at 9, 18, and 30 months (or 24
months) and autism screening at 18 and 24 months (M-CHAT). At 4, developmental surveillance
continues; ASQ-3 or Denver II may be used to confirm concerns. Braden = pressure injury risk; GCS =
consciousness; APGAR = newborn transition. These are not developmental screeners.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 3
, Q8: When is the M-CHAT-R autism screen typically administered during well-child visits?
A. At 9 and 18 months
B. At 18 and 24 months [CORRECT]
C. At 4 and 6 years
D. At birth only
Correct Answer: B
Rationale: The AAP recommends M-CHAT-R autism screening at 18 and 24 months. Sentinel U
expects the learner to know the AAP periodicity schedule. A 4-year visit relies on developmental
surveillance rather than M-CHAT, although any caregiver concern warrants follow-up screening and
referral.
Q9: Alonzo's head circumference is no longer routinely measured. At what age does routine head
circumference measurement typically stop?
A. 6 months
B. 12 months
C. 24-36 months (up to 3 years) [CORRECT]
D. 5 years
Correct Answer: C
Rationale: Head circumference is measured routinely from birth to about 24-36 months because brain
growth is most rapid in this window. After 3 years, head circumference is measured only if concerns
arise (e.g., macrocephaly, microcephaly, or neurodevelopmental concerns). Sentinel U competency:
know which measurements are age-appropriate at every well-child visit.
Q10: At age 4, Alonzo should demonstrate which cognitive developmental milestone consistent with
Piaget's preoperational stage?
A. Abstract reasoning and hypothesis testing
B. Symbolic thought, magical thinking, and egocentrism [CORRECT]
C. Object permanence
D. Conservation of mass and reversible thinking
Correct Answer: B
Rationale: Piaget's preoperational stage (ages 2-7) is characterized by symbolic thought, magical
thinking, egocentrism, and lack of conservation. Abstract reasoning (formal operations, adolescence),
object permanence (sensorimotor, infancy), and conservation (concrete operations, ~age 7-11) are
other stages. Sentinel U expects knowledge of developmental theory integrated with assessment
findings.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 4
Alonzo Harwood Case | Practice Exam & Clinical Competency Analysis
100 Questions | Activity Report Format | Northern Kentucky University - 2026/2027 Update
About this study guide: This 100-question practice exam aligns with the Sentinel U APS Pediatric Wellness Simulation (Alonzo
Harwood case) and Northern Kentucky University nursing program competencies for the 2026-2027 academic year. The exam
reflects a 100% score activity report standard, with 75% scenario-based and 25% direct-recall items. Cognitive mix: ~30% recall,
~50% application, ~20% analysis. Each rationale doubles as study content and links clinical reasoning to Sentinel U simulation
competencies (assessment, communication, EBI, clinical decision-making, safety, professionalism).
Section Questions Count
Pediatric Growth and Development Q1–Q12 12
Pediatric Health History and Physical Assessment Q13–Q26 14
Pediatric Wellness and Health Promotion Q27–Q40 14
Pediatric Pharmacology and Medication Safety Q41–Q53 13
Common Pediatric Conditions and Management Q54–Q67 14
Family-Centered Care and Communication Q68–Q80 13
Clinical Decision-Making and Documentation Q81–Q92 12
Sentinel U Simulation Competencies and Debriefing Q93–Q100 8
Section 1: Pediatric Growth and Development
Competencies covered: Developmental milestones (infant through adolescent), growth chart interpretation, BMI, head circumference,
Denver II, ASQ, M-CHAT
Q1: Alonzo Harwood is a 4-year-old boy presenting for his well-child visit. Which of the following gross
motor milestones should he have achieved by this age?
A. Sits without support
B. Walks independently
C. Hops on one foot and climbs stairs alternating feet [CORRECT]
D. Rides a two-wheel bicycle without training wheels
Correct Answer: C
Rationale: By age 4, a child should hop on one foot (briefly), climb stairs with alternating feet, and run
with control. Sitting without support (A) is achieved by ~6-8 months and walking (B) by ~12-15 months.
Riding a two-wheel bicycle without training wheels (D) is typical of school-age children (~6-8 years). In
Sentinel U, correct milestone identification is a 100% score competency under the Pediatric
Assessment domain.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 1
, Q2: When assessing Alonzo's language development at age 4, which finding is consistent with normal
milestones?
A. Uses 2-word phrases only
B. Tells a short story and uses future tense; strangers understand him most of the time [CORRECT]
C. Speaks only in single words; difficult for strangers to understand
D. Uses no consonant sounds yet
Correct Answer: B
Rationale: By age 4, a child uses sentences of 4-5 words, tells stories, uses future tense, and is
intelligible to strangers most of the time. Two-word phrases are typical at age 2; single words and
stranger unintelligibility warrant evaluation. Consonant sounds develop by 12-18 months. Sentinel U
competency scoring rewards accurate milestone identification and red-flag recognition.
Q3: Alonzo's weight is plotted at the 75th percentile for age on the CDC growth chart. Which
interpretation is correct?
A. Alonzo weighs 75% of the ideal weight for his age
B. Alonzo weighs more than 75% of boys his age and less than 25% of boys his age [CORRECT]
C. Alonzo is overweight because he is above the 50th percentile
D. Alonzo is in the 75th weight category for adults
Correct Answer: B
Rationale: A percentile indicates the child's rank relative to same-age, same-sex peers. The 75th
percentile means Alonzo weighs more than ~75% of 4-year-old boys. Being above the 50th percentile
is normal and does not indicate overweight, which is instead defined by BMI percentile (>=85th).
Misinterpreting percentile as a percentage of ideal weight is a common Sentinel U distractor.
Q4: Alonzo's BMI is 16.2, which plots at the 55th percentile for age and sex. How should the nurse
classify his weight status?
A. Underweight (less than 5th percentile)
B. Healthy weight (5th to less than 85th percentile) [CORRECT]
C. Overweight (85th to less than 95th percentile)
D. Obese (95th percentile or greater)
Correct Answer: B
Rationale: Pediatric BMI is plotted on sex-specific CDC growth charts (ages 2-20). Healthy weight =
5th to <85th percentile; overweight = 85th to <95th; obese = >=95th; underweight = <5th. Alonzo at the
55th percentile is healthy. Adult BMI cutoffs (25, 30) do NOT apply to children. This is a 100% score
competency in Sentinel U.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 2
, Q5: Which statement correctly distinguishes growth from development?
A. They are interchangeable terms describing the same process
B. Growth refers to measurable physical changes (height, weight); development refers to functional
skill acquisition (motor, language, social) [CORRECT]
C. Growth refers to language skills; development refers to physical changes
D. Growth refers to social skills only
Correct Answer: B
Rationale: Growth is the measurable increase in physical size (e.g., height, weight, head
circumference). Development is the progressive acquisition of skills and function across motor,
language, cognitive, and social-emotional domains. Confusing the two is a commonly tested concept
pair. Sentinel U evaluates recognition of both domains.
Q6: Alonzo's mother Maria mentions his 6-month-old cousin is also coming for a visit. Which fine
motor milestone should the 6-month-old infant demonstrate?
A. Pincer grasp (thumb and forefinger)
B. Transfers objects from hand to hand and rakes with a palmar grasp [CORRECT]
C. Builds a tower of two cubes
D. Draws a circle
Correct Answer: B
Rationale: By 6 months, infants transfer objects hand-to-hand and use a palmar/raking grasp. Pincer
grasp matures around 9-12 months; building a 2-cube tower at ~15-18 months; drawing a circle at ~3
years. Sentinel U expects nurses to recognize age-appropriate milestones across infancy.
Q7: Which of the following is a validated developmental screening tool recommended by the AAP at
the 4-year well-child visit?
A. Braden Scale
B. Ages and Stages Questionnaire (ASQ-3) and/or Denver II [CORRECT]
C. Glasgow Coma Scale
D. APGAR score
Correct Answer: B
Rationale: The AAP recommends structured developmental screening at 9, 18, and 30 months (or 24
months) and autism screening at 18 and 24 months (M-CHAT). At 4, developmental surveillance
continues; ASQ-3 or Denver II may be used to confirm concerns. Braden = pressure injury risk; GCS =
consciousness; APGAR = newborn transition. These are not developmental screeners.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 3
, Q8: When is the M-CHAT-R autism screen typically administered during well-child visits?
A. At 9 and 18 months
B. At 18 and 24 months [CORRECT]
C. At 4 and 6 years
D. At birth only
Correct Answer: B
Rationale: The AAP recommends M-CHAT-R autism screening at 18 and 24 months. Sentinel U
expects the learner to know the AAP periodicity schedule. A 4-year visit relies on developmental
surveillance rather than M-CHAT, although any caregiver concern warrants follow-up screening and
referral.
Q9: Alonzo's head circumference is no longer routinely measured. At what age does routine head
circumference measurement typically stop?
A. 6 months
B. 12 months
C. 24-36 months (up to 3 years) [CORRECT]
D. 5 years
Correct Answer: C
Rationale: Head circumference is measured routinely from birth to about 24-36 months because brain
growth is most rapid in this window. After 3 years, head circumference is measured only if concerns
arise (e.g., macrocephaly, microcephaly, or neurodevelopmental concerns). Sentinel U competency:
know which measurements are age-appropriate at every well-child visit.
Q10: At age 4, Alonzo should demonstrate which cognitive developmental milestone consistent with
Piaget's preoperational stage?
A. Abstract reasoning and hypothesis testing
B. Symbolic thought, magical thinking, and egocentrism [CORRECT]
C. Object permanence
D. Conservation of mass and reversible thinking
Correct Answer: B
Rationale: Piaget's preoperational stage (ages 2-7) is characterized by symbolic thought, magical
thinking, egocentrism, and lack of conservation. Abstract reasoning (formal operations, adolescence),
object permanence (sensorimotor, infancy), and conservation (concrete operations, ~age 7-11) are
other stages. Sentinel U expects knowledge of developmental theory integrated with assessment
findings.
Sentinel U APS Pediatric Wellness Simulation - Alonzo Harwood Case | NKU 2026/2027 Page 4
