NSG 548 Exam 2 Family NP Role w - Children
& Families (2026) Questions & Answers
A nurse practitioner is evaluating a 2-month-old infant at a well-child visit.
Which of the following physical assessment findings requires immediate
further investigation?
A) Persistent asymmetric tonic neck reflex (fencing reflex)
B) Head lag when pulling the infant from a supine to sitting position
C) Failure to track a brightly colored object past the midline
,D) A closed posterior fontanel on palpation
Answer: C
Rationale: By 2 months of age, an infant should be able to visually track an object
past the midline (to 180 degrees). Failure to do so warrants evaluation for visual
deficits or central nervous system delays. Head lag (B) is completely normal at 2
months and typically resolves by 4 months. The posterior fontanel (D) closes early,
usually by 1 to 2 months of age, which is normal. The asymmetric tonic neck reflex
is normal at this age and fades around 4–6 months.
At what age should the FNP counsel parents to expect their infant to
transition from rolling from front-to-back to successfully rolling from back-to-
front?
A) 2 months
B) 4 months
C) 6 months
D) 9 months
Answer: C
Rationale: Rolling front-to-back (stomach to back) requires less trunk control and
occurs around 4 months. Rolling back-to-front (supine to prone) requires greater
abdominal and oblique muscle coordination, which is universally expected around 6
months of age.
A mother brings her 9-month-old infant to the clinic. During the
developmental assessment, which of the following milestones should the
FNP expect the infant to have recently mastered?
A) Sitting independently without support and using a crude pincer grasp
B) Walking while holding onto furniture (cruising)
C) Building a tower of two cubes
D) Pulling a string to obtain a toy
Answer: A
,Rationale: Independent sitting and the development of a crude pincer grasp (using
the pads of the fingers rather than the tips) are classic 9-month milestones.
Cruising (B) occurs closer to 11–12 months. Stacking blocks (C) is a toddler
milestone (typically 15 months for 2 blocks).
The anterior fontanel is an important window for monitoring intracranial
pressure and structural growth. The FNP knows that this fontanel typically
closes within which time frame?
A) 2 to 4 months
B) 6 to 9 months
C) 10 to 18 months
D) 24 to 30 months
Answer: C
Rationale: While the posterior fontanel closes within 1–2 months, the anterior
fontanel requires more time for cranial expansion and typically ossifies and closes
between 10 and 18 months of age. Closure before 9 months or patency past 19
months requires investigation.
During a 12-month well-child examination, which fine motor skill best
demonstrates appropriate advanced development for this age?
A) Transferring an object from one hand to another
B) Using a mature palmar grasp on a crayon
C) Releasing a small object cleanly into a cup on request
D) Copying a distinct horizontal line
Answer: C
Rationale: Fine motor development at 12 months includes a neat, mature pincer
grasp (tips of thumb and index finger) and the ability to voluntarily release an object
into a container. Transferring objects (A) is a 6-month milestone. Drawing a line (D)
is a preschool milestone.
A parent brings a 15-month-old toddler to the clinic. The FNP notes the
toddler can walk independently, speaks two clear words with meaning, and
, can feed themselves with their fingers. Which developmental area is most
lacking based on standard milestones?
A) Gross motor
B) Language
C) Fine motor
D) None; the child is meeting all milestones
Answer: B
Rationale: By 15 months, a toddler should have a minimum vocabulary of 3 to 6
words with meaning, along with the ability to jargon and follow simple one-step
commands. Walking independently satisfies gross motor goals, and finger-feeding
satisfies fine motor targets.
An FNP is assessing a 24-month-old child. Which of the following structural
block-building capabilities aligns perfectly with this age milestone?
A) Stacking a tower of 2 blocks
B) Stacking a tower of 4 blocks
C) Stacking a tower of 6 to 7 blocks
D) Stacking a tower of 10 blocks and making a bridge
Answer: C
Rationale: A 24-month-old (2 years) should be able to stack a tower of 6 to 7
blocks. Stacking 3–4 blocks is typical at 18 months, whereas a tower of 9–10
blocks or constructing a bridge is a 3-year-old (36 months) milestone.
At what age does a child typically transition to using a spoon with minimal
spilling, washing and drying their hands superficially, and expressing clear
two-to-three-word phrases containing a subject and a verb?
A) 18 months
B) 24 months
C) 36 months
D) 4 years
Answer: B
& Families (2026) Questions & Answers
A nurse practitioner is evaluating a 2-month-old infant at a well-child visit.
Which of the following physical assessment findings requires immediate
further investigation?
A) Persistent asymmetric tonic neck reflex (fencing reflex)
B) Head lag when pulling the infant from a supine to sitting position
C) Failure to track a brightly colored object past the midline
,D) A closed posterior fontanel on palpation
Answer: C
Rationale: By 2 months of age, an infant should be able to visually track an object
past the midline (to 180 degrees). Failure to do so warrants evaluation for visual
deficits or central nervous system delays. Head lag (B) is completely normal at 2
months and typically resolves by 4 months. The posterior fontanel (D) closes early,
usually by 1 to 2 months of age, which is normal. The asymmetric tonic neck reflex
is normal at this age and fades around 4–6 months.
At what age should the FNP counsel parents to expect their infant to
transition from rolling from front-to-back to successfully rolling from back-to-
front?
A) 2 months
B) 4 months
C) 6 months
D) 9 months
Answer: C
Rationale: Rolling front-to-back (stomach to back) requires less trunk control and
occurs around 4 months. Rolling back-to-front (supine to prone) requires greater
abdominal and oblique muscle coordination, which is universally expected around 6
months of age.
A mother brings her 9-month-old infant to the clinic. During the
developmental assessment, which of the following milestones should the
FNP expect the infant to have recently mastered?
A) Sitting independently without support and using a crude pincer grasp
B) Walking while holding onto furniture (cruising)
C) Building a tower of two cubes
D) Pulling a string to obtain a toy
Answer: A
,Rationale: Independent sitting and the development of a crude pincer grasp (using
the pads of the fingers rather than the tips) are classic 9-month milestones.
Cruising (B) occurs closer to 11–12 months. Stacking blocks (C) is a toddler
milestone (typically 15 months for 2 blocks).
The anterior fontanel is an important window for monitoring intracranial
pressure and structural growth. The FNP knows that this fontanel typically
closes within which time frame?
A) 2 to 4 months
B) 6 to 9 months
C) 10 to 18 months
D) 24 to 30 months
Answer: C
Rationale: While the posterior fontanel closes within 1–2 months, the anterior
fontanel requires more time for cranial expansion and typically ossifies and closes
between 10 and 18 months of age. Closure before 9 months or patency past 19
months requires investigation.
During a 12-month well-child examination, which fine motor skill best
demonstrates appropriate advanced development for this age?
A) Transferring an object from one hand to another
B) Using a mature palmar grasp on a crayon
C) Releasing a small object cleanly into a cup on request
D) Copying a distinct horizontal line
Answer: C
Rationale: Fine motor development at 12 months includes a neat, mature pincer
grasp (tips of thumb and index finger) and the ability to voluntarily release an object
into a container. Transferring objects (A) is a 6-month milestone. Drawing a line (D)
is a preschool milestone.
A parent brings a 15-month-old toddler to the clinic. The FNP notes the
toddler can walk independently, speaks two clear words with meaning, and
, can feed themselves with their fingers. Which developmental area is most
lacking based on standard milestones?
A) Gross motor
B) Language
C) Fine motor
D) None; the child is meeting all milestones
Answer: B
Rationale: By 15 months, a toddler should have a minimum vocabulary of 3 to 6
words with meaning, along with the ability to jargon and follow simple one-step
commands. Walking independently satisfies gross motor goals, and finger-feeding
satisfies fine motor targets.
An FNP is assessing a 24-month-old child. Which of the following structural
block-building capabilities aligns perfectly with this age milestone?
A) Stacking a tower of 2 blocks
B) Stacking a tower of 4 blocks
C) Stacking a tower of 6 to 7 blocks
D) Stacking a tower of 10 blocks and making a bridge
Answer: C
Rationale: A 24-month-old (2 years) should be able to stack a tower of 6 to 7
blocks. Stacking 3–4 blocks is typical at 18 months, whereas a tower of 9–10
blocks or constructing a bridge is a 3-year-old (36 months) milestone.
At what age does a child typically transition to using a spoon with minimal
spilling, washing and drying their hands superficially, and expressing clear
two-to-three-word phrases containing a subject and a verb?
A) 18 months
B) 24 months
C) 36 months
D) 4 years
Answer: B
