BARKLEY PEDIATRIC PRIMARY CARE NP
(PNP-PC) REVIEW Practice Questions with
Answers & Detailed Rationales
SECTION 1: GROWTH & DEVELOPMENT (Questions 1-15)
Question 1
A 2-month-old infant should be able to perform which of the following?
A. Sit independently
B. Walk with support
C. Lift head briefly when prone
D. Use two-word phrases
Answer: C
Rationale: Head control begins around 2 months of age. Infants at this age can lift
their head briefly when in the prone position. Sitting independently typically occurs
around 6-8 months, walking with support around 9-12 months, and two-word
phrases around 18-24 months.
Question 2
,Separation anxiety normally begins at which age?
A. Birth
B. 3 months
C. 6-9 months
D. 2 years
Answer: C
Rationale: Separation anxiety and stranger awareness typically develop in late
infancy, around 6-9 months of age. This is a normal developmental milestone
reflecting attachment formation and object permanence.
Question 3
A normal finding in a 4-year-old child is:
A. Inability to hop
B. Balancing on one foot briefly
C. Using only single words
D. Lack of imaginative play
Answer: B
Rationale: Preschoolers (ages 3-5) show improved balance and coordination. A 4-
year-old should be able to balance on one foot briefly. Inability to hop, using only
single words, and lack of imaginative play would be developmental red flags at this
age.
,Question 4
Object permanence typically develops by which age?
A. 2 months
B. 4 months
C. 8-9 months
D. 18 months
Answer: C
Rationale: Object permanence—the understanding that objects continue to exist
even when they cannot be seen—typically develops around 8-9 months of age. This
cognitive milestone is foundational for the development of separation anxiety.
Question 5
Which finding is a developmental red flag at 18 months of age?
A. Limited vocabulary
B. Stranger anxiety
C. No walking independently
D. Parallel play
Answer: C
Rationale: By 18 months, most children can walk independently. Failure to walk by
18 months is a gross motor delay that requires evaluation. Limited vocabulary may
be concerning but is less specific than lack of independent walking. Stranger
anxiety and parallel play are normal at this age.
, Question 6
A 3-year-old child is unable to pedal a tricycle. This finding is:
A. Normal for a 3-year-old
B. A fine motor delay
C. A gross motor delay requiring evaluation
D. A sign of intellectual disability
Answer: A
Rationale: Pedaling a tricycle is a gross motor skill typically achieved between 3
and 4 years of age. A 3-year-old who cannot yet pedal a tricycle is within the normal
developmental range and does not require immediate evaluation.
Question 7
At what age should a child be able to copy a circle?
A. 2 years
B. 3 years
C. 4 years
D. 5 years
Answer: B
Rationale: By 3 years of age, most children can copy a circle. By 4 years, they can
copy a cross; by 5 years, they can copy a square; and by 6 years, they can copy a
triangle.
(PNP-PC) REVIEW Practice Questions with
Answers & Detailed Rationales
SECTION 1: GROWTH & DEVELOPMENT (Questions 1-15)
Question 1
A 2-month-old infant should be able to perform which of the following?
A. Sit independently
B. Walk with support
C. Lift head briefly when prone
D. Use two-word phrases
Answer: C
Rationale: Head control begins around 2 months of age. Infants at this age can lift
their head briefly when in the prone position. Sitting independently typically occurs
around 6-8 months, walking with support around 9-12 months, and two-word
phrases around 18-24 months.
Question 2
,Separation anxiety normally begins at which age?
A. Birth
B. 3 months
C. 6-9 months
D. 2 years
Answer: C
Rationale: Separation anxiety and stranger awareness typically develop in late
infancy, around 6-9 months of age. This is a normal developmental milestone
reflecting attachment formation and object permanence.
Question 3
A normal finding in a 4-year-old child is:
A. Inability to hop
B. Balancing on one foot briefly
C. Using only single words
D. Lack of imaginative play
Answer: B
Rationale: Preschoolers (ages 3-5) show improved balance and coordination. A 4-
year-old should be able to balance on one foot briefly. Inability to hop, using only
single words, and lack of imaginative play would be developmental red flags at this
age.
,Question 4
Object permanence typically develops by which age?
A. 2 months
B. 4 months
C. 8-9 months
D. 18 months
Answer: C
Rationale: Object permanence—the understanding that objects continue to exist
even when they cannot be seen—typically develops around 8-9 months of age. This
cognitive milestone is foundational for the development of separation anxiety.
Question 5
Which finding is a developmental red flag at 18 months of age?
A. Limited vocabulary
B. Stranger anxiety
C. No walking independently
D. Parallel play
Answer: C
Rationale: By 18 months, most children can walk independently. Failure to walk by
18 months is a gross motor delay that requires evaluation. Limited vocabulary may
be concerning but is less specific than lack of independent walking. Stranger
anxiety and parallel play are normal at this age.
, Question 6
A 3-year-old child is unable to pedal a tricycle. This finding is:
A. Normal for a 3-year-old
B. A fine motor delay
C. A gross motor delay requiring evaluation
D. A sign of intellectual disability
Answer: A
Rationale: Pedaling a tricycle is a gross motor skill typically achieved between 3
and 4 years of age. A 3-year-old who cannot yet pedal a tricycle is within the normal
developmental range and does not require immediate evaluation.
Question 7
At what age should a child be able to copy a circle?
A. 2 years
B. 3 years
C. 4 years
D. 5 years
Answer: B
Rationale: By 3 years of age, most children can copy a circle. By 4 years, they can
copy a cross; by 5 years, they can copy a square; and by 6 years, they can copy a
triangle.
