NURS 6541 MIDTERM EXAM
PRIMARY CARE OF CHILDREN & ADOLESCENTS (2026/2027
EDITION)
Walden University • Advanced Practice Nursing • Pediatric/Adolescent Health
AAP/CDC Guidelines • Bright Futures • 100 Questions with Answers & Rationale
Format: 100 multiple-choice questions (single best answer, A–D).
Structure: Nine sections spanning growth/development, health promotion, acute/chronic
conditions, assessment, pharmacology, adolescent health, safeguarding, and
clinical scenarios.
Cognitive ~30% recall • ~50% application • ~20% analysis.
levels:
Grading: One point per question; correct answer and rationale provided after each
item.
Content basis: Walden NURS 6541 curriculum, current AAP/CDC guidelines, Bright Futures
recommendations, and evidence-based pediatric primary care standards.
Special Immunization/vaccine schedule items; pediatric growth chart interpretation
inclusions: (BMI percentiles); comprehensive case studies.
Important This is an independent practice exam for educational study; it is not an official
note: Walden University exam.
, Section 1: Growth & Development – Infancy through Adolescence (15 questions)
Q1: At what age does an infant typically begin to sit without support?
A. 6-8 months [CORRECT]
B. 3-4 months
C. 12 months
D. 2 months
Correct Answer: A
Rationale: A is correct: infants typically sit without support by 6-8 months. B, C, and D are incorrect.
Q2: At what age does an infant typically begin to roll over?
A. 8-10 months
B. 4-6 months [CORRECT]
C. 12 months
D. 2 months
Correct Answer: B
Rationale: A is correct: rolling typically occurs at 4-6 months. B, C, and D are incorrect.
Q3: At what age does a toddler typically begin walking independently?
A. 6-8 months
B. 24 months
C. 12-15 months [CORRECT]
D. 9 months
Correct Answer: C
Rationale: A is correct: independent walking typically occurs by 12-15 months. B, C, and D are incorrect.
Q4: Which is a typical language milestone for a 2-year-old?
A. Speaks in full sentences
B. Recites the alphabet
C. Reads words
D. Uses two-word phrases [CORRECT]
Correct Answer: D
Rationale: A is correct: a 2-year-old uses two-word phrases. B, C, and D are later milestones.
Q5: Which is a typical gross motor milestone for a 4-year-old?
A. Hops on one foot [CORRECT]
B. Rides a bicycle
C. Skips with coordination
D. Runs in a straight line
Correct Answer: A
Rationale: A is correct: a 4-year-old can hop on one foot. B, C, and D are later.
Q6: Which is a typical fine motor milestone for a 6-month-old?
A. Uses a pincer grasp
B. Transfers objects from hand to hand [CORRECT]
C. Scribbles
D. Uses scissors
Correct Answer: B
Rationale: A is correct: 6-month-olds transfer objects. B (pincer) is ~9 months; C and D are later.
NURS 6541 Midterm Exam – Primary Care of Children & Adolescents (2026/2027) Page 2
, Q7: Which is a social-emotional milestone for a 9-month-old?
A. Parallel play
B. Cooperative play
C. Stranger anxiety [CORRECT]
D. Separation anxiety that is severe
Correct Answer: C
Rationale: A is correct: stranger anxiety is typical around 9 months. B and C are later; D is severe.
Q8: Which is a typical milestone for a 12-month-old?
A. Speaks in sentences
B. Names colors
C. Counts to ten
D. Says a few single words [CORRECT]
Correct Answer: D
Rationale: A is correct: a 12-month-old says a few words. B, C, and D are later.
Q9: Which best describes the pattern of head circumference growth in infancy?
A. Rapid growth in the first year, then slowing [CORRECT]
B. No growth
C. Growth only after age 2
D. Linear growth throughout
Correct Answer: A
Rationale: A is correct: head growth is rapid in the first year. B, C, and D are incorrect.
Q10: Which is a typical puberty milestone for a girl?
A. Menarche before thelarche
B. Thelarche (breast development) at about 8-13 years [CORRECT]
C. No breast development
D. Pubarche before adrenarche
Correct Answer: B
Rationale: A is correct: thelarche is typically the first pubertal sign in girls. B, C, and D are incorrect.
Q11: Which is a typical pubertal change in boys?
A. Voice changes first
B. No testicular growth
C. Testicular enlargement at about 9-14 years [CORRECT]
D. Growth spurt before testicular enlargement
Correct Answer: C
Rationale: A is correct: testicular enlargement is typically the first sign in boys. B, C, and D are incorrect.
Q12: Which is a normal finding in a toddler's appetite?
A. Always ravenous
B. No changes
C. Constant overeating
D. Decreased appetite and picky eating [CORRECT]
Correct Answer: D
Rationale: A is correct: toddlers commonly have decreased appetite/picky eating. B, C, and D are incorrect.
NURS 6541 Midterm Exam – Primary Care of Children & Adolescents (2026/2027) Page 3
PRIMARY CARE OF CHILDREN & ADOLESCENTS (2026/2027
EDITION)
Walden University • Advanced Practice Nursing • Pediatric/Adolescent Health
AAP/CDC Guidelines • Bright Futures • 100 Questions with Answers & Rationale
Format: 100 multiple-choice questions (single best answer, A–D).
Structure: Nine sections spanning growth/development, health promotion, acute/chronic
conditions, assessment, pharmacology, adolescent health, safeguarding, and
clinical scenarios.
Cognitive ~30% recall • ~50% application • ~20% analysis.
levels:
Grading: One point per question; correct answer and rationale provided after each
item.
Content basis: Walden NURS 6541 curriculum, current AAP/CDC guidelines, Bright Futures
recommendations, and evidence-based pediatric primary care standards.
Special Immunization/vaccine schedule items; pediatric growth chart interpretation
inclusions: (BMI percentiles); comprehensive case studies.
Important This is an independent practice exam for educational study; it is not an official
note: Walden University exam.
, Section 1: Growth & Development – Infancy through Adolescence (15 questions)
Q1: At what age does an infant typically begin to sit without support?
A. 6-8 months [CORRECT]
B. 3-4 months
C. 12 months
D. 2 months
Correct Answer: A
Rationale: A is correct: infants typically sit without support by 6-8 months. B, C, and D are incorrect.
Q2: At what age does an infant typically begin to roll over?
A. 8-10 months
B. 4-6 months [CORRECT]
C. 12 months
D. 2 months
Correct Answer: B
Rationale: A is correct: rolling typically occurs at 4-6 months. B, C, and D are incorrect.
Q3: At what age does a toddler typically begin walking independently?
A. 6-8 months
B. 24 months
C. 12-15 months [CORRECT]
D. 9 months
Correct Answer: C
Rationale: A is correct: independent walking typically occurs by 12-15 months. B, C, and D are incorrect.
Q4: Which is a typical language milestone for a 2-year-old?
A. Speaks in full sentences
B. Recites the alphabet
C. Reads words
D. Uses two-word phrases [CORRECT]
Correct Answer: D
Rationale: A is correct: a 2-year-old uses two-word phrases. B, C, and D are later milestones.
Q5: Which is a typical gross motor milestone for a 4-year-old?
A. Hops on one foot [CORRECT]
B. Rides a bicycle
C. Skips with coordination
D. Runs in a straight line
Correct Answer: A
Rationale: A is correct: a 4-year-old can hop on one foot. B, C, and D are later.
Q6: Which is a typical fine motor milestone for a 6-month-old?
A. Uses a pincer grasp
B. Transfers objects from hand to hand [CORRECT]
C. Scribbles
D. Uses scissors
Correct Answer: B
Rationale: A is correct: 6-month-olds transfer objects. B (pincer) is ~9 months; C and D are later.
NURS 6541 Midterm Exam – Primary Care of Children & Adolescents (2026/2027) Page 2
, Q7: Which is a social-emotional milestone for a 9-month-old?
A. Parallel play
B. Cooperative play
C. Stranger anxiety [CORRECT]
D. Separation anxiety that is severe
Correct Answer: C
Rationale: A is correct: stranger anxiety is typical around 9 months. B and C are later; D is severe.
Q8: Which is a typical milestone for a 12-month-old?
A. Speaks in sentences
B. Names colors
C. Counts to ten
D. Says a few single words [CORRECT]
Correct Answer: D
Rationale: A is correct: a 12-month-old says a few words. B, C, and D are later.
Q9: Which best describes the pattern of head circumference growth in infancy?
A. Rapid growth in the first year, then slowing [CORRECT]
B. No growth
C. Growth only after age 2
D. Linear growth throughout
Correct Answer: A
Rationale: A is correct: head growth is rapid in the first year. B, C, and D are incorrect.
Q10: Which is a typical puberty milestone for a girl?
A. Menarche before thelarche
B. Thelarche (breast development) at about 8-13 years [CORRECT]
C. No breast development
D. Pubarche before adrenarche
Correct Answer: B
Rationale: A is correct: thelarche is typically the first pubertal sign in girls. B, C, and D are incorrect.
Q11: Which is a typical pubertal change in boys?
A. Voice changes first
B. No testicular growth
C. Testicular enlargement at about 9-14 years [CORRECT]
D. Growth spurt before testicular enlargement
Correct Answer: C
Rationale: A is correct: testicular enlargement is typically the first sign in boys. B, C, and D are incorrect.
Q12: Which is a normal finding in a toddler's appetite?
A. Always ravenous
B. No changes
C. Constant overeating
D. Decreased appetite and picky eating [CORRECT]
Correct Answer: D
Rationale: A is correct: toddlers commonly have decreased appetite/picky eating. B, C, and D are incorrect.
NURS 6541 Midterm Exam – Primary Care of Children & Adolescents (2026/2027) Page 3
