NR602 / NR-602
Midterm Exam
Primary Care of the Childbearing & Childrearing Family Practicum
Guide Questions with Answers
100% Correct | Grade A
Chamberlain University
Latest Update
75 Questions | Comprehensive Review
,NR602 Midterm Exam | Primary Care of the Childbearing & Childrearing Family Practicum Chamberlain University 2026/2027
Section 1: Well-Child Care and Developmental Surveillance (Q1-15)
Q1: A 12-month-old infant is brought to the pediatric primary care clinic for a well-child visit. The parent reports the
child says 'mama' and 'dada' but does not yet point to objects. The infant sits without support, crawls, and has begun
pulling to stand. Which response by the nurse practitioner is most appropriate?
A. Refer the child to a developmental pediatrician immediately for further evaluation
B. Reassure the parent that the child's development is appropriate for 12 months of age
C. Perform a validated developmental screening tool and reassess at the 15-month visit [CORRECT]
D. Recommend early intervention services for suspected language delay
Correct Answer: C
Rationale: At 12 months, a child should demonstrate first words, pointing, crawling, and pulling to stand. Pointing typically
emerges around 9-12 months, so the absence at exactly 12 months warrants validated screening (e.g., ASQ-3 or PEDS) but not
immediate referral. Developmental trajectory over time is more important than a single-point assessment, so performing a
screening tool and reassessing at 15 months is the appropriate primary care approach. Option A is premature; option B does not
address the concern about pointing; option D oversteps without screening evidence.
Q2: During a well-child visit for an 18-month-old toddler, the nurse practitioner observes the child playing with blocks
and notices the child can stack two blocks. The parent asks if this is normal. Which response best reflects
evidence-based developmental surveillance?
A. This is below expectations; an 18-month-old should stack at least 6 blocks
B. This is concerning and warrants immediate referral to occupational therapy
C. This is within the expected range; fine motor skills should be reassessed at the 24-month visit [CORRECT]
D. Stacking two blocks is advanced for 18 months; your child is developmentally gifted
Correct Answer: C
Rationale: An 18-month-old typically stacks 2-3 blocks, making this child's performance within the expected range. By 24 months,
a child should stack 6 blocks. The NP should reassure the parent while continuing developmental surveillance at subsequent visits.
Option A overestimates expectations for this age; option B is an overreaction; option D incorrectly interprets normal performance
as advanced. The key principle is that developmental trajectory over time matters more than a single assessment.
Q3: A 4-year-old child presents for a well-child visit. The parent reports the child used to speak in full sentences but
now primarily uses single words and seems to avoid eye contact. Which finding is most concerning and requires
prompt evaluation?
A. The child occasionally stutters when excited
B. The child demonstrates developmental regression in language and social interaction [CORRECT]
C. The child prefers parallel play over cooperative play at this age
D. The child cannot tie shoelaces independently
Correct Answer: B
Rationale: Developmental regression, particularly in language and social skills, is a significant red flag requiring prompt
evaluation. Loss of previously acquired milestones can indicate neurodevelopmental disorders such as autism spectrum disorder or
other underlying pathology. Occasional stuttering (A) is normal in preschool children; parallel play (C) can be typical at age 4;
inability to tie shoelaces (D) is expected as this skill develops around age 5-6. Developmental regression should never be dismissed
without thorough evaluation.
Q4: The nurse practitioner is conducting a physical examination on a 2-year-old child. Which approach is most
developmentally appropriate?
A. Perform the ear examination first to address the chief complaint before the child becomes upset
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, NR602 Midterm Exam | Primary Care of the Childbearing & Childrearing Family Practicum Chamberlain University 2026/2027
B. Allow the caregiver to hold the child and begin with less invasive assessments such as observation and
auscultation [CORRECT]
C. Have the caregiver leave the room so the child does not become clingy during the examination
D. Perform all assessments while the child is lying on the examination table regardless of distress
Correct Answer: B
Rationale: The most developmentally appropriate approach for a toddler is to allow the caregiver to remain present for comfort
and begin with less invasive assessments. Toddlers experience separation anxiety and may become distressed by invasive
procedures. Starting with observation, palpation, and auscultation before ear or throat examinations reduces fear and improves
cooperation. Option A starts with an invasive assessment; option C increases separation anxiety; option D ignores the child's
developmental need for comfort.
Q5: A parent of a 3-month-old infant asks about safe sleep practices. Which statement by the nurse practitioner is
correct based on current AAP guidelines?
A. Place the infant on their side to prevent aspiration if they spit up
B. It is acceptable to use a soft bumper pad in the crib to prevent the baby from hitting the rails
C. Place the infant supine on a firm mattress with no soft objects, blankets, or pillows in the sleep area
[CORRECT]
D. Bed-sharing with a parent who does not smoke is safe and promotes bonding
Correct Answer: C
Rationale: The AAP recommends supine positioning (back to sleep) on a firm mattress in a safety-approved crib with no soft
objects, loose bedding, or pillows. Side positioning is unstable and increases the risk of rolling prone. Bumper pads pose
suffocation and entrapment risks. Bed-sharing increases the risk of suffocation, SIDS, and overlay regardless of parental smoking
status. Room-sharing without bed-sharing is recommended for at least the first 6 months as it reduces SIDS risk by up to 50%.
Q6: During a well-child visit for a 5-year-old, the nurse practitioner assesses school readiness. Which finding best
indicates the child is prepared for kindergarten entry?
A. The child can count to 100 and recite the alphabet backwards
B. The child can recognize basic colors and shapes, follows multi-step instructions, and engages in cooperative
play [CORRECT]
C. The child can read simple sight words and write complete sentences
D. The child can independently solve math problems involving addition and subtraction
Correct Answer: B
Rationale: School readiness at age 5 includes recognizing basic colors, shapes, and body parts; following multi-step instructions;
engaging in cooperative play; and demonstrating social-emotional skills such as sharing and following rules. Counting to 100 (A),
reading sight words (C), and solving math problems (D) exceed typical kindergarten entry expectations. The NP should focus on
holistic readiness including social-emotional competence, self-regulation, and communication skills rather than solely academic
milestones.
Q7: A 9-month-old infant is brought for a well-child visit. The nurse practitioner notes the infant sits without support,
crawls, uses a pincer grasp, and babbles. The parent asks what developmental milestones to expect next. Which
response is most accurate?
A. Your child should begin walking independently within the next month
B. Expect first words with specific meaning and pulling to stand over the next few months [CORRECT]
C. Your child should begin speaking two-word phrases and using a spoon independently
D. Expect your child to begin scribbling and hopping on one foot within the next few months
Correct Answer: B
Page 3
Midterm Exam
Primary Care of the Childbearing & Childrearing Family Practicum
Guide Questions with Answers
100% Correct | Grade A
Chamberlain University
Latest Update
75 Questions | Comprehensive Review
,NR602 Midterm Exam | Primary Care of the Childbearing & Childrearing Family Practicum Chamberlain University 2026/2027
Section 1: Well-Child Care and Developmental Surveillance (Q1-15)
Q1: A 12-month-old infant is brought to the pediatric primary care clinic for a well-child visit. The parent reports the
child says 'mama' and 'dada' but does not yet point to objects. The infant sits without support, crawls, and has begun
pulling to stand. Which response by the nurse practitioner is most appropriate?
A. Refer the child to a developmental pediatrician immediately for further evaluation
B. Reassure the parent that the child's development is appropriate for 12 months of age
C. Perform a validated developmental screening tool and reassess at the 15-month visit [CORRECT]
D. Recommend early intervention services for suspected language delay
Correct Answer: C
Rationale: At 12 months, a child should demonstrate first words, pointing, crawling, and pulling to stand. Pointing typically
emerges around 9-12 months, so the absence at exactly 12 months warrants validated screening (e.g., ASQ-3 or PEDS) but not
immediate referral. Developmental trajectory over time is more important than a single-point assessment, so performing a
screening tool and reassessing at 15 months is the appropriate primary care approach. Option A is premature; option B does not
address the concern about pointing; option D oversteps without screening evidence.
Q2: During a well-child visit for an 18-month-old toddler, the nurse practitioner observes the child playing with blocks
and notices the child can stack two blocks. The parent asks if this is normal. Which response best reflects
evidence-based developmental surveillance?
A. This is below expectations; an 18-month-old should stack at least 6 blocks
B. This is concerning and warrants immediate referral to occupational therapy
C. This is within the expected range; fine motor skills should be reassessed at the 24-month visit [CORRECT]
D. Stacking two blocks is advanced for 18 months; your child is developmentally gifted
Correct Answer: C
Rationale: An 18-month-old typically stacks 2-3 blocks, making this child's performance within the expected range. By 24 months,
a child should stack 6 blocks. The NP should reassure the parent while continuing developmental surveillance at subsequent visits.
Option A overestimates expectations for this age; option B is an overreaction; option D incorrectly interprets normal performance
as advanced. The key principle is that developmental trajectory over time matters more than a single assessment.
Q3: A 4-year-old child presents for a well-child visit. The parent reports the child used to speak in full sentences but
now primarily uses single words and seems to avoid eye contact. Which finding is most concerning and requires
prompt evaluation?
A. The child occasionally stutters when excited
B. The child demonstrates developmental regression in language and social interaction [CORRECT]
C. The child prefers parallel play over cooperative play at this age
D. The child cannot tie shoelaces independently
Correct Answer: B
Rationale: Developmental regression, particularly in language and social skills, is a significant red flag requiring prompt
evaluation. Loss of previously acquired milestones can indicate neurodevelopmental disorders such as autism spectrum disorder or
other underlying pathology. Occasional stuttering (A) is normal in preschool children; parallel play (C) can be typical at age 4;
inability to tie shoelaces (D) is expected as this skill develops around age 5-6. Developmental regression should never be dismissed
without thorough evaluation.
Q4: The nurse practitioner is conducting a physical examination on a 2-year-old child. Which approach is most
developmentally appropriate?
A. Perform the ear examination first to address the chief complaint before the child becomes upset
Page 2
, NR602 Midterm Exam | Primary Care of the Childbearing & Childrearing Family Practicum Chamberlain University 2026/2027
B. Allow the caregiver to hold the child and begin with less invasive assessments such as observation and
auscultation [CORRECT]
C. Have the caregiver leave the room so the child does not become clingy during the examination
D. Perform all assessments while the child is lying on the examination table regardless of distress
Correct Answer: B
Rationale: The most developmentally appropriate approach for a toddler is to allow the caregiver to remain present for comfort
and begin with less invasive assessments. Toddlers experience separation anxiety and may become distressed by invasive
procedures. Starting with observation, palpation, and auscultation before ear or throat examinations reduces fear and improves
cooperation. Option A starts with an invasive assessment; option C increases separation anxiety; option D ignores the child's
developmental need for comfort.
Q5: A parent of a 3-month-old infant asks about safe sleep practices. Which statement by the nurse practitioner is
correct based on current AAP guidelines?
A. Place the infant on their side to prevent aspiration if they spit up
B. It is acceptable to use a soft bumper pad in the crib to prevent the baby from hitting the rails
C. Place the infant supine on a firm mattress with no soft objects, blankets, or pillows in the sleep area
[CORRECT]
D. Bed-sharing with a parent who does not smoke is safe and promotes bonding
Correct Answer: C
Rationale: The AAP recommends supine positioning (back to sleep) on a firm mattress in a safety-approved crib with no soft
objects, loose bedding, or pillows. Side positioning is unstable and increases the risk of rolling prone. Bumper pads pose
suffocation and entrapment risks. Bed-sharing increases the risk of suffocation, SIDS, and overlay regardless of parental smoking
status. Room-sharing without bed-sharing is recommended for at least the first 6 months as it reduces SIDS risk by up to 50%.
Q6: During a well-child visit for a 5-year-old, the nurse practitioner assesses school readiness. Which finding best
indicates the child is prepared for kindergarten entry?
A. The child can count to 100 and recite the alphabet backwards
B. The child can recognize basic colors and shapes, follows multi-step instructions, and engages in cooperative
play [CORRECT]
C. The child can read simple sight words and write complete sentences
D. The child can independently solve math problems involving addition and subtraction
Correct Answer: B
Rationale: School readiness at age 5 includes recognizing basic colors, shapes, and body parts; following multi-step instructions;
engaging in cooperative play; and demonstrating social-emotional skills such as sharing and following rules. Counting to 100 (A),
reading sight words (C), and solving math problems (D) exceed typical kindergarten entry expectations. The NP should focus on
holistic readiness including social-emotional competence, self-regulation, and communication skills rather than solely academic
milestones.
Q7: A 9-month-old infant is brought for a well-child visit. The nurse practitioner notes the infant sits without support,
crawls, uses a pincer grasp, and babbles. The parent asks what developmental milestones to expect next. Which
response is most accurate?
A. Your child should begin walking independently within the next month
B. Expect first words with specific meaning and pulling to stand over the next few months [CORRECT]
C. Your child should begin speaking two-word phrases and using a spoon independently
D. Expect your child to begin scribbling and hopping on one foot within the next few months
Correct Answer: B
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