WGU D440 Exam Prep 2026 | Health &
Wellness Through Nutritional Science | Practice
Questions & Verified Answers with Rationales
SECTION 1 — GROWTH & DEVELOPMENT
Questions 1–15
Question 1
A nurse is assessing a 4-month-old infant during a well-child visit.
Which finding requires further evaluation?
A. Absence of head lag when pulled to sitting position
B. Ability to roll from back to side
C. Presence of the Moro reflex
D. Cooing and laughing aloud
Correct Answer: C. Presence of the Moro reflex
Rationale: The Moro reflex (startle reflex) is a primitive reflex that
typically disappears by 4-6 months of age. Its persistence beyond 6
months may indicate neurological dysfunction. Head lag should be
significantly diminished by 4 months, rolling from back to side is
expected at this age, and cooing/laughing are appropriate developmental
milestones.
Why the other options are incorrect:
A. Diminished head lag is expected at 4 months.
B. Rolling from back to side is a normal 4-month milestone.
C. Correct — the Moro reflex should be fading by 4 months.
D. Cooing and laughing are appropriate for 4 months.
Learning Objective: Identify expected developmental milestones and
recognize abnormal persistence of primitive reflexes.
,Difficulty: Moderate
Question Type: Application
Question 2
A nurse is providing anticipatory guidance to parents of a 2-year-old.
Which statement by the parents indicates understanding of appropriate
developmental expectations?
A. "My child should be able to tie shoelaces by now."
B. "It's normal for my child to say 'no' frequently and want to do things
independently."
C. "I expect my child to share toys willingly with other children."
D. "My child should be able to ride a bicycle without training wheels."
Correct Answer: B. "It's normal for my child to say 'no' frequently and
want to do things independently."
Rationale: Toddlers (1-3 years) are in Erikson's autonomy vs. shame and
doubt stage. They assert independence, frequently say "no," and want to
do things themselves. This is normal behavior. Tying shoelaces, sharing
willingly, and riding a bicycle without training wheels are skills
expected at later developmental stages.
Why the other options are incorrect:
A. Tying shoelaces is a fine motor skill typically achieved around 5-6
years.
B. Correct.
C. Parallel play (playing alongside but not with others) is typical for
toddlers; cooperative play develops in preschool years.
D. Riding a bicycle without training wheels is typically achieved around
6-8 years.
Learning Objective: Apply developmental theories (Erikson) to toddler
behavior.
Difficulty: Easy
,Question Type: Application
Question 3
A nurse is assessing a 9-month-old infant. Which finding indicates a
delay in gross motor development?
A. Inability to walk independently
B. Inability to sit without support
C. Inability to climb stairs
D. Inability to jump with both feet
Correct Answer: B. Inability to sit without support
Rationale: Sitting without support is a gross motor milestone expected
by 6-8 months. A 9-month-old who cannot sit without support may have
a gross motor delay. Walking independently is expected by 12-15
months, climbing stairs by 18-24 months, and jumping with both feet by
2-3 years.
Why the other options are incorrect:
A. Walking independently is not expected until 12-15 months.
B. Correct.
C. Climbing stairs is not expected until 18-24 months.
D. Jumping with both feet is not expected until 2-3 years.
Learning Objective: Identify gross motor milestones and recognize
delays.
Difficulty: Easy
Question Type: Application
Question 4
A nurse is teaching parents about toilet training readiness. Which finding
indicates the child is ready for toilet training?
A. The child is 12 months old and walks independently
, B. The child can stay dry for 2 hours and expresses interest in the toilet
C. The child can tie shoes and dress independently
D. The child has a daily bowel movement at the same time
Correct Answer: B. The child can stay dry for 2 hours and expresses
interest in the toilet
Rationale: Toilet training readiness includes physiological (staying dry
for 2 hours, regular bowel movements) and psychological (interest in the
toilet, desire for independence) signs. These typically emerge around 18-
24 months to 3 years. A 12-month-old is not developmentally ready for
toilet training.
Why the other options are incorrect:
A. Twelve months is too early for toilet training.
B. Correct.
C. Tying shoes and dressing independently are fine motor skills not
directly related to toilet training readiness.
D. A daily bowel movement at the same time is not a sufficient indicator
of toilet training readiness.
Learning Objective: Identify signs of toilet training readiness.
Difficulty: Easy
Question Type: Application
Question 5
A nurse is assessing a 3-year-old child. According to Piaget's theory of
cognitive development, this child is in which stage?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Correct Answer: B. Preoperational
Wellness Through Nutritional Science | Practice
Questions & Verified Answers with Rationales
SECTION 1 — GROWTH & DEVELOPMENT
Questions 1–15
Question 1
A nurse is assessing a 4-month-old infant during a well-child visit.
Which finding requires further evaluation?
A. Absence of head lag when pulled to sitting position
B. Ability to roll from back to side
C. Presence of the Moro reflex
D. Cooing and laughing aloud
Correct Answer: C. Presence of the Moro reflex
Rationale: The Moro reflex (startle reflex) is a primitive reflex that
typically disappears by 4-6 months of age. Its persistence beyond 6
months may indicate neurological dysfunction. Head lag should be
significantly diminished by 4 months, rolling from back to side is
expected at this age, and cooing/laughing are appropriate developmental
milestones.
Why the other options are incorrect:
A. Diminished head lag is expected at 4 months.
B. Rolling from back to side is a normal 4-month milestone.
C. Correct — the Moro reflex should be fading by 4 months.
D. Cooing and laughing are appropriate for 4 months.
Learning Objective: Identify expected developmental milestones and
recognize abnormal persistence of primitive reflexes.
,Difficulty: Moderate
Question Type: Application
Question 2
A nurse is providing anticipatory guidance to parents of a 2-year-old.
Which statement by the parents indicates understanding of appropriate
developmental expectations?
A. "My child should be able to tie shoelaces by now."
B. "It's normal for my child to say 'no' frequently and want to do things
independently."
C. "I expect my child to share toys willingly with other children."
D. "My child should be able to ride a bicycle without training wheels."
Correct Answer: B. "It's normal for my child to say 'no' frequently and
want to do things independently."
Rationale: Toddlers (1-3 years) are in Erikson's autonomy vs. shame and
doubt stage. They assert independence, frequently say "no," and want to
do things themselves. This is normal behavior. Tying shoelaces, sharing
willingly, and riding a bicycle without training wheels are skills
expected at later developmental stages.
Why the other options are incorrect:
A. Tying shoelaces is a fine motor skill typically achieved around 5-6
years.
B. Correct.
C. Parallel play (playing alongside but not with others) is typical for
toddlers; cooperative play develops in preschool years.
D. Riding a bicycle without training wheels is typically achieved around
6-8 years.
Learning Objective: Apply developmental theories (Erikson) to toddler
behavior.
Difficulty: Easy
,Question Type: Application
Question 3
A nurse is assessing a 9-month-old infant. Which finding indicates a
delay in gross motor development?
A. Inability to walk independently
B. Inability to sit without support
C. Inability to climb stairs
D. Inability to jump with both feet
Correct Answer: B. Inability to sit without support
Rationale: Sitting without support is a gross motor milestone expected
by 6-8 months. A 9-month-old who cannot sit without support may have
a gross motor delay. Walking independently is expected by 12-15
months, climbing stairs by 18-24 months, and jumping with both feet by
2-3 years.
Why the other options are incorrect:
A. Walking independently is not expected until 12-15 months.
B. Correct.
C. Climbing stairs is not expected until 18-24 months.
D. Jumping with both feet is not expected until 2-3 years.
Learning Objective: Identify gross motor milestones and recognize
delays.
Difficulty: Easy
Question Type: Application
Question 4
A nurse is teaching parents about toilet training readiness. Which finding
indicates the child is ready for toilet training?
A. The child is 12 months old and walks independently
, B. The child can stay dry for 2 hours and expresses interest in the toilet
C. The child can tie shoes and dress independently
D. The child has a daily bowel movement at the same time
Correct Answer: B. The child can stay dry for 2 hours and expresses
interest in the toilet
Rationale: Toilet training readiness includes physiological (staying dry
for 2 hours, regular bowel movements) and psychological (interest in the
toilet, desire for independence) signs. These typically emerge around 18-
24 months to 3 years. A 12-month-old is not developmentally ready for
toilet training.
Why the other options are incorrect:
A. Twelve months is too early for toilet training.
B. Correct.
C. Tying shoes and dressing independently are fine motor skills not
directly related to toilet training readiness.
D. A daily bowel movement at the same time is not a sufficient indicator
of toilet training readiness.
Learning Objective: Identify signs of toilet training readiness.
Difficulty: Easy
Question Type: Application
Question 5
A nurse is assessing a 3-year-old child. According to Piaget's theory of
cognitive development, this child is in which stage?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Correct Answer: B. Preoperational
