Barkley Pediatrics Practice Exam 200 Original
Practice Questions with Detailed Rationales
Latest Exam Update 2026 Graded A+
Table of Contents
1. Growth and Development (Questions 1–35)
2. Immunizations and Health Maintenance (Questions 36–65)
3. Respiratory Disorders (Questions 66–90)
4. Gastrointestinal and Nutritional Disorders (Questions 91–
110)
5. Cardiovascular Disorders (Questions 111–130)
6. Dermatologic and Infectious Disorders (Questions 131–150)
7. Endocrine and Metabolic Disorders (Questions 151–165)
8. Neurological and Musculoskeletal Disorders (Questions 166–
185)
9. Behavioral and Mental Health (Questions 186–200)
10. Answer Key Summary
11. Exam Preparation Tips
Section 1: Growth and Development (Questions 1–35)
1. A mother brings her 4-month-old daughter for a well-
child visit. She reports that the infant has a calm
temperament and will let anyone hold her without fussing.
The parents are concerned that she is "too easygoing" and
"too open to strangers." Which of the following is the most
appropriate response?
A. Children do not usually develop separation anxiety until 2
years of age
,B. Fear of strangers usually develops at about 6 months of age;
this behavior is normal for her age
C. The infant's behavior is abnormal, as she should be afraid of
strangers at her age
D. Refer to a pediatric neurologist for evaluation of social
disinhibition
Correct Answer: B. Fear of strangers usually develops at about 6
months of age; this behavior is normal for her age
Rationale: Fear of strangers (stranger anxiety) is a normal
developmental milestone that typically emerges around 6
to 9 months of age. At 4 months, infants are generally
sociable and do not yet discriminate between familiar and
unfamiliar caregivers. The infant's behavior is
developmentally appropriate.
2. A mother of an 8-month-old infant reports that her
daughter screams and clings to her when being dropped off
at daycare. What is the best information to provide the
mother concerning this behavior?
A. Something must be wrong in the environment, and she
should consider another option for care
B. The baby is exhibiting signs of serious mental illness
C. The infant is displaying separation anxiety, which is normal at
this age
D. The child is exhibiting signs of a serious physiological
condition
Correct Answer: C. The infant is displaying separation anxiety,
which is normal at this age
Rationale: Separation anxiety typically emerges around 9–
12 months of age and is a normal developmental milestone
,reflecting healthy attachment. The mother should be
reassured that this behavior is developmentally
appropriate.
3. A mother brings her 18-month-old toddler for a check-
up. The child knows how to say "momma" and "daddy," sits
independently to play, and cannot yet walk or speak many
other words but communicates by reaching and pointing.
What would you estimate the child's age to be?
A. 13 to 18 months
B. 6 to 9 months
C. 19 to 24 months
D. 10 to 12 months
Correct Answer: D. 10 to 12 months
Rationale: The milestones described—saying "momma" and
"daddy," sitting independently, and communicating by
reaching and pointing—are consistent with a 10- to 12-
month-old infant. Walking typically occurs around 12–15
months, and a 12-month-old typically says 1–2 words
besides "mama" and "dada".
4. A 4-year-old child is brought to the clinic for a well-child
visit. The parent reports the child can hop on one foot,
draw a circle, and use sentences of 4–5 words. Which of the
following developmental milestones would be most
concerning if not yet achieved at this age?
A. Tying shoelaces
B. Riding a tricycle
C. Copying a square
D. Engaging in cooperative play
Correct Answer: A. Tying shoelaces
, Rationale: Tying shoelaces is a fine motor skill typically not
expected until age 5–6 years. The other milestones (riding a
tricycle, copying a square, and cooperative play) are all
appropriate for a 4-year-old. The question tests the ability
to differentiate between age-appropriate and advanced
skills.
5. A 6-month-old infant is brought in for a health
maintenance visit. Which of the following immunizations is
NOT routinely recommended at this age?
A. DTaP
B. IPV
C. MMR
D. Hib
Correct Answer: C. MMR
Rationale: The MMR (Measles, Mumps, Rubella) vaccine is
first administered at 12–15 months of age. DTaP, IPV, Hib,
PCV, and RV are routinely given at 2, 4, and 6 months.
6. A 12-month-old infant is brought for a well-child visit.
Which developmental milestone should the nurse
practitioner expect to observe?
A. Walking independently
B. Speaking in two-word phrases
C. Using a spoon with some spilling
D. Stacking two blocks
Correct Answer: D. Stacking two blocks
Rationale: Stacking two blocks is a fine motor milestone
expected at 12 months. Walking independently typically
occurs at 12–15 months, two-word phrases at 18–24
Practice Questions with Detailed Rationales
Latest Exam Update 2026 Graded A+
Table of Contents
1. Growth and Development (Questions 1–35)
2. Immunizations and Health Maintenance (Questions 36–65)
3. Respiratory Disorders (Questions 66–90)
4. Gastrointestinal and Nutritional Disorders (Questions 91–
110)
5. Cardiovascular Disorders (Questions 111–130)
6. Dermatologic and Infectious Disorders (Questions 131–150)
7. Endocrine and Metabolic Disorders (Questions 151–165)
8. Neurological and Musculoskeletal Disorders (Questions 166–
185)
9. Behavioral and Mental Health (Questions 186–200)
10. Answer Key Summary
11. Exam Preparation Tips
Section 1: Growth and Development (Questions 1–35)
1. A mother brings her 4-month-old daughter for a well-
child visit. She reports that the infant has a calm
temperament and will let anyone hold her without fussing.
The parents are concerned that she is "too easygoing" and
"too open to strangers." Which of the following is the most
appropriate response?
A. Children do not usually develop separation anxiety until 2
years of age
,B. Fear of strangers usually develops at about 6 months of age;
this behavior is normal for her age
C. The infant's behavior is abnormal, as she should be afraid of
strangers at her age
D. Refer to a pediatric neurologist for evaluation of social
disinhibition
Correct Answer: B. Fear of strangers usually develops at about 6
months of age; this behavior is normal for her age
Rationale: Fear of strangers (stranger anxiety) is a normal
developmental milestone that typically emerges around 6
to 9 months of age. At 4 months, infants are generally
sociable and do not yet discriminate between familiar and
unfamiliar caregivers. The infant's behavior is
developmentally appropriate.
2. A mother of an 8-month-old infant reports that her
daughter screams and clings to her when being dropped off
at daycare. What is the best information to provide the
mother concerning this behavior?
A. Something must be wrong in the environment, and she
should consider another option for care
B. The baby is exhibiting signs of serious mental illness
C. The infant is displaying separation anxiety, which is normal at
this age
D. The child is exhibiting signs of a serious physiological
condition
Correct Answer: C. The infant is displaying separation anxiety,
which is normal at this age
Rationale: Separation anxiety typically emerges around 9–
12 months of age and is a normal developmental milestone
,reflecting healthy attachment. The mother should be
reassured that this behavior is developmentally
appropriate.
3. A mother brings her 18-month-old toddler for a check-
up. The child knows how to say "momma" and "daddy," sits
independently to play, and cannot yet walk or speak many
other words but communicates by reaching and pointing.
What would you estimate the child's age to be?
A. 13 to 18 months
B. 6 to 9 months
C. 19 to 24 months
D. 10 to 12 months
Correct Answer: D. 10 to 12 months
Rationale: The milestones described—saying "momma" and
"daddy," sitting independently, and communicating by
reaching and pointing—are consistent with a 10- to 12-
month-old infant. Walking typically occurs around 12–15
months, and a 12-month-old typically says 1–2 words
besides "mama" and "dada".
4. A 4-year-old child is brought to the clinic for a well-child
visit. The parent reports the child can hop on one foot,
draw a circle, and use sentences of 4–5 words. Which of the
following developmental milestones would be most
concerning if not yet achieved at this age?
A. Tying shoelaces
B. Riding a tricycle
C. Copying a square
D. Engaging in cooperative play
Correct Answer: A. Tying shoelaces
, Rationale: Tying shoelaces is a fine motor skill typically not
expected until age 5–6 years. The other milestones (riding a
tricycle, copying a square, and cooperative play) are all
appropriate for a 4-year-old. The question tests the ability
to differentiate between age-appropriate and advanced
skills.
5. A 6-month-old infant is brought in for a health
maintenance visit. Which of the following immunizations is
NOT routinely recommended at this age?
A. DTaP
B. IPV
C. MMR
D. Hib
Correct Answer: C. MMR
Rationale: The MMR (Measles, Mumps, Rubella) vaccine is
first administered at 12–15 months of age. DTaP, IPV, Hib,
PCV, and RV are routinely given at 2, 4, and 6 months.
6. A 12-month-old infant is brought for a well-child visit.
Which developmental milestone should the nurse
practitioner expect to observe?
A. Walking independently
B. Speaking in two-word phrases
C. Using a spoon with some spilling
D. Stacking two blocks
Correct Answer: D. Stacking two blocks
Rationale: Stacking two blocks is a fine motor milestone
expected at 12 months. Walking independently typically
occurs at 12–15 months, two-word phrases at 18–24
