BARKLEY PNP DRT 2 EXAM ACTUAL EXAM 2026 |
ALL QUESTIONS AND CORRECT ANSWERS |
VERIFIED ANSWERS | BRAND NEW VERSION!
SECTION I: GROWTH & DEVELOPMENT
1. A 4-month-old infant is brought to the clinic for a well-child visit. Which of the
following developmental milestones would be most concerning if not yet
achieved?
A. Social smile
B. Head control when held in sitting position
C. Rolling from front to back
D. Cooing and babbling
Correct Answer: A
Rationale: A social smile is expected by 2 months of age. Its absence at 4
months warrants further evaluation for developmental delay or maternal
depression. Head control (B) is expected by 4 months but may still be emerging.
Rolling front to back (C) is expected by 4–6 months. Cooing (D) begins at 2 months
and babbling by 4–6 months. Isolated absence of social smile is most concerning
for neurodevelopmental delay.
2. A parent asks the PNP when their 6-month-old should be able to sit without
support. The PNP should respond:
A. 4 months
B. 6 months
C. 8 months
D. 10 months
Correct Answer: C
Rationale: Independent sitting without support is typically achieved by 8
months. At 6 months, most infants can sit with support. By 4 months, head
control is present. By 10 months, most infants can pull to stand. The PNP should
,provide anticipatory guidance that independent sitting is a 7–9 month milestone.
3. A 9-month-old infant is evaluated at a well-child visit. Which gross and fine
motor milestone pair is expected at this age?
A. Rolls front to back and transfers objects hand to hand
B. Sits independently and uses a neat pincer grasp
C. Pulls to stand and uses an immature pincer grasp
D. Walks independently and stacks two blocks
Correct Answer: C
Rationale: By 9 months, expected milestones include pulling to stand,
crawling, and an emerging immature (inferior) pincer grasp, with a neat pincer
grasp developing by 12 months. Option A describes a 4–6 month infant. Option B
describes a 12-month infant. Option D describes a 15-month toddler.
4. A 15-month-old toddler is brought for a checkup. Which of the following
should the PNP expect the child to be able to do?
A. Speak in two-word phrases
B. Walk up stairs with alternating feet
C. Throw a ball overhand
D. Build a tower of 4 blocks
Correct Answer: A
Rationale: Two-word phrases are expected by 15–18 months. Walking up
stairs with alternating feet (B) is expected by 3 years. Throwing a ball overhand
(C) is expected by 18–24 months. Building a tower of 4 blocks (D) is expected by 2
years. The PNP should document this as appropriate for age.
5. A mother reports that her 18-month-old screams and clings when dropped off
at daycare. The PNP should explain:
A. This indicates a serious attachment disorder
B. This is normal separation anxiety for this age
C. The child should be evaluated for autism spectrum disorder
D. The daycare environment is likely inappropriate
, Correct Answer: B
Rationale: Separation anxiety is a normal developmental phase that peaks
between 10–18 months and may persist to 2 years. It reflects healthy attachment.
The PNP should reassure the parent and provide anticipatory guidance about
brief, predictable goodbyes. Options A, C, and D represent overreactions to a
normal developmental phenomenon.
6. A 2-year-old child is seen for a well-child visit. Which of the following
behaviors indicates the child is in Piaget's preoperational stage?
A. Object permanence is established
B. The child engages in symbolic play
C. The child can conserve volume
D. The child understands reversibility
Correct Answer: B
Rationale: The preoperational stage (2–7 years) is characterized by
symbolic play, egocentrism, and magical thinking. Object permanence (A)
develops in the sensorimotor stage (0–2 years). Conservation (C) and reversibility
(D) develop in the concrete operational stage (7–11 years). The PNP should
recognize play-based assessment as key in this age group.
7. A parent of a 3-year-old asks what fine motor skills are expected. The PNP
should state:
A. Drawing a stick figure with 6 parts
B. Copying a circle
C. Using scissors to cut a straight line
D. Buttoning large buttons
Correct Answer: B
Rationale: Copying a circle is expected by 3 years. Drawing a stick figure
with 6 parts (A) is expected by 5–6 years. Cutting a straight line with scissors (C) is
expected by 4 years. Buttoning large buttons (D) is expected by 3–4 years, but
copying a circle is the most reliably documented 3-year milestone.
, 8. A 5-year-old is brought for a kindergarten readiness assessment. The PNP
should expect the child to:
A. Count to 20
B. Write their first and last name
C. Hop on one foot
D. Read simple sentences
Correct Answer: C
Rationale: Hopping on one foot is a gross motor milestone expected by 4–
5 years. Counting to 20 (A) is expected by 5–6 years but is a cognitive/academic
skill. Writing first and last name (B) is expected by 5–6 years. Reading simple
sentences (D) is expected by 6–7 years. Gross motor milestones are the most
reliable indicators of neuromotor maturity at this age.
9. A 7-year-old child is in Piaget's concrete operational stage. Which cognitive
ability is characteristic of this stage?
A. Abstract reasoning
B. Conservation of mass
C. Egocentric thought
D. Hypothetical-deductive reasoning
Correct Answer: B
Rationale: Conservation (understanding that quantity remains constant
despite changes in appearance) develops in the concrete operational stage (7–11
years). Abstract reasoning (A) and hypothetical-deductive reasoning (D) develop
in formal operations (11+ years). Egocentric thought (C) is characteristic of
preoperational thinking.
10. An 8-month-old infant is brought to the clinic. The mother reports the baby
has been "screaming at night" and is difficult to console. The PNP should first
consider:
A. Colic
B. Teething
ALL QUESTIONS AND CORRECT ANSWERS |
VERIFIED ANSWERS | BRAND NEW VERSION!
SECTION I: GROWTH & DEVELOPMENT
1. A 4-month-old infant is brought to the clinic for a well-child visit. Which of the
following developmental milestones would be most concerning if not yet
achieved?
A. Social smile
B. Head control when held in sitting position
C. Rolling from front to back
D. Cooing and babbling
Correct Answer: A
Rationale: A social smile is expected by 2 months of age. Its absence at 4
months warrants further evaluation for developmental delay or maternal
depression. Head control (B) is expected by 4 months but may still be emerging.
Rolling front to back (C) is expected by 4–6 months. Cooing (D) begins at 2 months
and babbling by 4–6 months. Isolated absence of social smile is most concerning
for neurodevelopmental delay.
2. A parent asks the PNP when their 6-month-old should be able to sit without
support. The PNP should respond:
A. 4 months
B. 6 months
C. 8 months
D. 10 months
Correct Answer: C
Rationale: Independent sitting without support is typically achieved by 8
months. At 6 months, most infants can sit with support. By 4 months, head
control is present. By 10 months, most infants can pull to stand. The PNP should
,provide anticipatory guidance that independent sitting is a 7–9 month milestone.
3. A 9-month-old infant is evaluated at a well-child visit. Which gross and fine
motor milestone pair is expected at this age?
A. Rolls front to back and transfers objects hand to hand
B. Sits independently and uses a neat pincer grasp
C. Pulls to stand and uses an immature pincer grasp
D. Walks independently and stacks two blocks
Correct Answer: C
Rationale: By 9 months, expected milestones include pulling to stand,
crawling, and an emerging immature (inferior) pincer grasp, with a neat pincer
grasp developing by 12 months. Option A describes a 4–6 month infant. Option B
describes a 12-month infant. Option D describes a 15-month toddler.
4. A 15-month-old toddler is brought for a checkup. Which of the following
should the PNP expect the child to be able to do?
A. Speak in two-word phrases
B. Walk up stairs with alternating feet
C. Throw a ball overhand
D. Build a tower of 4 blocks
Correct Answer: A
Rationale: Two-word phrases are expected by 15–18 months. Walking up
stairs with alternating feet (B) is expected by 3 years. Throwing a ball overhand
(C) is expected by 18–24 months. Building a tower of 4 blocks (D) is expected by 2
years. The PNP should document this as appropriate for age.
5. A mother reports that her 18-month-old screams and clings when dropped off
at daycare. The PNP should explain:
A. This indicates a serious attachment disorder
B. This is normal separation anxiety for this age
C. The child should be evaluated for autism spectrum disorder
D. The daycare environment is likely inappropriate
, Correct Answer: B
Rationale: Separation anxiety is a normal developmental phase that peaks
between 10–18 months and may persist to 2 years. It reflects healthy attachment.
The PNP should reassure the parent and provide anticipatory guidance about
brief, predictable goodbyes. Options A, C, and D represent overreactions to a
normal developmental phenomenon.
6. A 2-year-old child is seen for a well-child visit. Which of the following
behaviors indicates the child is in Piaget's preoperational stage?
A. Object permanence is established
B. The child engages in symbolic play
C. The child can conserve volume
D. The child understands reversibility
Correct Answer: B
Rationale: The preoperational stage (2–7 years) is characterized by
symbolic play, egocentrism, and magical thinking. Object permanence (A)
develops in the sensorimotor stage (0–2 years). Conservation (C) and reversibility
(D) develop in the concrete operational stage (7–11 years). The PNP should
recognize play-based assessment as key in this age group.
7. A parent of a 3-year-old asks what fine motor skills are expected. The PNP
should state:
A. Drawing a stick figure with 6 parts
B. Copying a circle
C. Using scissors to cut a straight line
D. Buttoning large buttons
Correct Answer: B
Rationale: Copying a circle is expected by 3 years. Drawing a stick figure
with 6 parts (A) is expected by 5–6 years. Cutting a straight line with scissors (C) is
expected by 4 years. Buttoning large buttons (D) is expected by 3–4 years, but
copying a circle is the most reliably documented 3-year milestone.
, 8. A 5-year-old is brought for a kindergarten readiness assessment. The PNP
should expect the child to:
A. Count to 20
B. Write their first and last name
C. Hop on one foot
D. Read simple sentences
Correct Answer: C
Rationale: Hopping on one foot is a gross motor milestone expected by 4–
5 years. Counting to 20 (A) is expected by 5–6 years but is a cognitive/academic
skill. Writing first and last name (B) is expected by 5–6 years. Reading simple
sentences (D) is expected by 6–7 years. Gross motor milestones are the most
reliable indicators of neuromotor maturity at this age.
9. A 7-year-old child is in Piaget's concrete operational stage. Which cognitive
ability is characteristic of this stage?
A. Abstract reasoning
B. Conservation of mass
C. Egocentric thought
D. Hypothetical-deductive reasoning
Correct Answer: B
Rationale: Conservation (understanding that quantity remains constant
despite changes in appearance) develops in the concrete operational stage (7–11
years). Abstract reasoning (A) and hypothetical-deductive reasoning (D) develop
in formal operations (11+ years). Egocentric thought (C) is characteristic of
preoperational thinking.
10. An 8-month-old infant is brought to the clinic. The mother reports the baby
has been "screaming at night" and is difficult to console. The PNP should first
consider:
A. Colic
B. Teething
