,NRNP 6541 Primary Care of
Adolescents and Children Exam Prep —
Comprehensive Review + Practice
MCQs — Walden University 2025/2026
1. A 4-year-old child insists that a tall, thin glass contains more juice than a short, wide glass even after
watching the same amount poured from one to the other. According to Piaget, this child is in which stage of
cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Correct Answer: B
Rationale: Piaget's preoperational stage (2–7 years) is marked by centration and lack of conservation; the child
focuses on one dimension (height) and cannot mentally reverse the pouring action. Sensorimotor is birth to 2
years. Concrete operational children (7–11) grasp conservation. Formal operational begins around 11 years
with abstract thought .
2. A mother reports that her 2-year-old can put two words together, follows one-step commands, and points to
body parts when named. The nurse recognizes these skills as which of the following?
A. Advanced for age
B. Typical for a 2-year-old
C. Delayed, requiring speech therapy
D. Typical for a 12-month-old
,Correct Answer: B
Rationale: At 2 years, a child speaks in 2- to 3-word sentences, understands simple commands, and knows
body parts. These are age-appropriate milestones. A 12-month-old says single words and points. Advanced
skills would include 3-word sentences. No speech therapy is needed .
3. During a well-child visit, a 3-year-old is asked to copy a circle. The child produces a closed, round shape. This
fine motor skill is considered which of the following?
A. A 2-year milestone
B. A 3-year milestone
C. A 4-year milestone
D. A 5-year milestone
Correct Answer: B
Rationale: Copying a circle is a fine motor milestone expected at 3 years. A 2-year-old copies a vertical line; a 4-
year-old copies a cross; a 5-year-old copies a square. Mastering circle copying reflects appropriate hand-eye
coordination and pencil control for this age .
4. A parent of a 6-month-old infant reports the child can roll from back to stomach, reach for objects, and
transfer a toy between hands but does not wave bye-bye. The nurse should take which action?
A. Refer for early intervention
B. Reassure that these are normal findings
C. Evaluate for hearing loss
, D. Order a brain MRI
Correct Answer: B
Rationale: At 6 months, infants roll, grasp, transfer objects, and reach, but waving bye-bye emerges around 9–
10 months. The described skills are developmentally appropriate; no referral or testing is needed. Providing
reassurance supports parental confidence and accurate expectations .
5. A 30-month-old child walks on tiptoes, identifies six body parts, and speaks in short phrases that are 50%
understandable to strangers. Which gross motor skill would the nurse expect to be absent at this age?
A. Jumping with both feet
B. Balancing on one foot for 1 second
C. Walking up stairs alternating feet
D. Kicking a ball forward
Correct Answer: B
Rationale: At 30 months, a child cannot yet balance on one foot for 1 second; that skill emerges around 3–4
years. Jumping with both feet appears at 30 months. Kicking a ball and walking up stairs alternating feet are
also seen. The milestone pattern aligns with typical development .
6. A 15-month-old child is brought for a well visit. Which milestone would the provider expect the child to have
achieved?
A. Walks up stairs with alternating feet
B. Speaks in two-word phrases
Adolescents and Children Exam Prep —
Comprehensive Review + Practice
MCQs — Walden University 2025/2026
1. A 4-year-old child insists that a tall, thin glass contains more juice than a short, wide glass even after
watching the same amount poured from one to the other. According to Piaget, this child is in which stage of
cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Correct Answer: B
Rationale: Piaget's preoperational stage (2–7 years) is marked by centration and lack of conservation; the child
focuses on one dimension (height) and cannot mentally reverse the pouring action. Sensorimotor is birth to 2
years. Concrete operational children (7–11) grasp conservation. Formal operational begins around 11 years
with abstract thought .
2. A mother reports that her 2-year-old can put two words together, follows one-step commands, and points to
body parts when named. The nurse recognizes these skills as which of the following?
A. Advanced for age
B. Typical for a 2-year-old
C. Delayed, requiring speech therapy
D. Typical for a 12-month-old
,Correct Answer: B
Rationale: At 2 years, a child speaks in 2- to 3-word sentences, understands simple commands, and knows
body parts. These are age-appropriate milestones. A 12-month-old says single words and points. Advanced
skills would include 3-word sentences. No speech therapy is needed .
3. During a well-child visit, a 3-year-old is asked to copy a circle. The child produces a closed, round shape. This
fine motor skill is considered which of the following?
A. A 2-year milestone
B. A 3-year milestone
C. A 4-year milestone
D. A 5-year milestone
Correct Answer: B
Rationale: Copying a circle is a fine motor milestone expected at 3 years. A 2-year-old copies a vertical line; a 4-
year-old copies a cross; a 5-year-old copies a square. Mastering circle copying reflects appropriate hand-eye
coordination and pencil control for this age .
4. A parent of a 6-month-old infant reports the child can roll from back to stomach, reach for objects, and
transfer a toy between hands but does not wave bye-bye. The nurse should take which action?
A. Refer for early intervention
B. Reassure that these are normal findings
C. Evaluate for hearing loss
, D. Order a brain MRI
Correct Answer: B
Rationale: At 6 months, infants roll, grasp, transfer objects, and reach, but waving bye-bye emerges around 9–
10 months. The described skills are developmentally appropriate; no referral or testing is needed. Providing
reassurance supports parental confidence and accurate expectations .
5. A 30-month-old child walks on tiptoes, identifies six body parts, and speaks in short phrases that are 50%
understandable to strangers. Which gross motor skill would the nurse expect to be absent at this age?
A. Jumping with both feet
B. Balancing on one foot for 1 second
C. Walking up stairs alternating feet
D. Kicking a ball forward
Correct Answer: B
Rationale: At 30 months, a child cannot yet balance on one foot for 1 second; that skill emerges around 3–4
years. Jumping with both feet appears at 30 months. Kicking a ball and walking up stairs alternating feet are
also seen. The milestone pattern aligns with typical development .
6. A 15-month-old child is brought for a well visit. Which milestone would the provider expect the child to have
achieved?
A. Walks up stairs with alternating feet
B. Speaks in two-word phrases
