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Comprehensive Pediatric Primary Care 2026/2027: 100 Practice Questions with Answers
Overview
This study guide covers the core domains of pediatric primary care as tested on PNCB, PNP,
and FNP certification examinations. The content aligns with Burns' Pediatric Primary Care
(8th Edition) and the 2026/2027 immunization schedules and screening guidelines. The
questions span growth and development, preventive care, common acute illnesses, chronic
conditions, infectious diseases, behavioral health, and special populations .
Section 1: Growth and Development (Questions 1–15)
1. A 2-year-old child is brought to the clinic for a well-child visit. The parents report that
the child is using a spoon but frequently spills food. Which developmental milestone is
most appropriate for this age?
A. The child should be able to feed themselves without spilling
B. The child is demonstrating typical development
C. The child should be using a fork instead of a spoon
D. The child should be drinking from a cup independently
Correct Answer: B
Rationale: At 2 years of age, children are typically able to use a spoon but may still spill food.
This is a normal developmental milestone. By 3 years, children usually have better fine
motor control and spill less. Using a fork independently is a later milestone .
2. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting without support
B. Pulling to stand
C. Walking independently
D. Using a pincer grasp
Correct Answer: A
Rationale: At 6 months, infants typically sit with support or begin sitting without support.
Pulling to stand and pincer grasp occur around 9 months. Walking independently typically
occurs around 12–15 months .
3. A 9-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting without support
B. Pulling to stand
C. Walking independently
D. Using a pincer grasp
,2
Correct Answer: B
Rationale: At 9 months, infants typically sit without support, pull to stand, and use a pincer
grasp. Walking independently typically occurs around 12–15 months .
4. At what age should developmental surveillance begin in pediatric primary care?
A. At birth
B. At 2 months
C. At 6 months
D. At 12 months
Correct Answer: A
Rationale: Developmental surveillance should occur at every well-child visit, beginning at
birth. Standardized screening is recommended at 9, 18, and 30 months, with autism-specific
screening at 18 and 24 months .
5. Standardized developmental screening is recommended at which ages?
A. 6, 12, and 24 months
B. 9, 18, and 30 months
C. 4, 8, and 12 months
D. 12, 24, and 36 months
Correct Answer: B
Rationale: Standardized developmental screening should occur at 9, 18, and 30 months,
with autism-specific screening at 18 and 24 months .
6. A clinician is evaluating a premature infant's developmental milestones. What
adjustment should be made?
A. No adjustment is needed
B. Use corrected age until 2 years
C. Use chronological age only
D. Subtract 6 months from all milestones
Correct Answer: B
Rationale: For premature infants, clinicians should account for corrected age when
evaluating developmental milestones, typically until 2 years of age .
7. A parent asks when their child should be able to use a pincer grasp. What is the
expected age?
A. 4 months
B. 6 months
C. 9 months
D. 12 months
, 3
Correct Answer: C
Rationale: The pincer grasp (thumb and index finger) typically develops around 9 months of
age .
8. Which developmental domain includes the child's ability to interact with others and
express emotions?
A. Gross motor
B. Fine motor
C. Language
D. Social-emotional
Correct Answer: D
Rationale: The social-emotional domain encompasses interactions with others, emotional
expression, and relationship-building .
9. At what age does a child typically begin to walk independently?
A. 6–9 months
B. 9–12 months
C. 12–15 months
D. 18–24 months
Correct Answer: C
Rationale: Walking independently typically occurs between 12 and 15 months of age .
10. A parent reports their 18-month-old is not yet speaking any words. What is the
appropriate action?
A. Reassure the parent that this is normal
B. Refer for hearing evaluation and early intervention
C. Wait until 24 months to evaluate
D. Recommend increased screen time for language exposure
Correct Answer: B
Rationale: Language delays warrant prompt evaluation, including hearing screening and
early intervention referral. Early intervention can improve long-term outcomes .
11. The American Academy of Pediatrics recommends avoiding digital media for children
younger than what age (except video chatting)?
A. 6 months
B. 12 months
C. 18 months
D. 24 months
Correct Answer: C
Rationale: The AAP recommends avoiding digital media other than video chatting for
Comprehensive Pediatric Primary Care 2026/2027: 100 Practice Questions with Answers
Overview
This study guide covers the core domains of pediatric primary care as tested on PNCB, PNP,
and FNP certification examinations. The content aligns with Burns' Pediatric Primary Care
(8th Edition) and the 2026/2027 immunization schedules and screening guidelines. The
questions span growth and development, preventive care, common acute illnesses, chronic
conditions, infectious diseases, behavioral health, and special populations .
Section 1: Growth and Development (Questions 1–15)
1. A 2-year-old child is brought to the clinic for a well-child visit. The parents report that
the child is using a spoon but frequently spills food. Which developmental milestone is
most appropriate for this age?
A. The child should be able to feed themselves without spilling
B. The child is demonstrating typical development
C. The child should be using a fork instead of a spoon
D. The child should be drinking from a cup independently
Correct Answer: B
Rationale: At 2 years of age, children are typically able to use a spoon but may still spill food.
This is a normal developmental milestone. By 3 years, children usually have better fine
motor control and spill less. Using a fork independently is a later milestone .
2. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting without support
B. Pulling to stand
C. Walking independently
D. Using a pincer grasp
Correct Answer: A
Rationale: At 6 months, infants typically sit with support or begin sitting without support.
Pulling to stand and pincer grasp occur around 9 months. Walking independently typically
occurs around 12–15 months .
3. A 9-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting without support
B. Pulling to stand
C. Walking independently
D. Using a pincer grasp
,2
Correct Answer: B
Rationale: At 9 months, infants typically sit without support, pull to stand, and use a pincer
grasp. Walking independently typically occurs around 12–15 months .
4. At what age should developmental surveillance begin in pediatric primary care?
A. At birth
B. At 2 months
C. At 6 months
D. At 12 months
Correct Answer: A
Rationale: Developmental surveillance should occur at every well-child visit, beginning at
birth. Standardized screening is recommended at 9, 18, and 30 months, with autism-specific
screening at 18 and 24 months .
5. Standardized developmental screening is recommended at which ages?
A. 6, 12, and 24 months
B. 9, 18, and 30 months
C. 4, 8, and 12 months
D. 12, 24, and 36 months
Correct Answer: B
Rationale: Standardized developmental screening should occur at 9, 18, and 30 months,
with autism-specific screening at 18 and 24 months .
6. A clinician is evaluating a premature infant's developmental milestones. What
adjustment should be made?
A. No adjustment is needed
B. Use corrected age until 2 years
C. Use chronological age only
D. Subtract 6 months from all milestones
Correct Answer: B
Rationale: For premature infants, clinicians should account for corrected age when
evaluating developmental milestones, typically until 2 years of age .
7. A parent asks when their child should be able to use a pincer grasp. What is the
expected age?
A. 4 months
B. 6 months
C. 9 months
D. 12 months
, 3
Correct Answer: C
Rationale: The pincer grasp (thumb and index finger) typically develops around 9 months of
age .
8. Which developmental domain includes the child's ability to interact with others and
express emotions?
A. Gross motor
B. Fine motor
C. Language
D. Social-emotional
Correct Answer: D
Rationale: The social-emotional domain encompasses interactions with others, emotional
expression, and relationship-building .
9. At what age does a child typically begin to walk independently?
A. 6–9 months
B. 9–12 months
C. 12–15 months
D. 18–24 months
Correct Answer: C
Rationale: Walking independently typically occurs between 12 and 15 months of age .
10. A parent reports their 18-month-old is not yet speaking any words. What is the
appropriate action?
A. Reassure the parent that this is normal
B. Refer for hearing evaluation and early intervention
C. Wait until 24 months to evaluate
D. Recommend increased screen time for language exposure
Correct Answer: B
Rationale: Language delays warrant prompt evaluation, including hearing screening and
early intervention referral. Early intervention can improve long-term outcomes .
11. The American Academy of Pediatrics recommends avoiding digital media for children
younger than what age (except video chatting)?
A. 6 months
B. 12 months
C. 18 months
D. 24 months
Correct Answer: C
Rationale: The AAP recommends avoiding digital media other than video chatting for
