with Correct Answers
100 questions
1. Head circumference is measured at well-child visits in the first years of life because it reflects:
A. Lung growth
B. Bone age
C. Brain growth
D. Muscle strength
Correct Answer: C. Brain growth
Rationale: Rapid brain growth in infancy drives head size, so abnormal head growth may
indicate hydrocephalus, microcephaly or other problems. It does not measure lungs, bone age
or muscles.
2. Measuring the length of a child under 2 years should be done:
A. Standing against a wall
B. Lying down (recumbent) using a measuring board
C. Sitting in a chair
D. By estimating from the parent's height
Correct Answer: B. Lying down (recumbent) using a measuring board
Rationale: Infants and young toddlers cannot stand straight, so recumbent length with a board
is accurate. Standing height is used from about age 2, and estimation is unreliable.
3. By 12 months of age, a healthy infant's weight is usually about:
A. Double the birth weight
B. Four times the birth weight
C. The same as birth weight
D. Triple the birth weight
Correct Answer: D. Triple the birth weight
Rationale: Tripling birth weight by the first birthday is a common benchmark. Doubling occurs
earlier, quadrupling occurs around 2 to 2.5 years, and unchanged weight is failure to thrive.
,4. The first permanent teeth to erupt, around age 6, are usually the:
A. Wisdom teeth
B. First molars
C. Canines
D. Second premolars
Correct Answer: B. First molars
Rationale: First permanent molars appear behind the primary teeth around age 6 and are
important to protect with sealants. Wisdom teeth, canines and premolars come later.
5. Synaptic pruning in childhood and adolescence is a process in which:
A. All synapses are lost
B. Unused neural connections are eliminated, making brain networks more efficient
C. New neurons stop functioning permanently
D. The skull fuses
Correct Answer: B. Unused neural connections are eliminated, making brain networks more
efficient
Rationale: The brain strengthens frequently used connections and removes unused ones,
shaped by experience. It does not remove all synapses, stop neurons or relate to skull fusion.
6. The proximodistal principle explains why an infant:
A. Uses a pincer grasp before reaching
B. Walks before holding up the head
C. Speaks before babbling
D. Controls the shoulders and arms before the fingers
Correct Answer: D. Controls the shoulders and arms before the fingers
Rationale: Development moves from the center of the body outward, so gross arm movement
precedes fine finger control. A pincer grasp comes after reaching, head control comes before
walking, and babbling precedes words.
,7. The cephalocaudal principle of development states that development proceeds:
A. From the feet upward to the head
B. From the hands inward to the trunk
C. In a random order
D. From the head downward to the feet
Correct Answer: D. From the head downward to the feet
Rationale: Infants control the head before the trunk and the trunk before the legs, which is why
head control comes before sitting and walking. Development does not proceed from the feet
up, from the hands inward or randomly.
8. Measured growth below the 3rd percentile for height should prompt:
A. Reassurance without assessment
B. Immediate growth hormone treatment
C. Evaluation for possible pathologic causes of short stature
D. Weight-loss counseling
Correct Answer: C. Evaluation for possible pathologic causes of short stature
Rationale: Very short stature, especially with slow growth velocity, may reflect endocrine,
genetic or chronic disease and should be evaluated before treatment decisions. Reassurance
without assessment or immediate hormone therapy is inappropriate.
9. A child who is short but grows at a normal rate along a low percentile, with short parents and
normal bone age, most likely has:
A. Familial short stature
B. Growth hormone deficiency
C. Failure to thrive
D. Hypothyroidism
Correct Answer: A. Familial short stature
Rationale: Children with familial short stature grow normally along a percentile consistent with
their parents' heights. Hormone deficiencies and failure to thrive cause slowed growth velocity.
, 10. Chronic stress and adversity in early childhood, sometimes called toxic stress, can:
A. Strengthen all developmental skills
B. Have no lasting effect
C. Disrupt brain development and increase later health and learning problems
D. Speed physical growth
Correct Answer: C. Disrupt brain development and increase later health and learning
problems
Rationale: Prolonged activation of stress responses without buffering relationships can affect
brain architecture and health. Supportive caregiving reduces these effects. It does not
strengthen skills or speed growth.
11. Development generally proceeds from general to specific, which means an infant first:
A. Uses the whole hand to grasp before using thumb and finger
B. Uses a precise pincer grasp at birth
C. Writes before scribbling
D. Speaks in sentences before single words
Correct Answer: A. Uses the whole hand to grasp before using thumb and finger
Rationale: Mass, generalized movements become refined, specific skills, so a palmar grasp
comes before a pincer grasp and scribbling before writing. Single words precede sentences.
12. Developmental delay refers to:
A. Reaching milestones earlier than peers
B. Normal variation within a few weeks
C. Physical growth only
D. Achieving milestones significantly later than expected for age
Correct Answer: D. Achieving milestones significantly later than expected for age
Rationale: A delay is a significant lag in one or more domains such as motor or language skills,
requiring evaluation. Early achievement and minor variation are not delays.