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NELSON ESSENTIALS OF PEDIATRICS EXAM WITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
Section 1: Growth and Development (Questions 1-35)
1. A 4-month-old infant should be able to do which of the following
developmental milestones?
A. Sit without support
B. Roll from back to side
C. Develop a pincer grasp
D. Say two-word phrases
Rationale: A 4-month-old infant should be able to roll from back to side. Sitting without
support occurs at approximately 6-8 months, pincer grasp at 9-12 months, and two-
word phrases at 18-24 months.
2. The rooting reflex typically disappears by what age?
A. 1 month
B. 3-4 months
C. 6 months
D. 9 months
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Rationale: The rooting reflex typically disappears by 3-4 months of age. It is present at
birth to help the infant find the breast for feeding.
3. The palmar grasp reflex is assessed by doing which of the following?
A. Stroking the cheek and observing the infant turn toward the stimulus
B. Placing a finger in the infant's palm and observing the grasp
C. Making a loud noise and observing the startle response
D. Stroking the sole of the foot and observing toe fanning
Rationale: The palmar grasp reflex is assessed by placing a finger in the infant's palm
and observing the grasp. It typically disappears by 3-4 months.
4. A 5-year-old child should be able to do which of the following based on Piaget's
Theory?
A. Understand conservation of volume
B. Engage in symbolic play and use magical thinking
C. Think abstractly
D. Perform hypothetical-deductive reasoning
Rationale: A 5-year-old is in Piaget's preoperational stage, characterized by symbolic
play and magical thinking. Conservation is mastered in the concrete operational stage
(7-11 years).
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5. A 15-month-old toddler should be able to do all of the following EXCEPT:
A. Walk independently
B. Say 2-3 words
C. Stack 2-3 blocks
D. Ride a tricycle
Rationale: Riding a tricycle is typically achieved by 3 years of age. Walking
independently, saying 2-3 words, and stacking blocks are appropriate for a 15-month-
old.
6. The age by which a child can make a tower of 9 cubes and imitate a circular
stroke is:
A. 24 months
B. 30 months
C. 36 months
D. 48 months
Rationale: A 24-month-old (2 years) can make a tower of 6-7 cubes and imitate a
circular stroke. By 30 months, a tower of 8 cubes; by 36 months, a tower of 9-10 cubes.
7. A 4-year-old child should have achieved which developmental milestone?
A. Uses scissors to cut out a picture
B. Rides a tricycle
C. Writes their name
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D. Ties shoelaces
Rationale: A 4-year-old should be able to ride a tricycle. Using scissors to cut out a
picture is expected at 5 years, writing their name at 5-6 years, and tying shoelaces at 5-6
years.
8. The pincer grasp typically develops at what age?
A. 3 months
B. 6 months
C. 9-12 months
D. 18 months
Rationale: The pincer grasp (thumb and index finger) typically develops at 9-12 months
of age. It allows the infant to pick up small objects.
9. Which developmental milestone is typically achieved by a healthy infant at
approximately 6 months of age?
A. Walking independently
B. Rolling from back to front
C. Speaking two-word phrases
D. Developing a pincer grasp
Rationale: Rolling from back to front is typically achieved by 6 months. Walking
independently occurs at 12-15 months, two-word phrases at 18-24 months, and pincer
grasp at 9-12 months.
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NELSON ESSENTIALS OF PEDIATRICS EXAM WITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
Section 1: Growth and Development (Questions 1-35)
1. A 4-month-old infant should be able to do which of the following
developmental milestones?
A. Sit without support
B. Roll from back to side
C. Develop a pincer grasp
D. Say two-word phrases
Rationale: A 4-month-old infant should be able to roll from back to side. Sitting without
support occurs at approximately 6-8 months, pincer grasp at 9-12 months, and two-
word phrases at 18-24 months.
2. The rooting reflex typically disappears by what age?
A. 1 month
B. 3-4 months
C. 6 months
D. 9 months
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Rationale: The rooting reflex typically disappears by 3-4 months of age. It is present at
birth to help the infant find the breast for feeding.
3. The palmar grasp reflex is assessed by doing which of the following?
A. Stroking the cheek and observing the infant turn toward the stimulus
B. Placing a finger in the infant's palm and observing the grasp
C. Making a loud noise and observing the startle response
D. Stroking the sole of the foot and observing toe fanning
Rationale: The palmar grasp reflex is assessed by placing a finger in the infant's palm
and observing the grasp. It typically disappears by 3-4 months.
4. A 5-year-old child should be able to do which of the following based on Piaget's
Theory?
A. Understand conservation of volume
B. Engage in symbolic play and use magical thinking
C. Think abstractly
D. Perform hypothetical-deductive reasoning
Rationale: A 5-year-old is in Piaget's preoperational stage, characterized by symbolic
play and magical thinking. Conservation is mastered in the concrete operational stage
(7-11 years).
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5. A 15-month-old toddler should be able to do all of the following EXCEPT:
A. Walk independently
B. Say 2-3 words
C. Stack 2-3 blocks
D. Ride a tricycle
Rationale: Riding a tricycle is typically achieved by 3 years of age. Walking
independently, saying 2-3 words, and stacking blocks are appropriate for a 15-month-
old.
6. The age by which a child can make a tower of 9 cubes and imitate a circular
stroke is:
A. 24 months
B. 30 months
C. 36 months
D. 48 months
Rationale: A 24-month-old (2 years) can make a tower of 6-7 cubes and imitate a
circular stroke. By 30 months, a tower of 8 cubes; by 36 months, a tower of 9-10 cubes.
7. A 4-year-old child should have achieved which developmental milestone?
A. Uses scissors to cut out a picture
B. Rides a tricycle
C. Writes their name
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D. Ties shoelaces
Rationale: A 4-year-old should be able to ride a tricycle. Using scissors to cut out a
picture is expected at 5 years, writing their name at 5-6 years, and tying shoelaces at 5-6
years.
8. The pincer grasp typically develops at what age?
A. 3 months
B. 6 months
C. 9-12 months
D. 18 months
Rationale: The pincer grasp (thumb and index finger) typically develops at 9-12 months
of age. It allows the infant to pick up small objects.
9. Which developmental milestone is typically achieved by a healthy infant at
approximately 6 months of age?
A. Walking independently
B. Rolling from back to front
C. Speaking two-word phrases
D. Developing a pincer grasp
Rationale: Rolling from back to front is typically achieved by 6 months. Walking
independently occurs at 12-15 months, two-word phrases at 18-24 months, and pincer
grasp at 9-12 months.
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