,NRNP 6541 Final Exam | Primary Care of Adolescents &
Children (2026) Q&A | Walden University
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: Preoperational
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: Typical for a 2-year-old
,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: A 3-year milestone
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: Reassure that these are normal findings
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: Balancing on one foot for 1 second
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. Which term describes a misalignment of the eyes where they are unable to
simultaneously focus on the same object?
A) Nystagmus
Children (2026) Q&A | Walden University
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: Preoperational
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: Typical for a 2-year-old
,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: A 3-year milestone
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: Reassure that these are normal findings
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: Balancing on one foot for 1 second
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. Which term describes a misalignment of the eyes where they are unable to
simultaneously focus on the same object?
A) Nystagmus
