NSG6435 MIDTERM EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE ALREADY GRADED A+
This comprehensive set of 300 unique questions is meticulously designed for
the NSG6435 Pediatric Primary Care final exam. It covers essential topics
including growth and developmental milestones, immunizations, common
infectious diseases, behavioral and mental health disorders, musculoskeletal
and genetic conditions, and endocrine disturbances. Each multiple-choice
question is crafted to test your clinical reasoning and application of pediatric
guidelines. The detailed rationales provide immediate feedback by explaining
correct answers and clarifying common misconceptions, reinforcing your
understanding of key concepts. This resource is ideal for final exam
preparation, helping you build confidence and strengthen your knowledge
base in pediatric primary care. Use these questions to assess your readiness
and identify areas requiring further study.
Section 1: Growth and Developmental Milestones (Questions 1-50)
1. By what age do the head and chest circumferences generally become equal?
A) 6 months
B) 1 to 2 years
C) 3 to 4 years
D) 6 months to 1 year
Answer: B) 1 to 2 years
Rationale: At birth, the head circumference is approximately 2 cm larger than the
chest circumference. By 1 to 2 years of age, the head and chest circumferences
become approximately equal .
2. What is the expected weight of a 6-month-old infant who weighed 7 pounds at
birth?
A) 10 pounds
B) 14 pounds
C) 15 pounds
,D) 21 pounds
Answer: B) 14 pounds
Rationale: Infants typically double their birth weight by 4-5 months and triple it by
12 months. A 7-pound infant would be expected to weigh approximately 14
pounds at 6 months .
3. At what age does the anterior fontanel usually close?
A) 2 to 4 months
B) 6 to 8 months
C) 12 to 18 months
D) 24 to 30 months
Answer: C) 12 to 18 months
Rationale: The anterior fontanel typically closes between 12 and 18 months of age.
Early closure may indicate craniosynostosis, while delayed closure may suggest
hypothyroidism, rickets, or increased intracranial pressure .
4. What is the approximate average vision of a two-year-old child?
A) 20/20
B) 20/40
C) 20/70
D) 20/150
Answer: D) 20/150
Rationale: At age 2, visual acuity is approximately 20/100 to 20/150. This
improves progressively: 20/70 at age 3, 20/40 at age 4, and 20/30 by age 5. Adult-
level 20/20 vision is typically achieved by age 6-7 .
5. By what age does the posterior fontanel usually close?
A) Birth
B) 2 to 3 months
C) 6 to 8 weeks
D) 4 to 6 months
Answer: C) 6 to 8 weeks
Rationale: The posterior fontanel closes by 6 to 8 weeks of age. It is significantly
smaller than the anterior fontanel and closes much earlier .
6. What behavior indicates that an infant has developed object permanence?
A) Smiling at a familiar face
B) Actively searching for a hidden object
C) Following a moving toy with their eyes
D) Reaching for a bottle
,Answer: B) Actively searching for a hidden object
Rationale: According to Piaget, object permanence develops during the
sensorimotor stage (around 8-12 months). An infant who actively searches for a
hidden object demonstrates understanding that objects continue to exist even when
out of sight .
7. At what age do most infants begin to fear strangers (stranger anxiety)?
A) 2 months
B) 4 months
C) 6 months
D) 9 months
Answer: C) 6 months
Rationale: Stranger anxiety typically begins around 6 months of age and peaks at 8
to 10 months. This is a normal developmental milestone indicating attachment to
primary caregivers .
8. In terms of fine motor development, what should a 7-month-old infant be able to
do?
A) Build a tower of 2 cubes
B) Transfer objects from one hand to the other
C) Use a pincer grasp
D) Scribble spontaneously
Answer: B) Transfer objects from one hand to the other
Rationale: By 7 months of age, infants typically develop the ability to transfer
objects from one hand to the other. The pincer grasp develops between 9 and 12
months .
9. In terms of gross motor development, what would the nurse expect a 5-month-
old infant to be able to do?
A) Roll from abdomen to back
B) Sit unsupported
C) Crawl
D) Stand with support
Answer: A) Roll from abdomen to back
Rationale: By 5 months of age, most infants can roll from abdomen to back. Sitting
unsupported typically occurs around 8 months, crawling around 9 months, and
standing with support around 10-12 months .
10. According to Piaget, a 6-month-old infant is in which stage of the sensorimotor
phase?
, A) Primary circular reactions
B) Secondary circular reactions
C) Coordination of secondary schemes
D) Tertiary circular reactions
Answer: B) Secondary circular reactions
Rationale: According to Piaget, the 4- to 8-month-old infant is in the secondary
circular reactions stage, characterized by repetition of actions that produce
interesting results in the environment .
11. The parents of a 9-month-old infant tell the nurse that they have noticed foods
such as peas and corn are not completely digested and can be seen in their infant's
stool. The nurse should explain that this is:
A) A sign of malabsorption
B) A food allergy
C) Normal due to immature digestive processes
D) An indication of a gastrointestinal disorder
Answer: C) Normal due to immature digestive processes
Rationale: This is a normal finding in infants due to the immaturity of the digestive
system. Parents should be reassured that this is not a cause for concern .
12. At what age does the nurse expect an infant to begin smiling in response to
pleasurable stimuli?
A) Birth
B) 1 month
C) 2 months
D) 4 months
Answer: C) 2 months
Rationale: Social smiling typically emerges around 2 months of age. This is an
important developmental milestone indicating social engagement and
responsiveness to caregivers .
13. The nurse is assessing the gross motor development of a 9-month-old infant.
Which of the following would the nurse expect to observe?
A) Pulls to a standing position
B) Walks independently
C) Sits without support
D) Creeps on hands and knees
Answer: A) Pulls to a standing position
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE ALREADY GRADED A+
This comprehensive set of 300 unique questions is meticulously designed for
the NSG6435 Pediatric Primary Care final exam. It covers essential topics
including growth and developmental milestones, immunizations, common
infectious diseases, behavioral and mental health disorders, musculoskeletal
and genetic conditions, and endocrine disturbances. Each multiple-choice
question is crafted to test your clinical reasoning and application of pediatric
guidelines. The detailed rationales provide immediate feedback by explaining
correct answers and clarifying common misconceptions, reinforcing your
understanding of key concepts. This resource is ideal for final exam
preparation, helping you build confidence and strengthen your knowledge
base in pediatric primary care. Use these questions to assess your readiness
and identify areas requiring further study.
Section 1: Growth and Developmental Milestones (Questions 1-50)
1. By what age do the head and chest circumferences generally become equal?
A) 6 months
B) 1 to 2 years
C) 3 to 4 years
D) 6 months to 1 year
Answer: B) 1 to 2 years
Rationale: At birth, the head circumference is approximately 2 cm larger than the
chest circumference. By 1 to 2 years of age, the head and chest circumferences
become approximately equal .
2. What is the expected weight of a 6-month-old infant who weighed 7 pounds at
birth?
A) 10 pounds
B) 14 pounds
C) 15 pounds
,D) 21 pounds
Answer: B) 14 pounds
Rationale: Infants typically double their birth weight by 4-5 months and triple it by
12 months. A 7-pound infant would be expected to weigh approximately 14
pounds at 6 months .
3. At what age does the anterior fontanel usually close?
A) 2 to 4 months
B) 6 to 8 months
C) 12 to 18 months
D) 24 to 30 months
Answer: C) 12 to 18 months
Rationale: The anterior fontanel typically closes between 12 and 18 months of age.
Early closure may indicate craniosynostosis, while delayed closure may suggest
hypothyroidism, rickets, or increased intracranial pressure .
4. What is the approximate average vision of a two-year-old child?
A) 20/20
B) 20/40
C) 20/70
D) 20/150
Answer: D) 20/150
Rationale: At age 2, visual acuity is approximately 20/100 to 20/150. This
improves progressively: 20/70 at age 3, 20/40 at age 4, and 20/30 by age 5. Adult-
level 20/20 vision is typically achieved by age 6-7 .
5. By what age does the posterior fontanel usually close?
A) Birth
B) 2 to 3 months
C) 6 to 8 weeks
D) 4 to 6 months
Answer: C) 6 to 8 weeks
Rationale: The posterior fontanel closes by 6 to 8 weeks of age. It is significantly
smaller than the anterior fontanel and closes much earlier .
6. What behavior indicates that an infant has developed object permanence?
A) Smiling at a familiar face
B) Actively searching for a hidden object
C) Following a moving toy with their eyes
D) Reaching for a bottle
,Answer: B) Actively searching for a hidden object
Rationale: According to Piaget, object permanence develops during the
sensorimotor stage (around 8-12 months). An infant who actively searches for a
hidden object demonstrates understanding that objects continue to exist even when
out of sight .
7. At what age do most infants begin to fear strangers (stranger anxiety)?
A) 2 months
B) 4 months
C) 6 months
D) 9 months
Answer: C) 6 months
Rationale: Stranger anxiety typically begins around 6 months of age and peaks at 8
to 10 months. This is a normal developmental milestone indicating attachment to
primary caregivers .
8. In terms of fine motor development, what should a 7-month-old infant be able to
do?
A) Build a tower of 2 cubes
B) Transfer objects from one hand to the other
C) Use a pincer grasp
D) Scribble spontaneously
Answer: B) Transfer objects from one hand to the other
Rationale: By 7 months of age, infants typically develop the ability to transfer
objects from one hand to the other. The pincer grasp develops between 9 and 12
months .
9. In terms of gross motor development, what would the nurse expect a 5-month-
old infant to be able to do?
A) Roll from abdomen to back
B) Sit unsupported
C) Crawl
D) Stand with support
Answer: A) Roll from abdomen to back
Rationale: By 5 months of age, most infants can roll from abdomen to back. Sitting
unsupported typically occurs around 8 months, crawling around 9 months, and
standing with support around 10-12 months .
10. According to Piaget, a 6-month-old infant is in which stage of the sensorimotor
phase?
, A) Primary circular reactions
B) Secondary circular reactions
C) Coordination of secondary schemes
D) Tertiary circular reactions
Answer: B) Secondary circular reactions
Rationale: According to Piaget, the 4- to 8-month-old infant is in the secondary
circular reactions stage, characterized by repetition of actions that produce
interesting results in the environment .
11. The parents of a 9-month-old infant tell the nurse that they have noticed foods
such as peas and corn are not completely digested and can be seen in their infant's
stool. The nurse should explain that this is:
A) A sign of malabsorption
B) A food allergy
C) Normal due to immature digestive processes
D) An indication of a gastrointestinal disorder
Answer: C) Normal due to immature digestive processes
Rationale: This is a normal finding in infants due to the immaturity of the digestive
system. Parents should be reassured that this is not a cause for concern .
12. At what age does the nurse expect an infant to begin smiling in response to
pleasurable stimuli?
A) Birth
B) 1 month
C) 2 months
D) 4 months
Answer: C) 2 months
Rationale: Social smiling typically emerges around 2 months of age. This is an
important developmental milestone indicating social engagement and
responsiveness to caregivers .
13. The nurse is assessing the gross motor development of a 9-month-old infant.
Which of the following would the nurse expect to observe?
A) Pulls to a standing position
B) Walks independently
C) Sits without support
D) Creeps on hands and knees
Answer: A) Pulls to a standing position
