Development Milestones
A 4-month-old infant is assessed during a routine visit. Which Finding indicates expected development?
A. Pincer Grasp
B. Transfers objects hand to hand
C. Rolls from stomach to back
D. Sits unsupported
What is Rolls from stomach to back!
Rationale: Rolling from stomach to back occurs at 4 months of age
A 6-month-old weighs 9 lbs at birth. Which weight indicates normal growth?
A. 18 lbs
B. 22 lbs
C. 30 lbs
D. 10 lbs
What is 18 lbs!
Rationale: Weight doubles by 6 months
A 3-month-old repeatedly sucks their thumb after discovering it accidentally. According to Piaget, this is:
A. Secondary circular reaction
B. Coordination of reactions
C. Reflex stage
D. Primary circular reaction
What is Primary circular reaction
Which action best supports trust vs. mistrust in infants?
A. Allowing the infant to self-soothe consistently
B. Meeting needs predictably and consistently
C. Avoiding holding the infant too much
D. Withholding comfort to develop independence
What is Meeting needs predictably and consistently!
A 4-month-old should receive which nutrition?
A. Cow's milk
B. Formula or breast milk only
C. Rice cereal and juice
D. Pureed vegetables
What is formula or breast milk only!
The nurse observes an infant using a palmar grasp. Which age is most appropriate?
A. 1 Months
B. 5 Months
C. 8 Months
D. 10 months
What is 5 Months!
Rationale: Palmar grasp develops around 5 months
A nurse palpates an infant's head. Which finding is expected at 2 months?
A. Posterior fontanel closed
B. Anterior fontanel closed
C. Both fontanels open
D. Both fontanels closed
What is Posterior fontanel closed?
A 6-month-old intentionally bangs a spoon on the tray to hear the noise. This is an example of
A. Secondary circular reaction
B. Tertiary circular reaction
C. Symbolic thinking
D. Object permanence
What is Secondary circular reaction!
A nurse notes that a parent immediately responds to the infant's cues. This supports which developmental outcome?
A. Trust
B. Autonomy
C. Mistrust
D. Initiative
What is Trust!
Which toy is MOST appropriate for a 6-month-old?
A. Legos
B. Small marbles
C. Soft rattles
D. Board games
What is soft rattles!
A parent reports their 7-month-old is transferring toys between hands. What should the nurse do?
A. Refer for further developmental evaluation
B. Document as normal development
C. Screen for neuromusclar delay
D. Assess for hearing concerns
What is Document as normal development!
The parent of a 9-month-old is worried the anterior fontanelle is still open. The nurse responds:
A. "This is normal."
B. "This indicates dehydration."
C. "This is a sign of cranial pressure."
D. "This suggests delayed skull growth."
What is "This is normal."
Rationale: Closure occurs 9-18 months
A parent states, "He crawls across the room to get a toy!" This demonstrates which Piaget stage?
A. Coordination of reaction
B. Primary circular reaction
C. Reflex stage
D. Object Permanence
What is Coordination of reaction!
Rationale: Intentional, goal-directed behavior
Which behavior MOST reflects mistrust?
A. Cries when seeing a stranger
B. Shows little preference for the caregiver
C. Looks away during play
D. Smiles responsively
What is Shows little preference for caregiver!
Rationale: Lack of attachment -> mistrust
A parent reports their infant is "chewing everything" and "drooling a lot." This suggests:
A. Normal teething
B. Viral illness
C. Dehydration
D. Formula intolerance
What is normal teething!
A nurse reviews milestones with a parent. Which statement indicates a need for further teaching?
A. "My baby should be feeding himself with a spoon by 12 months."
B. "My baby will probably develop a pincer grasp around 9-10 months."
C. "My baby should be building a tower of two blocks by 1 year."
D. "My baby should walk independently by 8 months."
What is "My baby should walk independently by 8 months."!
Rationale: Walking independently occurs closer to 12 months.
Which sensory ability develops around 7 months?
A. Preference for black and white
B. Recognition of familiar faces
C. Social smile
D. Color vision
What is Color vision!
Which behavior indicates emerging object permanence?
A. Crying when hungry
B. Smiling at the caregiver
C. Searching for a dropped toy
D. Following objects with eyes
What is Searching for a dropped toy!
A 12-month-old becomes distressed when the month leaves. This is:
A. Reactive attachment disorder
B. Stranger fewar
C. Normal seperation anxiety
D. Insecure attachment
What is Normal Separation anxiety!
Which action best reduces a hospitalized infant's stranger fear?
A. Approach quickly
B. Immediately remove them from parents
C. Maintain frequent physical exams
D. Speak softly and stay at eye level
What is speak softly and stay at eye level
A nurse assesses a 1-month-old. Which finding requires follow-up?
A. Hands held in a clenched fist
B. Strong startle reflex
C. Lack of social smile
D. Absence of rooting reflex
What is Absence of rooting reflex!
Rationale: Rooting should be present at birth-4 months
The nurse assesses a 1-month-old. Which finding is expected according to sensory development?
A. Tracks objects fully horizontally
B. Discriminates mother from others
C. Prefers black and white patterns
D. Smiles responsively
What is Prefers black and white patterns!
An infant begins to show understanding of object permanence. This is expected at what range?
A. 1-3 months
B. 4-6 months
C. 7-10 months
D. 12-18 months
What is 7-10 months!
Which infant scenario requires further evaluation of psychosocial development?
A. Shows no preference between mother and strangers
B. Cries when mother leaves
C. Reaches for caregiver
D. Smiles and coos during play
What is shows no preference between mother and strangers
Rationale: Red flag for poor attachment
Which finding during teething requires immediate evaluation?
A. Drooling
B. Temperature 101.2°F
C. Mild irritability
D. Chewing on cold objects
What is temperature 101.2°F