A physical therapist is evaluating a 10-month-old infant referred for developmental screening. Which of the following gross motor skills would the therapist MOST expect a typically developing infant of this age to demonstrate?

Pulling to stand at furniture and beginning to cruise

Walking independently across the room

Rolling from prone to supine as the primary means of mobility

Ascending stairs with a reciprocal pattern while holding a rail

During an evaluation of an 8-month-old infant, the therapist observes that when the infant's head is turned to the right, the right arm extends and the left arm flexes — consistently and obligatorily. The infant is unable to roll and has difficulty bringing hands to midline. This finding is BEST interpreted as which of the following?

Persistence of the asymmetrical tonic neck reflex beyond its expected integration, interfering with motor development

A normal finding — this reflex typically integrates by 12 months

An emerging protective extension response that should be encouraged

Persistence of the Moro reflex requiring vestibular habituation

A 6-year-old child with spastic diplegic cerebral palsy walks with bilateral lower extremity scissoring and crouched posture but is able to ambulate in most settings with forearm crutches. The family's primary goal is improved walking at school. Which of the following intervention approaches is MOST appropriate as the foundation of the plan of care?

Task-specific gait training with high practice repetition in functional contexts

Passive stretching of the hip adductors performed by the therapist for the majority of each session

Deferring gait work until spasticity is eliminated through positioning

Non-weight-bearing strengthening only, to avoid reinforcing the abnormal gait pattern

A physical therapist is designing a community exercise program for an 9-year-old child with Down syndrome. Given the orthopedic risks associated with this diagnosis, which of the following activities requires the GREATEST caution or screening before participation?

Gymnastics activities involving forward rolls and tumbling

Stationary cycling with progressive resistance

Swimming with flotation support

Walking program on level surfaces with a peer group

The parents of a 4-year-old boy report that he has become clumsier over the past year, falls frequently, and has an unusual way of standing up from the floor: he rolls to his hands and knees, then pushes his hands against his shins, knees, and thighs to "walk" himself upright. Examination reveals firm, enlarged calf muscles bilaterally and proximal hip and shoulder weakness. These findings are MOST consistent with which of the following conditions?

Developmental coordination disorder

A physical therapist is preparing a treatment session for a 5-year-old child with myelomeningocele who has a ventriculoperitoneal shunt and a neurogenic bladder managed with intermittent catheterization. Which of the following precautions is MOST important when selecting equipment and materials for this child's sessions?

Avoiding latex-containing gloves, balloons, bands, and equipment

Avoiding all foam-padded surfaces due to pressure injury risk

Using only metallic equipment that can be autoclaved between sessions

Avoiding aquatic environments due to shunt displacement risk

A newborn delivered with shoulder dystocia presents with the left upper extremity held in shoulder adduction and internal rotation, elbow extension, forearm pronation, and wrist flexion — the classic "waiter's tip" posture. Grasp reflex is intact in the left hand. This presentation is MOST consistent with injury to which of the following?

C5–C6 nerve roots (Erb's palsy)

C8–T1 nerve roots (Klumpke's palsy)

Radial nerve at the spiral groove

A physical therapist is scheduling daily airway clearance sessions for a 7-year-old child with cystic fibrosis admitted for a pulmonary exacerbation. Which of the following scheduling decisions is MOST appropriate?

Before meals, or at least 1 to 2 hours after eating

Immediately after meals, when the child has the most energy

Only at bedtime, to clear secretions accumulated during the day

Timing is irrelevant as long as total daily treatment time is achieved

A 6-week-old infant with developmental dysplasia of the hip has been placed in a Pavlik harness. The parents ask the physical therapist what the harness is doing. Which of the following BEST describes the position the harness maintains and its purpose?

Hip flexion and abduction, to keep the femoral head seated in the acetabulum while it develops

Hip extension and adduction, to stretch the hip flexors and prevent contracture

Full hip internal rotation, to tighten the anterior capsule

Knee extension with the hips neutral, to promote symmetric leg growth

10 Free NPTE Pediatrics Practice Questions (2026) - Practitionr

About This Topic

How Pediatrics Is Tested on the NPTE

The FSBPT content outline tests knowledge across the lifespan within each body system, which means pediatric patients surface everywhere: a pediatric orthopedic condition in the musculoskeletal section, cerebral palsy in neuromuscular, cystic fibrosis in cardiopulmonary, developmental screening in examination items. Try our free 20-question timed NPTE practice test, Musculoskeletal practice questions, or Pharmacology practice questions to see how these threads run through the whole exam.

The pediatric knowledge the NPTE tests

→Gross motor milestone ages and the sequence they follow

→Primitive reflexes — patterns, integration windows, significance of persistence

→Cerebral palsy — classifications, GMFCS levels, evidence-based intervention

→Genetic and neuromuscular conditions — Down syndrome, DMD, SMA, spina bifida

→Pediatric orthopedics — DDH, torticollis, SCFE, Legg-Calvé-Perthes, Osgood-Schlatter

→Obstetric injuries — Erb’s and Klumpke’s palsy patterns

→Pediatric cardiopulmonary — cystic fibrosis, asthma, airway clearance

→Condition-specific precautions — atlantoaxial instability, latex allergy, fragility

Two families of pediatric questions dominate. Recognition questions hand you a presentation — Gowers’ sign, waiter’s tip, a neck mass with head tilt — and ask for the condition; these reward knowing each diagnosis as a complete picture. Management questions hand you the diagnosis and test whether you know the one precaution or principle attached to it — the tumbling restriction, the latex rule, the harness position. See our full NPTE exam format breakdown for how these items distribute across the 225-question structure.

The pattern to recognize

Age is the load-bearing detail in pediatric vignettes. The same hip pain is Legg-Calvé-Perthes at 5 and SCFE at 14; the same “floppy infant” concern means something different at 2 months than at 2 years; a reflex that is normal at 3 months is a red flag at 8. Before reasoning about any pediatric question, anchor on the age and ask what is developmentally expected at that exact point — most wrong answers in this domain are things that would be true at a different age.

Cross-Content Reasoning

Where Pediatric Questions Appear Across the Exam

Because pediatrics is a population rather than a section, its questions are distributed by body system. Pediatric orthopedic conditions — DDH, torticollis, SCFE, Legg-Calvé-Perthes, Osgood-Schlatter — are scored as musculoskeletal items. Cerebral palsy, spina bifida, DMD, and developmental assessment are scored as neuromuscular items. Cystic fibrosis and pediatric asthma live in cardiopulmonary, and pediatric equipment, safety, and family education appear in non-systems items.

This distribution has a practical consequence: a student who skips pediatric review doesn’t lose points in one place — they leak points across four content areas at once. The reverse is also true, which is what makes pediatric review efficient: one afternoon on milestones, reflexes, and the major condition profiles improves accuracy everywhere pediatric patients appear.

Pediatric questions also connect to the exam’s screening thread: recognizing when a “clumsy child” referral is actually presenting with early DMD, when persistent reflexes signal CNS pathology, or when new neck symptoms in a child with Down syndrome demand immediate medical referral. The professional responsibility to refer — the same skill tested with adult visceral referral patterns in the other systems — has a pediatric version, and it is tested.

Study tip

Make two reference cards. Card one: the milestone timeline (rolling 4-6 months, sitting 6-8, pull-to-stand and cruising 9-10, walking ~12) beside the reflex integration windows (ATNR and Moro by ~4-6 months). Card two: one line per condition — its signature presentation and its one tested precaution (Down syndrome → atlantoaxial screening; spina bifida → latex; DMD → Gowers\’ and avoiding overwork; CMT → tilt-toward, rotate-away). Those two cards cover the majority of pediatric points on the exam, and our complete NPTE study guide covers how to fold them into a full study plan.

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