NCLEX · Growth and Development

A 2-month-old infant is brought in for a well-child visit. Which milestone is EXPECTED at this age?

  1. A Sits without support
  2. B Social smile and holds head up briefly when prone
  3. C Pulls to a standing position
  4. D Walks independently

Why this is the answer

By age 2 months, normal developmental milestones include: SOCIAL SMILE (smiling in response to a face or voice — a key early social milestone, distinct from the reflexive newborn smile); HOLDS HEAD UP briefly when placed on the abdomen (prone position); follows objects with eyes past midline; responds to sound; coos and makes vowel sounds; recognizes parent's face and voice. SITTING WITHOUT SUPPORT typically develops around 6-8 months. PULLING TO STAND typically occurs around 8-10 months. WALKING INDEPENDENTLY usually happens around 9-15 months (average 12 months). RED FLAGS at 2 months: no social smile by 2 months; doesn't follow objects with eyes; doesn't react to loud sounds; very floppy tone or very stiff tone; doesn't coo or make sounds. PN role: document milestone assessment during well-child visits; report to RN/provider any delays; provide parents anticipatory guidance about upcoming milestones; reinforce safe sleep (supine position, firm mattress, no soft bedding — 'back to sleep' for SIDS prevention). DEVELOPMENTAL SCREENING tools used in clinical practice include the Denver Developmental Screening Test (Denver II), which assesses four domains: personal-social, fine motor, language, and gross motor. Early intervention referral is recommended when delays are identified.
Source: NCLEX-PN Test Plan: Health Promotion — Growth and Development, Infants