ATI PN Pediatrics Proctored Exam — 250
Practice Questions , Answers & Rationales | latest
update
QUICK REFERENCE SUMMARY
Section Questions Core Topics
Growth & Development 1–15 Milestones, Erikson, Piaget, immunizations
Respiratory Conditions 16–30 Croup, epiglottitis, asthma, bronchiolitis, CF, RSV
VSD, TOF, coarctation, digoxin, CHF, Kawasaki,
Cardiovascular Conditions 31–40
rheumatic fever
Neurological Conditions 41–50 Meningitis, seizures, ICP, hydrocephalus, head injury
Pyloric stenosis, intussusception, Hirschsprung, celiac,
Gastrointestinal Conditions 51–60
appendicitis
Nephrotic syndrome, glomerulonephritis, UTI, Wilms
Genitourinary Conditions 61–66
tumor
Musculoskeletal/Orthopedic 67–73 DDH, fractures, scoliosis, LCP, osteosarcoma
Hematologic Conditions 74–80 SCD, hemophilia, ITP, iron-deficiency anemia
Infectious/Communicable 81–90 Measles, varicella, pertussis, Lyme, RMSF, mono
Endocrine/Metabolic 91–97 DM1, DKA, hypoglycemia, hypothyroidism, CAH
Pain Assessment 98–100 FLACC, FACES, numeric scales
Child Abuse & Safety 101–105 Mandated reporting, shaken baby, neglect indicators
Medication Safety 106–110 Pediatric dosing, calculations, corticosteroids
Mental Health 111–115 Suicidal ideation, ADHD, anorexia, ASD, ODD
Comprehensive/Priority 116–250 ATI-style priority questions integrating all topics
SECTION 1: GROWTH & DEVELOPMENT (Q1–35)
1. A nurse is caring for a 2-year-old child. Which developmental milestone should
the nurse expect the child to have achieved?
A) Rides a tricycle B) Speaks in 5-word sentences C) Uses a spoon and fork with
some spilling ✅ (correct answer) D) Ties shoelaces independently
,Rationale: By age 2, toddlers can use utensils with some spilling, speak 2-3
word sentences, and walk up stairs with assistance. Riding a tricycle is
expected at age 3, 5-word sentences at age 4, and tying shoes at age 5-6. The
ATI exam frequently tests age-appropriate developmental milestones.
2. A nurse is assessing a 4-month-old infant. Which finding should the nurse report
as a developmental concern?
A) Holds head steady when sitting B) Rolls from front to back C) Absence of the
Moro reflex ✅ (correct answer) D) Brings hands to midline
Rationale: The Moro (startle) reflex should be present until 4-6 months of age.
Absence before 4 months suggests neurological abnormality and must be
reported. Holding head steady, rolling front to back, and bringing hands to
midline are all expected at 4 months. Primitive reflexes that should disappear
by certain ages are key ATI exam content.
3. A nurse is educating parents about the expected weight gain of a healthy infant.
Which statement is accurate?
A) Infants double their birth weight by 12 months B) Infants triple their birth
weight by 12 months ✅ (correct answer) C) Infants double their birth weight by
4 months D) Infants quadruple their birth weight by 12 months
Rationale: Normal infant weight gain milestones: birth weight doubles by 4-6
months and triples by 12 months. Birth weight quadruples by approximately
2.5 years. These weight gain benchmarks are standard ATI pediatrics content
used to assess normal infant growth and identify failure to thrive.
4. A nurse is assessing a 9-month-old infant. Which behavior is the MOST
concerning?
A) Pulls self to standing position B) Says "mama" and "dada" nonspecifically C)
No stranger anxiety ✅ (correct answer) D) Plays peek-a-boo
,Rationale: Stranger anxiety typically develops between 6-8 months. Its
absence at 9 months may indicate developmental delay or attachment issues
and warrants further assessment. Pulling to stand (9-12 months), saying
"mama/dada" nonspecifically (6-9 months), and playing peek-a-boo (9
months) are all age-appropriate behaviors.
5. A parent of a 3-year-old tells the nurse their child refuses to share toys and has
tantrums. The nurse's BEST response is:
A) "Your child may have behavioral disorder — I'll arrange an evaluation." B)
"This behavior is normal for this age — toddlers are egocentric and still
developing self-control." ✅ (correct answer) C) "You need to discipline more
firmly to correct this behavior immediately." D) "Three-year-olds should be able to
share — this is a developmental delay."
Rationale: Toddlers (ages 1-3) are developmentally egocentric — they
understand the world from their perspective only. Temper tantrums peak
between 18 months and 3 years and are a normal expression of frustration
when language skills don't match desires. This normal development
explanation reassures parents and prevents unnecessary concern.
6. According to Erikson's stages of psychosocial development, the developmental
task for a school-age child (6-12 years) is:
A) Trust vs. Mistrust B) Autonomy vs. Shame and Doubt C) Initiative vs. Guilt D)
Industry vs. Inferiority ✅ (correct answer)
Rationale: Erikson's stages: Infants (0-1 year) — Trust vs. Mistrust; Toddlers
(1-3) — Autonomy vs. Shame and Doubt; Preschool (3-6) — Initiative vs.
Guilt; School-age (6-12) — Industry vs. Inferiority (children want to achieve
and be competent; failure leads to feelings of inferiority). Adolescents —
Identity vs. Role Confusion.
7. A nurse is assessing a 15-month-old toddler. Which finding indicates normal
development?
, A) Walking independently ✅ (correct answer) B) Running without falling C)
Speaking 20 words D) Riding a tricycle
Rationale: Independent walking is expected between 12-15 months. Running
without falling is expected at 24 months. A 15-month-old typically speaks 4-6
words (not 20). Riding a tricycle is a 3-year-old milestone. Walking
independently is the key gross motor milestone for this age group.
8. A nurse is performing a developmental screening on a 5-year-old. Which finding
is MOST appropriate for this age?
A) Counts to 5 only B) Cannot copy a square shape C) Dresses and undresses
independently ✅ (correct answer) D) Engages only in parallel play
Rationale: By age 5, children can dress/undress independently, count to 10+,
copy squares and triangles, print letters, and engage in cooperative play.
Parallel play (playing beside but not with others) is a 2-3 year milestone. A 5-
year-old who cannot copy a square or dress independently warrants
developmental evaluation.
9. A nurse is teaching parents about Piaget's preoperational stage of cognitive
development. Which behavior BEST represents this stage?
A) Object permanence development B) Use of magical thinking and symbolic play
✅ (correct answer) C) Understanding conservation of mass D) Abstract thinking
and hypothetical reasoning
Rationale: Piaget's stages: Sensorimotor (0-2 years) — develops object
permanence; Preoperational (2-7 years) — uses magical thinking,
egocentrism, symbolic play, animism; Concrete Operations (7-11 years) —
understands conservation, logical thinking about concrete objects; Formal
Operations (12+) — abstract and hypothetical reasoning.
10. A nurse is assessing an 18-month-old child. Which finding should the nurse
report as a developmental RED FLAG?
Practice Questions , Answers & Rationales | latest
update
QUICK REFERENCE SUMMARY
Section Questions Core Topics
Growth & Development 1–15 Milestones, Erikson, Piaget, immunizations
Respiratory Conditions 16–30 Croup, epiglottitis, asthma, bronchiolitis, CF, RSV
VSD, TOF, coarctation, digoxin, CHF, Kawasaki,
Cardiovascular Conditions 31–40
rheumatic fever
Neurological Conditions 41–50 Meningitis, seizures, ICP, hydrocephalus, head injury
Pyloric stenosis, intussusception, Hirschsprung, celiac,
Gastrointestinal Conditions 51–60
appendicitis
Nephrotic syndrome, glomerulonephritis, UTI, Wilms
Genitourinary Conditions 61–66
tumor
Musculoskeletal/Orthopedic 67–73 DDH, fractures, scoliosis, LCP, osteosarcoma
Hematologic Conditions 74–80 SCD, hemophilia, ITP, iron-deficiency anemia
Infectious/Communicable 81–90 Measles, varicella, pertussis, Lyme, RMSF, mono
Endocrine/Metabolic 91–97 DM1, DKA, hypoglycemia, hypothyroidism, CAH
Pain Assessment 98–100 FLACC, FACES, numeric scales
Child Abuse & Safety 101–105 Mandated reporting, shaken baby, neglect indicators
Medication Safety 106–110 Pediatric dosing, calculations, corticosteroids
Mental Health 111–115 Suicidal ideation, ADHD, anorexia, ASD, ODD
Comprehensive/Priority 116–250 ATI-style priority questions integrating all topics
SECTION 1: GROWTH & DEVELOPMENT (Q1–35)
1. A nurse is caring for a 2-year-old child. Which developmental milestone should
the nurse expect the child to have achieved?
A) Rides a tricycle B) Speaks in 5-word sentences C) Uses a spoon and fork with
some spilling ✅ (correct answer) D) Ties shoelaces independently
,Rationale: By age 2, toddlers can use utensils with some spilling, speak 2-3
word sentences, and walk up stairs with assistance. Riding a tricycle is
expected at age 3, 5-word sentences at age 4, and tying shoes at age 5-6. The
ATI exam frequently tests age-appropriate developmental milestones.
2. A nurse is assessing a 4-month-old infant. Which finding should the nurse report
as a developmental concern?
A) Holds head steady when sitting B) Rolls from front to back C) Absence of the
Moro reflex ✅ (correct answer) D) Brings hands to midline
Rationale: The Moro (startle) reflex should be present until 4-6 months of age.
Absence before 4 months suggests neurological abnormality and must be
reported. Holding head steady, rolling front to back, and bringing hands to
midline are all expected at 4 months. Primitive reflexes that should disappear
by certain ages are key ATI exam content.
3. A nurse is educating parents about the expected weight gain of a healthy infant.
Which statement is accurate?
A) Infants double their birth weight by 12 months B) Infants triple their birth
weight by 12 months ✅ (correct answer) C) Infants double their birth weight by
4 months D) Infants quadruple their birth weight by 12 months
Rationale: Normal infant weight gain milestones: birth weight doubles by 4-6
months and triples by 12 months. Birth weight quadruples by approximately
2.5 years. These weight gain benchmarks are standard ATI pediatrics content
used to assess normal infant growth and identify failure to thrive.
4. A nurse is assessing a 9-month-old infant. Which behavior is the MOST
concerning?
A) Pulls self to standing position B) Says "mama" and "dada" nonspecifically C)
No stranger anxiety ✅ (correct answer) D) Plays peek-a-boo
,Rationale: Stranger anxiety typically develops between 6-8 months. Its
absence at 9 months may indicate developmental delay or attachment issues
and warrants further assessment. Pulling to stand (9-12 months), saying
"mama/dada" nonspecifically (6-9 months), and playing peek-a-boo (9
months) are all age-appropriate behaviors.
5. A parent of a 3-year-old tells the nurse their child refuses to share toys and has
tantrums. The nurse's BEST response is:
A) "Your child may have behavioral disorder — I'll arrange an evaluation." B)
"This behavior is normal for this age — toddlers are egocentric and still
developing self-control." ✅ (correct answer) C) "You need to discipline more
firmly to correct this behavior immediately." D) "Three-year-olds should be able to
share — this is a developmental delay."
Rationale: Toddlers (ages 1-3) are developmentally egocentric — they
understand the world from their perspective only. Temper tantrums peak
between 18 months and 3 years and are a normal expression of frustration
when language skills don't match desires. This normal development
explanation reassures parents and prevents unnecessary concern.
6. According to Erikson's stages of psychosocial development, the developmental
task for a school-age child (6-12 years) is:
A) Trust vs. Mistrust B) Autonomy vs. Shame and Doubt C) Initiative vs. Guilt D)
Industry vs. Inferiority ✅ (correct answer)
Rationale: Erikson's stages: Infants (0-1 year) — Trust vs. Mistrust; Toddlers
(1-3) — Autonomy vs. Shame and Doubt; Preschool (3-6) — Initiative vs.
Guilt; School-age (6-12) — Industry vs. Inferiority (children want to achieve
and be competent; failure leads to feelings of inferiority). Adolescents —
Identity vs. Role Confusion.
7. A nurse is assessing a 15-month-old toddler. Which finding indicates normal
development?
, A) Walking independently ✅ (correct answer) B) Running without falling C)
Speaking 20 words D) Riding a tricycle
Rationale: Independent walking is expected between 12-15 months. Running
without falling is expected at 24 months. A 15-month-old typically speaks 4-6
words (not 20). Riding a tricycle is a 3-year-old milestone. Walking
independently is the key gross motor milestone for this age group.
8. A nurse is performing a developmental screening on a 5-year-old. Which finding
is MOST appropriate for this age?
A) Counts to 5 only B) Cannot copy a square shape C) Dresses and undresses
independently ✅ (correct answer) D) Engages only in parallel play
Rationale: By age 5, children can dress/undress independently, count to 10+,
copy squares and triangles, print letters, and engage in cooperative play.
Parallel play (playing beside but not with others) is a 2-3 year milestone. A 5-
year-old who cannot copy a square or dress independently warrants
developmental evaluation.
9. A nurse is teaching parents about Piaget's preoperational stage of cognitive
development. Which behavior BEST represents this stage?
A) Object permanence development B) Use of magical thinking and symbolic play
✅ (correct answer) C) Understanding conservation of mass D) Abstract thinking
and hypothetical reasoning
Rationale: Piaget's stages: Sensorimotor (0-2 years) — develops object
permanence; Preoperational (2-7 years) — uses magical thinking,
egocentrism, symbolic play, animism; Concrete Operations (7-11 years) —
understands conservation, logical thinking about concrete objects; Formal
Operations (12+) — abstract and hypothetical reasoning.
10. A nurse is assessing an 18-month-old child. Which finding should the nurse
report as a developmental RED FLAG?
