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ATI RN NURSING CARE OF CHILDREN 2019
PROCTORED LATEST UPDATE | RN Nursing
Care of Children – Proctored Examination
Category I: Health Promotion & Maintenance (Questions 1-18)
Subcategory: Growth & Development Milestones (Q1-6)
Q1: The mother of a 9-month-old infant asks the nurse, "When will my baby start to
have stranger anxiety?" Which response by the nurse is MOST accurate?
A. "This usually begins around 2-3 months of age."
B. "Most infants don't develop stranger anxiety until 18 months."
C. "Stranger anxiety typically emerges between 6-8 months of age." [CORRECT]
D. "This is not a normal developmental milestone and should be evaluated."
Correct Answer: C
Rationale: Stranger anxiety normally appears between 6-8 months of age, peaks
around 9-12 months, and resolves by 18-24 months (Piaget's object permanence
development, Freud's oral stage transition). Common ATI trap: Option A (2-3
months is normal for social smiling, not stranger anxiety). Option B confuses
stranger anxiety with separation anxiety (18 months is normal for peak separation
anxiety).
Q2: A nurse is assessing a 4-month-old infant during a well-child visit. Which of the
following milestones should the nurse expect the infant to demonstrate?
A. Sitting upright without support
B. Transferring a toy from one hand to the other
C. Rolling from supine to prone [CORRECT]
D. Crawling on hands and knees
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Correct Answer: C
Rationale: By 4 months, infants typically roll from supine to prone. Sitting without
support occurs around 6-8 months, transferring objects at 6-7 months, and crawling
around 8-10 months. ATI tests precise developmental milestones to identify delays.
Q3: The parents of a 2-year-old toddler ask the nurse if their child's behavior is
normal. The toddler insists on wearing a specific shirt every day and gets upset
when the daily routine changes. Which of the following should the nurse respond?
A. "This is a sign of autism spectrum disorder; you should consult a specialist."
B. "This is typical toddler behavior known asritualism, which provides security."
[CORRECT]
C. "Your child is exhibiting signs of an anxiety disorder."
D. "This indicates your parenting style is too rigid."
Correct Answer: B
Rationale: Toddlers (1-3 years) engage in ritualism to establish security and
autonomy (Erikson's autonomy vs. shame and doubt). Strict adherence to routines
is normal. Common ATI trap: Pathologizing normal developmental behaviors like
ritualism or negativism.
Q4: A nurse is observing a 4-year-old child in the playroom. The child is playing with
a doll and pretending to feed it, while another child nearby is building a block
tower. They are not interacting. Which type of play is this child demonstrating?
A. Cooperative play
B. Associative play
C. Parallel play
D. Solo play [CORRECT]
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Correct Answer: D
Rationale: While parallel play is typical of toddlers, preschoolers engage in
associative or cooperative play. However, "solo play" (independent play) is also
common and normal as preschoolers have vivid imaginations (magical thinking).
ATI often tests distinguishing between play types: parallel (playing beside, not
with), associative (playing together without strict rules), and cooperative
(organized, rule-based).
Q5: Which of the following gross motor skills should the nurse expect a 5-year-old
child to accomplish?
A. Riding a tricycle
B. Hopping on one foot [CORRECT]
C. Standing on one foot for 1 second
D. Throwing a ball underhand
Correct Answer: B
Rationale: A 5-year-old child can typically hop on one foot and balance on one foot
for longer durations. Riding a tricycle is a 3-year-old milestone. Standing on one
foot for 1 second is expected at 2-3 years. ATI tests precise age-appropriate motor
milestones.
Q6: A nurse is performing a well-child assessment on a 14-year-old adolescent.
Which of the following developmental tasks should the nurse recognize as the
priority for this age group, according to Erikson?
A. Developing a sense of industry
B. Establishing a sense of identity [CORRECT]
C. Achieving autonomy
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D. Developing trust
Correct Answer: B
Rationale: According to Erikson, adolescents (12-18 years) are in the stage of
identity vs. role confusion, where peer relationships and self-concept are
paramount. Industry vs. inferiority applies to school-age children, autonomy vs.
shame/doubt to toddlers, and trust vs. mistrust to infants.
Subcategory: Immunization Schedules (Q7-10)
Q7: A 4-month-old infant is brought to the clinic for well-child visit. The parent
reports the infant received HepB at birth and at 2 months, and DTaP, IPV, and Hib
at 2 months. Which immunizations are due at this 4-month visit according to the
2019 CDC schedule?
A. HepB (third dose), DTaP (second dose), RV (first dose)
B. DTaP (second dose), Hib (second dose), IPV (second dose), RV (second dose)
[CORRECT]
C. MMR (first dose), Varicella (first dose), HepB (third dose)
D. PCV13 (first dose), DTaP (second dose), RV (first dose)
Correct Answer: B
Rationale: At 4 months: DTaP #2, Hib #2, IPV #2, PCV13 #2, RV #2 (if using 2-dose
Rotarix series). MMR/Varicella at 12-15 months. Option A error: third HepB is not
due until 6-18 months. Common ATI trap: forgetting PCV13 and including incorrect
vaccines.
Q8: A 12-month-old child is brought to the clinic for a well-child visit. The child
received all recommended vaccines up to 6 months but has not received any since.
Which of the following vaccines should the nurse prepare to administer today?
ATI RN NURSING CARE OF CHILDREN 2019
PROCTORED LATEST UPDATE | RN Nursing
Care of Children – Proctored Examination
Category I: Health Promotion & Maintenance (Questions 1-18)
Subcategory: Growth & Development Milestones (Q1-6)
Q1: The mother of a 9-month-old infant asks the nurse, "When will my baby start to
have stranger anxiety?" Which response by the nurse is MOST accurate?
A. "This usually begins around 2-3 months of age."
B. "Most infants don't develop stranger anxiety until 18 months."
C. "Stranger anxiety typically emerges between 6-8 months of age." [CORRECT]
D. "This is not a normal developmental milestone and should be evaluated."
Correct Answer: C
Rationale: Stranger anxiety normally appears between 6-8 months of age, peaks
around 9-12 months, and resolves by 18-24 months (Piaget's object permanence
development, Freud's oral stage transition). Common ATI trap: Option A (2-3
months is normal for social smiling, not stranger anxiety). Option B confuses
stranger anxiety with separation anxiety (18 months is normal for peak separation
anxiety).
Q2: A nurse is assessing a 4-month-old infant during a well-child visit. Which of the
following milestones should the nurse expect the infant to demonstrate?
A. Sitting upright without support
B. Transferring a toy from one hand to the other
C. Rolling from supine to prone [CORRECT]
D. Crawling on hands and knees
,2
Correct Answer: C
Rationale: By 4 months, infants typically roll from supine to prone. Sitting without
support occurs around 6-8 months, transferring objects at 6-7 months, and crawling
around 8-10 months. ATI tests precise developmental milestones to identify delays.
Q3: The parents of a 2-year-old toddler ask the nurse if their child's behavior is
normal. The toddler insists on wearing a specific shirt every day and gets upset
when the daily routine changes. Which of the following should the nurse respond?
A. "This is a sign of autism spectrum disorder; you should consult a specialist."
B. "This is typical toddler behavior known asritualism, which provides security."
[CORRECT]
C. "Your child is exhibiting signs of an anxiety disorder."
D. "This indicates your parenting style is too rigid."
Correct Answer: B
Rationale: Toddlers (1-3 years) engage in ritualism to establish security and
autonomy (Erikson's autonomy vs. shame and doubt). Strict adherence to routines
is normal. Common ATI trap: Pathologizing normal developmental behaviors like
ritualism or negativism.
Q4: A nurse is observing a 4-year-old child in the playroom. The child is playing with
a doll and pretending to feed it, while another child nearby is building a block
tower. They are not interacting. Which type of play is this child demonstrating?
A. Cooperative play
B. Associative play
C. Parallel play
D. Solo play [CORRECT]
,3
Correct Answer: D
Rationale: While parallel play is typical of toddlers, preschoolers engage in
associative or cooperative play. However, "solo play" (independent play) is also
common and normal as preschoolers have vivid imaginations (magical thinking).
ATI often tests distinguishing between play types: parallel (playing beside, not
with), associative (playing together without strict rules), and cooperative
(organized, rule-based).
Q5: Which of the following gross motor skills should the nurse expect a 5-year-old
child to accomplish?
A. Riding a tricycle
B. Hopping on one foot [CORRECT]
C. Standing on one foot for 1 second
D. Throwing a ball underhand
Correct Answer: B
Rationale: A 5-year-old child can typically hop on one foot and balance on one foot
for longer durations. Riding a tricycle is a 3-year-old milestone. Standing on one
foot for 1 second is expected at 2-3 years. ATI tests precise age-appropriate motor
milestones.
Q6: A nurse is performing a well-child assessment on a 14-year-old adolescent.
Which of the following developmental tasks should the nurse recognize as the
priority for this age group, according to Erikson?
A. Developing a sense of industry
B. Establishing a sense of identity [CORRECT]
C. Achieving autonomy
, 4
D. Developing trust
Correct Answer: B
Rationale: According to Erikson, adolescents (12-18 years) are in the stage of
identity vs. role confusion, where peer relationships and self-concept are
paramount. Industry vs. inferiority applies to school-age children, autonomy vs.
shame/doubt to toddlers, and trust vs. mistrust to infants.
Subcategory: Immunization Schedules (Q7-10)
Q7: A 4-month-old infant is brought to the clinic for well-child visit. The parent
reports the infant received HepB at birth and at 2 months, and DTaP, IPV, and Hib
at 2 months. Which immunizations are due at this 4-month visit according to the
2019 CDC schedule?
A. HepB (third dose), DTaP (second dose), RV (first dose)
B. DTaP (second dose), Hib (second dose), IPV (second dose), RV (second dose)
[CORRECT]
C. MMR (first dose), Varicella (first dose), HepB (third dose)
D. PCV13 (first dose), DTaP (second dose), RV (first dose)
Correct Answer: B
Rationale: At 4 months: DTaP #2, Hib #2, IPV #2, PCV13 #2, RV #2 (if using 2-dose
Rotarix series). MMR/Varicella at 12-15 months. Option A error: third HepB is not
due until 6-18 months. Common ATI trap: forgetting PCV13 and including incorrect
vaccines.
Q8: A 12-month-old child is brought to the clinic for a well-child visit. The child
received all recommended vaccines up to 6 months but has not received any since.
Which of the following vaccines should the nurse prepare to administer today?
