ATI RN Pediatrics Proctored Exam
2026/2027 | 70 Questions
Comprehensive Review — Aligned with NGN/CJMM Standards, AAP, CDC, and PALS Guidelines
Test Type: Proctored Exam | Time Limit: 2 Hours 30 Minutes
EXAM INSTRUCTIONS
1. Read each question carefully and select the best answer from the four options provided.
2. Only one answer is correct for each question.
3. There is no penalty for guessing. Answer every question.
4. Correct answers are marked in teal (cyan) and include clinical rationales.
5. Manage your time: approximately 2 minutes per question.
6. An answer key is provided at the end of the document for review.
SECTION I: GROWTH & DEVELOPMENT MILESTONES (Q1–Q10)
1. A nurse is assessing a 4-month-old infant. Which of the following developmental milestones should the
nurse expect the infant to demonstrate?
A. Rolling from back to front B. Sitting unsupported
C. Turning head side to side when prone D. Walking with assistance
Rationale: A 4-month-old infant should be able to lift the head 90 degrees when prone and turn the head side to
side. Rolling back to front typically occurs at 5–6 months, sitting unsupported at 6–8 months, and walking with
assistance at 10–12 months. These are all within normal developmental trajectory per the CDC milestones.
2. According to Erikson's psychosocial theory, which developmental task is most appropriate for a toddler
(1–3 years)?
A. Trust vs. mistrust B. Autonomy vs. shame and doubt
C. Initiative vs. guilt D. Industry vs. inferiority
Rationale: Toddlers (1–3 years) are in the autonomy vs. shame and doubt stage, focused on developing
independence and self-control through activities like feeding and dressing. Trust vs. mistrust is infancy (0–1),
initiative vs. guilt is preschool (3–6), and industry vs. inferiority is school-age (6–12).
3. A nurse is teaching parents of a 9-month-old infant about developmental milestones. Which of the
following should the nurse include as an expected milestone?
A. Speaking two-word phrases B. Pincer grasp
C. Tying shoelaces D. Hopping on one foot
1
,Rationale: The pincer grasp typically develops between 9 and 12 months, allowing the infant to pick up small
objects using the thumb and index finger. Two-word phrases emerge around 18–24 months, tying shoelaces
around 5–6 years, and hopping on one foot around 4–5 years.
4. A nurse is assessing a 5-year-old child's cognitive development using Piaget's stages. Which behavior
indicates the child is in the preoperational stage?
A. Uses abstract reasoning to solve problems B. Believes that a tall, narrow glass contains more
water than a short, wide one
C. Understands conservation of mass D. Thinks systematically using hypothesis testing
Rationale: The preoperational stage (2–7 years) is characterized by egocentrism and lack of conservation. A
child in this stage cannot conserve volume and will believe a tall, narrow glass holds more. Abstract reasoning
and systematic thinking occur in the formal operational stage, while conservation is understood in the concrete
operational stage.
5. A nurse is performing a developmental screening on a 12-month-old infant. Which finding requires
further evaluation?
A. Says 'mama' and 'dada' specifically B. Pulls to a standing position
C. Does not respond to name when called D. Transfers objects from one hand to the other
Rationale: A 12-month-old infant should respond to their name. Lack of response to name may indicate a hearing
deficit, social communication disorder, or developmental delay requiring further evaluation. The other milestones
are expected for a 12-month-old.
6. A nurse is preparing an immunization for a 2-month-old infant. The infant's mother asks about expected
weight gain since birth. The nurse should respond that the infant should have gained approximately:
A. 1 to 1.5 kg (2.2 to 3.3 lb) B. 2.5 to 3 kg (5.5 to 6.6 lb)
C. 4 to 5 kg (8.8 to 11 lb) D. 5.5 to 6.5 kg (12 to 14.3 lb)
Rationale: By 2 months of age, an infant typically gains approximately 2.5 to 3 kg (5.5 to 6.6 lb) above birth
weight. Birth weight is usually regained by 10–14 days, and the infant then gains about 20 to 30 g per day during
the first few months.
7. A nurse is assessing an 18-month-old toddler. Which developmental finding is consistent with this age?
A. Builds a tower of 6–7 cubes B. Throws a ball overhand
C. Draws a circle on request D. Can ride a tricycle
Rationale: An 18-month-old toddler can typically throw a ball overhand and stack 2–3 cubes. Building a tower of
6–7 cubes is expected at 3 years, drawing a circle at 3 years, and riding a tricycle at 3–4 years.
8. A nurse is discussing anticipatory guidance with the parents of a 4-year-old child. Which topic is most
appropriate to include?
A. Car seat safety in a rear-facing position B. Bicycle helmet use and pedestrian safety
C. Injury prevention related to firearm safety in the D. Teaching proper use of a microwave oven
home
2
, Rationale: At 4 years, children are increasingly active outdoors, making bicycle helmet use and pedestrian safety
important anticipatory guidance topics. Rear-facing car seats are discussed for infants. Firearm safety is
important but more relevant to discuss broadly with all parents. Microwave use teaching is more appropriate for
older school-age children.
9. A school-age child (10 years old) tells the nurse, 'I am not good at anything.' According to Erikson, which
psychosocial crisis is this child experiencing?
A. Identity vs. role confusion B. Industry vs. inferiority
C. Initiative vs. guilt D. Trust vs. mistrust
Rationale: School-age children (6–12 years) are in the industry vs. inferiority stage. They need to feel competent
in academic and social tasks. Feelings of inferiority can develop if they perceive themselves as inadequate
compared to peers. Identity vs. role confusion is the adolescent stage.
10. A nurse is assessing the anterior fontanelle of a 6-month-old infant. Which finding indicates the need for
further evaluation?
A. The fontanelle is soft and flat B. The fontanelle measures 3 cm × 3 cm
C. The fontanelle is bulging when the infant is at D. The fontanelle is barely palpable
rest
Rationale: A bulging anterior fontanelle at rest may indicate increased intracranial pressure, which requires
immediate evaluation. The anterior fontanelle normally measures about 2.5 × 2.5 cm at birth and closes between
12 and 18 months. A soft, flat fontanelle is normal, and becoming barely palpable is expected as it begins to close.
SECTION II: PEDIATRIC ASSESSMENT TECHNIQUES (Q11–Q17)
11. A nurse is using the Pediatric Assessment Triangle (PAT) to evaluate a child. Which of the following
components is assessed when observing the child's work of breathing?
A. Appearance B. Circulation
C. Breathing D. Abnormal posturing
Rationale: The PAT consists of three components: appearance (tone, interactiveness, consolability, look/gaze,
speech/cry), work of breathing (nasal flaring, retractions, positioning), and circulation to skin (pallor, mottling,
cyanosis). Work of breathing is part of the breathing component.
12. A nurse is assessing the vital signs of a 3-year-old child. Which of the following ranges represents an
expected respiratory rate for this age?
A. 12–20 breaths per minute B. 20–30 breaths per minute
C. 30–50 breaths per minute D. 35–60 breaths per minute
Rationale: A 3-year-old child typically has a respiratory rate of 20–30 breaths per minute. Neonates have rates of
30–60, infants 25–40, and adolescents/adults 12–20. Knowing age-specific norms is essential for accurate
assessment.
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2026/2027 | 70 Questions
Comprehensive Review — Aligned with NGN/CJMM Standards, AAP, CDC, and PALS Guidelines
Test Type: Proctored Exam | Time Limit: 2 Hours 30 Minutes
EXAM INSTRUCTIONS
1. Read each question carefully and select the best answer from the four options provided.
2. Only one answer is correct for each question.
3. There is no penalty for guessing. Answer every question.
4. Correct answers are marked in teal (cyan) and include clinical rationales.
5. Manage your time: approximately 2 minutes per question.
6. An answer key is provided at the end of the document for review.
SECTION I: GROWTH & DEVELOPMENT MILESTONES (Q1–Q10)
1. A nurse is assessing a 4-month-old infant. Which of the following developmental milestones should the
nurse expect the infant to demonstrate?
A. Rolling from back to front B. Sitting unsupported
C. Turning head side to side when prone D. Walking with assistance
Rationale: A 4-month-old infant should be able to lift the head 90 degrees when prone and turn the head side to
side. Rolling back to front typically occurs at 5–6 months, sitting unsupported at 6–8 months, and walking with
assistance at 10–12 months. These are all within normal developmental trajectory per the CDC milestones.
2. According to Erikson's psychosocial theory, which developmental task is most appropriate for a toddler
(1–3 years)?
A. Trust vs. mistrust B. Autonomy vs. shame and doubt
C. Initiative vs. guilt D. Industry vs. inferiority
Rationale: Toddlers (1–3 years) are in the autonomy vs. shame and doubt stage, focused on developing
independence and self-control through activities like feeding and dressing. Trust vs. mistrust is infancy (0–1),
initiative vs. guilt is preschool (3–6), and industry vs. inferiority is school-age (6–12).
3. A nurse is teaching parents of a 9-month-old infant about developmental milestones. Which of the
following should the nurse include as an expected milestone?
A. Speaking two-word phrases B. Pincer grasp
C. Tying shoelaces D. Hopping on one foot
1
,Rationale: The pincer grasp typically develops between 9 and 12 months, allowing the infant to pick up small
objects using the thumb and index finger. Two-word phrases emerge around 18–24 months, tying shoelaces
around 5–6 years, and hopping on one foot around 4–5 years.
4. A nurse is assessing a 5-year-old child's cognitive development using Piaget's stages. Which behavior
indicates the child is in the preoperational stage?
A. Uses abstract reasoning to solve problems B. Believes that a tall, narrow glass contains more
water than a short, wide one
C. Understands conservation of mass D. Thinks systematically using hypothesis testing
Rationale: The preoperational stage (2–7 years) is characterized by egocentrism and lack of conservation. A
child in this stage cannot conserve volume and will believe a tall, narrow glass holds more. Abstract reasoning
and systematic thinking occur in the formal operational stage, while conservation is understood in the concrete
operational stage.
5. A nurse is performing a developmental screening on a 12-month-old infant. Which finding requires
further evaluation?
A. Says 'mama' and 'dada' specifically B. Pulls to a standing position
C. Does not respond to name when called D. Transfers objects from one hand to the other
Rationale: A 12-month-old infant should respond to their name. Lack of response to name may indicate a hearing
deficit, social communication disorder, or developmental delay requiring further evaluation. The other milestones
are expected for a 12-month-old.
6. A nurse is preparing an immunization for a 2-month-old infant. The infant's mother asks about expected
weight gain since birth. The nurse should respond that the infant should have gained approximately:
A. 1 to 1.5 kg (2.2 to 3.3 lb) B. 2.5 to 3 kg (5.5 to 6.6 lb)
C. 4 to 5 kg (8.8 to 11 lb) D. 5.5 to 6.5 kg (12 to 14.3 lb)
Rationale: By 2 months of age, an infant typically gains approximately 2.5 to 3 kg (5.5 to 6.6 lb) above birth
weight. Birth weight is usually regained by 10–14 days, and the infant then gains about 20 to 30 g per day during
the first few months.
7. A nurse is assessing an 18-month-old toddler. Which developmental finding is consistent with this age?
A. Builds a tower of 6–7 cubes B. Throws a ball overhand
C. Draws a circle on request D. Can ride a tricycle
Rationale: An 18-month-old toddler can typically throw a ball overhand and stack 2–3 cubes. Building a tower of
6–7 cubes is expected at 3 years, drawing a circle at 3 years, and riding a tricycle at 3–4 years.
8. A nurse is discussing anticipatory guidance with the parents of a 4-year-old child. Which topic is most
appropriate to include?
A. Car seat safety in a rear-facing position B. Bicycle helmet use and pedestrian safety
C. Injury prevention related to firearm safety in the D. Teaching proper use of a microwave oven
home
2
, Rationale: At 4 years, children are increasingly active outdoors, making bicycle helmet use and pedestrian safety
important anticipatory guidance topics. Rear-facing car seats are discussed for infants. Firearm safety is
important but more relevant to discuss broadly with all parents. Microwave use teaching is more appropriate for
older school-age children.
9. A school-age child (10 years old) tells the nurse, 'I am not good at anything.' According to Erikson, which
psychosocial crisis is this child experiencing?
A. Identity vs. role confusion B. Industry vs. inferiority
C. Initiative vs. guilt D. Trust vs. mistrust
Rationale: School-age children (6–12 years) are in the industry vs. inferiority stage. They need to feel competent
in academic and social tasks. Feelings of inferiority can develop if they perceive themselves as inadequate
compared to peers. Identity vs. role confusion is the adolescent stage.
10. A nurse is assessing the anterior fontanelle of a 6-month-old infant. Which finding indicates the need for
further evaluation?
A. The fontanelle is soft and flat B. The fontanelle measures 3 cm × 3 cm
C. The fontanelle is bulging when the infant is at D. The fontanelle is barely palpable
rest
Rationale: A bulging anterior fontanelle at rest may indicate increased intracranial pressure, which requires
immediate evaluation. The anterior fontanelle normally measures about 2.5 × 2.5 cm at birth and closes between
12 and 18 months. A soft, flat fontanelle is normal, and becoming barely palpable is expected as it begins to close.
SECTION II: PEDIATRIC ASSESSMENT TECHNIQUES (Q11–Q17)
11. A nurse is using the Pediatric Assessment Triangle (PAT) to evaluate a child. Which of the following
components is assessed when observing the child's work of breathing?
A. Appearance B. Circulation
C. Breathing D. Abnormal posturing
Rationale: The PAT consists of three components: appearance (tone, interactiveness, consolability, look/gaze,
speech/cry), work of breathing (nasal flaring, retractions, positioning), and circulation to skin (pallor, mottling,
cyanosis). Work of breathing is part of the breathing component.
12. A nurse is assessing the vital signs of a 3-year-old child. Which of the following ranges represents an
expected respiratory rate for this age?
A. 12–20 breaths per minute B. 20–30 breaths per minute
C. 30–50 breaths per minute D. 35–60 breaths per minute
Rationale: A 3-year-old child typically has a respiratory rate of 20–30 breaths per minute. Neonates have rates of
30–60, infants 25–40, and adolescents/adults 12–20. Knowing age-specific norms is essential for accurate
assessment.
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