ATI RN Nursing Care of Children | 2026/2027 | Proctored Exam Prep | NGN-Aligned
ATI RN NURSING CARE OF CHILDREN
PROCTORED EXAM PREP
2026/2027 | 70 Questions with Correct Answers | NGN-Aligned
Graded A+ | 100% Verified | Evidence-Based Rationales
Instructions
This examination consists of 70 multiple-choice questions designed for ATI RN Nursing Care of Children proctored
assessment preparation. The exam covers seven clinical domains: Growth and Development Milestones and Pediatric
Assessment (14 questions), Respiratory Disorders (10 questions), Cardiovascular Disorders (8 questions),
Gastrointestinal and Endocrine Disorders (10 questions), Neurological, Hematological, and Oncological Disorders (12
questions), Infectious Diseases and Immunizations (8 questions), and Pharmacology, Family-Centered Care, Ethics, and
Prioritization (8 questions). The recommended time limit is 2 hours. Content is aligned with the NCSBN Clinical
Judgment Measurement Model (CJMM) and reflects NCLEX-RN test plan competencies. Correct answers are
displayed in bold teal with evidence-based rationales referencing ATI modules, AAP guidelines, CDC schedules, and
PALS protocols.
Select the single best answer for each question. Each question is worth one point. A score of 80% (56/70) or higher
indicates NCLEX-RN readiness in the pediatric nursing content area.
Section I: Growth & Development Milestones and Pediatric Assessment
1. According to Erikson's psychosocial theory, which developmental stage is a 2-year-old child in, and what is the
primary task?
A. Trust vs Mistrust; developing a sense of basic trust through consistent caregiving
B. Autonomy vs Shame and Doubt; gaining independence and control over self
C. Initiative vs Guilt; developing a sense of purpose through play and exploration
D. Industry vs Inferiority; mastering skills and gaining competence
Rationale: A 2-year-old is in the toddler stage of Erikson's Autonomy vs Shame and Doubt. The primary
developmental task is gaining a sense of independence and control, such as learning to dress, feed, and toilet
themselves. Nurses should encourage age-appropriate choices while maintaining safe boundaries. Per ATI
Nursing Care of Children modules and NCSBN NCLEX-RN test plan.
2. A nurse is assessing a 4-year-old child. According to Piaget's cognitive development theory, in which stage is
this child?
A. Sensorimotor stage; learning through sensory experiences and motor actions
B. Preoperational stage; developing symbolic thought and magical thinking
C. Concrete operations stage; understanding logical reasoning about concrete events
D. Formal operations stage; capable of abstract and hypothetical reasoning
Rationale: A 4-year-old is in Piaget's Preoperational stage (ages 2-7 years), characterized by symbolic thought,
egocentrism, magical thinking, and animism. The child believes that inanimate objects can think and feel. Nurses
1
, ATI RN Nursing Care of Children | 2026/2027 | Proctored Exam Prep | NGN-Aligned
should use simple, concrete language and therapeutic play during assessments. Per ATI Nursing Care of
Children and AAP developmental screening guidelines.
3. A nurse is obtaining vital signs on a 6-month-old infant. Which finding is within the expected range?
A. Heart rate of 80 bpm
B. Heart rate of 140 bpm
C. Respiratory rate of 14 breaths/min
D. Blood pressure of 110/70 mmHg
Rationale: The normal heart rate for an infant (6 months) is 110-160 bpm, with the typical range cited as 120-
160 bpm. A rate of 140 bpm is within normal limits. The respiratory rate for a 6-month-old is approximately 30-
60 breaths/min, and blood pressure averages 85/50 mmHg. Per AAP Pediatric Advanced Life Support (PALS)
guidelines and ATI Nursing Care of Children vital sign reference tables.
4. Which pain assessment tool is most appropriate for a 2-year-old child who is preverbal or has limited language
ability?
A. Numeric Rating Scale (0-10)
B. Visual Analog Scale (VAS)
C. FLACC Behavioral Pain Assessment Scale
D. McGill Pain Questionnaire
Rationale: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is the most appropriate pain assessment
tool for preverbal children (ages 2 months to 7 years) or those unable to self-report. Each category is scored 0-2,
with a maximum score of 10. The Wong-Baker FACES scale is appropriate for children ages 3-7 who can point to
a face. The Numeric Rating Scale is for ages 8 and older. Per ATI Nursing Care of Children and AAP guidelines.
5. At which age should a nurse expect an infant to sit independently without support?
A. 3 months
B. 6 months
C. 8 months
D. 12 months
Rationale: Infants typically achieve independent sitting at approximately 6 months of age. The developmental
progression for gross motor milestones includes: rolling over at 4-5 months, sitting with support at 5-6 months,
sitting independently at 6 months, and crawling at 8-9 months. Nurses use the Denver II developmental screening
tool to assess milestone attainment. Per AAP Bright Futures guidelines and ATI Nursing Care of Children
developmental milestones module.
6. A nurse is performing an initial pediatric assessment using the Pediatric Assessment Triangle (PAT). The PAT
evaluates which three components?
A. Heart rate, respiratory rate, and blood pressure
B. Appearance, Work of Breathing, and Circulation to Skin
C. Level of consciousness, pupil response, and motor function
D. Temperature, oxygen saturation, and capillary refill time
Rationale: The Pediatric Assessment Triangle (PAT) is a rapid, visual-first assessment tool used in emergency
and triage settings. It evaluates: Appearance (tone, interactiveness, consolability, look/gaze, speech/cry), Work of
Breathing (abnormal positioning, retractions, audible sounds), and Circulation to Skin (pallor, mottling,
cyanosis). It takes fewer than 30 seconds and guides urgency of intervention. Per PALS and ATI Nursing Care of
Children assessment module.
2
, ATI RN Nursing Care of Children | 2026/2027 | Proctored Exam Prep | NGN-Aligned
7. A nurse is reviewing a child's growth chart and notes the weight is at the 5th percentile for age. Which
interpretation is most accurate?
A. The child's weight is 5% below the ideal body weight for height
B. The child weighs more than 95% of children of the same age and sex
C. The child's weight is within normal range but at the lower end compared to peers of the same age
and sex
D. The child has experienced a 5% weight loss from the previous measurement
Rationale: The 5th percentile means the child's weight is greater than or equal to 5% of children of the same age
and sex in the reference population, but less than 95% of peers. A child at the 5th percentile may be normal if
growth has been consistent along that percentile curve. However, a drop of two or more percentile channels
warrants further evaluation for failure to thrive. Per CDC growth chart guidelines and ATI Nursing Care of
Children nutrition module.
8. A nurse is assessing the anterior fontanelle of a 4-month-old infant. Which finding requires further evaluation?
A. A soft, flat fontanelle that is slightly pulsatile
B. A bulging, tense fontanelle when the infant is quiet and upright
C. A fontanelle that measures approximately 2.5 x 2.5 cm
D. A fontanelle that is barely palpable and about to close
Rationale: A bulging, tense anterior fontanelle when the infant is quiet and in an upright position is an abnormal
finding suggestive of increased intracranial pressure (ICP). It may indicate conditions such as hydrocephalus,
meningitis, or intracranial hemorrhage. The anterior fontanelle normally closes between 12-18 months and
should be soft and flat. A bulging fontanelle requires immediate physician notification. Per ATI Nursing Care of
Children neurological assessment module and PALS.
9. A nurse is preparing to administer medications to a 3-year-old child. Which communication strategy is most
developmentally appropriate?
A. Explain the procedure in detail using medical terminology so the child understands
B. Use simple words, offer choices when possible, and allow the child to handle equipment to reduce
fear
C. Tell the child the procedure will not hurt to prevent anxiety
D. Have the parent leave the room to reduce the child's anxiety
Rationale: For a 3-year-old in Piaget's preoperational stage, developmentally appropriate communication
includes using simple, concrete words; offering limited choices (e.g., 'Would you like the red or blue cup?');
allowing the child to touch safe equipment; using therapeutic play; and ensuring parental presence. Lying about
pain erodes trust. The toddler stage is characterized by separation anxiety, so parental presence is crucial. Per
ATI Nursing Care of Children and AAP family-centered care guidelines.
10. A nurse is conducting a well-child visit for a 12-month-old infant. Which immunization is recommended at
this age per the CDC/AAP schedule?
A. HPV vaccine
B. DTaP, IPV, MMR, Varicella, PCV13, and Hepatitis A
C. Tdap booster and MCV4
D. Influenza and Pneumococcal polysaccharide (PPSV23) only
Rationale: At 12 months, the CDC/AAP immunization schedule includes: MMR (first dose), Varicella (first dose),
PCV13 (fourth dose), Hepatitis A (first dose, given between 12-23 months), and DTaP and IPV boosters may be
3
ATI RN NURSING CARE OF CHILDREN
PROCTORED EXAM PREP
2026/2027 | 70 Questions with Correct Answers | NGN-Aligned
Graded A+ | 100% Verified | Evidence-Based Rationales
Instructions
This examination consists of 70 multiple-choice questions designed for ATI RN Nursing Care of Children proctored
assessment preparation. The exam covers seven clinical domains: Growth and Development Milestones and Pediatric
Assessment (14 questions), Respiratory Disorders (10 questions), Cardiovascular Disorders (8 questions),
Gastrointestinal and Endocrine Disorders (10 questions), Neurological, Hematological, and Oncological Disorders (12
questions), Infectious Diseases and Immunizations (8 questions), and Pharmacology, Family-Centered Care, Ethics, and
Prioritization (8 questions). The recommended time limit is 2 hours. Content is aligned with the NCSBN Clinical
Judgment Measurement Model (CJMM) and reflects NCLEX-RN test plan competencies. Correct answers are
displayed in bold teal with evidence-based rationales referencing ATI modules, AAP guidelines, CDC schedules, and
PALS protocols.
Select the single best answer for each question. Each question is worth one point. A score of 80% (56/70) or higher
indicates NCLEX-RN readiness in the pediatric nursing content area.
Section I: Growth & Development Milestones and Pediatric Assessment
1. According to Erikson's psychosocial theory, which developmental stage is a 2-year-old child in, and what is the
primary task?
A. Trust vs Mistrust; developing a sense of basic trust through consistent caregiving
B. Autonomy vs Shame and Doubt; gaining independence and control over self
C. Initiative vs Guilt; developing a sense of purpose through play and exploration
D. Industry vs Inferiority; mastering skills and gaining competence
Rationale: A 2-year-old is in the toddler stage of Erikson's Autonomy vs Shame and Doubt. The primary
developmental task is gaining a sense of independence and control, such as learning to dress, feed, and toilet
themselves. Nurses should encourage age-appropriate choices while maintaining safe boundaries. Per ATI
Nursing Care of Children modules and NCSBN NCLEX-RN test plan.
2. A nurse is assessing a 4-year-old child. According to Piaget's cognitive development theory, in which stage is
this child?
A. Sensorimotor stage; learning through sensory experiences and motor actions
B. Preoperational stage; developing symbolic thought and magical thinking
C. Concrete operations stage; understanding logical reasoning about concrete events
D. Formal operations stage; capable of abstract and hypothetical reasoning
Rationale: A 4-year-old is in Piaget's Preoperational stage (ages 2-7 years), characterized by symbolic thought,
egocentrism, magical thinking, and animism. The child believes that inanimate objects can think and feel. Nurses
1
, ATI RN Nursing Care of Children | 2026/2027 | Proctored Exam Prep | NGN-Aligned
should use simple, concrete language and therapeutic play during assessments. Per ATI Nursing Care of
Children and AAP developmental screening guidelines.
3. A nurse is obtaining vital signs on a 6-month-old infant. Which finding is within the expected range?
A. Heart rate of 80 bpm
B. Heart rate of 140 bpm
C. Respiratory rate of 14 breaths/min
D. Blood pressure of 110/70 mmHg
Rationale: The normal heart rate for an infant (6 months) is 110-160 bpm, with the typical range cited as 120-
160 bpm. A rate of 140 bpm is within normal limits. The respiratory rate for a 6-month-old is approximately 30-
60 breaths/min, and blood pressure averages 85/50 mmHg. Per AAP Pediatric Advanced Life Support (PALS)
guidelines and ATI Nursing Care of Children vital sign reference tables.
4. Which pain assessment tool is most appropriate for a 2-year-old child who is preverbal or has limited language
ability?
A. Numeric Rating Scale (0-10)
B. Visual Analog Scale (VAS)
C. FLACC Behavioral Pain Assessment Scale
D. McGill Pain Questionnaire
Rationale: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is the most appropriate pain assessment
tool for preverbal children (ages 2 months to 7 years) or those unable to self-report. Each category is scored 0-2,
with a maximum score of 10. The Wong-Baker FACES scale is appropriate for children ages 3-7 who can point to
a face. The Numeric Rating Scale is for ages 8 and older. Per ATI Nursing Care of Children and AAP guidelines.
5. At which age should a nurse expect an infant to sit independently without support?
A. 3 months
B. 6 months
C. 8 months
D. 12 months
Rationale: Infants typically achieve independent sitting at approximately 6 months of age. The developmental
progression for gross motor milestones includes: rolling over at 4-5 months, sitting with support at 5-6 months,
sitting independently at 6 months, and crawling at 8-9 months. Nurses use the Denver II developmental screening
tool to assess milestone attainment. Per AAP Bright Futures guidelines and ATI Nursing Care of Children
developmental milestones module.
6. A nurse is performing an initial pediatric assessment using the Pediatric Assessment Triangle (PAT). The PAT
evaluates which three components?
A. Heart rate, respiratory rate, and blood pressure
B. Appearance, Work of Breathing, and Circulation to Skin
C. Level of consciousness, pupil response, and motor function
D. Temperature, oxygen saturation, and capillary refill time
Rationale: The Pediatric Assessment Triangle (PAT) is a rapid, visual-first assessment tool used in emergency
and triage settings. It evaluates: Appearance (tone, interactiveness, consolability, look/gaze, speech/cry), Work of
Breathing (abnormal positioning, retractions, audible sounds), and Circulation to Skin (pallor, mottling,
cyanosis). It takes fewer than 30 seconds and guides urgency of intervention. Per PALS and ATI Nursing Care of
Children assessment module.
2
, ATI RN Nursing Care of Children | 2026/2027 | Proctored Exam Prep | NGN-Aligned
7. A nurse is reviewing a child's growth chart and notes the weight is at the 5th percentile for age. Which
interpretation is most accurate?
A. The child's weight is 5% below the ideal body weight for height
B. The child weighs more than 95% of children of the same age and sex
C. The child's weight is within normal range but at the lower end compared to peers of the same age
and sex
D. The child has experienced a 5% weight loss from the previous measurement
Rationale: The 5th percentile means the child's weight is greater than or equal to 5% of children of the same age
and sex in the reference population, but less than 95% of peers. A child at the 5th percentile may be normal if
growth has been consistent along that percentile curve. However, a drop of two or more percentile channels
warrants further evaluation for failure to thrive. Per CDC growth chart guidelines and ATI Nursing Care of
Children nutrition module.
8. A nurse is assessing the anterior fontanelle of a 4-month-old infant. Which finding requires further evaluation?
A. A soft, flat fontanelle that is slightly pulsatile
B. A bulging, tense fontanelle when the infant is quiet and upright
C. A fontanelle that measures approximately 2.5 x 2.5 cm
D. A fontanelle that is barely palpable and about to close
Rationale: A bulging, tense anterior fontanelle when the infant is quiet and in an upright position is an abnormal
finding suggestive of increased intracranial pressure (ICP). It may indicate conditions such as hydrocephalus,
meningitis, or intracranial hemorrhage. The anterior fontanelle normally closes between 12-18 months and
should be soft and flat. A bulging fontanelle requires immediate physician notification. Per ATI Nursing Care of
Children neurological assessment module and PALS.
9. A nurse is preparing to administer medications to a 3-year-old child. Which communication strategy is most
developmentally appropriate?
A. Explain the procedure in detail using medical terminology so the child understands
B. Use simple words, offer choices when possible, and allow the child to handle equipment to reduce
fear
C. Tell the child the procedure will not hurt to prevent anxiety
D. Have the parent leave the room to reduce the child's anxiety
Rationale: For a 3-year-old in Piaget's preoperational stage, developmentally appropriate communication
includes using simple, concrete words; offering limited choices (e.g., 'Would you like the red or blue cup?');
allowing the child to touch safe equipment; using therapeutic play; and ensuring parental presence. Lying about
pain erodes trust. The toddler stage is characterized by separation anxiety, so parental presence is crucial. Per
ATI Nursing Care of Children and AAP family-centered care guidelines.
10. A nurse is conducting a well-child visit for a 12-month-old infant. Which immunization is recommended at
this age per the CDC/AAP schedule?
A. HPV vaccine
B. DTaP, IPV, MMR, Varicella, PCV13, and Hepatitis A
C. Tdap booster and MCV4
D. Influenza and Pneumococcal polysaccharide (PPSV23) only
Rationale: At 12 months, the CDC/AAP immunization schedule includes: MMR (first dose), Varicella (first dose),
PCV13 (fourth dose), Hepatitis A (first dose, given between 12-23 months), and DTaP and IPV boosters may be
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