ATI RN & PN Pediatric Nursing Exam Version 1 – Child Health
and Development Practice Questions Updated and Latest
Questions and Correct Answers with Rationale
Growth & Development
Q1. A 4-month-old infant should be able to perform which gross motor skill?
A. Sit unsupported
B. Roll from back to side
C. Crawl
D. Walk with support
Answer: B. Roll from back to side
Rationale: Rolling over typically begins at 4 months. Sitting unsupported occurs around 8
months, crawling at 6-9 months, and walking with support at 9-12 months.
Q2. According to Piaget, a toddler is in which cognitive stage?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: A. Sensorimotor (birth–2 years)
Rationale: Toddlers (12–24 months) are in the late sensorimotor stage, developing object
permanence and goal-directed behavior.
Q3. A 3-year-old child is hospitalized. Which behavior best reflects the preschooler’s concept
of illness?
A. “I got sick because I was bad.”
B. “The germs made me sick.”
C. “My friend gave me this cold.”
D. “I will be sick forever.”
Answer: A. “I got sick because I was bad.”
Rationale: Preschoolers engage in magical thinking and often believe illness is punishment for
misbehavior.
Q4. An 8-year-old child prefers playing board games with rules. This is most consistent with
which stage of Erikson’s theory?
A. Trust vs. Mistrust
,B. Autonomy vs. Shame
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: D. Industry vs. Inferiority
Rationale: School-age children (6–12 years) develop a sense of competence through structured
activities and following rules.
Q5. A nurse is assessing a 15-month-old toddler. Which finding requires further evaluation?
A. Walks independently
B. Says “mama” and “dada” specifically
C. Uses a spoon without spilling
D. Cannot point to named body parts
Answer: D. Cannot point to named body parts
Rationale: By 15 months, most children can point to at least one body part. Failure to do so may
indicate a language or developmental delay.
Pediatric Nursing Interventions
Q6. The priority nursing action for a child with moderate dehydration due to gastroenteritis is:
A. Administer antidiarrheal medication
B. Start oral rehydration solution (ORS)
C. Give clear liquids like apple juice
D. Restrict all fluids for 4 hours
Answer: B. Start oral rehydration solution (ORS)
Rationale: ORS (e.g., Pedialyte) is first-line for mild to moderate dehydration. Clear juices can
worsen diarrhea due to high sugar content.
Q7. A toddler is ordered amoxicillin suspension 250 mg PO BID. The concentration is 125 mg/5
mL. How many mL should the nurse give per dose?
A. 5 mL
B. 10 mL
C. 15 mL
D. 20 mL
Answer: B. 10 mL
Rationale: 125 mg/5 mL → 250 mg = 10 mL. (125×2=250, so 5×2=10 mL)
,Q8. When administering an IM injection to a 6-month-old infant, the preferred site is:
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Answer: C. Vastus lateralis
Rationale: The vastus lateralis is the preferred IM site for infants and young children due to
well-developed muscle mass and absence of major nerves/vessels.
Q9. A nurse is teaching parents about fever management. Which statement indicates correct
understanding?
A. “I’ll alternate acetaminophen and ibuprofen every 2 hours.”
B. “I’ll give a cold bath to bring the fever down quickly.”
C. “I’ll watch for lethargy or difficulty waking.”
D. “Fevers over 104°F are always dangerous.”
Answer: C. “I’ll watch for lethargy or difficulty waking.”
Rationale: Parental concern should focus on child’s behavior, not exact temperature. Lethargy,
irritability, or poor feeding warrant medical evaluation.
Common Pediatric Conditions
Q10. A 2-year-old presents with a barking cough, stridor, and low-grade fever. Most likely
diagnosis:
A. Epiglottitis
B. Bronchiolitis
C. Croup
D. Pertussis
Answer: C. Croup
Rationale: Croup (laryngotracheobronchitis) causes inspiratory stridor, barking cough, and
worse symptoms at night. Epiglottitis presents with high fever, drooling, and toxicity.
Q11. A child with sickle cell anemia develops sudden chest pain, fever, and cough. The nurse
suspects:
A. Acute chest syndrome
B. Simple pain crisis
C. Aplastic crisis
D. Splenic sequestration
, Answer: A. Acute chest syndrome
Rationale: Acute chest syndrome is a life-threatening complication of sickle cell disease, often
triggered by infection or fat embolism, presenting like pneumonia.
Q12. A 10-year-old with type 1 diabetes has morning blood glucose of 45 mg/dL and is
conscious. Initial action:
A. Give glucagon IM
B. Give 15 g fast-acting carbohydrate
C. Administer insulin
D. Call 911 immediately
Answer: B. Give 15 g fast-acting carbohydrate
Rationale: For conscious hypoglycemia, give 15 g carbs (e.g., 4 oz juice, glucose tablets).
Recheck in 15 minutes. Glucagon is for unconscious or seizing patients.
Safety & Immunizations
Q13. The first dose of the MMR vaccine is recommended at:
A. Birth
B. 6 months
C. 12–15 months
D. 4–6 years
Answer: C. 12–15 months
Rationale: MMR is given at 12–15 months and again at 4–6 years. Earlier doses (6 months) may
be given during outbreaks but do not count toward the series.
Q14. A nurse is teaching poison prevention to parents of a toddler. Most important
intervention:
A. Keep ipecac syrup at home
B. Store all medications in childproof containers
C. Wait for symptoms before calling poison control
D. Keep poisons in high cabinets with locks
Answer: D. Keep poisons in high cabinets with locks
Rationale: High, locked cabinets are most effective. Ipecac is no longer recommended. Call
poison control immediately — do not wait for symptoms.
Q15. Which finding in a school-age child post-head injury requires immediate intervention?
A. Vomiting once
B. Headache relieved by acetaminophen
and Development Practice Questions Updated and Latest
Questions and Correct Answers with Rationale
Growth & Development
Q1. A 4-month-old infant should be able to perform which gross motor skill?
A. Sit unsupported
B. Roll from back to side
C. Crawl
D. Walk with support
Answer: B. Roll from back to side
Rationale: Rolling over typically begins at 4 months. Sitting unsupported occurs around 8
months, crawling at 6-9 months, and walking with support at 9-12 months.
Q2. According to Piaget, a toddler is in which cognitive stage?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: A. Sensorimotor (birth–2 years)
Rationale: Toddlers (12–24 months) are in the late sensorimotor stage, developing object
permanence and goal-directed behavior.
Q3. A 3-year-old child is hospitalized. Which behavior best reflects the preschooler’s concept
of illness?
A. “I got sick because I was bad.”
B. “The germs made me sick.”
C. “My friend gave me this cold.”
D. “I will be sick forever.”
Answer: A. “I got sick because I was bad.”
Rationale: Preschoolers engage in magical thinking and often believe illness is punishment for
misbehavior.
Q4. An 8-year-old child prefers playing board games with rules. This is most consistent with
which stage of Erikson’s theory?
A. Trust vs. Mistrust
,B. Autonomy vs. Shame
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: D. Industry vs. Inferiority
Rationale: School-age children (6–12 years) develop a sense of competence through structured
activities and following rules.
Q5. A nurse is assessing a 15-month-old toddler. Which finding requires further evaluation?
A. Walks independently
B. Says “mama” and “dada” specifically
C. Uses a spoon without spilling
D. Cannot point to named body parts
Answer: D. Cannot point to named body parts
Rationale: By 15 months, most children can point to at least one body part. Failure to do so may
indicate a language or developmental delay.
Pediatric Nursing Interventions
Q6. The priority nursing action for a child with moderate dehydration due to gastroenteritis is:
A. Administer antidiarrheal medication
B. Start oral rehydration solution (ORS)
C. Give clear liquids like apple juice
D. Restrict all fluids for 4 hours
Answer: B. Start oral rehydration solution (ORS)
Rationale: ORS (e.g., Pedialyte) is first-line for mild to moderate dehydration. Clear juices can
worsen diarrhea due to high sugar content.
Q7. A toddler is ordered amoxicillin suspension 250 mg PO BID. The concentration is 125 mg/5
mL. How many mL should the nurse give per dose?
A. 5 mL
B. 10 mL
C. 15 mL
D. 20 mL
Answer: B. 10 mL
Rationale: 125 mg/5 mL → 250 mg = 10 mL. (125×2=250, so 5×2=10 mL)
,Q8. When administering an IM injection to a 6-month-old infant, the preferred site is:
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Answer: C. Vastus lateralis
Rationale: The vastus lateralis is the preferred IM site for infants and young children due to
well-developed muscle mass and absence of major nerves/vessels.
Q9. A nurse is teaching parents about fever management. Which statement indicates correct
understanding?
A. “I’ll alternate acetaminophen and ibuprofen every 2 hours.”
B. “I’ll give a cold bath to bring the fever down quickly.”
C. “I’ll watch for lethargy or difficulty waking.”
D. “Fevers over 104°F are always dangerous.”
Answer: C. “I’ll watch for lethargy or difficulty waking.”
Rationale: Parental concern should focus on child’s behavior, not exact temperature. Lethargy,
irritability, or poor feeding warrant medical evaluation.
Common Pediatric Conditions
Q10. A 2-year-old presents with a barking cough, stridor, and low-grade fever. Most likely
diagnosis:
A. Epiglottitis
B. Bronchiolitis
C. Croup
D. Pertussis
Answer: C. Croup
Rationale: Croup (laryngotracheobronchitis) causes inspiratory stridor, barking cough, and
worse symptoms at night. Epiglottitis presents with high fever, drooling, and toxicity.
Q11. A child with sickle cell anemia develops sudden chest pain, fever, and cough. The nurse
suspects:
A. Acute chest syndrome
B. Simple pain crisis
C. Aplastic crisis
D. Splenic sequestration
, Answer: A. Acute chest syndrome
Rationale: Acute chest syndrome is a life-threatening complication of sickle cell disease, often
triggered by infection or fat embolism, presenting like pneumonia.
Q12. A 10-year-old with type 1 diabetes has morning blood glucose of 45 mg/dL and is
conscious. Initial action:
A. Give glucagon IM
B. Give 15 g fast-acting carbohydrate
C. Administer insulin
D. Call 911 immediately
Answer: B. Give 15 g fast-acting carbohydrate
Rationale: For conscious hypoglycemia, give 15 g carbs (e.g., 4 oz juice, glucose tablets).
Recheck in 15 minutes. Glucagon is for unconscious or seizing patients.
Safety & Immunizations
Q13. The first dose of the MMR vaccine is recommended at:
A. Birth
B. 6 months
C. 12–15 months
D. 4–6 years
Answer: C. 12–15 months
Rationale: MMR is given at 12–15 months and again at 4–6 years. Earlier doses (6 months) may
be given during outbreaks but do not count toward the series.
Q14. A nurse is teaching poison prevention to parents of a toddler. Most important
intervention:
A. Keep ipecac syrup at home
B. Store all medications in childproof containers
C. Wait for symptoms before calling poison control
D. Keep poisons in high cabinets with locks
Answer: D. Keep poisons in high cabinets with locks
Rationale: High, locked cabinets are most effective. Ipecac is no longer recommended. Call
poison control immediately — do not wait for symptoms.
Q15. Which finding in a school-age child post-head injury requires immediate intervention?
A. Vomiting once
B. Headache relieved by acetaminophen
