ATI Pediatrics Proctored Exam Practice Questions and Answers Updated
2026 | Complete Pediatric Nursing Study Guide with Verified Questions,
Detailed Rationales, Growth & Development, Pediatric Pharmacology,
Respiratory Disorders, Infectious Diseases, Immunizations, Fluid &
Electrolyte Balance, Safety & Infection Control, Family-Centered Care &
NGN NCLEX Exam Prep
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit.
Which of the following developmental milestones should the nurse expect the
infant to demonstrate?
A. Pincer grasp
B. Sitting without support
C. Rolling from back to abdomen
D. Transferring objects hand-to-hand
CORRECT ANSWER: C. Rolling from back to abdomen
Rationale: By 6 months of age, infants typically achieve the motor milestone of rolling
from back to abdomen. The pincer grasp and transferring objects hand-to-hand
typically develop around 9-10 months. Sitting without support is usually achieved by 8
months. Recognizing age-appropriate milestones is essential for pediatric growth and
development assessment.
Question 2: A nurse is preparing to administer an intramuscular injection to a 4-
month-old infant. Which site is the preferred choice for this procedure?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
CORRECT ANSWER: C. Vastus lateralis
Rationale: The vastus lateralis muscle is the preferred site for intramuscular injections
in infants and young children because it is well-developed at birth, free of major nerves
and blood vessels, and can accommodate small to moderate volumes. The deltoid is
generally used for older children and adults, while the ventrogluteal may be used in
children who have been walking for at least one year. The dorsogluteal site is avoided in
pediatric patients due to the risk of sciatic nerve injury.
Question 3: A nurse is caring for a toddler who has been diagnosed with acute otitis
media. The parent asks why the child pulls at their ear. Which response should the
nurse provide?
A. "Ear pulling is a sign of teething discomfort."
B. "This behavior indicates the child is experiencing ear pain."
C. "Toddlers pull their ears when they are tired."
D. "Ear pulling suggests the child has a foreign body in the ear."
, CORRECT ANSWER: B. "This behavior indicates the child is experiencing ear pain."
Rationale: In toddlers, ear pulling or tugging is a common nonverbal indicator of ear
pain associated with acute otitis media. While teething or fatigue may cause irritability,
ear-specific behaviors in the context of infection typically reflect discomfort from
middle ear inflammation and pressure. The nurse should assess for additional signs
such as fever, irritability, or drainage.
Question 4: A nurse is teaching a parent about safe sleep practices to reduce the
risk of sudden infant death syndrome (SIDS). Which instruction should the nurse
include?
A. Place the infant on their side for sleep.
B. Use a soft mattress with loose bedding.
C. Position the infant supine for all sleep periods.
D. Allow the infant to sleep in an adult bed with parents.
CORRECT ANSWER: C. Position the infant supine for all sleep periods.
Rationale: The American Academy of Pediatrics recommends placing infants in a
supine (back-lying) position for all sleep periods to reduce the risk of SIDS. Side-lying is
unstable and increases risk. Soft bedding, loose blankets, pillows, and bed-sharing with
adults are associated with suffocation hazards and should be avoided. A firm sleep
surface with no soft objects is essential.
Question 5: A nurse is assessing a preschool-age child who has a fever of 39.4°C
(103°F). Which finding should the nurse identify as an early sign of respiratory
distress?
A. Cyanosis
B. Bradycardia
C. Nasal flaring
D. Decreased level of consciousness
CORRECT ANSWER: C. Nasal flaring
Rationale: Early signs of respiratory distress in pediatric patients include tachypnea,
nasal flaring, retractions, and restlessness. Cyanosis, bradycardia, and decreased level
of consciousness are late and ominous signs indicating severe hypoxia and potential
respiratory failure. Prompt recognition of early signs allows for timely intervention.
Question 6: A nurse is calculating a medication dose for a child who weighs 44 lb.
The prescribed dose is 5 mg/kg. How many mg should the nurse administer?
(Round to the nearest whole number.)
A. 50 mg
B. 100 mg
C. 150 mg
D. 200 mg
2026 | Complete Pediatric Nursing Study Guide with Verified Questions,
Detailed Rationales, Growth & Development, Pediatric Pharmacology,
Respiratory Disorders, Infectious Diseases, Immunizations, Fluid &
Electrolyte Balance, Safety & Infection Control, Family-Centered Care &
NGN NCLEX Exam Prep
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit.
Which of the following developmental milestones should the nurse expect the
infant to demonstrate?
A. Pincer grasp
B. Sitting without support
C. Rolling from back to abdomen
D. Transferring objects hand-to-hand
CORRECT ANSWER: C. Rolling from back to abdomen
Rationale: By 6 months of age, infants typically achieve the motor milestone of rolling
from back to abdomen. The pincer grasp and transferring objects hand-to-hand
typically develop around 9-10 months. Sitting without support is usually achieved by 8
months. Recognizing age-appropriate milestones is essential for pediatric growth and
development assessment.
Question 2: A nurse is preparing to administer an intramuscular injection to a 4-
month-old infant. Which site is the preferred choice for this procedure?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
CORRECT ANSWER: C. Vastus lateralis
Rationale: The vastus lateralis muscle is the preferred site for intramuscular injections
in infants and young children because it is well-developed at birth, free of major nerves
and blood vessels, and can accommodate small to moderate volumes. The deltoid is
generally used for older children and adults, while the ventrogluteal may be used in
children who have been walking for at least one year. The dorsogluteal site is avoided in
pediatric patients due to the risk of sciatic nerve injury.
Question 3: A nurse is caring for a toddler who has been diagnosed with acute otitis
media. The parent asks why the child pulls at their ear. Which response should the
nurse provide?
A. "Ear pulling is a sign of teething discomfort."
B. "This behavior indicates the child is experiencing ear pain."
C. "Toddlers pull their ears when they are tired."
D. "Ear pulling suggests the child has a foreign body in the ear."
, CORRECT ANSWER: B. "This behavior indicates the child is experiencing ear pain."
Rationale: In toddlers, ear pulling or tugging is a common nonverbal indicator of ear
pain associated with acute otitis media. While teething or fatigue may cause irritability,
ear-specific behaviors in the context of infection typically reflect discomfort from
middle ear inflammation and pressure. The nurse should assess for additional signs
such as fever, irritability, or drainage.
Question 4: A nurse is teaching a parent about safe sleep practices to reduce the
risk of sudden infant death syndrome (SIDS). Which instruction should the nurse
include?
A. Place the infant on their side for sleep.
B. Use a soft mattress with loose bedding.
C. Position the infant supine for all sleep periods.
D. Allow the infant to sleep in an adult bed with parents.
CORRECT ANSWER: C. Position the infant supine for all sleep periods.
Rationale: The American Academy of Pediatrics recommends placing infants in a
supine (back-lying) position for all sleep periods to reduce the risk of SIDS. Side-lying is
unstable and increases risk. Soft bedding, loose blankets, pillows, and bed-sharing with
adults are associated with suffocation hazards and should be avoided. A firm sleep
surface with no soft objects is essential.
Question 5: A nurse is assessing a preschool-age child who has a fever of 39.4°C
(103°F). Which finding should the nurse identify as an early sign of respiratory
distress?
A. Cyanosis
B. Bradycardia
C. Nasal flaring
D. Decreased level of consciousness
CORRECT ANSWER: C. Nasal flaring
Rationale: Early signs of respiratory distress in pediatric patients include tachypnea,
nasal flaring, retractions, and restlessness. Cyanosis, bradycardia, and decreased level
of consciousness are late and ominous signs indicating severe hypoxia and potential
respiratory failure. Prompt recognition of early signs allows for timely intervention.
Question 6: A nurse is calculating a medication dose for a child who weighs 44 lb.
The prescribed dose is 5 mg/kg. How many mg should the nurse administer?
(Round to the nearest whole number.)
A. 50 mg
B. 100 mg
C. 150 mg
D. 200 mg
