ATI RN NURSING CARE OF CHILDREN
PROCTORED EXAMINATION
2026/2027
Comprehensive Pediatric Nursing Competency Assessment
Assessment Technologies Institute / Pre-Licensure Nursing Programs
60 Multiple-Choice Questions with Detailed Rationales
Exam-Style Practice | 100% Verified | Graded A+
Total Questions: 60 MCQ
Testing Time: 90 Minutes
Format: Computer-Based | Proctored via ATI Testing Platform
Passing Score: 75-80% (45-48/60 Correct)
Content Domains: Growth & Development | Pediatric Assessment | Family-Centered Care | Resp & Cardio
| GI/Renal/Endocrine | Neuro/Heme/Onc | Infectious Disease/Immunizations | Medication Safety
Aligned with AACN Essentials, ATI Pediatric Nursing Curriculum, and NCLEX-RN Test Plan
, TABLE OF CONTENTS
Domain 1: Growth & Development Across the Lifespan (Q1 – Q10) [17%]
Infant Milestones: Rolling/Sitting/Pincer Grasp/Stranger Anxiety (Q1 – Q3)
Toddler Development: Autonomy vs. Shame/Parallel Play (Q4 – Q5)
Preschool Skills: Initiative vs. Guilt/Imaginative Play (Q6 – Q7)
School-Age Tasks: Industry vs. Inferiority/Peer Relationships (Q8 – Q9)
Adolescent Challenges: Identity vs. Role Confusion (Q10)
Domain 2: Pediatric Assessment & Clinical Reasoning (Q11 – Q18) [13%]
Vital Signs Norms by Age: HR/RR/BP/Temperature (Q11 – Q13)
Pain Assessment Tools: FLACC/Wong-Baker/NIPS/CRIES (Q14 – Q15)
Developmental Screening & PEWS Application (Q16 – Q17)
Family-Centered Assessment: Cultural/Literacy Considerations (Q18)
Domain 3: Family-Centered Care & Therapeutic Communication (Q19 – Q25) [12%]
Therapeutic Techniques: Play/Storytelling/Honest Explanations (Q19 – Q21)
Parental Involvement: Rooming-In/Teach-Back Method (Q22 – Q23)
Sibling Support & Grief/Loss Support (Q24 – Q25)
Domain 4: Respiratory & Cardiovascular Disorders (Q26 – Q34) [15%]
Asthma Management: Stepwise Therapy/Peak Flow/Triggers (Q26 – Q28)
Bronchiolitis/RSV & Croup vs. Epiglottitis (Q29 – Q31)
Congenital Heart Defects: Acyanotic vs. Cyanotic (Q32 – Q33)
Heart Failure in Children: Digoxin/Diuretics/Activity (Q34)
Domain 5: Gastrointestinal, Renal & Endocrine Conditions (Q35 – Q42) [13%]
GERD/Pyloric Stenosis & Hirschsprung/Celiac (Q35 – Q37)
Nephrotic Syndrome/Glomerulonephritis (Q38 – Q39)
Type 1 Diabetes: Insulin/Hypoglycemia/Sick Day Rules (Q40 – Q41)
Growth Hormone/Thyroid Disorders (Q42)
Domain 6: Neurological, Hematological & Oncological Care (Q43 – Q49) [12%]
Seizure Management & Meningitis (Q43 – Q45)
Cerebral Palsy/Spina Bifida (Q46)
Sickle Cell Disease: Pain Crisis/Hydration/Infection (Q47 – Q48)
Leukemia/Lymphoma: Chemo Safety/Neutropenic Precautions (Q49)
Domain 7: Infectious Diseases, Immunizations & Emergency Care (Q50 – Q55) [10%]
Immunization Schedule & Communicable Diseases (Q50 – Q52)
Poisoning Prevention & Pediatric Trauma (Q53 – Q54)
Abuse & Neglect Recognition & Mandatory Reporting (Q55)
Domain 8: Medication Safety & Dosage Calculations (Q56 – Q60) [8%]
Weight-Based Dosing & IV Fluid Management (Q56 – Q57)
High-Alert Medications: Insulin/Heparin/Opioids (Q58 – Q59)
Administration Techniques & Family Education (Q60)
, ━━━ DOMAIN 1: GROWTH & DEVELOPMENT ACROSS THE LIFESPAN ━━━
Q1 – Q10 | 17% of Examination
▸ Infant Milestones: Rolling, Sitting, Pincer Grasp & Stranger Anxiety
1. A nurse is performing a well-baby assessment on a 6-month-old infant. The parent
expresses concern that the infant is not yet sitting independently. Which response by the
nurse is most appropriate?
A. "Your infant should be sitting independently by now; let me refer you to a developmental
specialist."
B. "Most infants begin to sit with support around 6 months and sit independently by 8
months, so this is expected."
C. "Independent sitting typically occurs by 4 months, so your infant is showing a developmental
delay."
D. "Since your infant can roll front to back, sitting independently should follow within the next
week."
Correct Answer: B
Rationale: According to developmental milestone guidelines (Hockenberry & Wilson; AAP), infants
typically sit with support at approximately 6 months and achieve independent sitting by 8 months.
The parent's concern is premature, and the infant's development is within normal limits. Reassuring
the parent with accurate anticipatory guidance is the most appropriate nursing response.
2. During a well-child visit, the nurse observes a 10-month-old infant picking up small
cereal pieces using the thumb and index finger. The parent asks if this is a normal
milestone. The nurse should explain that this grasp typically emerges at which age range?
A. 6 to 7 months
B. 8 to 9 months
C. 9 to 12 months
D. 12 to 15 months
Correct Answer: C
Rationale: The pincer grasp, which involves using the thumb and index finger to pick up small
objects, typically develops between 9 and 12 months of age. A 10-month-old demonstrating this skill
is developmentally on track. This fine motor milestone reflects maturation of the corticospinal tract
and is an important indicator of neurological development in infants.
3. A nurse is providing anticipatory guidance to the parent of a 7-month-old infant. Which
of the following statements by the parent indicate understanding of stranger anxiety?
(Select All That Apply.) [SATA]
A. "My baby may cry when a new caregiver approaches even if I am holding her."
B. "Stranger anxiety typically resolves by 6 months of age."
C. "I should encourage unfamiliar adults to approach my baby slowly and wait for her
to respond."
D. "This behavior indicates my baby is developing a healthy attachment to me."
Correct Answers: A, C, D
Rationale: Stranger anxiety typically emerges between 6 and 8 months of age, peaks around 12-15
months, and gradually resolves by approximately 24 months. It represents a normal developmental
milestone reflecting the infant's growing ability to discriminate between familiar and unfamiliar
PROCTORED EXAMINATION
2026/2027
Comprehensive Pediatric Nursing Competency Assessment
Assessment Technologies Institute / Pre-Licensure Nursing Programs
60 Multiple-Choice Questions with Detailed Rationales
Exam-Style Practice | 100% Verified | Graded A+
Total Questions: 60 MCQ
Testing Time: 90 Minutes
Format: Computer-Based | Proctored via ATI Testing Platform
Passing Score: 75-80% (45-48/60 Correct)
Content Domains: Growth & Development | Pediatric Assessment | Family-Centered Care | Resp & Cardio
| GI/Renal/Endocrine | Neuro/Heme/Onc | Infectious Disease/Immunizations | Medication Safety
Aligned with AACN Essentials, ATI Pediatric Nursing Curriculum, and NCLEX-RN Test Plan
, TABLE OF CONTENTS
Domain 1: Growth & Development Across the Lifespan (Q1 – Q10) [17%]
Infant Milestones: Rolling/Sitting/Pincer Grasp/Stranger Anxiety (Q1 – Q3)
Toddler Development: Autonomy vs. Shame/Parallel Play (Q4 – Q5)
Preschool Skills: Initiative vs. Guilt/Imaginative Play (Q6 – Q7)
School-Age Tasks: Industry vs. Inferiority/Peer Relationships (Q8 – Q9)
Adolescent Challenges: Identity vs. Role Confusion (Q10)
Domain 2: Pediatric Assessment & Clinical Reasoning (Q11 – Q18) [13%]
Vital Signs Norms by Age: HR/RR/BP/Temperature (Q11 – Q13)
Pain Assessment Tools: FLACC/Wong-Baker/NIPS/CRIES (Q14 – Q15)
Developmental Screening & PEWS Application (Q16 – Q17)
Family-Centered Assessment: Cultural/Literacy Considerations (Q18)
Domain 3: Family-Centered Care & Therapeutic Communication (Q19 – Q25) [12%]
Therapeutic Techniques: Play/Storytelling/Honest Explanations (Q19 – Q21)
Parental Involvement: Rooming-In/Teach-Back Method (Q22 – Q23)
Sibling Support & Grief/Loss Support (Q24 – Q25)
Domain 4: Respiratory & Cardiovascular Disorders (Q26 – Q34) [15%]
Asthma Management: Stepwise Therapy/Peak Flow/Triggers (Q26 – Q28)
Bronchiolitis/RSV & Croup vs. Epiglottitis (Q29 – Q31)
Congenital Heart Defects: Acyanotic vs. Cyanotic (Q32 – Q33)
Heart Failure in Children: Digoxin/Diuretics/Activity (Q34)
Domain 5: Gastrointestinal, Renal & Endocrine Conditions (Q35 – Q42) [13%]
GERD/Pyloric Stenosis & Hirschsprung/Celiac (Q35 – Q37)
Nephrotic Syndrome/Glomerulonephritis (Q38 – Q39)
Type 1 Diabetes: Insulin/Hypoglycemia/Sick Day Rules (Q40 – Q41)
Growth Hormone/Thyroid Disorders (Q42)
Domain 6: Neurological, Hematological & Oncological Care (Q43 – Q49) [12%]
Seizure Management & Meningitis (Q43 – Q45)
Cerebral Palsy/Spina Bifida (Q46)
Sickle Cell Disease: Pain Crisis/Hydration/Infection (Q47 – Q48)
Leukemia/Lymphoma: Chemo Safety/Neutropenic Precautions (Q49)
Domain 7: Infectious Diseases, Immunizations & Emergency Care (Q50 – Q55) [10%]
Immunization Schedule & Communicable Diseases (Q50 – Q52)
Poisoning Prevention & Pediatric Trauma (Q53 – Q54)
Abuse & Neglect Recognition & Mandatory Reporting (Q55)
Domain 8: Medication Safety & Dosage Calculations (Q56 – Q60) [8%]
Weight-Based Dosing & IV Fluid Management (Q56 – Q57)
High-Alert Medications: Insulin/Heparin/Opioids (Q58 – Q59)
Administration Techniques & Family Education (Q60)
, ━━━ DOMAIN 1: GROWTH & DEVELOPMENT ACROSS THE LIFESPAN ━━━
Q1 – Q10 | 17% of Examination
▸ Infant Milestones: Rolling, Sitting, Pincer Grasp & Stranger Anxiety
1. A nurse is performing a well-baby assessment on a 6-month-old infant. The parent
expresses concern that the infant is not yet sitting independently. Which response by the
nurse is most appropriate?
A. "Your infant should be sitting independently by now; let me refer you to a developmental
specialist."
B. "Most infants begin to sit with support around 6 months and sit independently by 8
months, so this is expected."
C. "Independent sitting typically occurs by 4 months, so your infant is showing a developmental
delay."
D. "Since your infant can roll front to back, sitting independently should follow within the next
week."
Correct Answer: B
Rationale: According to developmental milestone guidelines (Hockenberry & Wilson; AAP), infants
typically sit with support at approximately 6 months and achieve independent sitting by 8 months.
The parent's concern is premature, and the infant's development is within normal limits. Reassuring
the parent with accurate anticipatory guidance is the most appropriate nursing response.
2. During a well-child visit, the nurse observes a 10-month-old infant picking up small
cereal pieces using the thumb and index finger. The parent asks if this is a normal
milestone. The nurse should explain that this grasp typically emerges at which age range?
A. 6 to 7 months
B. 8 to 9 months
C. 9 to 12 months
D. 12 to 15 months
Correct Answer: C
Rationale: The pincer grasp, which involves using the thumb and index finger to pick up small
objects, typically develops between 9 and 12 months of age. A 10-month-old demonstrating this skill
is developmentally on track. This fine motor milestone reflects maturation of the corticospinal tract
and is an important indicator of neurological development in infants.
3. A nurse is providing anticipatory guidance to the parent of a 7-month-old infant. Which
of the following statements by the parent indicate understanding of stranger anxiety?
(Select All That Apply.) [SATA]
A. "My baby may cry when a new caregiver approaches even if I am holding her."
B. "Stranger anxiety typically resolves by 6 months of age."
C. "I should encourage unfamiliar adults to approach my baby slowly and wait for her
to respond."
D. "This behavior indicates my baby is developing a healthy attachment to me."
Correct Answers: A, C, D
Rationale: Stranger anxiety typically emerges between 6 and 8 months of age, peaks around 12-15
months, and gradually resolves by approximately 24 months. It represents a normal developmental
milestone reflecting the infant's growing ability to discriminate between familiar and unfamiliar
