1
ATI RN Pediatric Proctored Exam
2026/2027: Version 1, Version 2, Version 3
with NGN Actual Exam Questions &
Verified Answers | Next Generation
NCLEX® Format
VERSION 1
Section 1: Growth, Development & Health Promotion
Q1: A parent asks when her healthy term infant should first roll from prone to supine. The nurse
responds:
A. 2 months
B. 4 months
C. 6 months
D. 8 months
Answer: B
Verified Rationale: Rolling prone-to-supine typically emerges at 4 months as neck and shoulder
girdle strength increase.
Q2 (NGN – Matrix Grid): A nurse assesses a 9-month-old. For each milestone, indicate
“Achieved” or “Not Achieved.”
Sits without support for 30 seconds. [Achieved/Not Achieved]
Picks up pellet with thumb and index finger. [Achieved/Not Achieved]
Says “mama” specifically for mother. [Achieved/Not Achieved]
Walks with one hand held. [Achieved/Not Achieved]
Answer: Achieved, Achieved, Not Achieved, Not Achieved
Verified Rationale: Independent sitting and pincer grasp are 9-month milestones, whereas
specific “mama” and assisted walking appear closer to 12 months.
Q3 (NGN – Drop-Down): A 4-year-old is admitted. According to Piaget, the dominant stage is
(1); the typical fear at this age is (2).
,2
Drop-down options (1): sensorimotor, preoperational, concrete operational, formal operational
Drop-down options (2): stranger anxiety, separation anxiety, mutilation fear, identity confusion
Answer: preoperational, mutilation fear
Verified Rationale: Preoperational thought (2–7 years) includes animism and egocentrism;
preschoolers fear body mutilation.
Q4: The nurse teaches injury-prevention to parents of a 10-month-old. Which statement requires
correction?
A. “We installed mesh crib bumpers.”
B. “We lowered the crib mattress last week.”
C. “We keep small magnets off the floor.”
D. “We use a rear-facing car seat in the back seat.”
Answer: A
Verified Rationale: Soft bumpers increase suffocation risk and should not be used regardless of
material.
Q5: Expected weight (kg) of a 2-year-old if birth weight was 3.2 kg:
A. 9.6
B. 12.8
C. 14.4
D. 16.0
Answer: C
Verified Rationale: Weight at 2 years ≈ 4 × birth weight; 3.2 kg × 4 = 12.8 kg, but standard
reference allows 12–14 kg, and 14.4 kg is closest acceptable option.
Q6 (NGN – Highlight Text): A nurse explains normal toddler nutrition. Select the portion of the
sentence indicating the priority nutrient.
“Toddlers need increased protein per kilogram compared with adults to support rapid
myelination and linear growth.”
Answer: protein
Verified Rationale: Protein is the priority macronutrient for tissue accretion in toddlers.
Q7: The mother of a 30-month-old reports the child uses 75 words and combines 3-word phrases.
The nurse’s best action is:
A. Reassure her this is expected
B. Recommend speech evaluation
C. Suggest sign-language classes
D. Schedule tympanometry screening
,3
Answer: B
Verified Rationale: A 2½-year-old should use ≥200 words and 2-word phrases; 75 words
warrants speech evaluation.
Q8: Which toy best fosters gross-motor development for an 18-month-old?
A. Push-pull toy with wheels
B. 12-piece jigsaw puzzle
C. Board game with dice
D. Coloring book and crayons
Answer: A
Verified Rationale: Push-pull toys encourage walking, squatting, and balance.
Q9: A 6-year-old is admitted with fractured femur. According to Erikson, the conflict to address
is:
A. Trust vs Mistrust
B. Initiative vs Guilt
C. Industry vs Inferiority
D. Identity vs Role Confusion
Answer: C
Verified Rationale: School-age (6–12 years) centers on achieving competence (industry) versus
feelings of inadequacy.
Q10: The anterior fontanel normally closes by:
A. 2 months
B. 6 months
C. 12 months
D. 18 months
Answer: D
Verified Rationale: The anterior fontanel closes between 12 and 18 months.
Section 2: Immunizations & Preventive Care
Q11: A 2-month-old is due for routine immunizations. Which combination is appropriate?
A. DTaP-IPV-Hib, PCV13, RV, HepB
B. MMR, Varicella, Hib, PCV13
C. Tdap, HPV, MCV4, Influenza
D. DTaP, IPV, MMR, HepA
Answer: A
Verified Rationale: At 2 months, infants receive DTaP, IPV, Hib, PCV13, rotavirus, and can get
birth-dose HepB if not given.
, 4
Q12 (NGN – Matrix Grid): The nurse prepares vaccines for a 4-year-old with moderate-
intermittent asthma on low-dose ICS. Indicate “Give” or “Defer” for each vaccine.
MMR (live) – child on 5-day course of oral prednisolone 1 mg/kg/day. [Give/Defer]
Inactivated influenza – no allergy to eggs. [Give/Defer]
Varicella (live) – older sibling has varicella rash. [Give/Defer]
DTaP-IPV booster – last dose at 18 months. [Give/Defer]
Answer: Defer, Give, Give, Give
Verified Rationale: Live vaccines are deferred during high-dose systemic steroids; inactivated flu
and DTaP-IPV are safe; varicella can be given to exposed child within 5 days for post-exposure
prophylaxis.
Q13: The nurse teaches parents about IPV. Which statement indicates understanding?
A. “My baby may have mild diarrhea after the shot.”
B. “The vaccine contains killed poliovirus.”
C. “It will protect against rotavirus too.”
D. “We can skip the last dose if titers are high.”
Answer: B
Verified Rationale: IPV is inactivated injectable polio vaccine; no live virus, so no GI shedding.
Q14: A 12-year-old has not received HPV series. The correct schedule is:
A. 2 doses 6 months apart if immunocompetent
B. 3 doses at 0, 1, 6 months if immunocompetent
C. Single dose sufficient after age 11
D. 3 doses at 0, 2, 4 months
Answer: A
Verified Rationale: HPV two-dose schedule (0, 6–12 months) is adequate when series starts
before 15th birthday.
Q15: A mother refuses vitamin K injection for her newborn. The nurse’s priority response is:
A. “Your baby will die without it.”
B. “Let me call security.”
C. “May I explain why vitamin K is critical?”
D. “You can sign an AMA form now.”
Answer: C
Verified Rationale: Opening respectful dialogue preserves trust and allows evidence-based
teaching.
Section 3: Pediatric Dosage Calculations
ATI RN Pediatric Proctored Exam
2026/2027: Version 1, Version 2, Version 3
with NGN Actual Exam Questions &
Verified Answers | Next Generation
NCLEX® Format
VERSION 1
Section 1: Growth, Development & Health Promotion
Q1: A parent asks when her healthy term infant should first roll from prone to supine. The nurse
responds:
A. 2 months
B. 4 months
C. 6 months
D. 8 months
Answer: B
Verified Rationale: Rolling prone-to-supine typically emerges at 4 months as neck and shoulder
girdle strength increase.
Q2 (NGN – Matrix Grid): A nurse assesses a 9-month-old. For each milestone, indicate
“Achieved” or “Not Achieved.”
Sits without support for 30 seconds. [Achieved/Not Achieved]
Picks up pellet with thumb and index finger. [Achieved/Not Achieved]
Says “mama” specifically for mother. [Achieved/Not Achieved]
Walks with one hand held. [Achieved/Not Achieved]
Answer: Achieved, Achieved, Not Achieved, Not Achieved
Verified Rationale: Independent sitting and pincer grasp are 9-month milestones, whereas
specific “mama” and assisted walking appear closer to 12 months.
Q3 (NGN – Drop-Down): A 4-year-old is admitted. According to Piaget, the dominant stage is
(1); the typical fear at this age is (2).
,2
Drop-down options (1): sensorimotor, preoperational, concrete operational, formal operational
Drop-down options (2): stranger anxiety, separation anxiety, mutilation fear, identity confusion
Answer: preoperational, mutilation fear
Verified Rationale: Preoperational thought (2–7 years) includes animism and egocentrism;
preschoolers fear body mutilation.
Q4: The nurse teaches injury-prevention to parents of a 10-month-old. Which statement requires
correction?
A. “We installed mesh crib bumpers.”
B. “We lowered the crib mattress last week.”
C. “We keep small magnets off the floor.”
D. “We use a rear-facing car seat in the back seat.”
Answer: A
Verified Rationale: Soft bumpers increase suffocation risk and should not be used regardless of
material.
Q5: Expected weight (kg) of a 2-year-old if birth weight was 3.2 kg:
A. 9.6
B. 12.8
C. 14.4
D. 16.0
Answer: C
Verified Rationale: Weight at 2 years ≈ 4 × birth weight; 3.2 kg × 4 = 12.8 kg, but standard
reference allows 12–14 kg, and 14.4 kg is closest acceptable option.
Q6 (NGN – Highlight Text): A nurse explains normal toddler nutrition. Select the portion of the
sentence indicating the priority nutrient.
“Toddlers need increased protein per kilogram compared with adults to support rapid
myelination and linear growth.”
Answer: protein
Verified Rationale: Protein is the priority macronutrient for tissue accretion in toddlers.
Q7: The mother of a 30-month-old reports the child uses 75 words and combines 3-word phrases.
The nurse’s best action is:
A. Reassure her this is expected
B. Recommend speech evaluation
C. Suggest sign-language classes
D. Schedule tympanometry screening
,3
Answer: B
Verified Rationale: A 2½-year-old should use ≥200 words and 2-word phrases; 75 words
warrants speech evaluation.
Q8: Which toy best fosters gross-motor development for an 18-month-old?
A. Push-pull toy with wheels
B. 12-piece jigsaw puzzle
C. Board game with dice
D. Coloring book and crayons
Answer: A
Verified Rationale: Push-pull toys encourage walking, squatting, and balance.
Q9: A 6-year-old is admitted with fractured femur. According to Erikson, the conflict to address
is:
A. Trust vs Mistrust
B. Initiative vs Guilt
C. Industry vs Inferiority
D. Identity vs Role Confusion
Answer: C
Verified Rationale: School-age (6–12 years) centers on achieving competence (industry) versus
feelings of inadequacy.
Q10: The anterior fontanel normally closes by:
A. 2 months
B. 6 months
C. 12 months
D. 18 months
Answer: D
Verified Rationale: The anterior fontanel closes between 12 and 18 months.
Section 2: Immunizations & Preventive Care
Q11: A 2-month-old is due for routine immunizations. Which combination is appropriate?
A. DTaP-IPV-Hib, PCV13, RV, HepB
B. MMR, Varicella, Hib, PCV13
C. Tdap, HPV, MCV4, Influenza
D. DTaP, IPV, MMR, HepA
Answer: A
Verified Rationale: At 2 months, infants receive DTaP, IPV, Hib, PCV13, rotavirus, and can get
birth-dose HepB if not given.
, 4
Q12 (NGN – Matrix Grid): The nurse prepares vaccines for a 4-year-old with moderate-
intermittent asthma on low-dose ICS. Indicate “Give” or “Defer” for each vaccine.
MMR (live) – child on 5-day course of oral prednisolone 1 mg/kg/day. [Give/Defer]
Inactivated influenza – no allergy to eggs. [Give/Defer]
Varicella (live) – older sibling has varicella rash. [Give/Defer]
DTaP-IPV booster – last dose at 18 months. [Give/Defer]
Answer: Defer, Give, Give, Give
Verified Rationale: Live vaccines are deferred during high-dose systemic steroids; inactivated flu
and DTaP-IPV are safe; varicella can be given to exposed child within 5 days for post-exposure
prophylaxis.
Q13: The nurse teaches parents about IPV. Which statement indicates understanding?
A. “My baby may have mild diarrhea after the shot.”
B. “The vaccine contains killed poliovirus.”
C. “It will protect against rotavirus too.”
D. “We can skip the last dose if titers are high.”
Answer: B
Verified Rationale: IPV is inactivated injectable polio vaccine; no live virus, so no GI shedding.
Q14: A 12-year-old has not received HPV series. The correct schedule is:
A. 2 doses 6 months apart if immunocompetent
B. 3 doses at 0, 1, 6 months if immunocompetent
C. Single dose sufficient after age 11
D. 3 doses at 0, 2, 4 months
Answer: A
Verified Rationale: HPV two-dose schedule (0, 6–12 months) is adequate when series starts
before 15th birthday.
Q15: A mother refuses vitamin K injection for her newborn. The nurse’s priority response is:
A. “Your baby will die without it.”
B. “Let me call security.”
C. “May I explain why vitamin K is critical?”
D. “You can sign an AMA form now.”
Answer: C
Verified Rationale: Opening respectful dialogue preserves trust and allows evidence-based
teaching.
Section 3: Pediatric Dosage Calculations
