VATI PN Care of Children Assessment (2026)
NGN-Style Questions | VATI Nursing Exam
Questions
SECTION 1: Growth & Development Milestones (Infant to Adolescent)
Questions 1–12
Q1: A PN is assessing a 4-month-old infant during a well-child visit. Which finding requires
immediate follow-up?
A. Anterior fontanelle that is flat and soft
B. Birth weight that has doubled since birth
C. Head lag when pulled from supine to sitting
D. Social smile in response to parent's face
Correct Answer: C
Rationale: Correct because by 4 months, head lag should be absent. Persistent head lag
indicates possible neuromuscular delay or hypotonia requiring further evaluation. The anterior
fontanelle normally remains open and soft until 12–18 months. Birth weight typically doubles
by 4–6 months. Social smile emerges by 2 months and is a normal finding.
Q2: A PN is teaching parents about expected developmental milestones for their 9-month-old
infant. Which activity should the PN include as appropriate for this age?
A. Building a tower of two cubes
B. Using a mature pincer grasp
C. Walking while holding furniture
D. Saying "mama" with meaning
Correct Answer: B
Rationale: Correct because a mature pincer grasp (using thumb and forefinger) typically
develops between 9–12 months. Building a tower of two cubes occurs at approximately 15
months. Walking while holding furniture (cruising) typically begins around 10–12 months.
,Saying "mama" with specific meaning usually occurs around 10–12 months, though babbling
consonants may appear earlier.
Q3: During a well-child visit, a PN assesses a 2-year-old toddler. According to Erikson's stages of
psychosocial development, which behavior indicates successful resolution of the current
developmental stage?
A. The child clings to the parent and refuses to explore the exam room
B. The child demonstrates autonomy by attempting to remove their own shoes
C. The child shows initiative by planning a complex block structure
D. The child cooperates with the exam while maintaining eye contact with the parent
Correct Answer: B
Rationale: Correct because Erikson's stage for toddlers (1–3 years) is Autonomy vs. Shame and
Doubt. Successful resolution is demonstrated by the child asserting independence and
attempting self-care tasks such as removing shoes. Clinging behavior indicates shame and
doubt. Initiative (planning complex activities) is the stage for preschoolers (3–6 years).
Cooperative behavior with maintained eye contact is more characteristic of school-age children.
Q4: A PN is evaluating a 6-year-old child using Piaget's theory of cognitive development. Which
statement by the child indicates typical thinking for this age?
A. "My teddy bear is sad because I left him home alone."
B. "The moon follows me when I walk because it likes me."
C. "If I drink my milk, I will grow as tall as my dad."
D. "Water looks different in this tall glass, but it's the same amount."
Correct Answer: C
Rationale: Correct because at age 6, children are in Piaget's preoperational stage (2–7 years),
characterized by egocentrism, animism, and magical thinking. The statement about growing tall
by drinking milk represents magical thinking typical of this stage. Animism (attributing life to
objects) is seen in option A. Egocentrism is demonstrated in option B. Conservation
understanding (option D) occurs in the concrete operational stage (7–11 years).
, Q5: A PN is assessing a 12-year-old female client during a school physical. The parent reports
the child has grown 3 inches in the past year and has begun developing breast buds. Which
response by the PN is most appropriate?
A. "This growth pattern indicates precocious puberty and requires endocrine evaluation."
B. "These changes are consistent with Tanner stage 2 and normal pubertal development."
C. "Your daughter should be evaluated for growth hormone deficiency."
D. "These physical changes are abnormal for a 12-year-old female."
Correct Answer: B
Rationale: Correct because breast budding (thelarche) and rapid linear growth are characteristic
of Tanner stage 2, which typically occurs between ages 8–13 in females. This represents normal
pubertal onset. Precocious puberty is diagnosed before age 8 in females. Growth hormone
deficiency would present with growth failure, not accelerated growth. These changes are
expected and normal for this age.
Q6: A PN is caring for a 15-year-old adolescent who was admitted for appendicitis. The client
refuses to have the parent present during the physical assessment and requests pain
medication without parental consultation. Which action by the PN is most appropriate?
A. Insist the parent remain present because the client is a minor
B. Honor the client's request and maintain confidentiality per adolescent rights
C. Contact the physician to determine if the client can make independent decisions
D. Require the parent to sign consent for all pain medication administration
Correct Answer: B
Rationale: Correct because adolescents have the right to confidential healthcare regarding
reproductive health, substance use, and mental health in many jurisdictions. Additionally,
mature minors may consent to treatment depending on state laws. The PN should respect the
adolescent's developing autonomy while ensuring appropriate care. Refusing the adolescent's
request violates their rights and may damage therapeutic trust. The physician does not
determine decision-making capacity in this context.
Q7: A PN is teaching parents about language development in their 18-month-old toddler. Which
finding should the PN report as requiring further evaluation?
A. The child uses approximately 10 words consistently
B. The child points to desired objects instead of verbalizing
NGN-Style Questions | VATI Nursing Exam
Questions
SECTION 1: Growth & Development Milestones (Infant to Adolescent)
Questions 1–12
Q1: A PN is assessing a 4-month-old infant during a well-child visit. Which finding requires
immediate follow-up?
A. Anterior fontanelle that is flat and soft
B. Birth weight that has doubled since birth
C. Head lag when pulled from supine to sitting
D. Social smile in response to parent's face
Correct Answer: C
Rationale: Correct because by 4 months, head lag should be absent. Persistent head lag
indicates possible neuromuscular delay or hypotonia requiring further evaluation. The anterior
fontanelle normally remains open and soft until 12–18 months. Birth weight typically doubles
by 4–6 months. Social smile emerges by 2 months and is a normal finding.
Q2: A PN is teaching parents about expected developmental milestones for their 9-month-old
infant. Which activity should the PN include as appropriate for this age?
A. Building a tower of two cubes
B. Using a mature pincer grasp
C. Walking while holding furniture
D. Saying "mama" with meaning
Correct Answer: B
Rationale: Correct because a mature pincer grasp (using thumb and forefinger) typically
develops between 9–12 months. Building a tower of two cubes occurs at approximately 15
months. Walking while holding furniture (cruising) typically begins around 10–12 months.
,Saying "mama" with specific meaning usually occurs around 10–12 months, though babbling
consonants may appear earlier.
Q3: During a well-child visit, a PN assesses a 2-year-old toddler. According to Erikson's stages of
psychosocial development, which behavior indicates successful resolution of the current
developmental stage?
A. The child clings to the parent and refuses to explore the exam room
B. The child demonstrates autonomy by attempting to remove their own shoes
C. The child shows initiative by planning a complex block structure
D. The child cooperates with the exam while maintaining eye contact with the parent
Correct Answer: B
Rationale: Correct because Erikson's stage for toddlers (1–3 years) is Autonomy vs. Shame and
Doubt. Successful resolution is demonstrated by the child asserting independence and
attempting self-care tasks such as removing shoes. Clinging behavior indicates shame and
doubt. Initiative (planning complex activities) is the stage for preschoolers (3–6 years).
Cooperative behavior with maintained eye contact is more characteristic of school-age children.
Q4: A PN is evaluating a 6-year-old child using Piaget's theory of cognitive development. Which
statement by the child indicates typical thinking for this age?
A. "My teddy bear is sad because I left him home alone."
B. "The moon follows me when I walk because it likes me."
C. "If I drink my milk, I will grow as tall as my dad."
D. "Water looks different in this tall glass, but it's the same amount."
Correct Answer: C
Rationale: Correct because at age 6, children are in Piaget's preoperational stage (2–7 years),
characterized by egocentrism, animism, and magical thinking. The statement about growing tall
by drinking milk represents magical thinking typical of this stage. Animism (attributing life to
objects) is seen in option A. Egocentrism is demonstrated in option B. Conservation
understanding (option D) occurs in the concrete operational stage (7–11 years).
, Q5: A PN is assessing a 12-year-old female client during a school physical. The parent reports
the child has grown 3 inches in the past year and has begun developing breast buds. Which
response by the PN is most appropriate?
A. "This growth pattern indicates precocious puberty and requires endocrine evaluation."
B. "These changes are consistent with Tanner stage 2 and normal pubertal development."
C. "Your daughter should be evaluated for growth hormone deficiency."
D. "These physical changes are abnormal for a 12-year-old female."
Correct Answer: B
Rationale: Correct because breast budding (thelarche) and rapid linear growth are characteristic
of Tanner stage 2, which typically occurs between ages 8–13 in females. This represents normal
pubertal onset. Precocious puberty is diagnosed before age 8 in females. Growth hormone
deficiency would present with growth failure, not accelerated growth. These changes are
expected and normal for this age.
Q6: A PN is caring for a 15-year-old adolescent who was admitted for appendicitis. The client
refuses to have the parent present during the physical assessment and requests pain
medication without parental consultation. Which action by the PN is most appropriate?
A. Insist the parent remain present because the client is a minor
B. Honor the client's request and maintain confidentiality per adolescent rights
C. Contact the physician to determine if the client can make independent decisions
D. Require the parent to sign consent for all pain medication administration
Correct Answer: B
Rationale: Correct because adolescents have the right to confidential healthcare regarding
reproductive health, substance use, and mental health in many jurisdictions. Additionally,
mature minors may consent to treatment depending on state laws. The PN should respect the
adolescent's developing autonomy while ensuring appropriate care. Refusing the adolescent's
request violates their rights and may damage therapeutic trust. The physician does not
determine decision-making capacity in this context.
Q7: A PN is teaching parents about language development in their 18-month-old toddler. Which
finding should the PN report as requiring further evaluation?
A. The child uses approximately 10 words consistently
B. The child points to desired objects instead of verbalizing
