NGN ATI Pediatrics Proctored Exam 2026: 450+
Practice Questions & Detailed Rationales | Latest
Update | Pass Guaranteed
Ace the ATI Pediatrics Proctored Exam with the most comprehensive, up-to-date study
guide for 2026! This resource features 450+ practice questions with detailed Rationales,
including NGN-style case scenarios to build clinical judgment. Covering key topics: growth
& development milestones, immunization schedules, pediatric pharmacology, and priority
interventions for respiratory, cardiac, and infectious diseases. Written for nursing students
at top universities. Pass with confidence on your first attempt or your money back!
Includes 3 practice exams mirroring the actual ATI testing format. Download now and start
mastering the content today!
,1. A nurse is assessing a 2-week-old newborn during a home visit. The nurse notes the
infant's skin and sclera appear yellow. The mother reports the infant is feeding well and
has at least 6 wet diapers per day. Which of the following actions should the nurse take?
A. Instruct the mother to stop breastfeeding for 24 hours.
B. Obtain a heel-stick blood sample for a bilirubin level.
C. Advise the mother to expose the infant to direct sunlight for 30 minutes twice daily.
D. Reassure the mother that this is normal physiological jaundice and no action is
needed.
*Correct Answer: B. Obtain a heel-stick blood sample for a bilirubin level. *
Rationale: Jaundice persisting beyond 2 weeks in a breastfed infant may indicate breast
milk jaundice or underlying pathology. A bilirubin level is needed to rule out pathological
causes. Discontinuing breastfeeding is not recommended; sunlight is not a safe or
controlled therapy; and reassurance without assessment is inappropriate for prolonged
jaundice.
2. A nurse is providing developmental screening for a 4-month-old infant. Which of the
following milestones should the nurse expect the infant to have achieved?
A. Sitting independently without support.
B. Transferring an object from one hand to the other.
C. Holding the head erect and steady when sitting with support.
D. Picking up small objects using a crude pincer grasp.
*Correct Answer: C. Holding the head erect and steady when sitting with support. *
Rationale: At 4 months, infants have good head control and can hold their head steady
when supported in a sitting position. Sitting independently occurs around 6-8 months;
transferring objects occurs at 6-7 months; pincer grasp develops at 9-10 months.
3. A nurse is assessing a 6-year-old child who has a history of asthma. Which of the
following findings should alert the nurse that the child is experiencing an acute
exacerbation?
A. Peak expiratory flow rate (PEFR) of 85% of personal best.
B. Oxygen saturation of 97% on room air.
C. Audible expiratory wheezing with a prolonged expiratory phase.
D. Respiratory rate of 20 breaths per minute.
*Correct Answer: C. Audible expiratory wheezing with a prolonged expiratory phase. *
Rationale: Audible wheezing and a prolonged expiratory phase indicate airway
narrowing and air trapping, hallmark signs of an acute asthma exacerbation. A PEFR of
, 85% is in the green zone (stable); O2 sat of 97% is normal; a respiratory rate of 20 is
normal for a 6-year-old.
4. A nurse is preparing to administer the MMR vaccine to a 12-month-old infant. Which of
the following is a valid contraindication to receiving this vaccine?
A. A current temperature of 38°C (100.4°F) from a mild cold.
B. A history of a severe anaphylactic reaction to gelatin.
C. A sibling at home who is receiving chemotherapy.
D. A recent exposure to a child who has chickenpox.
*Correct Answer: B. A history of a severe anaphylactic reaction to gelatin. *
Rationale: The MMR vaccine contains gelatin and neomycin; a severe allergic reaction to
these components is an absolute contraindication. A mild fever is not a contraindication;
it is a precaution. Having an immunocompromised sibling is a reason for family members
to be vaccinated (to protect the sibling), not a reason to withhold it. Chickenpox exposure
does not contraindicate the MMR vaccine.
5. A nurse is assessing a 10-year-old child who has acute glomerulonephritis. Which of the
following findings should the nurse expect?
A. Polyuria and polydipsia.
B. Tea-colored urine and periorbital edema.
C. Clear, colorless urine and hypotension.
D. Foul-smelling urine and suprapubic pain.
*Correct Answer: B. Tea-colored urine and periorbital edema. *
Rationale: Acute glomerulonephritis typically presents with hematuria (tea-colored or
cola-colored urine), proteinuria, and periorbital edema due to fluid retention and
decreased glomerular filtration. Polyuria and polydipsia are signs of diabetes. Foul-
smelling urine and suprapubic pain suggest a urinary tract infection.
6. A nurse is caring for a child who is receiving chemotherapy and has a platelet count of
20,000/mm³. Which of the following precautions should the nurse implement?
A. Place the child in a private room with positive-pressure airflow.
B. Use a soft-bristled toothbrush for oral care.
C. Restrict all visitors and staff with any respiratory symptoms.
D. Administer all medications via the intramuscular route.
*Correct Answer: B. Use a soft-bristled toothbrush for oral care. *
, Rationale: A platelet count of 20,000/mm³ indicates severe thrombocytopenia and a
high risk for bleeding. A soft-bristled toothbrush minimizes trauma to the gums. Positive-
pressure rooms and visitor restrictions are for neutropenic precautions (low WBC), not
low platelets. IM injections are avoided due to bleeding risk.
7. A nurse is assessing a 4-year-old child for signs of increased intracranial pressure (ICP)
following a head injury. Which of the following findings is an early manifestation?
A. Bradycardia and hypertension.
B. Sunsetting eyes and decerebrate posturing.
C. Irritability and high-pitched cry.
D. Nausea and vomiting without preceding fever.
*Correct Answer: D. Nausea and vomiting without preceding fever. *
Rationale: Vomiting, especially projectile vomiting without nausea or fever, is an early
sign of increased ICP in children due to pressure on the vomiting center. Bradycardia and
hypertension are late (Cushing's triad) signs. Sunsetting eyes and posturing are late,
ominous signs. A high-pitched cry is an early sign in infants, but less specific for a 4-year-
old than vomiting.
8. A nurse is teaching a parent about preventing sudden infant death syndrome (SIDS).
Which of the following instructions should the nurse include?
A. Place the infant on a soft, memory-foam mattress for comfort.
B. Use a home cardiorespiratory monitor for all infants under 6 months.
C. Offer a pacifier at naptime and bedtime once breastfeeding is established.
D. Keep the room temperature above 72°F (22°C) to prevent chilling.
*Correct Answer: C. Offer a pacifier at naptime and bedtime once breastfeeding is
established. *
Rationale: Pacifier use during sleep has been shown to reduce the risk of SIDS and should
be offered once breastfeeding is well-established (usually 3-4 weeks). Infants should
sleep on a firm, flat surface, not soft mattresses. Home monitors are not recommended
to prevent SIDS in healthy infants. The room should be kept at a comfortable
temperature, not overheated, as overheating increases SIDS risk.
9. A nurse is caring for a child with a diagnosis of Kawasaki disease. Which of the following
clinical findings should the nurse expect?
A. Desquamation of the fingers and toes.
Practice Questions & Detailed Rationales | Latest
Update | Pass Guaranteed
Ace the ATI Pediatrics Proctored Exam with the most comprehensive, up-to-date study
guide for 2026! This resource features 450+ practice questions with detailed Rationales,
including NGN-style case scenarios to build clinical judgment. Covering key topics: growth
& development milestones, immunization schedules, pediatric pharmacology, and priority
interventions for respiratory, cardiac, and infectious diseases. Written for nursing students
at top universities. Pass with confidence on your first attempt or your money back!
Includes 3 practice exams mirroring the actual ATI testing format. Download now and start
mastering the content today!
,1. A nurse is assessing a 2-week-old newborn during a home visit. The nurse notes the
infant's skin and sclera appear yellow. The mother reports the infant is feeding well and
has at least 6 wet diapers per day. Which of the following actions should the nurse take?
A. Instruct the mother to stop breastfeeding for 24 hours.
B. Obtain a heel-stick blood sample for a bilirubin level.
C. Advise the mother to expose the infant to direct sunlight for 30 minutes twice daily.
D. Reassure the mother that this is normal physiological jaundice and no action is
needed.
*Correct Answer: B. Obtain a heel-stick blood sample for a bilirubin level. *
Rationale: Jaundice persisting beyond 2 weeks in a breastfed infant may indicate breast
milk jaundice or underlying pathology. A bilirubin level is needed to rule out pathological
causes. Discontinuing breastfeeding is not recommended; sunlight is not a safe or
controlled therapy; and reassurance without assessment is inappropriate for prolonged
jaundice.
2. A nurse is providing developmental screening for a 4-month-old infant. Which of the
following milestones should the nurse expect the infant to have achieved?
A. Sitting independently without support.
B. Transferring an object from one hand to the other.
C. Holding the head erect and steady when sitting with support.
D. Picking up small objects using a crude pincer grasp.
*Correct Answer: C. Holding the head erect and steady when sitting with support. *
Rationale: At 4 months, infants have good head control and can hold their head steady
when supported in a sitting position. Sitting independently occurs around 6-8 months;
transferring objects occurs at 6-7 months; pincer grasp develops at 9-10 months.
3. A nurse is assessing a 6-year-old child who has a history of asthma. Which of the
following findings should alert the nurse that the child is experiencing an acute
exacerbation?
A. Peak expiratory flow rate (PEFR) of 85% of personal best.
B. Oxygen saturation of 97% on room air.
C. Audible expiratory wheezing with a prolonged expiratory phase.
D. Respiratory rate of 20 breaths per minute.
*Correct Answer: C. Audible expiratory wheezing with a prolonged expiratory phase. *
Rationale: Audible wheezing and a prolonged expiratory phase indicate airway
narrowing and air trapping, hallmark signs of an acute asthma exacerbation. A PEFR of
, 85% is in the green zone (stable); O2 sat of 97% is normal; a respiratory rate of 20 is
normal for a 6-year-old.
4. A nurse is preparing to administer the MMR vaccine to a 12-month-old infant. Which of
the following is a valid contraindication to receiving this vaccine?
A. A current temperature of 38°C (100.4°F) from a mild cold.
B. A history of a severe anaphylactic reaction to gelatin.
C. A sibling at home who is receiving chemotherapy.
D. A recent exposure to a child who has chickenpox.
*Correct Answer: B. A history of a severe anaphylactic reaction to gelatin. *
Rationale: The MMR vaccine contains gelatin and neomycin; a severe allergic reaction to
these components is an absolute contraindication. A mild fever is not a contraindication;
it is a precaution. Having an immunocompromised sibling is a reason for family members
to be vaccinated (to protect the sibling), not a reason to withhold it. Chickenpox exposure
does not contraindicate the MMR vaccine.
5. A nurse is assessing a 10-year-old child who has acute glomerulonephritis. Which of the
following findings should the nurse expect?
A. Polyuria and polydipsia.
B. Tea-colored urine and periorbital edema.
C. Clear, colorless urine and hypotension.
D. Foul-smelling urine and suprapubic pain.
*Correct Answer: B. Tea-colored urine and periorbital edema. *
Rationale: Acute glomerulonephritis typically presents with hematuria (tea-colored or
cola-colored urine), proteinuria, and periorbital edema due to fluid retention and
decreased glomerular filtration. Polyuria and polydipsia are signs of diabetes. Foul-
smelling urine and suprapubic pain suggest a urinary tract infection.
6. A nurse is caring for a child who is receiving chemotherapy and has a platelet count of
20,000/mm³. Which of the following precautions should the nurse implement?
A. Place the child in a private room with positive-pressure airflow.
B. Use a soft-bristled toothbrush for oral care.
C. Restrict all visitors and staff with any respiratory symptoms.
D. Administer all medications via the intramuscular route.
*Correct Answer: B. Use a soft-bristled toothbrush for oral care. *
, Rationale: A platelet count of 20,000/mm³ indicates severe thrombocytopenia and a
high risk for bleeding. A soft-bristled toothbrush minimizes trauma to the gums. Positive-
pressure rooms and visitor restrictions are for neutropenic precautions (low WBC), not
low platelets. IM injections are avoided due to bleeding risk.
7. A nurse is assessing a 4-year-old child for signs of increased intracranial pressure (ICP)
following a head injury. Which of the following findings is an early manifestation?
A. Bradycardia and hypertension.
B. Sunsetting eyes and decerebrate posturing.
C. Irritability and high-pitched cry.
D. Nausea and vomiting without preceding fever.
*Correct Answer: D. Nausea and vomiting without preceding fever. *
Rationale: Vomiting, especially projectile vomiting without nausea or fever, is an early
sign of increased ICP in children due to pressure on the vomiting center. Bradycardia and
hypertension are late (Cushing's triad) signs. Sunsetting eyes and posturing are late,
ominous signs. A high-pitched cry is an early sign in infants, but less specific for a 4-year-
old than vomiting.
8. A nurse is teaching a parent about preventing sudden infant death syndrome (SIDS).
Which of the following instructions should the nurse include?
A. Place the infant on a soft, memory-foam mattress for comfort.
B. Use a home cardiorespiratory monitor for all infants under 6 months.
C. Offer a pacifier at naptime and bedtime once breastfeeding is established.
D. Keep the room temperature above 72°F (22°C) to prevent chilling.
*Correct Answer: C. Offer a pacifier at naptime and bedtime once breastfeeding is
established. *
Rationale: Pacifier use during sleep has been shown to reduce the risk of SIDS and should
be offered once breastfeeding is well-established (usually 3-4 weeks). Infants should
sleep on a firm, flat surface, not soft mattresses. Home monitors are not recommended
to prevent SIDS in healthy infants. The room should be kept at a comfortable
temperature, not overheated, as overheating increases SIDS risk.
9. A nurse is caring for a child with a diagnosis of Kawasaki disease. Which of the following
clinical findings should the nurse expect?
A. Desquamation of the fingers and toes.
