ATI RN Pediatric Proctored Exam 2026 Practice
Questions with NGN-Style Format 3 Versions
Verified Answers & Detailed Rationales
Secure your Level 3 proficiency with the definitive 2026 preparation
guide for the ATI RN Pediatric CMS Proctored Exam, featuring Next
Generation NCLEX (NGN) style items. This comprehensive study
resource delivers realistic, high-yield practice questions, multi-stage
matrix items, and detailed developmental rationales covering pediatric
immunization schedules, acute congenital disorders, and emergency
interventions. Master pediatric fluid balance, drug dosage calculations,
and critical prioritization rules to pass your proctored evaluation on the
first attempt.
QUESTION 1
A nurse is assessing a 3-year-old child during a well-child visit. Which
of the following developmental milestones should the nurse expect
the child to have achieved?
A) Skipping with alternating feet
B) Riding a tricycle
C) Tying shoelaces
D) Drawing a square
Rationale: Riding a tricycle is a gross motor milestone expected at 3 years of
age. Skipping with alternating feet typically develops around 5 years. Tying
shoelaces and drawing a square are fine motor skills expected at 5-6 years .
,QUESTION 2
A nurse is reinforcing teaching with the parent of a 15-month-old
toddler about feeding and nutrition. Which of the following
statements by the parent indicates an understanding of the teaching?
A) "I will give my toddler peanut butter on crackers."
B) "I will cut hot dogs lengthwise before cooking."
C) "I will offer my toddler whole grapes as a snack."
D) "I will give my toddler popcorn as a snack."
Rationale: Cutting hot dogs lengthwise is a choking prevention strategy for
toddlers. Peanut butter on crackers, whole grapes, and popcorn are all
choking hazards and should be avoided or modified for safety .
QUESTION 3
A nurse is caring for a 10-year-old child who is hospitalized. Which of
the following diversional activities is most appropriate for the child?
A) Board games
B) Picture books
C) Musical toys
D) Push-pull toys
Rationale: School-age children (6-12 years) enjoy board games, puzzles, and
activities that involve rules and strategy. Picture books are for preschoolers,
musical toys are for infants and toddlers, and push-pull toys are for toddlers .
QUESTION 4
A nurse is assessing a 24-month-old toddler. Which of the following
findings should the nurse report to the provider?
,A) The child cannot stack six blocks.
B) The child uses two-word sentences.
C) The child walks independently.
D) The child can turn pages of a book.
Rationale: By 24 months, a toddler should be able to stack 6-7 blocks.
Inability to do so may indicate a developmental delay requiring further
evaluation. Two-word sentences, walking independently, and turning pages
are all expected milestones .
QUESTION 5
A nurse is reinforcing teaching about sudden infant death syndrome
(SIDS) with the parent of a 2-month-old infant. Which of the following
statements by the parent indicates an understanding of the teaching?
A) "I will place my baby on her back to sleep."
B) "I will use a soft blanket in the crib."
C) "I will place my baby on her stomach to sleep."
D) "I will allow my baby to sleep with a stuffed animal."
Rationale: Placing infants on their backs to sleep is the most important
measure to prevent SIDS. Soft blankets, stuffed animals, and stomach
sleeping are all risk factors for SIDS .
QUESTION 6
A nurse is assessing a newborn who is 24 hours old. Which of the
following findings should the nurse report to the provider?
A) Weight 3.2 kg
B) Respiratory rate 65/min
, C) Heart rate 140/min
D) Temperature 36.5°C (97.7°F)
Rationale: A respiratory rate of 65/min is tachypneic in a newborn (normal
is 30-60/min) and should be reported. Weight 3.2 kg, heart rate 140/min, and
temperature 36.5°C are within expected ranges .
QUESTION 7
A nurse is preparing to administer immunizations to a 2-month-old
infant. Which of the following vaccines should the nurse administer?
A) MMR
B) DTaP
C) Varicella
D) HPV
Rationale: At 2 months, the infant should receive DTaP, IPV, Hib, PCV, and
RV. MMR and varicella are given at 12 months, and HPV is given starting at
11-12 years .
QUESTION 8
A nurse is caring for a child who has a diagnosis of acute otitis media.
Which of the following findings should the nurse expect?
A) Clear drainage from the ear
B) Bulging, red tympanic membrane
C) Decreased pain when lying flat
D) Normal tympanic membrane
Rationale: A bulging, red tympanic membrane with decreased mobility is a
classic finding of acute otitis media. Clear drainage is not typical, pain is
Questions with NGN-Style Format 3 Versions
Verified Answers & Detailed Rationales
Secure your Level 3 proficiency with the definitive 2026 preparation
guide for the ATI RN Pediatric CMS Proctored Exam, featuring Next
Generation NCLEX (NGN) style items. This comprehensive study
resource delivers realistic, high-yield practice questions, multi-stage
matrix items, and detailed developmental rationales covering pediatric
immunization schedules, acute congenital disorders, and emergency
interventions. Master pediatric fluid balance, drug dosage calculations,
and critical prioritization rules to pass your proctored evaluation on the
first attempt.
QUESTION 1
A nurse is assessing a 3-year-old child during a well-child visit. Which
of the following developmental milestones should the nurse expect
the child to have achieved?
A) Skipping with alternating feet
B) Riding a tricycle
C) Tying shoelaces
D) Drawing a square
Rationale: Riding a tricycle is a gross motor milestone expected at 3 years of
age. Skipping with alternating feet typically develops around 5 years. Tying
shoelaces and drawing a square are fine motor skills expected at 5-6 years .
,QUESTION 2
A nurse is reinforcing teaching with the parent of a 15-month-old
toddler about feeding and nutrition. Which of the following
statements by the parent indicates an understanding of the teaching?
A) "I will give my toddler peanut butter on crackers."
B) "I will cut hot dogs lengthwise before cooking."
C) "I will offer my toddler whole grapes as a snack."
D) "I will give my toddler popcorn as a snack."
Rationale: Cutting hot dogs lengthwise is a choking prevention strategy for
toddlers. Peanut butter on crackers, whole grapes, and popcorn are all
choking hazards and should be avoided or modified for safety .
QUESTION 3
A nurse is caring for a 10-year-old child who is hospitalized. Which of
the following diversional activities is most appropriate for the child?
A) Board games
B) Picture books
C) Musical toys
D) Push-pull toys
Rationale: School-age children (6-12 years) enjoy board games, puzzles, and
activities that involve rules and strategy. Picture books are for preschoolers,
musical toys are for infants and toddlers, and push-pull toys are for toddlers .
QUESTION 4
A nurse is assessing a 24-month-old toddler. Which of the following
findings should the nurse report to the provider?
,A) The child cannot stack six blocks.
B) The child uses two-word sentences.
C) The child walks independently.
D) The child can turn pages of a book.
Rationale: By 24 months, a toddler should be able to stack 6-7 blocks.
Inability to do so may indicate a developmental delay requiring further
evaluation. Two-word sentences, walking independently, and turning pages
are all expected milestones .
QUESTION 5
A nurse is reinforcing teaching about sudden infant death syndrome
(SIDS) with the parent of a 2-month-old infant. Which of the following
statements by the parent indicates an understanding of the teaching?
A) "I will place my baby on her back to sleep."
B) "I will use a soft blanket in the crib."
C) "I will place my baby on her stomach to sleep."
D) "I will allow my baby to sleep with a stuffed animal."
Rationale: Placing infants on their backs to sleep is the most important
measure to prevent SIDS. Soft blankets, stuffed animals, and stomach
sleeping are all risk factors for SIDS .
QUESTION 6
A nurse is assessing a newborn who is 24 hours old. Which of the
following findings should the nurse report to the provider?
A) Weight 3.2 kg
B) Respiratory rate 65/min
, C) Heart rate 140/min
D) Temperature 36.5°C (97.7°F)
Rationale: A respiratory rate of 65/min is tachypneic in a newborn (normal
is 30-60/min) and should be reported. Weight 3.2 kg, heart rate 140/min, and
temperature 36.5°C are within expected ranges .
QUESTION 7
A nurse is preparing to administer immunizations to a 2-month-old
infant. Which of the following vaccines should the nurse administer?
A) MMR
B) DTaP
C) Varicella
D) HPV
Rationale: At 2 months, the infant should receive DTaP, IPV, Hib, PCV, and
RV. MMR and varicella are given at 12 months, and HPV is given starting at
11-12 years .
QUESTION 8
A nurse is caring for a child who has a diagnosis of acute otitis media.
Which of the following findings should the nurse expect?
A) Clear drainage from the ear
B) Bulging, red tympanic membrane
C) Decreased pain when lying flat
D) Normal tympanic membrane
Rationale: A bulging, red tympanic membrane with decreased mobility is a
classic finding of acute otitis media. Clear drainage is not typical, pain is
