ATI RN Pediatric Nursing
Practice Exam 2026
180 Original Practice Questions with Answers & Rationales
Organized by Content Area • NCLEX-Style Format • For Study and Review
Purposes
About This Practice Exam
This practice exam contains 180 original questions written to help you review core pediatric nursing
content commonly covered on ATI-style proctored exams. Questions are organized into 15 content
areas, each containing 12 questions in traditional multiple-choice format.
Instructions: Read each question and all answer choices carefully before selecting your answer. Each
question is followed immediately by the correct answer and a brief rationale to support your learning.
Consider covering the answer while you work through each question, then check your reasoning
against the explanation provided.
Contents
Growth and Development Questions 1–12
Safety and Injury Prevention Questions 13–24
Nutrition Questions 25–36
Immunizations Questions 37–48
Respiratory Disorders Questions 49–60
Cardiovascular Disorders Questions 61–72
Gastrointestinal Disorders Questions 73–84
Genitourinary and Renal Disorders Questions 85–96
Neurological Disorders Questions 97–108
Musculoskeletal Disorders Questions 109–120
Hematology and Oncology Questions 121–132
Endocrine and Metabolic Disorders Questions 133–144
Infectious and Communicable Diseases Questions 145–156
Pharmacology and Dosage Calculations Questions 157–168
Psychosocial Care, Family-Centered Care, and Emergencies Questions 169–180
, Section 1: Growth and Development (Questions 1–12)
1. A nurse is performing a developmental screening on a 9-month-old infant. Which
finemotor skill should the nurse expect the infant to demonstrate?
A. Build a tower of two cubes
B. Use a crude pincer grasp
C. Turn pages in a book
D. Copy a circle
Answer: B. A crude pincer grasp typically develops around 9 months. Tower-building (12-15 months)
and page-turning (12-18 months) occur later; copying shapes is a preschool skill.
2. A nurse is providing anticipatory guidance to parents of a 4-year-old child.
Whichdisciplinary strategy is most appropriate for this age group?
A. Time-out lasting approximately 4 minutes
B. Encouraging a nap after misbehavior
C. A reward system for all behaviors
D. Physical guidance to correct behavior
Answer: A. The general guideline is one minute of time-out per year of age, making 4 minutes
appropriate for a 4-year-old.
3. A nurse is assessing a 12-month-old during a well-child visit. Which finding should
thenurse report to the provider?
A. Anterior fontanel is closed
B. Birth weight has tripled
C. Two to four teeth have erupted
D. Child pulls to stand while holding furniture
Answer: A. The anterior fontanel normally closes between 12 and 18 months; premature closure
warrants provider evaluation, while the other findings are expected at 12 months.
4. Which behavior would the nurse expect to observe in a toddler experiencing
separationanxiety during hospitalization?
A. Protest, despair, and detachment
B. Regression to earlier developmental stages only
C. Complete indifference to caregivers
D. Increased cooperation with strangers
Answer: A. Separation anxiety in toddlers classically progresses through protest, despair, and
detachment phases.
5. A school-age child (7 years old) is hospitalized. According to Erikson, which activity
bestsupports this child's developmental stage?
A. Completing simple craft projects independently
B. Being fed by the nurse
C. Playing peek-a-boo
D. Choosing between two shirts to wear
,Answer: A. School-age children are in the industry vs. inferiority stage and benefit from opportunities
to complete tasks and feel a sense of accomplishment.
6. An adolescent newly diagnosed with type 1 diabetes is withdrawn and reluctant to
testblood glucose in front of peers. This behavior reflects which developmental
concern?
A. Identity vs. role confusion and body image
B. Trust vs. mistrust
C. Initiative vs. guilt
D. Generativity vs. stagnation
Answer: A. Adolescents are working through identity formation and are highly sensitive to appearing
different from peers, which affects adherence behaviors.
7. A nurse is teaching a parent about expected language development. Which milestone
isappropriate for an 18-month-old?
A. Uses 2-word phrases
B. Speaks in full sentences
C. Uses approximately 10 words
D. Understands only single words
Answer: C. By 18 months, toddlers typically have a vocabulary of about 10-25 words; 2-word phrases
usually emerge closer to 24 months.
8. Which toy is most appropriate for the nurse to recommend for a 6-month-old infant?
A. Small building blocks with sharp edges
B. A soft rattle that is easy to grasp
C. A board book with small pop-up pieces
D. A balloon for batting practice
Answer: B. Infants at 6 months explore objects orally and need large, soft, easily grasped toys
without small or sharp parts due to choking risk.
9. A nurse notes that a 2-year-old repeatedly says 'no' to nearly every request. The
nurseshould recognize this as:
A. A normal attempt to assert autonomy
B. A sign of a behavioral disorder
C. Evidence of poor parenting
D. An indication of developmental delay
Answer: A. Toddlers commonly exhibit negativism as part of developing autonomy, consistent with
Erikson's autonomy vs. shame and doubt stage.
10. Which finding during a developmental assessment of a 5-year-old would be
mostconcerning to the nurse?
A. Cannot hop on one foot
B. Unable to speak in full sentences understood by strangers
C. Prefers parallel play over group play
D. Draws a person with 3 body parts
, Answer: B. By age 5, speech should be clearly intelligible to strangers; significant delays in speech
clarity warrant further evaluation.
11. A nurse is assessing reflexes in a 2-month-old infant. Which reflex should have
alreadydisappeared?
A. Rooting reflex
B. Stepping reflex
C. Babinski reflex
D. Palmar grasp
Answer: B. The stepping (walking) reflex typically disappears by 2 months of age, while rooting,
palmar grasp, and Babinski persist longer.
12. A nurse is teaching parents of a preschooler about typical fears at this
developmentalstage. Which fear is most common?
A. Fear of the dark and imaginary creatures
B. Fear of strangers
C. Fear of loud noises only
D. Fear of separation from siblings
Answer: A. Preschoolers commonly develop fears of the dark, monsters, and body mutilation due to
magical thinking characteristic of this age.
Section 2: Safety and Injury Prevention (Questions 13–24)
13. Which statement by a parent of a 2-year-old indicates a need for further teaching
aboutcar seat safety?
A. "I'll switch her to forward-facing now that she is 2."
B. "I'll keep her rear-facing as long as the seat allows by weight and height."
C. "She'll ride in the back seat."
D. "I'll use the seat based on her size, not just her age."
Answer: A. Current guidance recommends keeping children rear-facing until they reach the maximum
height or weight limit of the car seat, not switching based on age alone.
14. A nurse is teaching a parent about poison prevention for a toddler. Which
statementrequires correction?
A. "I'll store cleaning products in a locked cabinet."
B. "I'll keep the poison control number by the phone."
C. "I'll keep medications in their original containers."
D. "I'll induce vomiting if he swallows something toxic."
Answer: D. Vomiting should never be induced without first consulting poison control or a provider, as
some substances cause more harm coming back up.
15. Which age group is at greatest risk for aspiration of small objects and should avoid
toyswith small parts?
A. Children younger than 4 years
B. School-age children
Practice Exam 2026
180 Original Practice Questions with Answers & Rationales
Organized by Content Area • NCLEX-Style Format • For Study and Review
Purposes
About This Practice Exam
This practice exam contains 180 original questions written to help you review core pediatric nursing
content commonly covered on ATI-style proctored exams. Questions are organized into 15 content
areas, each containing 12 questions in traditional multiple-choice format.
Instructions: Read each question and all answer choices carefully before selecting your answer. Each
question is followed immediately by the correct answer and a brief rationale to support your learning.
Consider covering the answer while you work through each question, then check your reasoning
against the explanation provided.
Contents
Growth and Development Questions 1–12
Safety and Injury Prevention Questions 13–24
Nutrition Questions 25–36
Immunizations Questions 37–48
Respiratory Disorders Questions 49–60
Cardiovascular Disorders Questions 61–72
Gastrointestinal Disorders Questions 73–84
Genitourinary and Renal Disorders Questions 85–96
Neurological Disorders Questions 97–108
Musculoskeletal Disorders Questions 109–120
Hematology and Oncology Questions 121–132
Endocrine and Metabolic Disorders Questions 133–144
Infectious and Communicable Diseases Questions 145–156
Pharmacology and Dosage Calculations Questions 157–168
Psychosocial Care, Family-Centered Care, and Emergencies Questions 169–180
, Section 1: Growth and Development (Questions 1–12)
1. A nurse is performing a developmental screening on a 9-month-old infant. Which
finemotor skill should the nurse expect the infant to demonstrate?
A. Build a tower of two cubes
B. Use a crude pincer grasp
C. Turn pages in a book
D. Copy a circle
Answer: B. A crude pincer grasp typically develops around 9 months. Tower-building (12-15 months)
and page-turning (12-18 months) occur later; copying shapes is a preschool skill.
2. A nurse is providing anticipatory guidance to parents of a 4-year-old child.
Whichdisciplinary strategy is most appropriate for this age group?
A. Time-out lasting approximately 4 minutes
B. Encouraging a nap after misbehavior
C. A reward system for all behaviors
D. Physical guidance to correct behavior
Answer: A. The general guideline is one minute of time-out per year of age, making 4 minutes
appropriate for a 4-year-old.
3. A nurse is assessing a 12-month-old during a well-child visit. Which finding should
thenurse report to the provider?
A. Anterior fontanel is closed
B. Birth weight has tripled
C. Two to four teeth have erupted
D. Child pulls to stand while holding furniture
Answer: A. The anterior fontanel normally closes between 12 and 18 months; premature closure
warrants provider evaluation, while the other findings are expected at 12 months.
4. Which behavior would the nurse expect to observe in a toddler experiencing
separationanxiety during hospitalization?
A. Protest, despair, and detachment
B. Regression to earlier developmental stages only
C. Complete indifference to caregivers
D. Increased cooperation with strangers
Answer: A. Separation anxiety in toddlers classically progresses through protest, despair, and
detachment phases.
5. A school-age child (7 years old) is hospitalized. According to Erikson, which activity
bestsupports this child's developmental stage?
A. Completing simple craft projects independently
B. Being fed by the nurse
C. Playing peek-a-boo
D. Choosing between two shirts to wear
,Answer: A. School-age children are in the industry vs. inferiority stage and benefit from opportunities
to complete tasks and feel a sense of accomplishment.
6. An adolescent newly diagnosed with type 1 diabetes is withdrawn and reluctant to
testblood glucose in front of peers. This behavior reflects which developmental
concern?
A. Identity vs. role confusion and body image
B. Trust vs. mistrust
C. Initiative vs. guilt
D. Generativity vs. stagnation
Answer: A. Adolescents are working through identity formation and are highly sensitive to appearing
different from peers, which affects adherence behaviors.
7. A nurse is teaching a parent about expected language development. Which milestone
isappropriate for an 18-month-old?
A. Uses 2-word phrases
B. Speaks in full sentences
C. Uses approximately 10 words
D. Understands only single words
Answer: C. By 18 months, toddlers typically have a vocabulary of about 10-25 words; 2-word phrases
usually emerge closer to 24 months.
8. Which toy is most appropriate for the nurse to recommend for a 6-month-old infant?
A. Small building blocks with sharp edges
B. A soft rattle that is easy to grasp
C. A board book with small pop-up pieces
D. A balloon for batting practice
Answer: B. Infants at 6 months explore objects orally and need large, soft, easily grasped toys
without small or sharp parts due to choking risk.
9. A nurse notes that a 2-year-old repeatedly says 'no' to nearly every request. The
nurseshould recognize this as:
A. A normal attempt to assert autonomy
B. A sign of a behavioral disorder
C. Evidence of poor parenting
D. An indication of developmental delay
Answer: A. Toddlers commonly exhibit negativism as part of developing autonomy, consistent with
Erikson's autonomy vs. shame and doubt stage.
10. Which finding during a developmental assessment of a 5-year-old would be
mostconcerning to the nurse?
A. Cannot hop on one foot
B. Unable to speak in full sentences understood by strangers
C. Prefers parallel play over group play
D. Draws a person with 3 body parts
, Answer: B. By age 5, speech should be clearly intelligible to strangers; significant delays in speech
clarity warrant further evaluation.
11. A nurse is assessing reflexes in a 2-month-old infant. Which reflex should have
alreadydisappeared?
A. Rooting reflex
B. Stepping reflex
C. Babinski reflex
D. Palmar grasp
Answer: B. The stepping (walking) reflex typically disappears by 2 months of age, while rooting,
palmar grasp, and Babinski persist longer.
12. A nurse is teaching parents of a preschooler about typical fears at this
developmentalstage. Which fear is most common?
A. Fear of the dark and imaginary creatures
B. Fear of strangers
C. Fear of loud noises only
D. Fear of separation from siblings
Answer: A. Preschoolers commonly develop fears of the dark, monsters, and body mutilation due to
magical thinking characteristic of this age.
Section 2: Safety and Injury Prevention (Questions 13–24)
13. Which statement by a parent of a 2-year-old indicates a need for further teaching
aboutcar seat safety?
A. "I'll switch her to forward-facing now that she is 2."
B. "I'll keep her rear-facing as long as the seat allows by weight and height."
C. "She'll ride in the back seat."
D. "I'll use the seat based on her size, not just her age."
Answer: A. Current guidance recommends keeping children rear-facing until they reach the maximum
height or weight limit of the car seat, not switching based on age alone.
14. A nurse is teaching a parent about poison prevention for a toddler. Which
statementrequires correction?
A. "I'll store cleaning products in a locked cabinet."
B. "I'll keep the poison control number by the phone."
C. "I'll keep medications in their original containers."
D. "I'll induce vomiting if he swallows something toxic."
Answer: D. Vomiting should never be induced without first consulting poison control or a provider, as
some substances cause more harm coming back up.
15. Which age group is at greatest risk for aspiration of small objects and should avoid
toyswith small parts?
A. Children younger than 4 years
B. School-age children
