ATI Pediatric Proctored Exam – Assessment Technologies
Institute (ATI) – 2026/2027 Academic
SECTION I: GROWTH AND DEVELOPMENT MILESTONES
(Questions 1–20)
1. A nurse is assessing a 4-year-old child during a well-child visit. Which of the
following developmental milestones should the nurse expect the child to
demonstrate?
A. Ties shoelaces independently
B. Rides a tricycle
C. Prints first name
D. Uses scissors to cut out simple shapes
Correct Answer: B
Rationale: A 4-year-old child typically rides a tricycle and can hop on one foot.
Tying shoelaces and printing first names are expected at 5–6 years. While using
scissors to cut out simple shapes is also a 4-year-old milestone, riding a tricycle is
the classic gross motor milestone for this age. The nurse should assess gross
motor skills first as they are foundational for other developmental domains.
2. A nurse is providing education to the parent of a 6-month-old infant about
developmental milestones. Which of the following statements by the parent
indicates an understanding of the teaching?
A. "My baby should be able to sit without support by now."
B. "My baby should be able to transfer objects from one hand to the other."
C. "My baby should be able to say 'mama' and 'dada' specifically."
D. "My baby should be able to walk while holding onto furniture."
Correct Answer: B
Rationale: At 6 months, infants typically begin to transfer objects from one hand
to the other (fine motor milestone). Sitting without support occurs around 8
,months. Saying "mama" and "dada" specifically occurs around 10–12 months.
Cruising (walking while holding furniture) occurs around 9–10 months. The
parent's understanding is confirmed by identifying the correct 6-month
milestone.
3. A nurse is assessing a 2-year-old toddler. Which of the following findings
should the nurse report to the provider?
A. The toddler has a vocabulary of approximately 50 words.
B. The toddler can walk up and down stairs with assistance.
C. The toddler is unable to jump with both feet.
D. The toddler can stack four to six blocks.
Correct Answer: C
Rationale: By age 2, toddlers should be able to jump with both feet. A vocabulary
of 50 words, walking up and down stairs with assistance, and stacking 4–6 blocks
are all expected developmental milestones at 24 months. Inability to jump with
both feet may indicate a developmental delay requiring further evaluation.
4. A nurse is performing a developmental screening on a 10-month-old infant.
Which of the following fine motor skills should the nurse expect to observe?
A. Pincer grasp
B. Building a tower of two blocks
C. Scribbling spontaneously
D. Using a spoon without spilling
Correct Answer: A
Rationale: The pincer grasp (using thumb and forefinger to pick up small objects)
typically develops between 9–10 months of age. Building a tower of two blocks is
expected around 15 months. Scribbling spontaneously occurs around 18 months.
Using a spoon without spilling is not typically expected until 24–30 months.
,5. A nurse is teaching the parents of a 15-month-old toddler about expected
developmental milestones. Which of the following should the nurse include?
A. The child should be able to run well.
B. The child should be able to walk independently.
C. The child should be able to climb stairs with alternating feet.
D. The child should be able to stand on one foot.
Correct Answer: B
Rationale: Most toddlers walk independently by 12–15 months of age. Running
well occurs around 18–24 months. Climbing stairs with alternating feet is a 3-
year-old milestone. Standing on one foot is typically achieved around 4–5 years.
6. A nurse is assessing a 3-year-old preschooler. Which of the following gross
motor skills should the nurse expect?
A. Hopping on one foot
B. Skipping
C. Pedaling a tricycle
D. Walking backward
Correct Answer: C
Rationale: A 3-year-old can pedal a tricycle and walk up stairs with alternating
feet. Hopping on one foot is expected at 4 years. Skipping is a 5-year-old
milestone. Walking backward is expected at 2 years.
7. A nurse is assessing a 7-month-old infant. Which of the following
developmental findings is consistent with this age?
A. The infant sits without support.
B. The infant rolls from back to abdomen.
C. The infant exhibits the Moro reflex.
D. The infant exhibits the tonic neck reflex.
Correct Answer: B
, Rationale: By 7 months, infants can roll from back to abdomen in both directions
and typically sit with support. Sitting without support occurs around 8 months.
The Moro reflex disappears by 4–6 months. The tonic neck reflex disappears by 4
months. Persistence of primitive reflexes beyond expected ages requires further
evaluation.
8. A nurse is providing anticipatory guidance to the parents of a 4-month-old
infant. Which of the following statements should the nurse include?
A. "Your baby will begin to teethe within the next few months."
B. "Your baby should be able to roll from back to abdomen."
C. "Your baby will begin to show stranger anxiety."
D. "Your baby should be able to sit without support."
Correct Answer: A
Rationale: Teething typically begins around 4–6 months of age. Rolling from back
to abdomen is expected around 5–6 months. Stranger anxiety typically begins
around 6–8 months. Sitting without support occurs around 8 months. The nurse
should provide education on teething management including teething rings and
appropriate pain relief.
9. A nurse is assessing a 5-year-old child. Which of the following developmental
milestones should the nurse expect?
A. The child can copy a square.
B. The child can tie shoelaces.
C. The child can print first name.
D. The child can draw a person with six body parts.
Correct Answer: C
Rationale: A 5-year-old can print their first name, copy a triangle, and draw a
person with a body. Copying a square is a 4-year-old milestone. Tying shoelaces is
typically not expected until 6–7 years. Drawing a person with six body parts is a 5-
Institute (ATI) – 2026/2027 Academic
SECTION I: GROWTH AND DEVELOPMENT MILESTONES
(Questions 1–20)
1. A nurse is assessing a 4-year-old child during a well-child visit. Which of the
following developmental milestones should the nurse expect the child to
demonstrate?
A. Ties shoelaces independently
B. Rides a tricycle
C. Prints first name
D. Uses scissors to cut out simple shapes
Correct Answer: B
Rationale: A 4-year-old child typically rides a tricycle and can hop on one foot.
Tying shoelaces and printing first names are expected at 5–6 years. While using
scissors to cut out simple shapes is also a 4-year-old milestone, riding a tricycle is
the classic gross motor milestone for this age. The nurse should assess gross
motor skills first as they are foundational for other developmental domains.
2. A nurse is providing education to the parent of a 6-month-old infant about
developmental milestones. Which of the following statements by the parent
indicates an understanding of the teaching?
A. "My baby should be able to sit without support by now."
B. "My baby should be able to transfer objects from one hand to the other."
C. "My baby should be able to say 'mama' and 'dada' specifically."
D. "My baby should be able to walk while holding onto furniture."
Correct Answer: B
Rationale: At 6 months, infants typically begin to transfer objects from one hand
to the other (fine motor milestone). Sitting without support occurs around 8
,months. Saying "mama" and "dada" specifically occurs around 10–12 months.
Cruising (walking while holding furniture) occurs around 9–10 months. The
parent's understanding is confirmed by identifying the correct 6-month
milestone.
3. A nurse is assessing a 2-year-old toddler. Which of the following findings
should the nurse report to the provider?
A. The toddler has a vocabulary of approximately 50 words.
B. The toddler can walk up and down stairs with assistance.
C. The toddler is unable to jump with both feet.
D. The toddler can stack four to six blocks.
Correct Answer: C
Rationale: By age 2, toddlers should be able to jump with both feet. A vocabulary
of 50 words, walking up and down stairs with assistance, and stacking 4–6 blocks
are all expected developmental milestones at 24 months. Inability to jump with
both feet may indicate a developmental delay requiring further evaluation.
4. A nurse is performing a developmental screening on a 10-month-old infant.
Which of the following fine motor skills should the nurse expect to observe?
A. Pincer grasp
B. Building a tower of two blocks
C. Scribbling spontaneously
D. Using a spoon without spilling
Correct Answer: A
Rationale: The pincer grasp (using thumb and forefinger to pick up small objects)
typically develops between 9–10 months of age. Building a tower of two blocks is
expected around 15 months. Scribbling spontaneously occurs around 18 months.
Using a spoon without spilling is not typically expected until 24–30 months.
,5. A nurse is teaching the parents of a 15-month-old toddler about expected
developmental milestones. Which of the following should the nurse include?
A. The child should be able to run well.
B. The child should be able to walk independently.
C. The child should be able to climb stairs with alternating feet.
D. The child should be able to stand on one foot.
Correct Answer: B
Rationale: Most toddlers walk independently by 12–15 months of age. Running
well occurs around 18–24 months. Climbing stairs with alternating feet is a 3-
year-old milestone. Standing on one foot is typically achieved around 4–5 years.
6. A nurse is assessing a 3-year-old preschooler. Which of the following gross
motor skills should the nurse expect?
A. Hopping on one foot
B. Skipping
C. Pedaling a tricycle
D. Walking backward
Correct Answer: C
Rationale: A 3-year-old can pedal a tricycle and walk up stairs with alternating
feet. Hopping on one foot is expected at 4 years. Skipping is a 5-year-old
milestone. Walking backward is expected at 2 years.
7. A nurse is assessing a 7-month-old infant. Which of the following
developmental findings is consistent with this age?
A. The infant sits without support.
B. The infant rolls from back to abdomen.
C. The infant exhibits the Moro reflex.
D. The infant exhibits the tonic neck reflex.
Correct Answer: B
, Rationale: By 7 months, infants can roll from back to abdomen in both directions
and typically sit with support. Sitting without support occurs around 8 months.
The Moro reflex disappears by 4–6 months. The tonic neck reflex disappears by 4
months. Persistence of primitive reflexes beyond expected ages requires further
evaluation.
8. A nurse is providing anticipatory guidance to the parents of a 4-month-old
infant. Which of the following statements should the nurse include?
A. "Your baby will begin to teethe within the next few months."
B. "Your baby should be able to roll from back to abdomen."
C. "Your baby will begin to show stranger anxiety."
D. "Your baby should be able to sit without support."
Correct Answer: A
Rationale: Teething typically begins around 4–6 months of age. Rolling from back
to abdomen is expected around 5–6 months. Stranger anxiety typically begins
around 6–8 months. Sitting without support occurs around 8 months. The nurse
should provide education on teething management including teething rings and
appropriate pain relief.
9. A nurse is assessing a 5-year-old child. Which of the following developmental
milestones should the nurse expect?
A. The child can copy a square.
B. The child can tie shoelaces.
C. The child can print first name.
D. The child can draw a person with six body parts.
Correct Answer: C
Rationale: A 5-year-old can print their first name, copy a triangle, and draw a
person with a body. Copying a square is a 4-year-old milestone. Tying shoelaces is
typically not expected until 6–7 years. Drawing a person with six body parts is a 5-
