ATI RN Pediatric Nursing Proctored Examination 2026:
Comprehensive NGN-Style Practice Assessment with
Clinical Case Scenarios and Evidence-Based Rationales
EXAMINATION OVERVIEW
This comprehensive practice examination contains 200 original multiple-choice
questions designed to reflect the current ATI RN Pediatric Nursing Proctored Exam blueprint for
2026. Questions are formatted to include Next Generation NCLEX (NGN)-style elements,
including unfolding case scenarios, priority-setting exercises, and select-all-that-apply items.
Each question includes a detailed evidence-based rationale explaining the CORRECT ANSWER
and why distractors are incorrect.
GROWTH AND DEVELOPMENT
(Questions 1-25)
Question 1
A nurse is performing a developmental screening on a 12-month-old infant during a well-child
visit. Which of the following fine motor milestones should the nurse expect the infant to have
achieved?
A) Building a tower of two blocks
B) Scribbling spontaneously
C) Pincer grasp
D) Using a spoon without spilling
CORRECT ANSWER: C
Rationale: By 12 months of age, infants typically have developed a pincer grasp, using the
thumb and forefinger to pick up small objects. Building a tower of two blocks is typically
achieved around 15 months, and scribbling spontaneously is expected around 18 months. Using
a spoon without spilling is a skill that develops later in toddlerhood.
Question 2
According to Erikson's theory of psychosocial development, a nurse should expect a 4-year-old
child to be working on which developmental task?
,A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
CORRECT ANSWER: C
Rationale: According to Erikson, preschool-age children (ages 3-5 years) are in the initiative
versus guilt stage. During this stage, children begin to assert control and power over their
environment by initiating activities, planning games, and interacting with others. Trust versus
mistrust occurs in infancy (birth to 18 months), autonomy versus shame and doubt occurs in
toddlerhood (18 months to 3 years), and industry versus inferiority occurs in school-age children
(6-12 years).
Question 3
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 have achieved?
A) Identifying right from left hand reliably
B) Using a utensil to spread butter on bread
C) Cutting an outlined shape using child-safe scissors
D) Drawing a stick figure with seven body parts
CORRECT ANSWER: C
Rationale: By age 4, children typically can use child-safe scissors to cut on a line or cut out simple
outlined shapes. Identifying right from left reliably and spreading butter on bread are skills more
aligned with older children (school-age). Drawing a stick figure with multiple body parts is not
typically expected until later developmental stages.
Question 4
A nurse is providing teaching to the guardian of a 6-month-old infant regarding proper car seat
use. Which of the following statements by the guardian indicates correct understanding?
A) "I should switch the seat to face forward as soon as my baby weighs 20 lb."
B) "I must place the infant's car seat in the front passenger seat for quick access."
C) "I should secure the car seat using the LATCH system if my car has it."
D) "I need to position rolled towels around my baby for extra padding."
CORRECT ANSWER: C
Rationale: The LATCH (Lower Anchors and Tethers for Children) system is recommended for
,securing infant car seats and provides a more secure anchor than standard seat belts when
properly installed. Infants should remain rear-facing until they reach the maximum height or
weight limit of the car seat (at least 2 years of age). Car seats should never be placed in the
front passenger seat due to airbag risks, and rolled towels should not be used as padding as
they can interfere with proper harness positioning.
Question 5
A nurse is reinforcing teaching with the parent of a 1-month-old infant about sudden infant
death syndrome (SIDS) prevention. Which of the following statements by the parent indicates
an understanding of the teaching?
A) "I will let my baby sleep with me in bed at night."
B) "I will allow my baby to have a pacifier while sleeping."
C) "I will place my baby on a soft mattress to sleep."
D) "I will cover my baby with a quilt while sleeping."
CORRECT ANSWER: B
Rationale: Pacifier use during sleep has been associated with a reduced risk of SIDS and is
recommended as a preventive measure. Room-sharing without bed-sharing is recommended,
infants should be placed on a firm sleep surface (not soft mattresses), and loose bedding such as
quilts should be avoided to reduce suffocation risk.
Question 6
A nurse is assessing a toddler during a well-child visit. The parent reports that the child is "into
everything" and frequently says "no" to requests. According to Erikson, the nurse should
recognize that this behavior is consistent with which developmental stage?
A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
CORRECT ANSWER: B
Rationale: The toddler stage (18 months to 3 years) corresponds to Erikson's autonomy versus
shame and doubt. Toddlers assert independence by exploring, saying "no," and wanting to do
things for themselves. The child's behavior reflects healthy development of autonomy and is not
a sign of defiance.
, Question 7
A nurse is performing a developmental screening on an 18-month-old toddler. Which of the
following fine motor skills should the nurse expect the toddler to have achieved?
A) Pincer grasp
B) Building a tower of four blocks
C) Scribbling spontaneously
D) Using a spoon without spilling
CORRECT ANSWER: C
Rationale: By 18 months of age, toddlers typically can scribble spontaneously. The pincer grasp
is typically achieved by 12 months. Building a tower of four blocks is usually expected around 24
months, and using a spoon without spilling is a later skill often not fully developed until 3-4
years of age.
Question 8
A nurse is providing anticipatory guidance to the parent of a 2-year-old child. Which of the
following statements accurately reflects expected developmental changes during this stage?
A) "Your child should be able to ride a tricycle at this age."
B) "Your child will likely show parallel play rather than interactive play with other children."
C) "Your child should have all primary teeth by this age."
D) "Your child should be able to dress independently."
CORRECT ANSWER: B
Rationale: Toddlers typically engage in parallel play (playing alongside rather than with other
children) at 2 years of age. Riding a tricycle is a skill expected in preschool years (3-4 years).
While primary teeth eruption begins, a full set of 20 primary teeth is not typically complete until
age 3. Dressing independently is not expected until the preschool years.
Question 9
A nurse is teaching a parent about developmental milestones for a 9-month-old infant. Which of
the following gross motor milestones should the nurse include as expected for this age?
A) Sitting without support
B) Cruising while holding onto furniture
C) Walking independently
D) Creeping on hands and knees
Comprehensive NGN-Style Practice Assessment with
Clinical Case Scenarios and Evidence-Based Rationales
EXAMINATION OVERVIEW
This comprehensive practice examination contains 200 original multiple-choice
questions designed to reflect the current ATI RN Pediatric Nursing Proctored Exam blueprint for
2026. Questions are formatted to include Next Generation NCLEX (NGN)-style elements,
including unfolding case scenarios, priority-setting exercises, and select-all-that-apply items.
Each question includes a detailed evidence-based rationale explaining the CORRECT ANSWER
and why distractors are incorrect.
GROWTH AND DEVELOPMENT
(Questions 1-25)
Question 1
A nurse is performing a developmental screening on a 12-month-old infant during a well-child
visit. Which of the following fine motor milestones should the nurse expect the infant to have
achieved?
A) Building a tower of two blocks
B) Scribbling spontaneously
C) Pincer grasp
D) Using a spoon without spilling
CORRECT ANSWER: C
Rationale: By 12 months of age, infants typically have developed a pincer grasp, using the
thumb and forefinger to pick up small objects. Building a tower of two blocks is typically
achieved around 15 months, and scribbling spontaneously is expected around 18 months. Using
a spoon without spilling is a skill that develops later in toddlerhood.
Question 2
According to Erikson's theory of psychosocial development, a nurse should expect a 4-year-old
child to be working on which developmental task?
,A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
CORRECT ANSWER: C
Rationale: According to Erikson, preschool-age children (ages 3-5 years) are in the initiative
versus guilt stage. During this stage, children begin to assert control and power over their
environment by initiating activities, planning games, and interacting with others. Trust versus
mistrust occurs in infancy (birth to 18 months), autonomy versus shame and doubt occurs in
toddlerhood (18 months to 3 years), and industry versus inferiority occurs in school-age children
(6-12 years).
Question 3
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 have achieved?
A) Identifying right from left hand reliably
B) Using a utensil to spread butter on bread
C) Cutting an outlined shape using child-safe scissors
D) Drawing a stick figure with seven body parts
CORRECT ANSWER: C
Rationale: By age 4, children typically can use child-safe scissors to cut on a line or cut out simple
outlined shapes. Identifying right from left reliably and spreading butter on bread are skills more
aligned with older children (school-age). Drawing a stick figure with multiple body parts is not
typically expected until later developmental stages.
Question 4
A nurse is providing teaching to the guardian of a 6-month-old infant regarding proper car seat
use. Which of the following statements by the guardian indicates correct understanding?
A) "I should switch the seat to face forward as soon as my baby weighs 20 lb."
B) "I must place the infant's car seat in the front passenger seat for quick access."
C) "I should secure the car seat using the LATCH system if my car has it."
D) "I need to position rolled towels around my baby for extra padding."
CORRECT ANSWER: C
Rationale: The LATCH (Lower Anchors and Tethers for Children) system is recommended for
,securing infant car seats and provides a more secure anchor than standard seat belts when
properly installed. Infants should remain rear-facing until they reach the maximum height or
weight limit of the car seat (at least 2 years of age). Car seats should never be placed in the
front passenger seat due to airbag risks, and rolled towels should not be used as padding as
they can interfere with proper harness positioning.
Question 5
A nurse is reinforcing teaching with the parent of a 1-month-old infant about sudden infant
death syndrome (SIDS) prevention. Which of the following statements by the parent indicates
an understanding of the teaching?
A) "I will let my baby sleep with me in bed at night."
B) "I will allow my baby to have a pacifier while sleeping."
C) "I will place my baby on a soft mattress to sleep."
D) "I will cover my baby with a quilt while sleeping."
CORRECT ANSWER: B
Rationale: Pacifier use during sleep has been associated with a reduced risk of SIDS and is
recommended as a preventive measure. Room-sharing without bed-sharing is recommended,
infants should be placed on a firm sleep surface (not soft mattresses), and loose bedding such as
quilts should be avoided to reduce suffocation risk.
Question 6
A nurse is assessing a toddler during a well-child visit. The parent reports that the child is "into
everything" and frequently says "no" to requests. According to Erikson, the nurse should
recognize that this behavior is consistent with which developmental stage?
A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
CORRECT ANSWER: B
Rationale: The toddler stage (18 months to 3 years) corresponds to Erikson's autonomy versus
shame and doubt. Toddlers assert independence by exploring, saying "no," and wanting to do
things for themselves. The child's behavior reflects healthy development of autonomy and is not
a sign of defiance.
, Question 7
A nurse is performing a developmental screening on an 18-month-old toddler. Which of the
following fine motor skills should the nurse expect the toddler to have achieved?
A) Pincer grasp
B) Building a tower of four blocks
C) Scribbling spontaneously
D) Using a spoon without spilling
CORRECT ANSWER: C
Rationale: By 18 months of age, toddlers typically can scribble spontaneously. The pincer grasp
is typically achieved by 12 months. Building a tower of four blocks is usually expected around 24
months, and using a spoon without spilling is a later skill often not fully developed until 3-4
years of age.
Question 8
A nurse is providing anticipatory guidance to the parent of a 2-year-old child. Which of the
following statements accurately reflects expected developmental changes during this stage?
A) "Your child should be able to ride a tricycle at this age."
B) "Your child will likely show parallel play rather than interactive play with other children."
C) "Your child should have all primary teeth by this age."
D) "Your child should be able to dress independently."
CORRECT ANSWER: B
Rationale: Toddlers typically engage in parallel play (playing alongside rather than with other
children) at 2 years of age. Riding a tricycle is a skill expected in preschool years (3-4 years).
While primary teeth eruption begins, a full set of 20 primary teeth is not typically complete until
age 3. Dressing independently is not expected until the preschool years.
Question 9
A nurse is teaching a parent about developmental milestones for a 9-month-old infant. Which of
the following gross motor milestones should the nurse include as expected for this age?
A) Sitting without support
B) Cruising while holding onto furniture
C) Walking independently
D) Creeping on hands and knees
