2026 ATI RN Pediatric Nursing Proctored Exam Practice Test
Bank | Original Exam-Style Multiple-Choice Questions &
Clinical Rationales
Secure a Level 3 proficiency rating on your proctored specialty assessment with this
high-yield 2026 ATI RN Pediatric Nursing master practice test bank. Master complex
pediatric nursing care domains, including developmental milestones
(Piaget/Erikson), congenital cardiovascular anomalies (including cyanotic vs.
acyanotic defects), pediatric fluid resuscitation math, and Next Generation
NCLEX (NGN) clinical judgment trend items. Every unique, verified multiple-choice
question features a highly detailed clinical rationale to sharpen your nursing judgment
and ensure success on your first attempt.
1. A nurse is assessing a 6-month-old infant. Which finding should the nurse report as a
delay in development?
A. Ability to sit without support
B. Ability to roll from back to stomach
C. Ability to transfer objects from hand to hand
D. Lack of head control when pulled to sit
Answer: D. Lack of head control when pulled to sit
Rationale: Head control when pulled to sit should be present by 4 months. Lack of head
control at 6 months indicates a developmental delay.
2. A nurse is caring for a 2-year-old child. Which behavior indicates the child is in
Piaget’s sensorimotor stage?
A. Using words to express needs
B. Understanding object permanence
,C. Engaging in pretend play
D. Solving simple puzzles
Answer: B. Understanding object permanence
Rationale: Object permanence develops during the sensorimotor stage (birth to 2 years).
By 2 years, the child is transitioning to preoperational thought but still demonstrates
sensorimotor achievements.
3. A nurse is teaching a parent about introducing solid foods to an infant. Which food
should be introduced first?
A. Iron-fortified rice cereal
B. Whole milk
C. Egg whites
D. Peanut butter
Answer: A. Iron-fortified rice cereal
Rationale: Iron-fortified rice cereal is typically the first solid food introduced at about 6
months because it provides iron and is least allergenic.
4. A nurse is assessing a 4-year-old child. Which finding indicates the child is at risk for
lead poisoning?
A. Living in a home built before 1978
B. Playing with age-appropriate toys
C. Eating a balanced diet
D. Receiving routine immunizations
Answer: A. Living in a home built before 1978
Rationale: Homes built before 1978 may contain lead-based paint, which is a major source
of lead exposure for young children.
,5. A nurse is caring for a child with sickle cell anemia. Which finding indicates a vaso-
occlusive crisis?
A. Pale skin and fatigue
B. Severe pain in the extremities
C. Bradycardia and hypertension
D. Increased urine output
Answer: B. Severe pain in the extremities
Rationale: Vaso-occlusive crisis causes severe pain due to sickled cells blocking blood flow,
often in the hands, feet, and long bones.
6. A nurse is administering digoxin to a child. Which action should the nurse take before
giving the dose?
A. Check the apical pulse for 1 full minute
B. Check the radial pulse for 15 seconds
C. Administer with food
D. Hold if the heart rate is above 100 bpm
Answer: A. Check the apical pulse for 1 full minute
Rationale: Digoxin slows heart rate. The apical pulse must be checked for 1 full minute
before administration. Hold if below the prescribed rate (typically <90–110 depending on
age).
7. A nurse is teaching a parent about car seat safety for a 2-year-old child. Which
instruction should the nurse include?
A. Use a rear-facing car seat until age 2 or until the child reaches the height/weight limit
B. Use a forward-facing car seat with a lap belt only
C. Place the child in the front seat with the seat belt
D. Use a booster seat with a lap-shoulder belt
Answer: A. Use a rear-facing car seat until age 2 or until the child reaches the
height/weight limit
, Rationale: The AAP recommends rear-facing car seats until age 2 or until the child reaches
the maximum height/weight for the seat.
8. A nurse is assessing a newborn immediately after birth. Which finding requires
immediate intervention?
A. Heart rate 120 bpm
B. Respiratory rate 50 breaths/min
C. Central cyanosis
D. Acrocyanosis
Answer: C. Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate
intervention. Acrocyanosis is a normal finding in newborns.
9. A nurse is caring for a child with Kawasaki disease. Which medication is used to
prevent coronary artery aneurysms?
A. Acetaminophen
B. Ibuprofen
C. Aspirin
D. Penicillin
Answer: C. Aspirin
Rationale: High-dose aspirin is used in Kawasaki disease to reduce inflammation and
prevent coronary artery aneurysms, followed by low-dose aspirin.
10. A nurse is teaching a parent about preventing sudden infant death syndrome (SIDS).
Which instruction should the nurse include?
A. Place the infant on the stomach to sleep
B. Place the infant on the back to sleep
Bank | Original Exam-Style Multiple-Choice Questions &
Clinical Rationales
Secure a Level 3 proficiency rating on your proctored specialty assessment with this
high-yield 2026 ATI RN Pediatric Nursing master practice test bank. Master complex
pediatric nursing care domains, including developmental milestones
(Piaget/Erikson), congenital cardiovascular anomalies (including cyanotic vs.
acyanotic defects), pediatric fluid resuscitation math, and Next Generation
NCLEX (NGN) clinical judgment trend items. Every unique, verified multiple-choice
question features a highly detailed clinical rationale to sharpen your nursing judgment
and ensure success on your first attempt.
1. A nurse is assessing a 6-month-old infant. Which finding should the nurse report as a
delay in development?
A. Ability to sit without support
B. Ability to roll from back to stomach
C. Ability to transfer objects from hand to hand
D. Lack of head control when pulled to sit
Answer: D. Lack of head control when pulled to sit
Rationale: Head control when pulled to sit should be present by 4 months. Lack of head
control at 6 months indicates a developmental delay.
2. A nurse is caring for a 2-year-old child. Which behavior indicates the child is in
Piaget’s sensorimotor stage?
A. Using words to express needs
B. Understanding object permanence
,C. Engaging in pretend play
D. Solving simple puzzles
Answer: B. Understanding object permanence
Rationale: Object permanence develops during the sensorimotor stage (birth to 2 years).
By 2 years, the child is transitioning to preoperational thought but still demonstrates
sensorimotor achievements.
3. A nurse is teaching a parent about introducing solid foods to an infant. Which food
should be introduced first?
A. Iron-fortified rice cereal
B. Whole milk
C. Egg whites
D. Peanut butter
Answer: A. Iron-fortified rice cereal
Rationale: Iron-fortified rice cereal is typically the first solid food introduced at about 6
months because it provides iron and is least allergenic.
4. A nurse is assessing a 4-year-old child. Which finding indicates the child is at risk for
lead poisoning?
A. Living in a home built before 1978
B. Playing with age-appropriate toys
C. Eating a balanced diet
D. Receiving routine immunizations
Answer: A. Living in a home built before 1978
Rationale: Homes built before 1978 may contain lead-based paint, which is a major source
of lead exposure for young children.
,5. A nurse is caring for a child with sickle cell anemia. Which finding indicates a vaso-
occlusive crisis?
A. Pale skin and fatigue
B. Severe pain in the extremities
C. Bradycardia and hypertension
D. Increased urine output
Answer: B. Severe pain in the extremities
Rationale: Vaso-occlusive crisis causes severe pain due to sickled cells blocking blood flow,
often in the hands, feet, and long bones.
6. A nurse is administering digoxin to a child. Which action should the nurse take before
giving the dose?
A. Check the apical pulse for 1 full minute
B. Check the radial pulse for 15 seconds
C. Administer with food
D. Hold if the heart rate is above 100 bpm
Answer: A. Check the apical pulse for 1 full minute
Rationale: Digoxin slows heart rate. The apical pulse must be checked for 1 full minute
before administration. Hold if below the prescribed rate (typically <90–110 depending on
age).
7. A nurse is teaching a parent about car seat safety for a 2-year-old child. Which
instruction should the nurse include?
A. Use a rear-facing car seat until age 2 or until the child reaches the height/weight limit
B. Use a forward-facing car seat with a lap belt only
C. Place the child in the front seat with the seat belt
D. Use a booster seat with a lap-shoulder belt
Answer: A. Use a rear-facing car seat until age 2 or until the child reaches the
height/weight limit
, Rationale: The AAP recommends rear-facing car seats until age 2 or until the child reaches
the maximum height/weight for the seat.
8. A nurse is assessing a newborn immediately after birth. Which finding requires
immediate intervention?
A. Heart rate 120 bpm
B. Respiratory rate 50 breaths/min
C. Central cyanosis
D. Acrocyanosis
Answer: C. Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate
intervention. Acrocyanosis is a normal finding in newborns.
9. A nurse is caring for a child with Kawasaki disease. Which medication is used to
prevent coronary artery aneurysms?
A. Acetaminophen
B. Ibuprofen
C. Aspirin
D. Penicillin
Answer: C. Aspirin
Rationale: High-dose aspirin is used in Kawasaki disease to reduce inflammation and
prevent coronary artery aneurysms, followed by low-dose aspirin.
10. A nurse is teaching a parent about preventing sudden infant death syndrome (SIDS).
Which instruction should the nurse include?
A. Place the infant on the stomach to sleep
B. Place the infant on the back to sleep
