ATI RN Pediatrics 2026 Proctored Exam with
NGN Questions and 100% Correct Answers
to Score 98% and Above in the New 2026
RN ATI Pediatrics Proctored Assessment,
Updated Exam Review Materials,
Comprehensive Study Guide and Practice
Questions
Growth & Development
1. A nurse is assessing a 6-month-old infant. Which finding should the nurse
expect?
• A. Birth weight doubled
• B. Birth weight tripled
• C. Able to sit without support
• D. Able to walk with assistance
Correct Answer: A
Rationale: Birth weight typically doubles by 5–6 months and triples by 12
months. Sitting without support occurs around 8 months, and walking with
assistance around 9–12 months.
2. A nurse is teaching parents about toddler development. Which behavior
indicates a 2-year-old is meeting expected milestones?
• A. Uses 2–3 word sentences
• B. Can hop on one foot
• C. Knows full name and address
• D. Plays cooperatively with peers
, Correct Answer: A
Rationale: A 2-year-old uses 2–3 word sentences. Hopping on one foot is
expected at 4 years, knowing full name/address at 5 years, and cooperative play
at 4–5 years.
3. Which is the priority nursing action when a 4-month-old infant has not doubled
birth weight?
• A. Encourage more frequent feedings
• B. Assess for underlying cardiac or metabolic issues
• C. Reassure the parent this is normal
• D. Refer to a nutritionist
Correct Answer: B
Rationale: Birth weight should double by 5–6 months. Failure to thrive may
indicate cardiac, metabolic, or feeding problems requiring further assessment.
4. A nurse is assessing a 5-year-old. Which fine motor skill should be present?
• A. Tying shoelaces
• B. Drawing a stick figure
• C. Using scissors to cut a circle
• D. Writing full sentences
Correct Answer: C
Rationale: A 5-year-old can cut a circle with scissors. Tying shoelaces and
drawing a stick figure are expected at 6 years. Writing full sentences is later.
5. The nurse is teaching about Piaget’s stages. A 9-year-old is in which stage?
• A. Sensorimotor
• B. Preoperational
• C. Concrete operational
• D. Formal operational
, Correct Answer: C
Rationale: Concrete operational (7–11 years) involves logical thinking about
concrete events. Formal operational begins at 11 years.
Fluid & Electrolytes
6. A 2-year-old is admitted with severe dehydration. Which IV fluid is most
appropriate for initial bolus?
• A. 0.45% NaCl
• B. 0.9% NaCl
• C. D5W
• D. D5 0.45% NaCl
Correct Answer: B
Rationale: Isotonic 0.9% NaCl (normal saline) is the fluid of choice for initial
bolus in pediatric dehydration. Hypotonic fluids can cause cerebral edema.
7. A child weighs 22 lb. What is the maintenance fluid requirement per hour using
the 4-2-1 rule?
• A. 30 mL/hr
• B. 40 mL/hr
• C. 44 mL/hr
• D. 50 mL/hr
Correct Answer: B
Rationale: 22 lb = 10 kg. 4 mL/kg for first 10 kg = 40 mL/hr. The 4-2-1 rule: 4
mL/kg/hr for first 10 kg.
8. Which sign indicates hyperkalemia in a child?
• A. Muscle weakness
• B. Hyperactive reflexes
• C. Peaked T waves on ECG
, • D. Increased urine output
Correct Answer: C
Rationale: Hyperkalemia causes peaked T waves, muscle weakness, and
bradycardia. Hyperactive reflexes and increased urine output are not typical.
9. A child with diarrhea is at risk for which acid-base imbalance?
• A. Metabolic alkalosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Respiratory acidosis
Correct Answer: B
Rationale: Diarrhea causes loss of bicarbonate, leading to metabolic acidosis.
10. A nurse is assessing a child with hyponatremia. Which finding is expected?
• A. Increased thirst
• B. Lethargy and confusion
• C. Hypertension
• D. Hyperactive bowel sounds
Correct Answer: B
Rationale: Hyponatremia causes neurologic symptoms: lethargy, confusion,
seizures. Hypertension is not typical.
Respiratory
11. A child with asthma is prescribed albuterol. Which instruction is correct?
• A. Use daily for prevention
• B. Use as a rescue inhaler
• C. Use before bedtime only
• D. Use with food
NGN Questions and 100% Correct Answers
to Score 98% and Above in the New 2026
RN ATI Pediatrics Proctored Assessment,
Updated Exam Review Materials,
Comprehensive Study Guide and Practice
Questions
Growth & Development
1. A nurse is assessing a 6-month-old infant. Which finding should the nurse
expect?
• A. Birth weight doubled
• B. Birth weight tripled
• C. Able to sit without support
• D. Able to walk with assistance
Correct Answer: A
Rationale: Birth weight typically doubles by 5–6 months and triples by 12
months. Sitting without support occurs around 8 months, and walking with
assistance around 9–12 months.
2. A nurse is teaching parents about toddler development. Which behavior
indicates a 2-year-old is meeting expected milestones?
• A. Uses 2–3 word sentences
• B. Can hop on one foot
• C. Knows full name and address
• D. Plays cooperatively with peers
, Correct Answer: A
Rationale: A 2-year-old uses 2–3 word sentences. Hopping on one foot is
expected at 4 years, knowing full name/address at 5 years, and cooperative play
at 4–5 years.
3. Which is the priority nursing action when a 4-month-old infant has not doubled
birth weight?
• A. Encourage more frequent feedings
• B. Assess for underlying cardiac or metabolic issues
• C. Reassure the parent this is normal
• D. Refer to a nutritionist
Correct Answer: B
Rationale: Birth weight should double by 5–6 months. Failure to thrive may
indicate cardiac, metabolic, or feeding problems requiring further assessment.
4. A nurse is assessing a 5-year-old. Which fine motor skill should be present?
• A. Tying shoelaces
• B. Drawing a stick figure
• C. Using scissors to cut a circle
• D. Writing full sentences
Correct Answer: C
Rationale: A 5-year-old can cut a circle with scissors. Tying shoelaces and
drawing a stick figure are expected at 6 years. Writing full sentences is later.
5. The nurse is teaching about Piaget’s stages. A 9-year-old is in which stage?
• A. Sensorimotor
• B. Preoperational
• C. Concrete operational
• D. Formal operational
, Correct Answer: C
Rationale: Concrete operational (7–11 years) involves logical thinking about
concrete events. Formal operational begins at 11 years.
Fluid & Electrolytes
6. A 2-year-old is admitted with severe dehydration. Which IV fluid is most
appropriate for initial bolus?
• A. 0.45% NaCl
• B. 0.9% NaCl
• C. D5W
• D. D5 0.45% NaCl
Correct Answer: B
Rationale: Isotonic 0.9% NaCl (normal saline) is the fluid of choice for initial
bolus in pediatric dehydration. Hypotonic fluids can cause cerebral edema.
7. A child weighs 22 lb. What is the maintenance fluid requirement per hour using
the 4-2-1 rule?
• A. 30 mL/hr
• B. 40 mL/hr
• C. 44 mL/hr
• D. 50 mL/hr
Correct Answer: B
Rationale: 22 lb = 10 kg. 4 mL/kg for first 10 kg = 40 mL/hr. The 4-2-1 rule: 4
mL/kg/hr for first 10 kg.
8. Which sign indicates hyperkalemia in a child?
• A. Muscle weakness
• B. Hyperactive reflexes
• C. Peaked T waves on ECG
, • D. Increased urine output
Correct Answer: C
Rationale: Hyperkalemia causes peaked T waves, muscle weakness, and
bradycardia. Hyperactive reflexes and increased urine output are not typical.
9. A child with diarrhea is at risk for which acid-base imbalance?
• A. Metabolic alkalosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Respiratory acidosis
Correct Answer: B
Rationale: Diarrhea causes loss of bicarbonate, leading to metabolic acidosis.
10. A nurse is assessing a child with hyponatremia. Which finding is expected?
• A. Increased thirst
• B. Lethargy and confusion
• C. Hypertension
• D. Hyperactive bowel sounds
Correct Answer: B
Rationale: Hyponatremia causes neurologic symptoms: lethargy, confusion,
seizures. Hypertension is not typical.
Respiratory
11. A child with asthma is prescribed albuterol. Which instruction is correct?
• A. Use daily for prevention
• B. Use as a rescue inhaler
• C. Use before bedtime only
• D. Use with food
