ATI RN Pediatric Nursing Practice Exam 2026
Question 1: A nurse is assessing a 12-month-old infant during a well-
child visit. Which of the following developmental milestones should the
nurse expect the infant to have achieved?
A. Walks independently and uses a two-word vocabulary
B. Sits unsupported and exhibits stranger anxiety
C. Pulls to a stand and drinks from a cup with assistance
D. Builds a tower of six blocks and rides a tricycle
Correct Answer: C. Pulls to a stand and drinks from a cup with
assistance
Rationale: At 12 months of age, infants typically can pull themselves
to a standing position, cruise around furniture, and begin drinking
from a cup with assistance. Walking independently and two-word
phrases are expected around 15-18 months and 24 months
respectively. Sitting unsupported occurs around 6-8 months. Building
a six-block tower and riding a tricycle are toddler milestones (ages 2-
3 years).
Question 2: A nurse is teaching the parent of a 6-month-old infant about
introducing solid foods. Which of the following instructions should the
nurse include?
A. Introduce cow's milk as the primary beverage alongside iron-
fortified cereal.
B. Introduce new single-ingredient foods at intervals of 5 to 7 days.
C. Mix pureed honey into cereals to improve palatability for the
infant.
D. Delay the introduction of iron-fortified rice cereal until 9 months
of age.
, Correct Answer: B. Introduce new single-ingredient foods at
intervals of 5 to 7 days.
Rationale: New foods should be introduced one at a time, allowing 5
to 7 days between each new food to easily identify any potential food
allergies or intolerances. Cow's milk should not be given before 12
months. Honey must be avoided before 12 months due to the risk of
infant botulism. Iron-fortified cereals are typically introduced around
4 to 6 months.
Question 3: A nurse is assessing a preschooler during a routine health
supervision visit. Which of the following behaviors indicates expected
psychosocial development according to Erikson?
A. Demonstrates a sense of trust in primary caregivers
B. Exhibits initiative by exploring new activities and asking many
questions
C. Achieves a sense of industry through school and extracurricular
accomplishments
D. Develops autonomy by controlling bodily functions during toilet
training
Correct Answer: B. Exhibits initiative by exploring new activities
and asking many questions
Rationale: According to Erikson, the psychosocial stage for
preschool-aged children (3-6 years) is initiative versus guilt. They
show initiative by creating games, exploring surroundings, and
asking constant questions. Trust vs. mistrust is infancy (0-1 year),
industry vs. inferiority is school-age (6-12 years), and autonomy vs.
shame/doubt is toddlerhood (1-3 years).
Question 4: An adolescent client expresses concern about body changes
during puberty. Which of the following is the first sign of female sexual
maturation?
, A. Onset of menarche
B. Appearance of axillary hair
C. Breast bud development (thelarche)
D. Widening of the pelvic girdle
Correct Answer: C. Breast bud development (thelarche)
Rationale: The initial sign of female sexual maturation (puberty) is
breast bud development, known as thelarche, which typically occurs
between ages 9 and 11. Menarche is a late sign of puberty occurring
approximately 2 years after breast budding. Axillary hair and
widening hips appear later in Tanner staging.
Question 5: A nurse is providing anticipatory guidance to the parents of
a toddler regarding toilet training readiness. Which of the following
behavioral cues indicates readiness?
A. The toddler can recognize the urge to urinate or defecate and
communicate it.
B. The toddler consistently hides when having a bowel movement in
a diaper.
C. The toddler expresses intense dislike for wearing clean diapers.
D. The toddler is able to completely dress and undress independently.
Correct Answer: A. The toddler can recognize the urge to urinate or
defecate and communicate it.
Rationale: Physiological and psychological readiness for toilet
training requires motor readiness, cognitive awareness of the
sensation of elimination, and the ability to verbally or non-verbally
communicate the need to go before or while it is happening. Hiding
or disliking diapers are signs, but conscious communication and
sphincter control are essential.
, Question 6: A nurse is monitoring the growth parameters of an 18-
month-old toddler. At birth, the toddler's weight was 3.2 kg (7 lbs).
Based on expected growth patterns, what should the nurse anticipate the
toddler's current weight to be?
A. 6.4 kg (14 lbs)
B. 9.6 kg (21 lbs)
C. 12.8 kg (28 lbs)
D. 16.0 kg (35 lbs)
Correct Answer: B. 9.6 kg (21 lbs)
Rationale: An infant's birth weight typically doubles by 6 months of
age and triples by 12 months (1 year). By 24 months (2 years), birth
weight has quadrupled. Therefore, an 18-month-old toddler who
weighed 3.2 kg at birth is expected to weigh approximately triple the
birth weight (3.2 x 3 = 9.6 kg), plus additional weight gained during
the second year.
Question 7: A nurse is assessing a 4-year-old child's cognitive
development using Piaget's stages. Which of the following
characteristics should the nurse expect?
A. Abstract thinking and formal logical deduction
B. Conservation of mass and volume in liquid measurements
C. Egocentric thinking and symbolic play
D. Object permanence without understanding reversibility
Correct Answer: C. Egocentric thinking and symbolic play
Rationale: Preschoolers (ages 2-7) are in Piaget's preoperational
stage, characterized by egocentrism (viewing the world solely from
their own perspective), symbolic play, and animism. Concrete
operations (conservation and reversibility) develop in school-age
children. Formal operations (abstract thought) develop in
Question 1: A nurse is assessing a 12-month-old infant during a well-
child visit. Which of the following developmental milestones should the
nurse expect the infant to have achieved?
A. Walks independently and uses a two-word vocabulary
B. Sits unsupported and exhibits stranger anxiety
C. Pulls to a stand and drinks from a cup with assistance
D. Builds a tower of six blocks and rides a tricycle
Correct Answer: C. Pulls to a stand and drinks from a cup with
assistance
Rationale: At 12 months of age, infants typically can pull themselves
to a standing position, cruise around furniture, and begin drinking
from a cup with assistance. Walking independently and two-word
phrases are expected around 15-18 months and 24 months
respectively. Sitting unsupported occurs around 6-8 months. Building
a six-block tower and riding a tricycle are toddler milestones (ages 2-
3 years).
Question 2: A nurse is teaching the parent of a 6-month-old infant about
introducing solid foods. Which of the following instructions should the
nurse include?
A. Introduce cow's milk as the primary beverage alongside iron-
fortified cereal.
B. Introduce new single-ingredient foods at intervals of 5 to 7 days.
C. Mix pureed honey into cereals to improve palatability for the
infant.
D. Delay the introduction of iron-fortified rice cereal until 9 months
of age.
, Correct Answer: B. Introduce new single-ingredient foods at
intervals of 5 to 7 days.
Rationale: New foods should be introduced one at a time, allowing 5
to 7 days between each new food to easily identify any potential food
allergies or intolerances. Cow's milk should not be given before 12
months. Honey must be avoided before 12 months due to the risk of
infant botulism. Iron-fortified cereals are typically introduced around
4 to 6 months.
Question 3: A nurse is assessing a preschooler during a routine health
supervision visit. Which of the following behaviors indicates expected
psychosocial development according to Erikson?
A. Demonstrates a sense of trust in primary caregivers
B. Exhibits initiative by exploring new activities and asking many
questions
C. Achieves a sense of industry through school and extracurricular
accomplishments
D. Develops autonomy by controlling bodily functions during toilet
training
Correct Answer: B. Exhibits initiative by exploring new activities
and asking many questions
Rationale: According to Erikson, the psychosocial stage for
preschool-aged children (3-6 years) is initiative versus guilt. They
show initiative by creating games, exploring surroundings, and
asking constant questions. Trust vs. mistrust is infancy (0-1 year),
industry vs. inferiority is school-age (6-12 years), and autonomy vs.
shame/doubt is toddlerhood (1-3 years).
Question 4: An adolescent client expresses concern about body changes
during puberty. Which of the following is the first sign of female sexual
maturation?
, A. Onset of menarche
B. Appearance of axillary hair
C. Breast bud development (thelarche)
D. Widening of the pelvic girdle
Correct Answer: C. Breast bud development (thelarche)
Rationale: The initial sign of female sexual maturation (puberty) is
breast bud development, known as thelarche, which typically occurs
between ages 9 and 11. Menarche is a late sign of puberty occurring
approximately 2 years after breast budding. Axillary hair and
widening hips appear later in Tanner staging.
Question 5: A nurse is providing anticipatory guidance to the parents of
a toddler regarding toilet training readiness. Which of the following
behavioral cues indicates readiness?
A. The toddler can recognize the urge to urinate or defecate and
communicate it.
B. The toddler consistently hides when having a bowel movement in
a diaper.
C. The toddler expresses intense dislike for wearing clean diapers.
D. The toddler is able to completely dress and undress independently.
Correct Answer: A. The toddler can recognize the urge to urinate or
defecate and communicate it.
Rationale: Physiological and psychological readiness for toilet
training requires motor readiness, cognitive awareness of the
sensation of elimination, and the ability to verbally or non-verbally
communicate the need to go before or while it is happening. Hiding
or disliking diapers are signs, but conscious communication and
sphincter control are essential.
, Question 6: A nurse is monitoring the growth parameters of an 18-
month-old toddler. At birth, the toddler's weight was 3.2 kg (7 lbs).
Based on expected growth patterns, what should the nurse anticipate the
toddler's current weight to be?
A. 6.4 kg (14 lbs)
B. 9.6 kg (21 lbs)
C. 12.8 kg (28 lbs)
D. 16.0 kg (35 lbs)
Correct Answer: B. 9.6 kg (21 lbs)
Rationale: An infant's birth weight typically doubles by 6 months of
age and triples by 12 months (1 year). By 24 months (2 years), birth
weight has quadrupled. Therefore, an 18-month-old toddler who
weighed 3.2 kg at birth is expected to weigh approximately triple the
birth weight (3.2 x 3 = 9.6 kg), plus additional weight gained during
the second year.
Question 7: A nurse is assessing a 4-year-old child's cognitive
development using Piaget's stages. Which of the following
characteristics should the nurse expect?
A. Abstract thinking and formal logical deduction
B. Conservation of mass and volume in liquid measurements
C. Egocentric thinking and symbolic play
D. Object permanence without understanding reversibility
Correct Answer: C. Egocentric thinking and symbolic play
Rationale: Preschoolers (ages 2-7) are in Piaget's preoperational
stage, characterized by egocentrism (viewing the world solely from
their own perspective), symbolic play, and animism. Concrete
operations (conservation and reversibility) develop in school-age
children. Formal operations (abstract thought) develop in
