ATI Pediatrics Nursing Exam 2026/2027 | ACTUAL-
Style Practice Questions & Answers, Pediatric
Nursing, Growth and Development, Childhood
Diseases, Pediatric Pharmacology, and Detailed
Rationales
Question 1: A nurse is assessing a 6-month-old infant during a well-
child visit. Which developmental milestone should the nurse expect
the infant to demonstrate?
A. Rolling from back to abdomen
B. Sitting without support
C. Transferring objects hand to hand
D. Pincer grasp
CORRECT ANSWER: A. Rolling from back to abdomen
Rationale: Rolling from back to abdomen typically emerges around 5–6
months of age. Sitting without support is expected around 8 months,
transferring objects hand to hand around 7 months, and pincer grasp
around 9–10 months.
Question 2: A nurse is caring for a 2-year-old child. According to
Piaget, which stage of cognitive development is the child in?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
CORRECT ANSWER: B. Preoperational
Rationale: The preoperational stage (2–7 years) is characterized by
egocentric thinking and symbolic play. Sensorimotor is birth to 2 years,
concrete operational is 7–11 years, and formal operational begins at 11
years.
Question 3: A nurse is preparing to administer the MMR vaccine to
a 12-month-old. Which finding should the nurse identify as a
contraindication?
A. Mild upper respiratory infection
B. Current antibiotic therapy
C. Severe immunodeficiency
D. Low-grade fever of 99.8°F
,CORRECT ANSWER: C. Severe immunodeficiency
Rationale: MMR is a live attenuated vaccine and is contraindicated in
severe immunodeficiency. Mild illness, antibiotics, and low-grade fever are
not contraindications.
Question 4: A nurse is assessing a newborn 1 minute after birth.
Heart rate is 110, respiratory effort is slow and irregular, muscle
tone is flexed, reflex irritability is grimace, and color is
acrocyanotic. What Apgar score should the nurse assign?
A. 5
B. 6
C. 7
D. 8
CORRECT ANSWER: C. 7
Rationale: Heart rate 110 = 2, slow irregular respirations = 1, flexed tone =
2, grimace = 1, acrocyanosis = 1. Total = 7.
Question 5: A nurse is teaching a parent about introducing solid
foods to an infant. Which food should the nurse recommend
introducing first?
A. Pureed carrots
B. Iron-fortified rice cereal
C. Scrambled eggs
D. Whole cow's milk
CORRECT ANSWER: B. Iron-fortified rice cereal
Rationale: Iron-fortified single-grain cereal is traditionally the first solid
introduced at about 6 months because it provides iron and has low allergy
potential. Eggs and cow's milk are introduced later.
Question 6: A nurse is caring for a child with acute epiglottitis.
Which action should the nurse take first?
A. Obtain a throat culture
B. Inspect the throat with a tongue blade
C. Maintain a patent airway and keep the child calm
D. Administer oral antibiotics
,CORRECT ANSWER: C. Maintain a patent airway and keep the
child calm
Rationale: Epiglottitis can cause sudden airway obstruction. Throat
inspection with a tongue blade is contraindicated because it may precipitate
complete airway closure. Airway maintenance and minimizing agitation are
priority.
Question 7: A nurse is assessing a 9-month-old infant. Which
finding should the nurse report as a possible sign of developmental
delay?
A. Ability to sit without support
B. Absence of pincer grasp
C. Presence of stranger anxiety
D. Ability to say "mama" nonspecifically
CORRECT ANSWER: B. Absence of pincer grasp
Rationale: Pincer grasp typically develops by 9 months. Its absence at 9
months may indicate fine motor delay. Sitting without support, stranger
anxiety, and nonspecific babbling are appropriate for this age.
Question 8: A nurse is caring for a child receiving digoxin. Which
finding should the nurse report immediately?
A. Heart rate of 90 beats/min in a 5-year-old
B. Serum potassium of 4.0 mEq/L
C. Vomiting and bradycardia
D. Weight gain of 0.5 kg
CORRECT ANSWER: C. Vomiting and bradycardia
Rationale: Vomiting and bradycardia are classic signs of digoxin toxicity.
The nurse should hold the dose and notify the provider immediately.
Question 9: A nurse is teaching the parents of a child with sickle
cell disease about preventing vaso-occlusive crises. Which
instruction is most important?
A. Encourage rigorous physical activity
B. Maintain adequate hydration
C. Restrict fluids to prevent overload
D. Avoid all immunizations
, CORRECT ANSWER: B. Maintain adequate hydration
Rationale: Hydration reduces blood viscosity and helps prevent sickling and
vaso-occlusion. Strenuous activity, fluid restriction, and avoiding
immunizations are incorrect.
Question 10: A nurse is assessing a child with suspected Kawasaki
disease. Which clinical finding is most characteristic?
A. Strawberry tongue and conjunctivitis
B. Koplik spots
C. Honey-colored crusted lesions
D. Slapped cheek rash
CORRECT ANSWER: A. Strawberry tongue and conjunctivitis
Rationale: Kawasaki disease presents with fever, conjunctivitis, strawberry
tongue, rash, extremity changes, and cervical lymphadenopathy. Koplik
spots are seen in measles.
Question 11: A nurse is calculating the maintenance fluid
requirement for a 20-kg child using the Holliday-Segar method.
What is the daily requirement?
A. 1,200 mL
B. 1,500 mL
C. 1,800 mL
D. 2,000 mL
CORRECT ANSWER: B. 1,500 mL
Rationale: Holliday-Segar: 100 mL/kg for first 10 kg = 1,000 mL; 50 mL/kg
for next 10 kg = 500 mL; total = 1,500 mL/day.
Question 12: A nurse is caring for a 4-year-old child with croup.
Which intervention should the nurse implement?
A. Administer prescribed nebulized racemic epinephrine
B. Place the child in a supine position
C. Restrict oral fluids
D. Encourage coughing forcefully
CORRECT ANSWER: A. Administer prescribed nebulized racemic
epinephrine
Style Practice Questions & Answers, Pediatric
Nursing, Growth and Development, Childhood
Diseases, Pediatric Pharmacology, and Detailed
Rationales
Question 1: A nurse is assessing a 6-month-old infant during a well-
child visit. Which developmental milestone should the nurse expect
the infant to demonstrate?
A. Rolling from back to abdomen
B. Sitting without support
C. Transferring objects hand to hand
D. Pincer grasp
CORRECT ANSWER: A. Rolling from back to abdomen
Rationale: Rolling from back to abdomen typically emerges around 5–6
months of age. Sitting without support is expected around 8 months,
transferring objects hand to hand around 7 months, and pincer grasp
around 9–10 months.
Question 2: A nurse is caring for a 2-year-old child. According to
Piaget, which stage of cognitive development is the child in?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
CORRECT ANSWER: B. Preoperational
Rationale: The preoperational stage (2–7 years) is characterized by
egocentric thinking and symbolic play. Sensorimotor is birth to 2 years,
concrete operational is 7–11 years, and formal operational begins at 11
years.
Question 3: A nurse is preparing to administer the MMR vaccine to
a 12-month-old. Which finding should the nurse identify as a
contraindication?
A. Mild upper respiratory infection
B. Current antibiotic therapy
C. Severe immunodeficiency
D. Low-grade fever of 99.8°F
,CORRECT ANSWER: C. Severe immunodeficiency
Rationale: MMR is a live attenuated vaccine and is contraindicated in
severe immunodeficiency. Mild illness, antibiotics, and low-grade fever are
not contraindications.
Question 4: A nurse is assessing a newborn 1 minute after birth.
Heart rate is 110, respiratory effort is slow and irregular, muscle
tone is flexed, reflex irritability is grimace, and color is
acrocyanotic. What Apgar score should the nurse assign?
A. 5
B. 6
C. 7
D. 8
CORRECT ANSWER: C. 7
Rationale: Heart rate 110 = 2, slow irregular respirations = 1, flexed tone =
2, grimace = 1, acrocyanosis = 1. Total = 7.
Question 5: A nurse is teaching a parent about introducing solid
foods to an infant. Which food should the nurse recommend
introducing first?
A. Pureed carrots
B. Iron-fortified rice cereal
C. Scrambled eggs
D. Whole cow's milk
CORRECT ANSWER: B. Iron-fortified rice cereal
Rationale: Iron-fortified single-grain cereal is traditionally the first solid
introduced at about 6 months because it provides iron and has low allergy
potential. Eggs and cow's milk are introduced later.
Question 6: A nurse is caring for a child with acute epiglottitis.
Which action should the nurse take first?
A. Obtain a throat culture
B. Inspect the throat with a tongue blade
C. Maintain a patent airway and keep the child calm
D. Administer oral antibiotics
,CORRECT ANSWER: C. Maintain a patent airway and keep the
child calm
Rationale: Epiglottitis can cause sudden airway obstruction. Throat
inspection with a tongue blade is contraindicated because it may precipitate
complete airway closure. Airway maintenance and minimizing agitation are
priority.
Question 7: A nurse is assessing a 9-month-old infant. Which
finding should the nurse report as a possible sign of developmental
delay?
A. Ability to sit without support
B. Absence of pincer grasp
C. Presence of stranger anxiety
D. Ability to say "mama" nonspecifically
CORRECT ANSWER: B. Absence of pincer grasp
Rationale: Pincer grasp typically develops by 9 months. Its absence at 9
months may indicate fine motor delay. Sitting without support, stranger
anxiety, and nonspecific babbling are appropriate for this age.
Question 8: A nurse is caring for a child receiving digoxin. Which
finding should the nurse report immediately?
A. Heart rate of 90 beats/min in a 5-year-old
B. Serum potassium of 4.0 mEq/L
C. Vomiting and bradycardia
D. Weight gain of 0.5 kg
CORRECT ANSWER: C. Vomiting and bradycardia
Rationale: Vomiting and bradycardia are classic signs of digoxin toxicity.
The nurse should hold the dose and notify the provider immediately.
Question 9: A nurse is teaching the parents of a child with sickle
cell disease about preventing vaso-occlusive crises. Which
instruction is most important?
A. Encourage rigorous physical activity
B. Maintain adequate hydration
C. Restrict fluids to prevent overload
D. Avoid all immunizations
, CORRECT ANSWER: B. Maintain adequate hydration
Rationale: Hydration reduces blood viscosity and helps prevent sickling and
vaso-occlusion. Strenuous activity, fluid restriction, and avoiding
immunizations are incorrect.
Question 10: A nurse is assessing a child with suspected Kawasaki
disease. Which clinical finding is most characteristic?
A. Strawberry tongue and conjunctivitis
B. Koplik spots
C. Honey-colored crusted lesions
D. Slapped cheek rash
CORRECT ANSWER: A. Strawberry tongue and conjunctivitis
Rationale: Kawasaki disease presents with fever, conjunctivitis, strawberry
tongue, rash, extremity changes, and cervical lymphadenopathy. Koplik
spots are seen in measles.
Question 11: A nurse is calculating the maintenance fluid
requirement for a 20-kg child using the Holliday-Segar method.
What is the daily requirement?
A. 1,200 mL
B. 1,500 mL
C. 1,800 mL
D. 2,000 mL
CORRECT ANSWER: B. 1,500 mL
Rationale: Holliday-Segar: 100 mL/kg for first 10 kg = 1,000 mL; 50 mL/kg
for next 10 kg = 500 mL; total = 1,500 mL/day.
Question 12: A nurse is caring for a 4-year-old child with croup.
Which intervention should the nurse implement?
A. Administer prescribed nebulized racemic epinephrine
B. Place the child in a supine position
C. Restrict oral fluids
D. Encourage coughing forcefully
CORRECT ANSWER: A. Administer prescribed nebulized racemic
epinephrine
