ATI Pediatrics Proctored Exam Study Guide
100 Questions & Answers with Rationales
Format: Each question includes the correct answer marked with , detailed rationale, and key
concepts.
Growth & Development (Questions 1-20)
1. According to Piaget, which stage is a 4-year-old child in?
A) Sensorimotor
B) Preoperational
C) Concrete Operational
D) Formal Operational
Rationale: The preoperational stage (ages 2-7) involves symbolic thinking, egocentrism, and
imagination but lacks logical operations.
2. A 2-month-old infant should be able to:
A) Sit without support
B) Roll from back to front
C) Follow objects past midline
D) Say 2-3 words
Rationale: Visual tracking improves by 2 months. Sitting alone occurs around 6 months, rolling
at 4-6 months, words at 12 months.
3. The anterior fontanel normally closes by:
A) 2-4 months
B) 6-8 months
C) 12-18 months
D) 24-30 months
Rationale: Anterior fontanel closes between 12-18 months; posterior fontanel closes by 2-3
months.
,4. Which vaccine is contraindicated in a child with a severe egg allergy?
A) MMR
B) Varicella
C) Influenza
D) HPV
Rationale: Influenza vaccine is cultured in egg embryos and may trigger reactions in severe egg
allergy (consult allergist possible administration protocols).
5. A 6-year-old with frequent bedwetting. Initial nursing action:
A) Recommend limiting fluids at night
B) Assess child's perception and family history
C) Refer to urology immediately
D) Start medication (desmopressin)
Rationale: Nocturnal enuresis is common. Assess first for stressors, family history, rule-out UTI
before interventions.
6. Expected weight gain for an infant in the first 6 months:
A) 10 g/day
B) 20 g/day
C) 30 g/day
D) 40 g/day
Rationale: Infants gain about 20-30 g/day in first 6 months (doubling birth weight by 6 months).
7. Erickson's stage for a toddler (1-3 years):
A) Trust vs. Mistrust
B) Autonomy vs. Shame/Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Rationale: Toddlers strive for independence (autonomy); encourage choices within limits.
,8. Priority teaching for parents of a newborn regarding SIDS prevention:
A) Use bumper pads in crib
B) Place infant supine to sleep
C) Offer pacifier dipped in honey
D) Share bed with parents
Rationale: Back to sleep, firm mattress, no soft bedding, room-sharing without bed-sharing
reduces SIDS risk.
9. Fine motor skill for a 5-year-old:
A) Builds tower of 2 cubes
B) Copies a circle
C) Uses spoon well
D) Ties shoelaces
Rationale: By age 5-6, children can tie shoelaces, draw a person with 6 parts, and print some
letters.
10. Leading cause of death in adolescents:
A) Cancer
B) Heart disease
C) Unintentional injuries (including MVAs)
D) Homicide
Rationale: Unintentional injuries (MVAs, poisoning, drowning) are top cause; suicide and
homicide also high.
(Due to length constraints, I'll continue in condensed format while maintaining structure.)
11. Expected pulse rate for a 2-year-old:
A) 80-100
B) 100-120
C) 120-140
D) 140-160
*Rationale: Toddler HR 80-130 typical; 120-140 common when active.*
, 12. Signs of developmental dysplasia of hip in infant:
A) Symmetrical thigh folds
B) Limited hip abduction
C) Longer leg on affected side
D) Foot turning inward
Rationale: Asymmetry, limited abduction, Ortolani/Barlow signs.
13. First sign of puberty in females:
A) Menarche
B) Breast buds
C) Pubic hair
D) Growth spurt
*Rationale: Breast budding (thelarche) typically first, ages 8-13.*
14. Appropriate toy for 9-month-old:
A) Push-pull toy
B) Large building blocks
C) Peek-a-boo
D) Board game
Rationale: Object permanence games, safe chewable toys, texture exploration.
15. Age for first MMR vaccine:
A) Birth
B) 2 months
C) 6 months
D) 12-15 months
*Rationale: First dose at 12-15 months; second at 4-6 years.*
16. Warning sign for autism spectrum disorder in toddler:
A) Walking at 12 months
B) Babbling at 6 months
C) No single words by 16 months
D) Stranger anxiety at 9 months
Rationale: Language/social delays, lack of pretend play, poor eye contact.
17. Car seat direction for 9-month-old (22 lbs):
A) Forward-facing
B) Rear-facing
C) Booster seat
100 Questions & Answers with Rationales
Format: Each question includes the correct answer marked with , detailed rationale, and key
concepts.
Growth & Development (Questions 1-20)
1. According to Piaget, which stage is a 4-year-old child in?
A) Sensorimotor
B) Preoperational
C) Concrete Operational
D) Formal Operational
Rationale: The preoperational stage (ages 2-7) involves symbolic thinking, egocentrism, and
imagination but lacks logical operations.
2. A 2-month-old infant should be able to:
A) Sit without support
B) Roll from back to front
C) Follow objects past midline
D) Say 2-3 words
Rationale: Visual tracking improves by 2 months. Sitting alone occurs around 6 months, rolling
at 4-6 months, words at 12 months.
3. The anterior fontanel normally closes by:
A) 2-4 months
B) 6-8 months
C) 12-18 months
D) 24-30 months
Rationale: Anterior fontanel closes between 12-18 months; posterior fontanel closes by 2-3
months.
,4. Which vaccine is contraindicated in a child with a severe egg allergy?
A) MMR
B) Varicella
C) Influenza
D) HPV
Rationale: Influenza vaccine is cultured in egg embryos and may trigger reactions in severe egg
allergy (consult allergist possible administration protocols).
5. A 6-year-old with frequent bedwetting. Initial nursing action:
A) Recommend limiting fluids at night
B) Assess child's perception and family history
C) Refer to urology immediately
D) Start medication (desmopressin)
Rationale: Nocturnal enuresis is common. Assess first for stressors, family history, rule-out UTI
before interventions.
6. Expected weight gain for an infant in the first 6 months:
A) 10 g/day
B) 20 g/day
C) 30 g/day
D) 40 g/day
Rationale: Infants gain about 20-30 g/day in first 6 months (doubling birth weight by 6 months).
7. Erickson's stage for a toddler (1-3 years):
A) Trust vs. Mistrust
B) Autonomy vs. Shame/Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Rationale: Toddlers strive for independence (autonomy); encourage choices within limits.
,8. Priority teaching for parents of a newborn regarding SIDS prevention:
A) Use bumper pads in crib
B) Place infant supine to sleep
C) Offer pacifier dipped in honey
D) Share bed with parents
Rationale: Back to sleep, firm mattress, no soft bedding, room-sharing without bed-sharing
reduces SIDS risk.
9. Fine motor skill for a 5-year-old:
A) Builds tower of 2 cubes
B) Copies a circle
C) Uses spoon well
D) Ties shoelaces
Rationale: By age 5-6, children can tie shoelaces, draw a person with 6 parts, and print some
letters.
10. Leading cause of death in adolescents:
A) Cancer
B) Heart disease
C) Unintentional injuries (including MVAs)
D) Homicide
Rationale: Unintentional injuries (MVAs, poisoning, drowning) are top cause; suicide and
homicide also high.
(Due to length constraints, I'll continue in condensed format while maintaining structure.)
11. Expected pulse rate for a 2-year-old:
A) 80-100
B) 100-120
C) 120-140
D) 140-160
*Rationale: Toddler HR 80-130 typical; 120-140 common when active.*
, 12. Signs of developmental dysplasia of hip in infant:
A) Symmetrical thigh folds
B) Limited hip abduction
C) Longer leg on affected side
D) Foot turning inward
Rationale: Asymmetry, limited abduction, Ortolani/Barlow signs.
13. First sign of puberty in females:
A) Menarche
B) Breast buds
C) Pubic hair
D) Growth spurt
*Rationale: Breast budding (thelarche) typically first, ages 8-13.*
14. Appropriate toy for 9-month-old:
A) Push-pull toy
B) Large building blocks
C) Peek-a-boo
D) Board game
Rationale: Object permanence games, safe chewable toys, texture exploration.
15. Age for first MMR vaccine:
A) Birth
B) 2 months
C) 6 months
D) 12-15 months
*Rationale: First dose at 12-15 months; second at 4-6 years.*
16. Warning sign for autism spectrum disorder in toddler:
A) Walking at 12 months
B) Babbling at 6 months
C) No single words by 16 months
D) Stranger anxiety at 9 months
Rationale: Language/social delays, lack of pretend play, poor eye contact.
17. Car seat direction for 9-month-old (22 lbs):
A) Forward-facing
B) Rear-facing
C) Booster seat
