ATI NURSING CARE OF
CHILDREN PROCTORED EXAM
REVIEW
2026/2027 | 70 Questions and Correct Answers
with Rationales
Official Elsevier ATI Content Mastery Series® Specification |
NGN-Integrated
Pre-Licensure RN Program Competency Assessment
Already Graded A+ | 100% Verified
IMPORTANT CLARIFICATION
This document is an institutional course review and study guide created for nursing students preparing for
pediatric nursing examinations. It is designed to reinforce clinical knowledge aligned with the ATI Content
Mastery Series® blueprint and NCSBN NCLEX-RN Test Plan categories. This material does not contain actual
ATI exam questions, answers, or proprietary content. All scenarios and questions are original and developed for
educational purposes only.
,Introduction
This comprehensive review contains 70 clinical scenario-based questions aligned with the ATI
Content Mastery Series® Nursing Care of Children blueprint and the NCSBN NCLEX-RN Detailed
Test Plan. The questions are distributed across major content areas to reflect actual exam
weighting: Health Promotion and Maintenance (approximately 40–50%), Safe and Effective Care
Environment (approximately 15–20%), Psychosocial Integrity (approximately 15–20%), and
Physiological Integrity (approximately 10–20%).
Each question includes four answer options (A–D) with one best answer, followed by a detailed
rationale explaining why the correct answer is optimal and why each distractor is incorrect.
Rationales reference current clinical guidelines from the American Academy of Pediatrics (AAP),
Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and standard
pediatric nursing textbooks including Hockenberry & Wilson’s Wong’s Nursing Care of Children.
Questions incorporate Next-Generation NCLEX (NGN) item formats aligned with the NCSBN Clinical
Judgment Measurement Model (CJMM): Recognize Cues, Analyze Cues, Prioritize Hypotheses,
Generate Solutions, Take Action, and Evaluate Outcomes. Clinical scenarios span the full pediatric
age spectrum—neonates through adolescents—and emphasize family-centered care, safety,
developmentally appropriate communication, and evidence-based nursing interventions.
Answer Format: Each question displays the correct answer in bold cyan with a green
background highlight. Detailed rationales follow every question.
,Domain 1: Growth & Development Across Pediatric Stages
1. A nurse is assessing a 10-month-old infant during a well-child visit. The infant can crawl,
pull to a standing position, and say 'mama' and 'dada' with meaning. The nurse identifies the
infant is in which stage of Erikson's psychosocial development?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Rationale: The correct answer is A. Erikson's Trust vs. Mistrust stage spans from birth to 12 months. During this
stage, infants develop trust when caregivers consistently meet their basic needs for feeding, comfort, and
affection. The 10-month-old infant described is still within this developmental period. Autonomy vs. Shame and
Doubt occurs from 1 to 3 years (toddlers), Initiative vs. Guilt from 3 to 6 years (preschoolers), and Industry vs.
Inferiority from 6 to 12 years (school-age). Understanding Erikson's stages guides nursing interventions to
support appropriate psychosocial development (Hockenberry & Wilson, Wong's Nursing Care of Children, 12th
ed.).
2. A nurse is preparing a 2-year-old toddler for a surgical procedure. Based on Piaget's
cognitive development theory, which approach should the nurse use to explain the
procedure?
A) Provide a detailed explanation of the surgical anatomy and expected outcomes
B) Use simple words and demonstrate the procedure on a doll, focusing on what the
child will feel
C) Provide written materials and a video explaining the procedure step by step
D) Discuss the procedure using abstract concepts and encourage the child to ask questions
Rationale: The correct answer is B. According to Piaget, toddlers (ages 1-3 years) are in the sensorimotor to
preoperational stage transition, characterized by egocentric thinking and limited ability to understand abstract
concepts. Demonstrating the procedure on a doll uses concrete, visual learning that matches their cognitive level.
Option A uses complex language inappropriate for this age. Option C relies on literacy skills not yet developed.
Option D involves abstract reasoning beyond a 2-year-old's capacity (NCSBN NCLEX-RN Test Plan, Health
Promotion and Maintenance; AAP Guidelines for Preparing Children for Procedures).
3. A nurse is caring for a 4-year-old child who tells the nurse, 'I'm in the hospital because I
was bad.' Which developmental concept best explains the child's statement?
A) Egocentrism
B) Animism
, C) Immanent justice
D) Object permanence
Rationale: The correct answer is C. Immanent justice is the belief that negative events happen as punishment for
bad behavior. This is common in the preschool period (ages 3-6 years) and is part of preoperational cognitive
development per Piaget. The nurse should immediately reassure the child that hospitalization is not punishment.
Egocentrism (A) refers to the inability to see another's perspective. Animism (B) is attributing life to inanimate
objects. Object permanence (D) is an infant's understanding that objects exist even when unseen (Hockenberry &
Wilson; NCSBN NCLEX-RN Detailed Test Plan, Psychosocial Integrity).
4. A nurse is providing anticipatory guidance to the parent of a 9-month-old infant. Which
statement by the parent indicates understanding of age-appropriate developmental
milestones?
A) 'My baby should be able to walk independently by now.'
B) 'My baby should be able to drink from a cup with assistance.'
C) 'My baby should be able to use two-word sentences.'
D) 'My baby should be able to scribble with a crayon.'
Rationale: The correct answer is B. At 9 months, infants can begin to drink from a cup with assistance. Fine
motor development at this age includes a crude pincer grasp and transferring objects between hands. Walking
independently typically occurs around 12-15 months (A is incorrect). Two-word sentences develop around 18-24
months (C is incorrect). Scribbling with a crayon typically emerges around 12-15 months (D is premature). The
CDC developmental milestones guidelines provide age-specific expectations that nurses should use for
anticipatory guidance (CDC Milestone Checklist, 2024; AAP Bright Futures Guidelines).
5. A nurse is assessing a 12-month-old infant's gross motor development. Which finding
would the nurse expect for this age?
A) Jumping with both feet
B) Walking independently
C) Riding a tricycle
D) Hopping on one foot
Rationale: The correct answer is B. By 12 months, most infants can walk independently or take several steps
without support. Jumping with both feet (A) develops around 24-30 months. Riding a tricycle (C) is expected
around age 3 years. Hopping on one foot (D) typically develops around age 4-5 years. Gross motor milestones
follow a cephalocaudal and proximodistal pattern, and nurses should assess for deviations that may indicate
developmental delay (CDC Developmental Milestones; Hockenberry & Wilson, Wong's Nursing Care of Children).
CHILDREN PROCTORED EXAM
REVIEW
2026/2027 | 70 Questions and Correct Answers
with Rationales
Official Elsevier ATI Content Mastery Series® Specification |
NGN-Integrated
Pre-Licensure RN Program Competency Assessment
Already Graded A+ | 100% Verified
IMPORTANT CLARIFICATION
This document is an institutional course review and study guide created for nursing students preparing for
pediatric nursing examinations. It is designed to reinforce clinical knowledge aligned with the ATI Content
Mastery Series® blueprint and NCSBN NCLEX-RN Test Plan categories. This material does not contain actual
ATI exam questions, answers, or proprietary content. All scenarios and questions are original and developed for
educational purposes only.
,Introduction
This comprehensive review contains 70 clinical scenario-based questions aligned with the ATI
Content Mastery Series® Nursing Care of Children blueprint and the NCSBN NCLEX-RN Detailed
Test Plan. The questions are distributed across major content areas to reflect actual exam
weighting: Health Promotion and Maintenance (approximately 40–50%), Safe and Effective Care
Environment (approximately 15–20%), Psychosocial Integrity (approximately 15–20%), and
Physiological Integrity (approximately 10–20%).
Each question includes four answer options (A–D) with one best answer, followed by a detailed
rationale explaining why the correct answer is optimal and why each distractor is incorrect.
Rationales reference current clinical guidelines from the American Academy of Pediatrics (AAP),
Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and standard
pediatric nursing textbooks including Hockenberry & Wilson’s Wong’s Nursing Care of Children.
Questions incorporate Next-Generation NCLEX (NGN) item formats aligned with the NCSBN Clinical
Judgment Measurement Model (CJMM): Recognize Cues, Analyze Cues, Prioritize Hypotheses,
Generate Solutions, Take Action, and Evaluate Outcomes. Clinical scenarios span the full pediatric
age spectrum—neonates through adolescents—and emphasize family-centered care, safety,
developmentally appropriate communication, and evidence-based nursing interventions.
Answer Format: Each question displays the correct answer in bold cyan with a green
background highlight. Detailed rationales follow every question.
,Domain 1: Growth & Development Across Pediatric Stages
1. A nurse is assessing a 10-month-old infant during a well-child visit. The infant can crawl,
pull to a standing position, and say 'mama' and 'dada' with meaning. The nurse identifies the
infant is in which stage of Erikson's psychosocial development?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Rationale: The correct answer is A. Erikson's Trust vs. Mistrust stage spans from birth to 12 months. During this
stage, infants develop trust when caregivers consistently meet their basic needs for feeding, comfort, and
affection. The 10-month-old infant described is still within this developmental period. Autonomy vs. Shame and
Doubt occurs from 1 to 3 years (toddlers), Initiative vs. Guilt from 3 to 6 years (preschoolers), and Industry vs.
Inferiority from 6 to 12 years (school-age). Understanding Erikson's stages guides nursing interventions to
support appropriate psychosocial development (Hockenberry & Wilson, Wong's Nursing Care of Children, 12th
ed.).
2. A nurse is preparing a 2-year-old toddler for a surgical procedure. Based on Piaget's
cognitive development theory, which approach should the nurse use to explain the
procedure?
A) Provide a detailed explanation of the surgical anatomy and expected outcomes
B) Use simple words and demonstrate the procedure on a doll, focusing on what the
child will feel
C) Provide written materials and a video explaining the procedure step by step
D) Discuss the procedure using abstract concepts and encourage the child to ask questions
Rationale: The correct answer is B. According to Piaget, toddlers (ages 1-3 years) are in the sensorimotor to
preoperational stage transition, characterized by egocentric thinking and limited ability to understand abstract
concepts. Demonstrating the procedure on a doll uses concrete, visual learning that matches their cognitive level.
Option A uses complex language inappropriate for this age. Option C relies on literacy skills not yet developed.
Option D involves abstract reasoning beyond a 2-year-old's capacity (NCSBN NCLEX-RN Test Plan, Health
Promotion and Maintenance; AAP Guidelines for Preparing Children for Procedures).
3. A nurse is caring for a 4-year-old child who tells the nurse, 'I'm in the hospital because I
was bad.' Which developmental concept best explains the child's statement?
A) Egocentrism
B) Animism
, C) Immanent justice
D) Object permanence
Rationale: The correct answer is C. Immanent justice is the belief that negative events happen as punishment for
bad behavior. This is common in the preschool period (ages 3-6 years) and is part of preoperational cognitive
development per Piaget. The nurse should immediately reassure the child that hospitalization is not punishment.
Egocentrism (A) refers to the inability to see another's perspective. Animism (B) is attributing life to inanimate
objects. Object permanence (D) is an infant's understanding that objects exist even when unseen (Hockenberry &
Wilson; NCSBN NCLEX-RN Detailed Test Plan, Psychosocial Integrity).
4. A nurse is providing anticipatory guidance to the parent of a 9-month-old infant. Which
statement by the parent indicates understanding of age-appropriate developmental
milestones?
A) 'My baby should be able to walk independently by now.'
B) 'My baby should be able to drink from a cup with assistance.'
C) 'My baby should be able to use two-word sentences.'
D) 'My baby should be able to scribble with a crayon.'
Rationale: The correct answer is B. At 9 months, infants can begin to drink from a cup with assistance. Fine
motor development at this age includes a crude pincer grasp and transferring objects between hands. Walking
independently typically occurs around 12-15 months (A is incorrect). Two-word sentences develop around 18-24
months (C is incorrect). Scribbling with a crayon typically emerges around 12-15 months (D is premature). The
CDC developmental milestones guidelines provide age-specific expectations that nurses should use for
anticipatory guidance (CDC Milestone Checklist, 2024; AAP Bright Futures Guidelines).
5. A nurse is assessing a 12-month-old infant's gross motor development. Which finding
would the nurse expect for this age?
A) Jumping with both feet
B) Walking independently
C) Riding a tricycle
D) Hopping on one foot
Rationale: The correct answer is B. By 12 months, most infants can walk independently or take several steps
without support. Jumping with both feet (A) develops around 24-30 months. Riding a tricycle (C) is expected
around age 3 years. Hopping on one foot (D) typically develops around age 4-5 years. Gross motor milestones
follow a cephalocaudal and proximodistal pattern, and nurses should assess for deviations that may indicate
developmental delay (CDC Developmental Milestones; Hockenberry & Wilson, Wong's Nursing Care of Children).
