ATI PEDIATRICS CMS
COMPREHENSIVE PRACTICE EXAM
200 Questions with Correct Detailed Answers and Rationales
Aligned with 2026-2027 ATI Pediatrics CMS Standards
and NCLEX-RN Pediatric Nursing Competencies
Content Mastery Series Examination Preparation
Comprehensive Document for PEDS CMS | A+ Graded
25% Recall | 55% Application | 20% Analysis
,Section 1: Growth and Development (Infancy, Toddler, Preschool, School-Age,
Adolescent)
Q1: A nurse is assessing a 2-month-old infant. Which of the following developmental milestones should the
nurse expect the infant to demonstrate?
A. Lifts head slightly off the bed when prone [CORRECT]
B. Rolls from back to side
C. Sits independently without support
D. Walks while holding onto furniture
Correct Answer: A
Rationale: At 2 months, infants can lift their head slightly off the bed when in a prone position, which reflects developing neck
and shoulder muscle strength. Rolling from back to side typically occurs around 4-5 months. Sitting independently is expected at
approximately 6-7 months. Walking while holding onto furniture (cruising) emerges around 9-12 months. According to ATI CMS
standards, head control develops progressively during the first 3 months as part of gross motor development in the sensorimotor
stage.
Q2: A nurse is teaching the parents of a 4-month-old infant about age-appropriate nutrition. Which of the
following statements by a parent indicates an understanding of the teaching?
A. "I will start giving my baby cow's milk at 6 months."
B. "I will introduce iron-fortified rice cereal as the first solid food." [CORRECT]
C. "I can add honey to the cereal to sweeten it for my baby."
D. "I will give whole eggs as the first food to introduce."
Correct Answer: B
Rationale: Iron-fortified rice cereal is the recommended first solid food for infants at 4-6 months because it provides essential
iron and has a low allergenic potential. Cow's milk should not be introduced before 12 months because its protein content is
difficult for infants to digest and it can cause gastrointestinal bleeding. Honey is contraindicated before 12 months due to the risk
of infant botulism from Clostridium botulinum spores. Whole eggs are not typically the first food introduced; single-ingredient
pureed fruits, vegetables, and cereals are recommended initially.
Q3: A nurse is assessing a 6-month-old infant. Which of the following behaviors indicates the infant has
achieved object permanence?
A. The infant looks for a toy that was hidden under a blanket [CORRECT]
B. The infant smiles when the parent enters the room
C. The infant coos and babbles in response to sounds
D. The infant grasps a rattle placed in their hand
Correct Answer: A
Rationale: Object permanence is the understanding that objects continue to exist even when they cannot be seen, heard, or
touched. This milestone typically emerges around 7-9 months during the sensorimotor stage of Piaget's cognitive development
theory. Looking for a hidden toy demonstrates that the infant mentally represents the object's continued existence. Smiling at a
parent reflects social development rather than cognitive object permanence. Cooing and babbling represent language development,
and grasping a rattle is a reflexive and fine motor behavior, not a cognitive milestone.
Q4: According to Erikson's theory of psychosocial development, which of the following stages applies to a
toddler aged 18 months?
, A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt [CORRECT]
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Correct Answer: B
Rationale: Erikson's stage of Autonomy vs. Shame and Doubt applies to toddlers from approximately 1 to 3 years of age. During
this period, toddlers develop a sense of independence by mastering skills such as walking, feeding themselves, and toilet training.
Trust vs. Mistrust is the stage for infants from birth to 1 year, focused on the consistency of caregivers meeting basic needs.
Initiative vs. Guilt characterizes preschoolers aged 3-5 years, who begin to take initiative in play and social interactions. Industry
vs. Inferiority applies to school-age children from 6-12 years, who develop competence through academic and social activities.
Q5: A nurse is preparing to assess a 15-month-old toddler using the Denver II developmental screening tool.
Which of the following skills should the nurse expect the toddler to be able to perform?
A. Point to and identify body parts [CORRECT]
B. Tie shoelaces independently
C. Write their first name
D. Count to 10 verbally
Correct Answer: A
Rationale: The Denver II screening tool indicates that a 15-month-old toddler should be able to point to and identify body parts
such as the nose, eyes, and mouth. This falls within expected language and cognitive developmental norms. Tying shoelaces is a
fine motor skill typically achieved around 5-6 years of age. Writing their first name is expected around 4-5 years. Counting to 10
verbally typically emerges around 3-4 years. The Denver II assesses four domains: personal-social, fine motor-adaptive, language,
and gross motor development.
Q6: A nurse is providing anticipatory guidance to the parents of a 12-month-old infant. Which of the
following safety recommendations is the priority for this age group?
A. Install window guards on all second-story windows [CORRECT]
B. Keep poison control number accessible: 1-800-222-1222
C. Ensure the infant is placed on their back for sleep
D. Use a rear-facing car seat until age 2
Correct Answer: A
Rationale: At 12 months, infants are becoming mobile and curious, climbing and exploring their environment. Installing window
guards is a critical safety priority because toddlers can climb onto furniture and fall out of unsecured windows. While the poison
control number is important, poisoning risk increases more significantly in the toddler years (1-3 years) when children become
more independent explorers. Back-to-sleep positioning is most critical for younger infants under 6 months to prevent SIDS.
Rear-facing car seats are essential but represent ongoing safety rather than a new priority at 12 months.
Q7: A 3-year-old child is hospitalized for surgery. The child repeatedly says, "My tummy doesn't hurt" even
though preoperative assessments indicate moderate pain. Which of the following developmental concepts best
explains this behavior?
A. Magical thinking
B. Egocentrism [CORRECT]
C. Animism
D. Transductive reasoning
Correct Answer: B
, Rationale: Egocentrism, a characteristic of Piaget's preoperational stage (ages 2-7 years), causes the child to believe that their
thoughts and perceptions are shared by others. The preschooler may think that if they say the pain does not exist, it will truly not be
there. This is not magical thinking, which involves believing that thoughts or actions can cause unrelated events. Animism is the
belief that inanimate objects have lifelike qualities. Transductive reasoning involves drawing conclusions about cause and effect
without logical connections. According to ATI CMS, understanding egocentrism is essential for effective pain assessment in
pediatric patients.
Q8: A nurse is assessing a 4-year-old child. The parent reports the child uses approximately 1,500 words and
speaks in complex sentences, frequently asking "why" questions. The nurse should recognize this language
development as:
A. Delayed and requires a speech therapy referral
B. Within the expected range for a preschool-age child [CORRECT]
C. Advanced and suggests giftedness
D. Consistent with a toddler's language development
Correct Answer: B
Rationale: A 4-year-old preschooler using approximately 1,500 words and speaking in complex sentences with frequent "why"
questions is demonstrating age-appropriate language development. The preschool period (3-5 years) is marked by rapid vocabulary
expansion, increasingly complex sentence structures, and growing curiosity about the world. A toddler (1-3 years) typically uses
2-3 word sentences at age 2 and 4-5 word sentences at age 3. While the upper end of vocabulary range may vary, this pattern does
not independently indicate giftedness. A referral for speech therapy would be warranted only if significant delays were present,
such as an inability to form 3-word sentences by age 3.
Q9: A nurse is teaching the parents of a 9-month-old infant about developmental milestones. Which of the
following should the nurse include as an expected milestone for this age?
A. Pulling to a standing position [CORRECT]
B. Walking independently
C. Using a pincer grasp
D. Speaking two-word phrases
Correct Answer: A
Rationale: At 9 months, an infant is expected to pull to a standing position by holding onto furniture or a caregiver. This
represents the progression of gross motor development that begins with rolling (4-6 months), sitting independently (6-8 months),
and leads to cruising (9-12 months). Walking independently typically emerges around 12-15 months. The pincer grasp (using
thumb and index finger) develops around 9-10 months, but pulling to stand is a more prominent gross motor milestone emphasized
in ATI CMS for this age. Two-word phrases are a language milestone expected at approximately 18-24 months during the toddler
period.
Q10: A nurse is caring for a 5-year-old child who is being prepared for an upcoming procedure. Which of the
following play activities is most appropriate for this developmental stage?
A. Parallel play with blocks alongside other children
B. Competitive board games with clear rules
C. Cooperative play involving group activities [CORRECT]
D. Solitary play with stacking rings
Correct Answer: C
Rationale: At 5 years, children in the preschool age group engage in cooperative play, which involves group activities with shared
goals, role-taking, and interactive play scenarios. This represents the most advanced form of social play in early childhood. Parallel
play, where children play alongside but not directly with each other, is characteristic of toddlers (1-3 years). Competitive board
games with clear rules are more appropriate for school-age children (6-12 years). Solitary play with simple objects is typical of
COMPREHENSIVE PRACTICE EXAM
200 Questions with Correct Detailed Answers and Rationales
Aligned with 2026-2027 ATI Pediatrics CMS Standards
and NCLEX-RN Pediatric Nursing Competencies
Content Mastery Series Examination Preparation
Comprehensive Document for PEDS CMS | A+ Graded
25% Recall | 55% Application | 20% Analysis
,Section 1: Growth and Development (Infancy, Toddler, Preschool, School-Age,
Adolescent)
Q1: A nurse is assessing a 2-month-old infant. Which of the following developmental milestones should the
nurse expect the infant to demonstrate?
A. Lifts head slightly off the bed when prone [CORRECT]
B. Rolls from back to side
C. Sits independently without support
D. Walks while holding onto furniture
Correct Answer: A
Rationale: At 2 months, infants can lift their head slightly off the bed when in a prone position, which reflects developing neck
and shoulder muscle strength. Rolling from back to side typically occurs around 4-5 months. Sitting independently is expected at
approximately 6-7 months. Walking while holding onto furniture (cruising) emerges around 9-12 months. According to ATI CMS
standards, head control develops progressively during the first 3 months as part of gross motor development in the sensorimotor
stage.
Q2: A nurse is teaching the parents of a 4-month-old infant about age-appropriate nutrition. Which of the
following statements by a parent indicates an understanding of the teaching?
A. "I will start giving my baby cow's milk at 6 months."
B. "I will introduce iron-fortified rice cereal as the first solid food." [CORRECT]
C. "I can add honey to the cereal to sweeten it for my baby."
D. "I will give whole eggs as the first food to introduce."
Correct Answer: B
Rationale: Iron-fortified rice cereal is the recommended first solid food for infants at 4-6 months because it provides essential
iron and has a low allergenic potential. Cow's milk should not be introduced before 12 months because its protein content is
difficult for infants to digest and it can cause gastrointestinal bleeding. Honey is contraindicated before 12 months due to the risk
of infant botulism from Clostridium botulinum spores. Whole eggs are not typically the first food introduced; single-ingredient
pureed fruits, vegetables, and cereals are recommended initially.
Q3: A nurse is assessing a 6-month-old infant. Which of the following behaviors indicates the infant has
achieved object permanence?
A. The infant looks for a toy that was hidden under a blanket [CORRECT]
B. The infant smiles when the parent enters the room
C. The infant coos and babbles in response to sounds
D. The infant grasps a rattle placed in their hand
Correct Answer: A
Rationale: Object permanence is the understanding that objects continue to exist even when they cannot be seen, heard, or
touched. This milestone typically emerges around 7-9 months during the sensorimotor stage of Piaget's cognitive development
theory. Looking for a hidden toy demonstrates that the infant mentally represents the object's continued existence. Smiling at a
parent reflects social development rather than cognitive object permanence. Cooing and babbling represent language development,
and grasping a rattle is a reflexive and fine motor behavior, not a cognitive milestone.
Q4: According to Erikson's theory of psychosocial development, which of the following stages applies to a
toddler aged 18 months?
, A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt [CORRECT]
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Correct Answer: B
Rationale: Erikson's stage of Autonomy vs. Shame and Doubt applies to toddlers from approximately 1 to 3 years of age. During
this period, toddlers develop a sense of independence by mastering skills such as walking, feeding themselves, and toilet training.
Trust vs. Mistrust is the stage for infants from birth to 1 year, focused on the consistency of caregivers meeting basic needs.
Initiative vs. Guilt characterizes preschoolers aged 3-5 years, who begin to take initiative in play and social interactions. Industry
vs. Inferiority applies to school-age children from 6-12 years, who develop competence through academic and social activities.
Q5: A nurse is preparing to assess a 15-month-old toddler using the Denver II developmental screening tool.
Which of the following skills should the nurse expect the toddler to be able to perform?
A. Point to and identify body parts [CORRECT]
B. Tie shoelaces independently
C. Write their first name
D. Count to 10 verbally
Correct Answer: A
Rationale: The Denver II screening tool indicates that a 15-month-old toddler should be able to point to and identify body parts
such as the nose, eyes, and mouth. This falls within expected language and cognitive developmental norms. Tying shoelaces is a
fine motor skill typically achieved around 5-6 years of age. Writing their first name is expected around 4-5 years. Counting to 10
verbally typically emerges around 3-4 years. The Denver II assesses four domains: personal-social, fine motor-adaptive, language,
and gross motor development.
Q6: A nurse is providing anticipatory guidance to the parents of a 12-month-old infant. Which of the
following safety recommendations is the priority for this age group?
A. Install window guards on all second-story windows [CORRECT]
B. Keep poison control number accessible: 1-800-222-1222
C. Ensure the infant is placed on their back for sleep
D. Use a rear-facing car seat until age 2
Correct Answer: A
Rationale: At 12 months, infants are becoming mobile and curious, climbing and exploring their environment. Installing window
guards is a critical safety priority because toddlers can climb onto furniture and fall out of unsecured windows. While the poison
control number is important, poisoning risk increases more significantly in the toddler years (1-3 years) when children become
more independent explorers. Back-to-sleep positioning is most critical for younger infants under 6 months to prevent SIDS.
Rear-facing car seats are essential but represent ongoing safety rather than a new priority at 12 months.
Q7: A 3-year-old child is hospitalized for surgery. The child repeatedly says, "My tummy doesn't hurt" even
though preoperative assessments indicate moderate pain. Which of the following developmental concepts best
explains this behavior?
A. Magical thinking
B. Egocentrism [CORRECT]
C. Animism
D. Transductive reasoning
Correct Answer: B
, Rationale: Egocentrism, a characteristic of Piaget's preoperational stage (ages 2-7 years), causes the child to believe that their
thoughts and perceptions are shared by others. The preschooler may think that if they say the pain does not exist, it will truly not be
there. This is not magical thinking, which involves believing that thoughts or actions can cause unrelated events. Animism is the
belief that inanimate objects have lifelike qualities. Transductive reasoning involves drawing conclusions about cause and effect
without logical connections. According to ATI CMS, understanding egocentrism is essential for effective pain assessment in
pediatric patients.
Q8: A nurse is assessing a 4-year-old child. The parent reports the child uses approximately 1,500 words and
speaks in complex sentences, frequently asking "why" questions. The nurse should recognize this language
development as:
A. Delayed and requires a speech therapy referral
B. Within the expected range for a preschool-age child [CORRECT]
C. Advanced and suggests giftedness
D. Consistent with a toddler's language development
Correct Answer: B
Rationale: A 4-year-old preschooler using approximately 1,500 words and speaking in complex sentences with frequent "why"
questions is demonstrating age-appropriate language development. The preschool period (3-5 years) is marked by rapid vocabulary
expansion, increasingly complex sentence structures, and growing curiosity about the world. A toddler (1-3 years) typically uses
2-3 word sentences at age 2 and 4-5 word sentences at age 3. While the upper end of vocabulary range may vary, this pattern does
not independently indicate giftedness. A referral for speech therapy would be warranted only if significant delays were present,
such as an inability to form 3-word sentences by age 3.
Q9: A nurse is teaching the parents of a 9-month-old infant about developmental milestones. Which of the
following should the nurse include as an expected milestone for this age?
A. Pulling to a standing position [CORRECT]
B. Walking independently
C. Using a pincer grasp
D. Speaking two-word phrases
Correct Answer: A
Rationale: At 9 months, an infant is expected to pull to a standing position by holding onto furniture or a caregiver. This
represents the progression of gross motor development that begins with rolling (4-6 months), sitting independently (6-8 months),
and leads to cruising (9-12 months). Walking independently typically emerges around 12-15 months. The pincer grasp (using
thumb and index finger) develops around 9-10 months, but pulling to stand is a more prominent gross motor milestone emphasized
in ATI CMS for this age. Two-word phrases are a language milestone expected at approximately 18-24 months during the toddler
period.
Q10: A nurse is caring for a 5-year-old child who is being prepared for an upcoming procedure. Which of the
following play activities is most appropriate for this developmental stage?
A. Parallel play with blocks alongside other children
B. Competitive board games with clear rules
C. Cooperative play involving group activities [CORRECT]
D. Solitary play with stacking rings
Correct Answer: C
Rationale: At 5 years, children in the preschool age group engage in cooperative play, which involves group activities with shared
goals, role-taking, and interactive play scenarios. This represents the most advanced form of social play in early childhood. Parallel
play, where children play alongside but not directly with each other, is characteristic of toddlers (1-3 years). Competitive board
games with clear rules are more appropriate for school-age children (6-12 years). Solitary play with simple objects is typical of
