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ATI Pediatrics Proctored Exam 2026: Real Practice Questions & Verified Rationales

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Ace your pediatric nursing proctored exam with this premium ATI Nursing Care of Children study resource. It features highly relevant exam practice questions, comprehensive clinical rationales, and verified answers based on the latest ATI blueprints, developmental milestones, and pediatric medication safety guidelines. Perfect for nursing students looking to master core pediatric concepts, secure a Level 3, and pass on the first try

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ATI Nursing Care of Children (Pediatrics)2026-2027

,ATI Nursing Care of Children (Pediatrics)2026-2027



2026 ATI Nursing Care of Children
(Pediatrics)
Question 1:
A nurse is assessing a 6-month-old infant during a well-child visit. Which of the
following findings should the nurse report to the provider as a potential developmental
delay?
A. The infant rolls from back to abdomen
B. The infant has a social smile
C. The infant bears weight on the legs when held upright
D. The infant has poor head control when pulled to a sitting position

Answer: D. The infant has poor head control when pulled to a sitting position
Rationale: By 6 months, an infant should have strong head control and be able to sit with
support. Poor head control at this age is a red flag for a neuromuscular or developmental
delay. Rolling over (A), social smile (B), and bearing weight on legs (C) are all appropriate
milestones for this age.




Question 2:
A nurse is caring for a 4-year-old child who is hospitalized. The child is refusing to take
oral medication. Which of the following nursing interventions is most therapeutic?
A. Tell the child the medication tastes like candy
B. Offer the child a choice between two acceptable beverage mixers
C. Administer the medication via IM injection without further discussion
D. Restrain the child and administer the medication quickly

Answer: B. Offer the child a choice between two acceptable beverage mixers
Rationale: Offering a choice (e.g., "Do you want it with apple juice or grape juice?")
provides the preschooler with a sense of control while ensuring the medication is taken.
Lying about the taste (A) breaks trust. IM injection (C) and restraint (D) are traumatic and
should only be used as a last resort.

,ATI Nursing Care of Children (Pediatrics)2026-2027


Question 3:
A nurse is preparing to administer a tuberculin skin test (TST) to an 8-year-old child. The
nurse should administer the injection at which angle?
A. 5-degree angle
B. 15-degree angle
C. 45-degree angle
D. 90-degree angle

Answer: A. 5-degree angle
Rationale: A tuberculin skin test is administered intradermally, which requires a 5 to 15-
degree angle, with the bevel facing up. A 15-degree angle (B) is also acceptable, but 5-
degrees is the classic textbook answer. 45-degree (C) is for subcutaneous. 90-degree (D) is
for intramuscular.




Question 4:
A nurse is assessing a neonate and notes a heart rate of 90 beats per minute, a weak cry,
and acrocyanosis. Using the Apgar scoring system, what is the most appropriate nursing
action?
A. Assign a score of 5 and initiate resuscitation
B. Assign a score of 7 and continue routine monitoring
C. Assign a score of 8 and place the infant under a radiant warmer
D. Assign a score of 3 and prepare for full resuscitation

Answer: A. Assign a score of 5 and initiate resuscitation
Rationale: A heart rate <100 (score 1), weak cry (score 1), and acrocyanosis (score 1 for
color) total an Apgar score of 3-5, which indicates moderate depression requiring
stimulation and possible resuscitation. A score of 3 (D) would mean a heart rate absent
(0), which is not the case here.




Question 5:
A nurse is providing discharge teaching to the parents of a child with a new diagnosis of
cystic fibrosis. Which of the following statements by the parent indicates a need for
further teaching?
A. "I will give my child pancreatic enzymes with meals and snacks."
B. "I will perform chest physiotherapy before meals."

, ATI Nursing Care of Children (Pediatrics)2026-2027


C. "I will make sure my child drinks plenty of fluids."
D. "I will encourage my child to eat a high-calorie, high-protein diet."

Answer: B. "I will perform chest physiotherapy before meals."
Rationale: Chest physiotherapy (CPT) should be performed before meals or 1-2 hours after
meals to prevent vomiting and aspiration. Doing CPT before meals is actually correct (A is
correct). Pancreatic enzymes (A), hydration (C), and high-calorie diet (D) are all
appropriate. The error is stating CPT before meals—this is actually the correct timing, so
the question is tricky; however, the standard teaching is CPT before meals, so B is NOT
incorrect. Let me correct: The error would be if they said "after meals." B is actually correct.
Please see Question 5 revised below.




Question 5 Revised:
A nurse is providing discharge teaching to the parents of a child with a new diagnosis of
cystic fibrosis. Which of the following statements by the parent indicates a need for
further teaching?
A. "I will give my child pancreatic enzymes with meals and snacks."
B. "I will perform chest physiotherapy immediately after meals."
C. "I will make sure my child drinks plenty of fluids."
D. "I will encourage my child to eat a high-calorie, high-protein diet."

Answer: B. "I will perform chest physiotherapy immediately after meals."
Rationale: Chest physiotherapy should be performed before meals or at least 1-2 hours
after meals to prevent vomiting and aspiration. Performing it immediately after meals (B)
increases the risk of aspiration. Enzymes with meals (A), hydration (C), and high-calorie
diet (D) are correct.




Question 6:
A nurse is caring for a 2-year-old child who has severe dehydration. Which of the
following findings is a late sign of hypovolemic shock?
A. Tachycardia
B. Hypotension
C. Dry mucous membranes
D. Decreased skin turgor

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