Next Generation NCLEX (NGN) ATI
Pediatrics: Proctored Exam Questions
with Detailed Rationales
Section 1: Growth & Development Milestones
Q1. A nurse is assessing a 4-month-old infant during a well-child visit.
Which developmental milestone should the nurse expect to observe?
A) Rolls from front to back
B) Sits without support
C) Transfers objects from hand to hand
D) Walks independently
Answer: A) Rolls from front to back
Rationale: Rolling from front to back typically occurs at 4 months of age.
Sitting without support is expected at 6-8 months, transferring objects at 7
months, and walking independently at 12-15 months .
Q2. A nurse is assessing a 2-year-old toddler. Which finding is
expected?
A) The toddler can draw a circle
B) The toddler can ride a tricycle
C) The toddler has a vocabulary of 50 words
D) The toddler can use two-word phrases
Answer: D) The toddler can use two-word phrases
Rationale: Two-year-olds typically use two-word phrases (e.g., "me go"). A
vocabulary of 50 words is expected at 24-30 months. Drawing a circle and
riding a tricycle occur at 3-4 years .
,Q3. A nurse is providing discipline guidance to parents of a 3-year-old
preschooler. Which instruction should the nurse include?
A) Use physical punishment such as spanking
B) Use time out for 3 minutes
C) Use time out for 15 minutes
D) Ignore all misbehavior
Answer: B) Use time out for 3 minutes
Rationale: Time out is effective for preschoolers and should last 1 minute
per year of age—3 minutes for a 3-year-old. Physical punishment is not
recommended as it can lead to aggression and does not teach appropriate
behavior .
Q4. A nurse is assessing a 4-year-old preschooler. Which finding is
expected?
A) The child can tie shoelaces
B) The child can hop on one foot
C) The child can button clothing
D) The child can write their first name
Answer: B) The child can hop on one foot
Rationale: Hopping on one foot typically develops at 4 years of age. Tying
shoelaces and writing their first name occur at 5-6 years .
Q5. A nurse is providing injury prevention teaching to parents of a 5-
year-old child. Which instruction should the nurse include?
A) The child should use a booster seat in the car until age 8-12 years
B) The child can sit in the front seat
C) The child no longer needs a car seat
D) The child can use an adult seat belt alone
Answer: A) The child should use a booster seat in the car until age 8-12
years
,Rationale: Children should use a booster seat until the adult seat belt fits
properly, typically at age 8-12 years or when the child is 4 feet 9 inches tall.
Premature use of adult seat belts can cause abdominal and spinal injuries .
Q6. A nurse is assessing a 6-year-old school-age child. Which
developmental task is expected?
A) The child understands conservation of mass
B) The child thinks abstractly
C) The child has an imaginary friend
D) The child is egocentric
Answer: A) The child understands conservation of mass
Rationale: School-age children in Piaget's concrete operational stage
understand conservation of mass, number, and volume. Abstract thinking
develops in adolescence .
Q7. According to Erikson's theory, which developmental task is most
characteristic of a preschooler?
A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
Answer: C) Initiative versus guilt
Rationale: Preschoolers (3-5 years) are in the initiative versus guilt stage,
where they develop a sense of purpose. Trust is infancy, autonomy is
toddlerhood, and industry is school-age .
Q8. A nurse is performing hearing screenings at a community health
fair. Which child should be referred for a more extensive hearing
evaluation?
A) An 18-month-old toddler who has unintelligible speech
B) A 3-month-old infant who has an exaggerated startle response
, C) An 8-month-old infant who is not yet making babbling sounds
D) A 4-year-old preschooler who prefers playing with others rather than
alone
Answer: C) An 8-month-old infant who is not yet making babbling
sounds
Rationale: An 8-month-old should be making babbling sounds. Lack of
babbling can indicate hearing impairment. Unintelligible speech at 18
months is normal .
Q9. A nurse is assessing a 10-year-old school-age child. Which finding
is expected?
A) The child has a growth spurt
B) The child develops secondary sexual characteristics
C) The child is at increased risk for injury due to risk-taking behavior
D) The child understands cause and effect
Answer: D) The child understands cause and effect
Rationale: School-age children understand cause and effect and can think
logically. Growth spurts and secondary sexual characteristics occur in
adolescence .
Q10. A nurse is planning an educational program about bicycle safety
for school-age children. Which information should the nurse include?
A) The child should be able to stand on the balls of their feet when sitting
on the bike.
B) The child should ride their bike 2 feet to the side of other bike riders.
C) The child should wear dark-colored clothing when riding at night.
D) The child should ride facing traffic when riding in the street.
Answer: A) The child should be able to stand on the balls of their feet
when sitting on the bike
Rationale: For proper bike fit, the child should be able to stand on the balls
Pediatrics: Proctored Exam Questions
with Detailed Rationales
Section 1: Growth & Development Milestones
Q1. A nurse is assessing a 4-month-old infant during a well-child visit.
Which developmental milestone should the nurse expect to observe?
A) Rolls from front to back
B) Sits without support
C) Transfers objects from hand to hand
D) Walks independently
Answer: A) Rolls from front to back
Rationale: Rolling from front to back typically occurs at 4 months of age.
Sitting without support is expected at 6-8 months, transferring objects at 7
months, and walking independently at 12-15 months .
Q2. A nurse is assessing a 2-year-old toddler. Which finding is
expected?
A) The toddler can draw a circle
B) The toddler can ride a tricycle
C) The toddler has a vocabulary of 50 words
D) The toddler can use two-word phrases
Answer: D) The toddler can use two-word phrases
Rationale: Two-year-olds typically use two-word phrases (e.g., "me go"). A
vocabulary of 50 words is expected at 24-30 months. Drawing a circle and
riding a tricycle occur at 3-4 years .
,Q3. A nurse is providing discipline guidance to parents of a 3-year-old
preschooler. Which instruction should the nurse include?
A) Use physical punishment such as spanking
B) Use time out for 3 minutes
C) Use time out for 15 minutes
D) Ignore all misbehavior
Answer: B) Use time out for 3 minutes
Rationale: Time out is effective for preschoolers and should last 1 minute
per year of age—3 minutes for a 3-year-old. Physical punishment is not
recommended as it can lead to aggression and does not teach appropriate
behavior .
Q4. A nurse is assessing a 4-year-old preschooler. Which finding is
expected?
A) The child can tie shoelaces
B) The child can hop on one foot
C) The child can button clothing
D) The child can write their first name
Answer: B) The child can hop on one foot
Rationale: Hopping on one foot typically develops at 4 years of age. Tying
shoelaces and writing their first name occur at 5-6 years .
Q5. A nurse is providing injury prevention teaching to parents of a 5-
year-old child. Which instruction should the nurse include?
A) The child should use a booster seat in the car until age 8-12 years
B) The child can sit in the front seat
C) The child no longer needs a car seat
D) The child can use an adult seat belt alone
Answer: A) The child should use a booster seat in the car until age 8-12
years
,Rationale: Children should use a booster seat until the adult seat belt fits
properly, typically at age 8-12 years or when the child is 4 feet 9 inches tall.
Premature use of adult seat belts can cause abdominal and spinal injuries .
Q6. A nurse is assessing a 6-year-old school-age child. Which
developmental task is expected?
A) The child understands conservation of mass
B) The child thinks abstractly
C) The child has an imaginary friend
D) The child is egocentric
Answer: A) The child understands conservation of mass
Rationale: School-age children in Piaget's concrete operational stage
understand conservation of mass, number, and volume. Abstract thinking
develops in adolescence .
Q7. According to Erikson's theory, which developmental task is most
characteristic of a preschooler?
A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
Answer: C) Initiative versus guilt
Rationale: Preschoolers (3-5 years) are in the initiative versus guilt stage,
where they develop a sense of purpose. Trust is infancy, autonomy is
toddlerhood, and industry is school-age .
Q8. A nurse is performing hearing screenings at a community health
fair. Which child should be referred for a more extensive hearing
evaluation?
A) An 18-month-old toddler who has unintelligible speech
B) A 3-month-old infant who has an exaggerated startle response
, C) An 8-month-old infant who is not yet making babbling sounds
D) A 4-year-old preschooler who prefers playing with others rather than
alone
Answer: C) An 8-month-old infant who is not yet making babbling
sounds
Rationale: An 8-month-old should be making babbling sounds. Lack of
babbling can indicate hearing impairment. Unintelligible speech at 18
months is normal .
Q9. A nurse is assessing a 10-year-old school-age child. Which finding
is expected?
A) The child has a growth spurt
B) The child develops secondary sexual characteristics
C) The child is at increased risk for injury due to risk-taking behavior
D) The child understands cause and effect
Answer: D) The child understands cause and effect
Rationale: School-age children understand cause and effect and can think
logically. Growth spurts and secondary sexual characteristics occur in
adolescence .
Q10. A nurse is planning an educational program about bicycle safety
for school-age children. Which information should the nurse include?
A) The child should be able to stand on the balls of their feet when sitting
on the bike.
B) The child should ride their bike 2 feet to the side of other bike riders.
C) The child should wear dark-colored clothing when riding at night.
D) The child should ride facing traffic when riding in the street.
Answer: A) The child should be able to stand on the balls of their feet
when sitting on the bike
Rationale: For proper bike fit, the child should be able to stand on the balls
