ATI RN Pediatric Nursing Proctored Exam 2026
Comprising 70 Questions and Answers
1. A nurse is assessing a 12-month-old infant during a well-child visit. Which fine motor skill
should the nurse expect the infant to perform?
• A. Build a tower of two blocks
• B. Hold a crayon and scribble spontaneously
• C. Use a pincer grasp to pick up a small object
• D. Turn the pages of a book one at a time
Answer: C.
Rationale: By 12 months, the infant should have developed a refined pincer grasp (using the
thumb and forefinger). Building a two-block tower (A) is expected at 15 months. Scribbling
spontaneously (B) occurs around 18 months. Turning pages one at a time (D) is a 3-year-old skill.
2. A nurse is providing anticipatory guidance to the parents of a 6-month-old infant. The
parents ask about introducing solid foods. Which statement by the parents indicates
understanding?
• A. "We will start with pureed meats and eggs."
• B. "We will introduce one new food every 5 to 7 days."
• C. "We will mix rice cereal in a bottle to help him sleep."
• D. "We will start with citrus fruits for vitamin C."
Answer: B.
Rationale: New foods should be introduced one at a time over 5–7 days to observe for allergic
reactions. Pureed meats (A) are often introduced later; single-grain iron-fortified cereal is the
typical first food. Mixing cereal in a bottle (C) is a choking hazard and not recommended. Citrus
fruits (D) are acidic and often delayed until after 12 months.
3. A nurse is assessing a 3-year-old preschooler. Which gross motor skill should the nurse
expect the child to perform?
, • A. Hop on one foot
• B. Stand on one foot for 5 seconds
• C. Ride a tricycle
• D. Skip with alternating feet
Answer: C.
Rationale: A 3-year-old should be able to pedal a tricycle. Hopping on one foot (A) and standing
on one foot for 5 seconds (B) are 4-year-old skills. Skipping with alternating feet (D) is a 5-year-
old skill.
4. A nurse is assessing a 7-year-old school-age child. According to Erikson's theory of
psychosocial development, which behavior reflects the child's current developmental stage?
• A. The child cries when the parent leaves the room.
• B. The child says, "I want to be a doctor when I grow up."
• C. The child expresses pride in completing a school project.
• D. The child refuses to wear the clothes the parent picks out.
Answer: C.
Rationale: School-age children (6–12 years) are in Erikson's "Industry vs. Inferiority" stage,
where they derive satisfaction from completing tasks and receiving recognition. Crying when a
parent leaves (A) is separation anxiety (infancy/toddler). Saying "I want to be a doctor" (B)
reflects initiative (preschool). Refusing clothes (D) reflects autonomy (toddler).
5. A nurse is teaching a parent about toilet training a 2-year-old toddler. Which statement by
the parent indicates readiness for toilet training?
• A. "My child stays dry for 2 hours during the day."
• B. "My child can pull their pants up and down independently."
• C. "My child expresses interest in wearing 'big kid' underwear."
• D. "My child has a bowel movement at the same time every day."
Answer: B.
Rationale: Physical readiness includes the ability to pull pants up and down independently.
, Staying dry for 2 hours (A) indicates bladder control, which is readiness, but the question asks
for indicates—pulling pants is the most definitive physical milestone. Interest in underwear (C) is
psychological readiness. Regular bowel movements (D) are helpful but not a primary readiness
sign. All are signs, but B is the clearest physical indicator.
Questions 21–40: Respiratory & Cardiovascular Disorders
21. A nurse is caring for a 3-year-old child with croup (laryngotracheobronchitis). Which
finding requires immediate intervention?
• A. Barking cough and hoarseness
• B. Stridor that is audible at rest
• C. Low-grade fever of 100.4°F
• D. Slight wheezing on expiration
Answer: B.
Rationale: Stridor that is audible at rest indicates significant airway narrowing and impending
respiratory failure. This requires immediate intervention (e.g., racemic epinephrine,
corticosteroids). A barking cough (A), low-grade fever (C), and mild wheezing (D) are expected
findings in croup but do not indicate imminent airway compromise.
22. A nurse is caring for a child with status asthmaticus who is receiving continuous albuterol
nebulization. The nurse notes the child's heart rate has increased from 120 to 160 bpm. What
is the nurse's priority action?
• A. Stop the albuterol immediately and notify the provider.
• B. Continue the albuterol and continue to monitor the heart rate.
• C. Administer a beta-blocker to lower the heart rate.
• D. Switch to a different bronchodilator.
Answer: B.
Rationale: Tachycardia is an expected, systemic side effect of albuterol (a beta-2 agonist). In
status asthmaticus, the priority is maintaining airway patency; the benefits of albuterol
outweigh the risk of tachycardia. Stopping the medication (A) could lead to respiratory arrest.
Beta-blockers (C) are contraindicated in asthma as they can cause bronchospasm.
Comprising 70 Questions and Answers
1. A nurse is assessing a 12-month-old infant during a well-child visit. Which fine motor skill
should the nurse expect the infant to perform?
• A. Build a tower of two blocks
• B. Hold a crayon and scribble spontaneously
• C. Use a pincer grasp to pick up a small object
• D. Turn the pages of a book one at a time
Answer: C.
Rationale: By 12 months, the infant should have developed a refined pincer grasp (using the
thumb and forefinger). Building a two-block tower (A) is expected at 15 months. Scribbling
spontaneously (B) occurs around 18 months. Turning pages one at a time (D) is a 3-year-old skill.
2. A nurse is providing anticipatory guidance to the parents of a 6-month-old infant. The
parents ask about introducing solid foods. Which statement by the parents indicates
understanding?
• A. "We will start with pureed meats and eggs."
• B. "We will introduce one new food every 5 to 7 days."
• C. "We will mix rice cereal in a bottle to help him sleep."
• D. "We will start with citrus fruits for vitamin C."
Answer: B.
Rationale: New foods should be introduced one at a time over 5–7 days to observe for allergic
reactions. Pureed meats (A) are often introduced later; single-grain iron-fortified cereal is the
typical first food. Mixing cereal in a bottle (C) is a choking hazard and not recommended. Citrus
fruits (D) are acidic and often delayed until after 12 months.
3. A nurse is assessing a 3-year-old preschooler. Which gross motor skill should the nurse
expect the child to perform?
, • A. Hop on one foot
• B. Stand on one foot for 5 seconds
• C. Ride a tricycle
• D. Skip with alternating feet
Answer: C.
Rationale: A 3-year-old should be able to pedal a tricycle. Hopping on one foot (A) and standing
on one foot for 5 seconds (B) are 4-year-old skills. Skipping with alternating feet (D) is a 5-year-
old skill.
4. A nurse is assessing a 7-year-old school-age child. According to Erikson's theory of
psychosocial development, which behavior reflects the child's current developmental stage?
• A. The child cries when the parent leaves the room.
• B. The child says, "I want to be a doctor when I grow up."
• C. The child expresses pride in completing a school project.
• D. The child refuses to wear the clothes the parent picks out.
Answer: C.
Rationale: School-age children (6–12 years) are in Erikson's "Industry vs. Inferiority" stage,
where they derive satisfaction from completing tasks and receiving recognition. Crying when a
parent leaves (A) is separation anxiety (infancy/toddler). Saying "I want to be a doctor" (B)
reflects initiative (preschool). Refusing clothes (D) reflects autonomy (toddler).
5. A nurse is teaching a parent about toilet training a 2-year-old toddler. Which statement by
the parent indicates readiness for toilet training?
• A. "My child stays dry for 2 hours during the day."
• B. "My child can pull their pants up and down independently."
• C. "My child expresses interest in wearing 'big kid' underwear."
• D. "My child has a bowel movement at the same time every day."
Answer: B.
Rationale: Physical readiness includes the ability to pull pants up and down independently.
, Staying dry for 2 hours (A) indicates bladder control, which is readiness, but the question asks
for indicates—pulling pants is the most definitive physical milestone. Interest in underwear (C) is
psychological readiness. Regular bowel movements (D) are helpful but not a primary readiness
sign. All are signs, but B is the clearest physical indicator.
Questions 21–40: Respiratory & Cardiovascular Disorders
21. A nurse is caring for a 3-year-old child with croup (laryngotracheobronchitis). Which
finding requires immediate intervention?
• A. Barking cough and hoarseness
• B. Stridor that is audible at rest
• C. Low-grade fever of 100.4°F
• D. Slight wheezing on expiration
Answer: B.
Rationale: Stridor that is audible at rest indicates significant airway narrowing and impending
respiratory failure. This requires immediate intervention (e.g., racemic epinephrine,
corticosteroids). A barking cough (A), low-grade fever (C), and mild wheezing (D) are expected
findings in croup but do not indicate imminent airway compromise.
22. A nurse is caring for a child with status asthmaticus who is receiving continuous albuterol
nebulization. The nurse notes the child's heart rate has increased from 120 to 160 bpm. What
is the nurse's priority action?
• A. Stop the albuterol immediately and notify the provider.
• B. Continue the albuterol and continue to monitor the heart rate.
• C. Administer a beta-blocker to lower the heart rate.
• D. Switch to a different bronchodilator.
Answer: B.
Rationale: Tachycardia is an expected, systemic side effect of albuterol (a beta-2 agonist). In
status asthmaticus, the priority is maintaining airway patency; the benefits of albuterol
outweigh the risk of tachycardia. Stopping the medication (A) could lead to respiratory arrest.
Beta-blockers (C) are contraindicated in asthma as they can cause bronchospasm.
