ATI RN Pediatric Proctored Exam 2026 Practice
Questions with NGN-Style Format 2 Versions
Verified Answers & Detailed Rationales
Secure your Level 3 proficiency with the definitive 2026 preparation
guide for the ATI RN Pediatric CMS Proctored Exam, featuring Next
Generation NCLEX (NGN) style items. This comprehensive study
resource delivers realistic, high-yield practice questions, multi-stage
matrix items, and detailed developmental rationales covering pediatric
immunization schedules, acute congenital disorders, and emergency
interventions. Master pediatric fluid balance, drug dosage calculations,
and critical prioritization rules to pass your proctored evaluation on the
first attempt.
QUESTION 1
A nurse is assessing a 2-week-old newborn. Which of the following
findings should the nurse report to the provider?
A) Acrocyanosis of the hands and feet
B) Head circumference 35 cm
C) Weight 3.5 kg
D) Heart rate 145/min
Rationale: Acrocyanosis (bluish discoloration of hands and feet) is a normal
finding in newborns for the first few days to weeks due to immature
peripheral circulation. Head circumference 35 cm, weight 3.5 kg, and heart
rate 145/min are all within expected ranges for a 2-week-old infant .
,QUESTION 2
A nurse is providing teaching to the parent of a 9-month-old infant
about age-appropriate feeding. Which of the following statements by
the parent indicates understanding?
A) "I will give my baby whole cow's milk."
B) "I will give my baby small pieces of banana."
C) "I will give my baby a cup of orange juice."
D) "I will give my baby honey on toast."
Rationale: By 9 months, infants can handle soft, small pieces of table foods
like banana. Whole cow's milk is not recommended until 12 months. Citrus
juice may cause allergic reactions or gastrointestinal upset. Honey is
contraindicated before 12 months due to botulism risk .
QUESTION 3
A nurse is caring for a 7-year-old child who is hospitalized. Which of
the following diversional activities should the nurse provide?
A) Board games and card games
B) Large building blocks
C) Simple cloth books
D) Musical mobiles
Rationale: School-age children (6-12 years) enjoy board games, card games,
and activities that involve rules and competition. Building blocks are for
toddlers, cloth books for infants, and mobiles for infants .
,QUESTION 4
A nurse is collecting data from a 12-month-old infant during a well-
child visit. Which of the following findings is a deviation from
expected growth?
A) Anterior fontanel has closed.
B) Birth weight has tripled.
C) Head circumference is larger than chest circumference.
D) Infant can stand while holding onto furniture.
Rationale: By 12 months, the chest circumference should be equal to or
slightly greater than the head circumference. Head circumference larger than
chest circumference is expected in the newborn period, but by 12 months, this
finding would be a deviation .
QUESTION 5
A nurse is caring for an adolescent client who has a new diagnosis of
type 2 diabetes mellitus. Which of the following instructions should
the nurse include in the teaching?
A) "You should administer insulin via subcutaneous injection."
B) "You should include physical activity as part of your daily routine."
C) "You should check your blood glucose level once a week."
D) "You should follow a low-protein diet."
Rationale: For type 2 diabetes mellitus, lifestyle modifications including
regular physical activity are essential for blood glucose management. Insulin
is typically used for type 1 diabetes or advanced type 2. Blood glucose
monitoring should be done more frequently than once a week. A low-protein
diet is not the primary recommendation; carbohydrate management is key .
, QUESTION 6
A nurse is reinforcing teaching with the guardian of a child who has
iron deficiency anemia. Which of the following foods should the nurse
recommend to increase iron absorption?
A) Orange juice
B) Milk
C) Whole wheat bread
D) Cheese
Rationale: Vitamin C (found in orange juice) enhances iron absorption. Milk
and cheese contain calcium which can inhibit iron absorption. Whole wheat
bread contains phytic acid which can also inhibit iron absorption .
QUESTION 7
A nurse is caring for a child who has a diagnosis of Kawasaki disease.
Which of the following findings should the nurse expect?
A) Desquamation of the hands and feet
B) Strawberry tongue
C) Unilateral cervical lymphadenopathy
D) Hypotension
Rationale: Strawberry tongue (erythema and prominent papillae) is a classic
finding of Kawasaki disease. Desquamation occurs in the subacute phase
(weeks later). Lymphadenopathy is typically unilateral cervical >1.5 cm.
Hypertension, not hypotension, may occur .
QUESTION 8
A nurse is providing emergency care for a child who has a suspected
epiglottitis. Which of the following actions should the nurse take?
Questions with NGN-Style Format 2 Versions
Verified Answers & Detailed Rationales
Secure your Level 3 proficiency with the definitive 2026 preparation
guide for the ATI RN Pediatric CMS Proctored Exam, featuring Next
Generation NCLEX (NGN) style items. This comprehensive study
resource delivers realistic, high-yield practice questions, multi-stage
matrix items, and detailed developmental rationales covering pediatric
immunization schedules, acute congenital disorders, and emergency
interventions. Master pediatric fluid balance, drug dosage calculations,
and critical prioritization rules to pass your proctored evaluation on the
first attempt.
QUESTION 1
A nurse is assessing a 2-week-old newborn. Which of the following
findings should the nurse report to the provider?
A) Acrocyanosis of the hands and feet
B) Head circumference 35 cm
C) Weight 3.5 kg
D) Heart rate 145/min
Rationale: Acrocyanosis (bluish discoloration of hands and feet) is a normal
finding in newborns for the first few days to weeks due to immature
peripheral circulation. Head circumference 35 cm, weight 3.5 kg, and heart
rate 145/min are all within expected ranges for a 2-week-old infant .
,QUESTION 2
A nurse is providing teaching to the parent of a 9-month-old infant
about age-appropriate feeding. Which of the following statements by
the parent indicates understanding?
A) "I will give my baby whole cow's milk."
B) "I will give my baby small pieces of banana."
C) "I will give my baby a cup of orange juice."
D) "I will give my baby honey on toast."
Rationale: By 9 months, infants can handle soft, small pieces of table foods
like banana. Whole cow's milk is not recommended until 12 months. Citrus
juice may cause allergic reactions or gastrointestinal upset. Honey is
contraindicated before 12 months due to botulism risk .
QUESTION 3
A nurse is caring for a 7-year-old child who is hospitalized. Which of
the following diversional activities should the nurse provide?
A) Board games and card games
B) Large building blocks
C) Simple cloth books
D) Musical mobiles
Rationale: School-age children (6-12 years) enjoy board games, card games,
and activities that involve rules and competition. Building blocks are for
toddlers, cloth books for infants, and mobiles for infants .
,QUESTION 4
A nurse is collecting data from a 12-month-old infant during a well-
child visit. Which of the following findings is a deviation from
expected growth?
A) Anterior fontanel has closed.
B) Birth weight has tripled.
C) Head circumference is larger than chest circumference.
D) Infant can stand while holding onto furniture.
Rationale: By 12 months, the chest circumference should be equal to or
slightly greater than the head circumference. Head circumference larger than
chest circumference is expected in the newborn period, but by 12 months, this
finding would be a deviation .
QUESTION 5
A nurse is caring for an adolescent client who has a new diagnosis of
type 2 diabetes mellitus. Which of the following instructions should
the nurse include in the teaching?
A) "You should administer insulin via subcutaneous injection."
B) "You should include physical activity as part of your daily routine."
C) "You should check your blood glucose level once a week."
D) "You should follow a low-protein diet."
Rationale: For type 2 diabetes mellitus, lifestyle modifications including
regular physical activity are essential for blood glucose management. Insulin
is typically used for type 1 diabetes or advanced type 2. Blood glucose
monitoring should be done more frequently than once a week. A low-protein
diet is not the primary recommendation; carbohydrate management is key .
, QUESTION 6
A nurse is reinforcing teaching with the guardian of a child who has
iron deficiency anemia. Which of the following foods should the nurse
recommend to increase iron absorption?
A) Orange juice
B) Milk
C) Whole wheat bread
D) Cheese
Rationale: Vitamin C (found in orange juice) enhances iron absorption. Milk
and cheese contain calcium which can inhibit iron absorption. Whole wheat
bread contains phytic acid which can also inhibit iron absorption .
QUESTION 7
A nurse is caring for a child who has a diagnosis of Kawasaki disease.
Which of the following findings should the nurse expect?
A) Desquamation of the hands and feet
B) Strawberry tongue
C) Unilateral cervical lymphadenopathy
D) Hypotension
Rationale: Strawberry tongue (erythema and prominent papillae) is a classic
finding of Kawasaki disease. Desquamation occurs in the subacute phase
(weeks later). Lymphadenopathy is typically unilateral cervical >1.5 cm.
Hypertension, not hypotension, may occur .
QUESTION 8
A nurse is providing emergency care for a child who has a suspected
epiglottitis. Which of the following actions should the nurse take?
