2026 ATI RN Pediatric Nursing Proctored Exam Practice Test
Bank | Original Exam-Style Multiple-Choice Questions &
Clinical Rationales 3 Versions
Secure a Level 3 proficiency rating on your proctored specialty assessment with this
high-yield 2026 ATI RN Pediatric Nursing master practice test bank. Master complex
pediatric nursing care domains, including developmental milestones
(Piaget/Erikson), congenital cardiovascular anomalies (including cyanotic vs.
acyanotic defects), pediatric fluid resuscitation math, and Next Generation
NCLEX (NGN) clinical judgment trend items. Every unique, verified multiple-choice
question features a highly detailed clinical rationale to sharpen your nursing judgment
and ensure success on your first attempt.
1. A nurse is assessing a newborn with fetal alcohol syndrome. Which facial feature is
characteristic?
A. Microcephaly
B. Prominent epicanthal folds
C. Smooth philtrum
D. Macroglossia
Answer: C. Smooth philtrum
Rationale: A smooth philtrum, thin vermilion border, and small palpebral fissures are
characteristic facial features of fetal alcohol syndrome. Macroglossia is associated with
Beckwith-Wiedemann syndrome.
2. A nurse is caring for an infant with neonatal abstinence syndrome. Which finding is
expected?
A. Lethargy
B. Poor feeding
C. High-pitched cry
D. Hypothermia
Answer: C. High-pitched cry
,Rationale: Neonatal abstinence syndrome causes irritability, high-pitched cry, tremors,
hypertonia, and feeding difficulties. Lethargy and hypothermia are not typical.
3. A nurse is assessing a child with shaken baby syndrome. Which finding is most
indicative?
A. Retinal hemorrhages
B. Bruises on the knees
C. A single forehead bruise
D. Swelling of the ankles
Answer: A. Retinal hemorrhages
Rationale: Retinal hemorrhages, subdural hematomas, and brain swelling are classic signs
of shaken baby syndrome.
4. A nurse is teaching a parent about failure to thrive. Which definition is correct?
A. Weight below the 5th percentile for age
B. Height below the 10th percentile for age
C. Weight below the 3rd percentile for age
D. Head circumference below the 5th percentile
Answer: C. Weight below the 3rd percentile for age
Rationale: Failure to thrive is defined as weight below the 3rd percentile for age or a
significant drop in weight percentile.
5. A nurse is assessing a child with kwashiorkor. Which finding is expected?
A. Edema
B. Severe muscle wasting
C. Normal hair
D. Hyperpigmented skin
Answer: A. Edema
,Rationale: Kwashiorkor is characterized by edema, fatty liver, and skin/hair changes.
Marasmus causes severe muscle wasting without edema.
6. A nurse is assessing a child with marasmus. Which finding is expected?
A. Edema
B. Severe muscle wasting
C. Fatty liver
D. Normal weight
Answer: B. Severe muscle wasting
Rationale: Marasmus causes severe muscle wasting and loss of subcutaneous fat without
edema.
7. A nurse is teaching a parent about rickets. Which finding is expected?
A. Bowlegs
B. Knock-knees
C. Craniotabes
D. All of the above
Answer: D. All of the above
Rationale: Rickets causes bowlegs, knock-knees, craniotabes, and other skeletal deformities
due to vitamin D deficiency.
8. A nurse is assessing a child with scurvy. Which finding is expected?
A. Bleeding gums
B. Edema
C. Bradycardia
D. Hypertension
Answer: A. Bleeding gums
, Rationale: Scurvy is caused by vitamin C deficiency and leads to bleeding gums, poor
wound healing, and petechiae.
9. A nurse is teaching a parent about pinworm treatment. Which instruction should the
nurse include?
A. Treat all family members
B. Only treat the affected child
C. Avoid handwashing
D. Apply topical corticosteroids
Answer: A. Treat all family members
Rationale: Pinworms are highly contagious, so all household members should be treated
simultaneously.
10. A nurse is teaching a parent about lice treatment. Which instruction should the
nurse include?
A. Wash bedding in hot water
B. Use a hair dryer on hot setting
C. Apply mayonnaise to the hair
D. Avoid combing the hair
Answer: A. Wash bedding in hot water
Rationale: Washing bedding and clothing in hot water helps eliminate lice and nits.
Combs and pediculicides are also used.
11. A nurse is assessing a child with scabies. Which finding is expected?
A. Intense itching worse at night
B. Painless rash
C. Vesicles on the palms
D. Rash on the face only
Bank | Original Exam-Style Multiple-Choice Questions &
Clinical Rationales 3 Versions
Secure a Level 3 proficiency rating on your proctored specialty assessment with this
high-yield 2026 ATI RN Pediatric Nursing master practice test bank. Master complex
pediatric nursing care domains, including developmental milestones
(Piaget/Erikson), congenital cardiovascular anomalies (including cyanotic vs.
acyanotic defects), pediatric fluid resuscitation math, and Next Generation
NCLEX (NGN) clinical judgment trend items. Every unique, verified multiple-choice
question features a highly detailed clinical rationale to sharpen your nursing judgment
and ensure success on your first attempt.
1. A nurse is assessing a newborn with fetal alcohol syndrome. Which facial feature is
characteristic?
A. Microcephaly
B. Prominent epicanthal folds
C. Smooth philtrum
D. Macroglossia
Answer: C. Smooth philtrum
Rationale: A smooth philtrum, thin vermilion border, and small palpebral fissures are
characteristic facial features of fetal alcohol syndrome. Macroglossia is associated with
Beckwith-Wiedemann syndrome.
2. A nurse is caring for an infant with neonatal abstinence syndrome. Which finding is
expected?
A. Lethargy
B. Poor feeding
C. High-pitched cry
D. Hypothermia
Answer: C. High-pitched cry
,Rationale: Neonatal abstinence syndrome causes irritability, high-pitched cry, tremors,
hypertonia, and feeding difficulties. Lethargy and hypothermia are not typical.
3. A nurse is assessing a child with shaken baby syndrome. Which finding is most
indicative?
A. Retinal hemorrhages
B. Bruises on the knees
C. A single forehead bruise
D. Swelling of the ankles
Answer: A. Retinal hemorrhages
Rationale: Retinal hemorrhages, subdural hematomas, and brain swelling are classic signs
of shaken baby syndrome.
4. A nurse is teaching a parent about failure to thrive. Which definition is correct?
A. Weight below the 5th percentile for age
B. Height below the 10th percentile for age
C. Weight below the 3rd percentile for age
D. Head circumference below the 5th percentile
Answer: C. Weight below the 3rd percentile for age
Rationale: Failure to thrive is defined as weight below the 3rd percentile for age or a
significant drop in weight percentile.
5. A nurse is assessing a child with kwashiorkor. Which finding is expected?
A. Edema
B. Severe muscle wasting
C. Normal hair
D. Hyperpigmented skin
Answer: A. Edema
,Rationale: Kwashiorkor is characterized by edema, fatty liver, and skin/hair changes.
Marasmus causes severe muscle wasting without edema.
6. A nurse is assessing a child with marasmus. Which finding is expected?
A. Edema
B. Severe muscle wasting
C. Fatty liver
D. Normal weight
Answer: B. Severe muscle wasting
Rationale: Marasmus causes severe muscle wasting and loss of subcutaneous fat without
edema.
7. A nurse is teaching a parent about rickets. Which finding is expected?
A. Bowlegs
B. Knock-knees
C. Craniotabes
D. All of the above
Answer: D. All of the above
Rationale: Rickets causes bowlegs, knock-knees, craniotabes, and other skeletal deformities
due to vitamin D deficiency.
8. A nurse is assessing a child with scurvy. Which finding is expected?
A. Bleeding gums
B. Edema
C. Bradycardia
D. Hypertension
Answer: A. Bleeding gums
, Rationale: Scurvy is caused by vitamin C deficiency and leads to bleeding gums, poor
wound healing, and petechiae.
9. A nurse is teaching a parent about pinworm treatment. Which instruction should the
nurse include?
A. Treat all family members
B. Only treat the affected child
C. Avoid handwashing
D. Apply topical corticosteroids
Answer: A. Treat all family members
Rationale: Pinworms are highly contagious, so all household members should be treated
simultaneously.
10. A nurse is teaching a parent about lice treatment. Which instruction should the
nurse include?
A. Wash bedding in hot water
B. Use a hair dryer on hot setting
C. Apply mayonnaise to the hair
D. Avoid combing the hair
Answer: A. Wash bedding in hot water
Rationale: Washing bedding and clothing in hot water helps eliminate lice and nits.
Combs and pediculicides are also used.
11. A nurse is assessing a child with scabies. Which finding is expected?
A. Intense itching worse at night
B. Painless rash
C. Vesicles on the palms
D. Rash on the face only
