ATI NURSING CARE OF CHILDREN PROCTORED EXAM (2026/2027)
ATI Nursing Care of Children Proctored Examination | Core Domains: Pediatric Growth &
Development, Health Promotion & Disease Prevention, Common Pediatric Illnesses &
Disorders, Pediatric Pharmacology & Medication Administration, Family-Centered Care &
Communication, Pediatric Emergencies & Critical Care, Chronic Conditions & Disability
Management, and Pediatric Assessment Techniques | Pediatric Nursing Competency Focus |
Proctored Predictor Exam Format
Exam Structure
The ATI Nursing Care of Children Proctored Exam for the 2026/2027 academic cycle is a
70-question, multiple-choice question (MCQ) examination.
Introduction
This ATI Nursing Care of Children Proctored Exam guide for the 2026/2027 cycle prepares
nursing students for the high-stakes proctored assessment of pediatric nursing knowledge. The
content evaluates clinical judgment and application of evidence-based care for children from
infancy through adolescence, emphasizing developmental considerations, safe medication
administration, family dynamics, and the management of acute and chronic pediatric
conditions.
Answer Format
All correct answers and pediatric nursing interventions must be presented in bold and green,
followed by detailed rationales that integrate developmental theory (Erikson, Piaget), apply
weight-based dosage calculations, explain pediatric-specific pathophysiology, and prioritize
family-centered care and safety.
Questions (70 Total)
1. A nurse is caring for a 6-month-old infant diagnosed with bronchiolitis caused by respiratory
syncytial virus (RSV). Which of the following actions should the nurse take first?
A. Administer albuterol via nebulizer
B. Place the infant in contact isolation
C. Suction the nares to maintain airway patency
D. Encourage oral fluid intake every hour
Rationale: Infants with RSV-induced bronchiolitis often have significant nasal congestion
that impairs breathing and feeding. Suctioning the nares (especially before feeds and sleep) is
critical to maintain airway patency. Albuterol is not routinely recommended for bronchiolitis
per AAP guidelines. RSV requires contact and droplet precautions, but airway management
takes priority. Oral fluids are encouraged, but only after ensuring the infant can breathe
effectively.
,2. A 3-year-old child is admitted with suspected epiglottitis. Which action should the nurse
prioritize?
A. Administer IV antibiotics immediately
B. Obtain a throat culture using a tongue depressor
C. Avoid throat examination and prepare for possible intubation
D. Place the child in a supine position for comfort
Rationale: Epiglottitis is a medical emergency. Manipulating the throat can cause complete
airway obstruction. The child should not be laid flat; they often sit upright leaning forward
(“tripod position”). Airway stabilization precedes antibiotic administration. This aligns with
Erikson’s “Initiative vs. Guilt” stage—minimizing fear by avoiding unnecessary procedures
supports emotional safety.
3. A nurse is teaching parents about car seat safety for their 18-month-old toddler who weighs
24 lb (10.9 kg). Which statement by the parent indicates understanding?
A. “I will switch to a forward-facing car seat now.”
B. “My child should remain rear-facing until at least age 2.”
C. “It’s okay to use a booster seat since he’s over 20 pounds.”
D. “As long as he’s in any car seat, he’s safe.”
Rationale: The American Academy of Pediatrics (AAP) recommends children remain in
rear-facing car seats until at least age 2 or until they reach the maximum height/weight limit
for the seat. At 18 months, rear-facing is still safest. This reflects Piaget’s preoperational
stage—children cannot anticipate danger, so passive safety measures are essential.
4. A 10-year-old child with type 1 diabetes mellitus has a blood glucose level of 52 mg/dL. Which
intervention should the nurse implement first?
A. Administer glucagon IM
B. Give 15 g of fast-acting carbohydrate
C. Provide 4 oz of orange juice or regular soda
D. Notify the provider and await orders
Rationale: For a conscious child with hypoglycemia (glucose <70 mg/dL), the first step is 15
g of fast-acting carbohydrate (e.g., 4 oz juice or regular soda). Glucagon is reserved for
unconscious/unresponsive patients. The child is in Piaget’s concrete operational stage and can
cooperate with oral treatment. Recheck glucose in 15 minutes (Rule of 15).
, 5. A nurse is assessing a 2-year-old during a well-child visit. Which finding requires further
evaluation?
A. Uses two-word phrases
B. Walks up stairs with assistance
C. Does not imitate others’ actions
D. Feeds self with fingers
Rationale: By age 2, children typically imitate adult behaviors (e.g., sweeping, talking on toy
phone)—a key social milestone per Erikson’s autonomy stage. Not imitating may indicate
developmental delay. Two-word phrases, self-feeding, and assisted stair climbing are
age-appropriate.
6. A 7-year-old is prescribed amoxicillin 45 mg/kg/day divided every 12 hours. The child weighs
44 lb (20 kg). The available suspension is 250 mg/5 mL. How many mL should the nurse
administer per dose? (Round to the nearest whole number.)
A. 7 mL
B. 9 mL
C. 11 mL
D. 13 mL
Rationale: Weight = 44 lb ÷ 2.2 = 20 kg. Total daily dose = 45 mg/kg × 20 kg = 900 mg/day.
Per dose (every 12 hrs) = 900 ÷ 2 = 450 mg. Concentration = 250 mg/5 mL → 50 mg/mL.
Volume = 450 mg ÷ 50 mg/mL = 9 mL. Accurate weight-based dosing prevents toxicity or
underdosing in pediatric pharmacology.
7. A nurse is caring for an infant with congenital heart disease who is experiencing heart failure.
Which medication should the nurse anticipate administering?
A. Furosemide
B. Digoxin
C. Acetaminophen
D. Albuterol
Rationale: Digoxin increases cardiac contractility and is used in pediatric heart failure,
especially with left-to-right shunts (e.g., VSD). Furosemide is also used for fluid overload, but
digoxin directly improves myocardial function. Monitor for bradycardia and serum levels.
ATI Nursing Care of Children Proctored Examination | Core Domains: Pediatric Growth &
Development, Health Promotion & Disease Prevention, Common Pediatric Illnesses &
Disorders, Pediatric Pharmacology & Medication Administration, Family-Centered Care &
Communication, Pediatric Emergencies & Critical Care, Chronic Conditions & Disability
Management, and Pediatric Assessment Techniques | Pediatric Nursing Competency Focus |
Proctored Predictor Exam Format
Exam Structure
The ATI Nursing Care of Children Proctored Exam for the 2026/2027 academic cycle is a
70-question, multiple-choice question (MCQ) examination.
Introduction
This ATI Nursing Care of Children Proctored Exam guide for the 2026/2027 cycle prepares
nursing students for the high-stakes proctored assessment of pediatric nursing knowledge. The
content evaluates clinical judgment and application of evidence-based care for children from
infancy through adolescence, emphasizing developmental considerations, safe medication
administration, family dynamics, and the management of acute and chronic pediatric
conditions.
Answer Format
All correct answers and pediatric nursing interventions must be presented in bold and green,
followed by detailed rationales that integrate developmental theory (Erikson, Piaget), apply
weight-based dosage calculations, explain pediatric-specific pathophysiology, and prioritize
family-centered care and safety.
Questions (70 Total)
1. A nurse is caring for a 6-month-old infant diagnosed with bronchiolitis caused by respiratory
syncytial virus (RSV). Which of the following actions should the nurse take first?
A. Administer albuterol via nebulizer
B. Place the infant in contact isolation
C. Suction the nares to maintain airway patency
D. Encourage oral fluid intake every hour
Rationale: Infants with RSV-induced bronchiolitis often have significant nasal congestion
that impairs breathing and feeding. Suctioning the nares (especially before feeds and sleep) is
critical to maintain airway patency. Albuterol is not routinely recommended for bronchiolitis
per AAP guidelines. RSV requires contact and droplet precautions, but airway management
takes priority. Oral fluids are encouraged, but only after ensuring the infant can breathe
effectively.
,2. A 3-year-old child is admitted with suspected epiglottitis. Which action should the nurse
prioritize?
A. Administer IV antibiotics immediately
B. Obtain a throat culture using a tongue depressor
C. Avoid throat examination and prepare for possible intubation
D. Place the child in a supine position for comfort
Rationale: Epiglottitis is a medical emergency. Manipulating the throat can cause complete
airway obstruction. The child should not be laid flat; they often sit upright leaning forward
(“tripod position”). Airway stabilization precedes antibiotic administration. This aligns with
Erikson’s “Initiative vs. Guilt” stage—minimizing fear by avoiding unnecessary procedures
supports emotional safety.
3. A nurse is teaching parents about car seat safety for their 18-month-old toddler who weighs
24 lb (10.9 kg). Which statement by the parent indicates understanding?
A. “I will switch to a forward-facing car seat now.”
B. “My child should remain rear-facing until at least age 2.”
C. “It’s okay to use a booster seat since he’s over 20 pounds.”
D. “As long as he’s in any car seat, he’s safe.”
Rationale: The American Academy of Pediatrics (AAP) recommends children remain in
rear-facing car seats until at least age 2 or until they reach the maximum height/weight limit
for the seat. At 18 months, rear-facing is still safest. This reflects Piaget’s preoperational
stage—children cannot anticipate danger, so passive safety measures are essential.
4. A 10-year-old child with type 1 diabetes mellitus has a blood glucose level of 52 mg/dL. Which
intervention should the nurse implement first?
A. Administer glucagon IM
B. Give 15 g of fast-acting carbohydrate
C. Provide 4 oz of orange juice or regular soda
D. Notify the provider and await orders
Rationale: For a conscious child with hypoglycemia (glucose <70 mg/dL), the first step is 15
g of fast-acting carbohydrate (e.g., 4 oz juice or regular soda). Glucagon is reserved for
unconscious/unresponsive patients. The child is in Piaget’s concrete operational stage and can
cooperate with oral treatment. Recheck glucose in 15 minutes (Rule of 15).
, 5. A nurse is assessing a 2-year-old during a well-child visit. Which finding requires further
evaluation?
A. Uses two-word phrases
B. Walks up stairs with assistance
C. Does not imitate others’ actions
D. Feeds self with fingers
Rationale: By age 2, children typically imitate adult behaviors (e.g., sweeping, talking on toy
phone)—a key social milestone per Erikson’s autonomy stage. Not imitating may indicate
developmental delay. Two-word phrases, self-feeding, and assisted stair climbing are
age-appropriate.
6. A 7-year-old is prescribed amoxicillin 45 mg/kg/day divided every 12 hours. The child weighs
44 lb (20 kg). The available suspension is 250 mg/5 mL. How many mL should the nurse
administer per dose? (Round to the nearest whole number.)
A. 7 mL
B. 9 mL
C. 11 mL
D. 13 mL
Rationale: Weight = 44 lb ÷ 2.2 = 20 kg. Total daily dose = 45 mg/kg × 20 kg = 900 mg/day.
Per dose (every 12 hrs) = 900 ÷ 2 = 450 mg. Concentration = 250 mg/5 mL → 50 mg/mL.
Volume = 450 mg ÷ 50 mg/mL = 9 mL. Accurate weight-based dosing prevents toxicity or
underdosing in pediatric pharmacology.
7. A nurse is caring for an infant with congenital heart disease who is experiencing heart failure.
Which medication should the nurse anticipate administering?
A. Furosemide
B. Digoxin
C. Acetaminophen
D. Albuterol
Rationale: Digoxin increases cardiac contractility and is used in pediatric heart failure,
especially with left-to-right shunts (e.g., VSD). Furosemide is also used for fluid overload, but
digoxin directly improves myocardial function. Monitor for bradycardia and serum levels.
