ATI RN PROCTORED NURSING CARE OF CHILDREN EXAM | FORM B | LATEST EXAM |
UPDATED 2026/2027
ATI RN Proctored Nursing Care of Children Examination Form B | Core Domains: Pediatric Growth &
Development Milestones, 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 RN Proctored Nursing Care of Children Exam Form B for the 2026/2027 academic cycle is a
70-question, multiple-choice question (MCQ) examination.
Introduction
This ATI RN Proctored Nursing Care of Children Exam Form B guide for the 2026/2027 cycle prepares
nursing students for the high-stakes, proctored assessment of pediatric nursing knowledge. Form B
evaluates clinical judgment and application of evidence-based care for children from infancy through
adolescence, with a specific emphasis on developmental considerations, safe medication administration,
family dynamics, and 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, prioritize family-centered care and safety, and
utilize ATI's recommended test-taking strategies for pediatric scenarios.
Questions (70 Total)
1. A 6-month-old infant should be able to:
A. Walk with support
B. Roll from back to front and sit with support
C. Say two-word phrases
D. Feed self with a spoon
Rationale: By 6 months, infants typically roll from back to front, sit with minimal support, babble,
and reach for objects. Walking with support occurs around 9–12 months; two-word phrases emerge at
18–24 months; self-feeding with a spoon develops around 12–15 months. This aligns with CDC
developmental milestones and Piaget’s sensorimotor stage.
2. A child weighs 16 kg and is prescribed amoxicillin 45 mg/kg/day divided every 12 hours. The
suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?
A. 6.2 mL
,B. 7.2 mL
C. 8.0 mL
D. 9.0 mL
Rationale: Total daily dose = 45 mg/kg × 16 kg = 720 mg. Divided BID = 360 mg/dose. Concentration
= 250 mg/5 mL = 50 mg/mL. Volume = 360 ÷ 50 = 7.2 mL. Accurate weight-based calculation prevents
under/over-treatment in pediatric pharmacology.
3. Which vaccine is contraindicated in a child with a severe egg allergy?
A. DTaP
B. None—MMR and influenza vaccines are safe even with egg allergy
C. Hepatitis B
D. Polio
Rationale: Current guidelines (CDC, AAP) state that MMR and influenza vaccines can be safely
administered to children with egg allergy, including anaphylaxis. The amount of egg protein is
negligible. No pediatric vaccine is absolutely contraindicated due to egg allergy alone.
4. A 2-year-old with croup has stridor at rest and retractions. What is the priority intervention?
A. Administer oral antibiotics
B. Provide nebulized epinephrine and corticosteroids
C. Encourage fluids only
D. Place in supine position
Rationale: Moderate to severe croup (stridor at rest, retractions) requires nebulized epinephrine for
rapid airway edema reduction and corticosteroids (e.g., dexamethasone) for sustained
anti-inflammatory effect. Antibiotics are ineffective (viral etiology). Upright positioning eases
breathing; supine worsens obstruction.
5. When communicating with a hospitalized preschooler, the nurse should:
A. Use abstract explanations
B. Use play therapy and simple, concrete language
C. Avoid discussing procedures to reduce anxiety
D. Speak only to the parents
, Rationale: Preschoolers (3–5 years) are in Piaget’s preoperational stage—they think concretely and
use magical thinking. Play therapy (e.g., dolls, drawings) helps them express fears. Simple, honest
explanations reduce anxiety. Always include the child in age-appropriate communication.
6. A child with type 1 diabetes has a blood glucose of 52 mg/dL and is conscious. What should the nurse
do first?
A. Administer glucagon IM
B. Give 15 grams of fast-acting carbohydrate (e.g., 4 oz juice)
C. Inject regular insulin IV
D. Offer a protein snack
Rationale: For a conscious hypoglycemic child, follow the “Rule of 15”: 15 g fast-acting carb (juice,
glucose tablets), recheck in 15 minutes. Glucagon is for unconscious/unresponsive patients. Insulin
would worsen hypoglycemia. Protein slows glucose absorption and is not first-line.
7. Which sign is most indicative of increased intracranial pressure (ICP) in an infant?
A. High-pitched cry
B. Bulging fontanelle
C. Fever
D. Vomiting once
Rationale: Infants have open fontanelles, so bulging is a key sign of elevated ICP. Other signs include
sunset eyes, irritability, and increased head circumference. High-pitched cry may occur but is less
specific. Vomiting and fever are nonspecific.
8. A child with asthma uses a metered-dose inhaler (MDI). What teaching should the nurse provide?
A. “Inhale quickly after pressing the canister.”
B. “Use a spacer to improve medication delivery to the lungs.”
C. “Rinse mouth before using.”
D. “Hold breath for 1 second after inhaling.”
Rationale: Spacers increase drug deposition in the lungs by slowing aerosol velocity and reducing
oropharyngeal deposition. Teach to shake the MDI, exhale fully, press canister while inhaling slowly
over 3–5 seconds, then hold breath for 10 seconds. Rinse mouth after corticosteroid inhalers to prevent
thrush.
9. A 4-year-old is scheduled for surgery. The nurse should expect the child to express fear about:
UPDATED 2026/2027
ATI RN Proctored Nursing Care of Children Examination Form B | Core Domains: Pediatric Growth &
Development Milestones, 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 RN Proctored Nursing Care of Children Exam Form B for the 2026/2027 academic cycle is a
70-question, multiple-choice question (MCQ) examination.
Introduction
This ATI RN Proctored Nursing Care of Children Exam Form B guide for the 2026/2027 cycle prepares
nursing students for the high-stakes, proctored assessment of pediatric nursing knowledge. Form B
evaluates clinical judgment and application of evidence-based care for children from infancy through
adolescence, with a specific emphasis on developmental considerations, safe medication administration,
family dynamics, and 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, prioritize family-centered care and safety, and
utilize ATI's recommended test-taking strategies for pediatric scenarios.
Questions (70 Total)
1. A 6-month-old infant should be able to:
A. Walk with support
B. Roll from back to front and sit with support
C. Say two-word phrases
D. Feed self with a spoon
Rationale: By 6 months, infants typically roll from back to front, sit with minimal support, babble,
and reach for objects. Walking with support occurs around 9–12 months; two-word phrases emerge at
18–24 months; self-feeding with a spoon develops around 12–15 months. This aligns with CDC
developmental milestones and Piaget’s sensorimotor stage.
2. A child weighs 16 kg and is prescribed amoxicillin 45 mg/kg/day divided every 12 hours. The
suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?
A. 6.2 mL
,B. 7.2 mL
C. 8.0 mL
D. 9.0 mL
Rationale: Total daily dose = 45 mg/kg × 16 kg = 720 mg. Divided BID = 360 mg/dose. Concentration
= 250 mg/5 mL = 50 mg/mL. Volume = 360 ÷ 50 = 7.2 mL. Accurate weight-based calculation prevents
under/over-treatment in pediatric pharmacology.
3. Which vaccine is contraindicated in a child with a severe egg allergy?
A. DTaP
B. None—MMR and influenza vaccines are safe even with egg allergy
C. Hepatitis B
D. Polio
Rationale: Current guidelines (CDC, AAP) state that MMR and influenza vaccines can be safely
administered to children with egg allergy, including anaphylaxis. The amount of egg protein is
negligible. No pediatric vaccine is absolutely contraindicated due to egg allergy alone.
4. A 2-year-old with croup has stridor at rest and retractions. What is the priority intervention?
A. Administer oral antibiotics
B. Provide nebulized epinephrine and corticosteroids
C. Encourage fluids only
D. Place in supine position
Rationale: Moderate to severe croup (stridor at rest, retractions) requires nebulized epinephrine for
rapid airway edema reduction and corticosteroids (e.g., dexamethasone) for sustained
anti-inflammatory effect. Antibiotics are ineffective (viral etiology). Upright positioning eases
breathing; supine worsens obstruction.
5. When communicating with a hospitalized preschooler, the nurse should:
A. Use abstract explanations
B. Use play therapy and simple, concrete language
C. Avoid discussing procedures to reduce anxiety
D. Speak only to the parents
, Rationale: Preschoolers (3–5 years) are in Piaget’s preoperational stage—they think concretely and
use magical thinking. Play therapy (e.g., dolls, drawings) helps them express fears. Simple, honest
explanations reduce anxiety. Always include the child in age-appropriate communication.
6. A child with type 1 diabetes has a blood glucose of 52 mg/dL and is conscious. What should the nurse
do first?
A. Administer glucagon IM
B. Give 15 grams of fast-acting carbohydrate (e.g., 4 oz juice)
C. Inject regular insulin IV
D. Offer a protein snack
Rationale: For a conscious hypoglycemic child, follow the “Rule of 15”: 15 g fast-acting carb (juice,
glucose tablets), recheck in 15 minutes. Glucagon is for unconscious/unresponsive patients. Insulin
would worsen hypoglycemia. Protein slows glucose absorption and is not first-line.
7. Which sign is most indicative of increased intracranial pressure (ICP) in an infant?
A. High-pitched cry
B. Bulging fontanelle
C. Fever
D. Vomiting once
Rationale: Infants have open fontanelles, so bulging is a key sign of elevated ICP. Other signs include
sunset eyes, irritability, and increased head circumference. High-pitched cry may occur but is less
specific. Vomiting and fever are nonspecific.
8. A child with asthma uses a metered-dose inhaler (MDI). What teaching should the nurse provide?
A. “Inhale quickly after pressing the canister.”
B. “Use a spacer to improve medication delivery to the lungs.”
C. “Rinse mouth before using.”
D. “Hold breath for 1 second after inhaling.”
Rationale: Spacers increase drug deposition in the lungs by slowing aerosol velocity and reducing
oropharyngeal deposition. Teach to shake the MDI, exhale fully, press canister while inhaling slowly
over 3–5 seconds, then hold breath for 10 seconds. Rinse mouth after corticosteroid inhalers to prevent
thrush.
9. A 4-year-old is scheduled for surgery. The nurse should expect the child to express fear about:
