ATI RN PEDIATRIC NURSING PROCTORED EXAM WITH NGN
2023 70 QUESTIONS and SOLUTION
SECTION 1: GROWTH AND DEVELOPMENT
1 A nurse is caring for a 2-year-old child. Which behavior is expected for this age?
A) Shares toys willingly with peers B)
Engages in parallel play
C) Participates in cooperative play
D) Plays organized group games
Answer: B) Engages in parallel play
Rationale: Toddlers (1-3 years) characteristically engage in parallel play, playing
alongside but not with other children. Cooperative play develops around 4-5 years.
Toddlers are egocentric and do not share willingly. Organized games are appropriate for
school-age children .
2. A nurse is assessing an 18-month-old toddler. Which finding requires further
evaluation?
A) Uses 10-15 words
B) Unable to walk independently
C) Points to desired objects
D) Follows simple commands
Answer: B) Unable to walk independently
Rationale: Most toddlers walk independently by 15 months. Failure to walk
independently by 18 months requires further evaluation. Using 10-15 words, pointing,
and following simple commands are expected at this age .
3. A 2-year-old is hospitalized. The parent must leave for work. The child screams
"Don't go!" and then becomes quiet and withdrawn. This behavior indicates:
A) Protest phase
B) Despair phase
C) Detachment phase
D) Regression
Answer: B) Despair phase
,Rationale: The despair phase is characterized by the child becoming withdrawn, quiet,
sad, and no longer crying. The protest phase is the initial screaming and clinging.
Detachment occurs when the child ignores the parents upon their return .
4. A nurse is assessing a preschooler (3-5 years). Which type of play is typical?
A) Parallel play
B) Solitary play
C) Cooperative play
D) Competitive play
Answer: C) Cooperative play
Rationale: Preschoolers engage in cooperative play, playing with others and sharing.
Parallel play is typical for toddlers, solitary play for infants, and competitive play is for
school-age children .
5. A nurse is assessing a 7-year-old child. The parent asks about chores. Which
chore is appropriate for this child?
A) Mowing the lawn
B) Making their bed with reminders
C) Cooking a full meal
D) Doing the family laundry
Answer: B) Making their bed with reminders
Rationale: A 7-year-old (school-age) can make their bed with reminders. Mowing the
lawn and cooking are preteen/teen tasks. Laundry is typically 10+ years .
6. Which Erikson stage corresponds with the preschool period (3-5 years)?
A) Trust vs. mistrust
B) Autonomy vs. shame/doubt
C) Initiative vs. guilt
D) Industry vs. inferiority
Answer: C) Initiative vs. guilt
Rationale: Preschoolers are in the initiative vs. guilt stage, exploring, asking questions,
and starting activities. Trust is infancy. Autonomy is toddler. Industry is school-age .
7. A nurse is counseling parents of a 15-year-old. Which statement about
adolescent development should the nurse include?
A) Peer relationships are less important than family
B) Risk-taking behavior is abnormal
C) Abstract thinking develops during this stage
,D) Physical appearance is not a concern
Answer: C) Abstract thinking develops during this stage
Rationale: Abstract thinking (formal operational thought) develops during adolescence.
Peer relationships become extremely important. Risk-taking is common due to
underdeveloped prefrontal cortex. Physical appearance is a major concern due to body
image issues .
8. A nurse is assessing a 4-month-old infant. Which finding indicates normal
development?
A) Rolls from abdomen to back
B) Sits without support
C) Pulls to standing position
D) Walks with assistance
Answer: A) Rolls from abdomen to back
Rationale: At 4 months, infants typically begin rolling from abdomen to back. Sitting
without support occurs around 6-7 months. Pulling to stand occurs around 9-10
months. Walking with assistance occurs around 11-12 months .
9. A nurse is assessing a 4-month-old infant. Which milestone should the nurse
expect?
A) Rolls from back to abdomen
B) Bears weight on legs when held standing
C) Sits unsupported
D) Pincer grasp present
Answer: B) Bears weight on legs when held standing
Rationale: By 4 months, infants can bear weight on legs when held in a standing
position. Rolling over typically occurs at 6 months, sitting unsupported at 8 months, and
pincer grasp at 9 months .
10. A nurse is teaching parents about introducing solid foods to their 6-month-old
infant. Which instruction should the nurse include?
A) Introduce multiple new foods at once
B) Begin with iron-fortified rice cereal
C) Add honey to cereals for taste
D) Delay introduction until 9 months
Answer: B) Begin with iron-fortified rice cereal
, Rationale: Iron-fortified rice cereal is recommended as the first solid food because it is
easily digestible, rarely allergenic, and provides iron which becomes depleted around 6
months. New foods should be introduced one at a time, 4-7 days apart, to identify
allergies. Honey should never be given to infants under 12 months due to botulism risk .
4. A nurse is assessing a 6-month-old infant. Which finding should the nurse
report to the provider? A) Posterior fontanel closed
B) Birth weight doubled
C) Anterior fontanel open
D) Unable to sit unsupported
Answer: B) Birth weight doubled
Rationale: Birth weight should double by 6 months. Anterior fontanel closes by 12-18
months (open at 6 months is normal). Sitting unsupported is an 8-month milestone.
Posterior fontanel closes by 2-3 months .
12. A 15-year-old adolescent is most likely to be concerned with:
A) Losing teeth
B) Peer acceptance and body image
C) Learning to read
D) Separation anxiety from parents
Answer: B) Peer acceptance and body image
Rationale: Adolescents focus on peer relationships, identity, and body image. Losing
teeth is school-age. Learning to read is early school-age. Separation anxiety is
toddler/preschool .
13. A nurse is teaching a parent about the anterior fontanel. When should it close?
A) 2-3 months
B) 6-8 months
C) 12-18 months
D) 24-36 months
Answer: C) 12-18 months
Rationale: The anterior fontanel (soft spot) typically closes between 12-18 months of
age. The posterior fontanel closes earlier, by 2-3 months. A bulging fontanel may
indicate increased intracranial pressure, while a sunken fontanel may indicate
dehydration .
14. A nurse is assessing a newborn. Which reflex should be present?
2023 70 QUESTIONS and SOLUTION
SECTION 1: GROWTH AND DEVELOPMENT
1 A nurse is caring for a 2-year-old child. Which behavior is expected for this age?
A) Shares toys willingly with peers B)
Engages in parallel play
C) Participates in cooperative play
D) Plays organized group games
Answer: B) Engages in parallel play
Rationale: Toddlers (1-3 years) characteristically engage in parallel play, playing
alongside but not with other children. Cooperative play develops around 4-5 years.
Toddlers are egocentric and do not share willingly. Organized games are appropriate for
school-age children .
2. A nurse is assessing an 18-month-old toddler. Which finding requires further
evaluation?
A) Uses 10-15 words
B) Unable to walk independently
C) Points to desired objects
D) Follows simple commands
Answer: B) Unable to walk independently
Rationale: Most toddlers walk independently by 15 months. Failure to walk
independently by 18 months requires further evaluation. Using 10-15 words, pointing,
and following simple commands are expected at this age .
3. A 2-year-old is hospitalized. The parent must leave for work. The child screams
"Don't go!" and then becomes quiet and withdrawn. This behavior indicates:
A) Protest phase
B) Despair phase
C) Detachment phase
D) Regression
Answer: B) Despair phase
,Rationale: The despair phase is characterized by the child becoming withdrawn, quiet,
sad, and no longer crying. The protest phase is the initial screaming and clinging.
Detachment occurs when the child ignores the parents upon their return .
4. A nurse is assessing a preschooler (3-5 years). Which type of play is typical?
A) Parallel play
B) Solitary play
C) Cooperative play
D) Competitive play
Answer: C) Cooperative play
Rationale: Preschoolers engage in cooperative play, playing with others and sharing.
Parallel play is typical for toddlers, solitary play for infants, and competitive play is for
school-age children .
5. A nurse is assessing a 7-year-old child. The parent asks about chores. Which
chore is appropriate for this child?
A) Mowing the lawn
B) Making their bed with reminders
C) Cooking a full meal
D) Doing the family laundry
Answer: B) Making their bed with reminders
Rationale: A 7-year-old (school-age) can make their bed with reminders. Mowing the
lawn and cooking are preteen/teen tasks. Laundry is typically 10+ years .
6. Which Erikson stage corresponds with the preschool period (3-5 years)?
A) Trust vs. mistrust
B) Autonomy vs. shame/doubt
C) Initiative vs. guilt
D) Industry vs. inferiority
Answer: C) Initiative vs. guilt
Rationale: Preschoolers are in the initiative vs. guilt stage, exploring, asking questions,
and starting activities. Trust is infancy. Autonomy is toddler. Industry is school-age .
7. A nurse is counseling parents of a 15-year-old. Which statement about
adolescent development should the nurse include?
A) Peer relationships are less important than family
B) Risk-taking behavior is abnormal
C) Abstract thinking develops during this stage
,D) Physical appearance is not a concern
Answer: C) Abstract thinking develops during this stage
Rationale: Abstract thinking (formal operational thought) develops during adolescence.
Peer relationships become extremely important. Risk-taking is common due to
underdeveloped prefrontal cortex. Physical appearance is a major concern due to body
image issues .
8. A nurse is assessing a 4-month-old infant. Which finding indicates normal
development?
A) Rolls from abdomen to back
B) Sits without support
C) Pulls to standing position
D) Walks with assistance
Answer: A) Rolls from abdomen to back
Rationale: At 4 months, infants typically begin rolling from abdomen to back. Sitting
without support occurs around 6-7 months. Pulling to stand occurs around 9-10
months. Walking with assistance occurs around 11-12 months .
9. A nurse is assessing a 4-month-old infant. Which milestone should the nurse
expect?
A) Rolls from back to abdomen
B) Bears weight on legs when held standing
C) Sits unsupported
D) Pincer grasp present
Answer: B) Bears weight on legs when held standing
Rationale: By 4 months, infants can bear weight on legs when held in a standing
position. Rolling over typically occurs at 6 months, sitting unsupported at 8 months, and
pincer grasp at 9 months .
10. A nurse is teaching parents about introducing solid foods to their 6-month-old
infant. Which instruction should the nurse include?
A) Introduce multiple new foods at once
B) Begin with iron-fortified rice cereal
C) Add honey to cereals for taste
D) Delay introduction until 9 months
Answer: B) Begin with iron-fortified rice cereal
, Rationale: Iron-fortified rice cereal is recommended as the first solid food because it is
easily digestible, rarely allergenic, and provides iron which becomes depleted around 6
months. New foods should be introduced one at a time, 4-7 days apart, to identify
allergies. Honey should never be given to infants under 12 months due to botulism risk .
4. A nurse is assessing a 6-month-old infant. Which finding should the nurse
report to the provider? A) Posterior fontanel closed
B) Birth weight doubled
C) Anterior fontanel open
D) Unable to sit unsupported
Answer: B) Birth weight doubled
Rationale: Birth weight should double by 6 months. Anterior fontanel closes by 12-18
months (open at 6 months is normal). Sitting unsupported is an 8-month milestone.
Posterior fontanel closes by 2-3 months .
12. A 15-year-old adolescent is most likely to be concerned with:
A) Losing teeth
B) Peer acceptance and body image
C) Learning to read
D) Separation anxiety from parents
Answer: B) Peer acceptance and body image
Rationale: Adolescents focus on peer relationships, identity, and body image. Losing
teeth is school-age. Learning to read is early school-age. Separation anxiety is
toddler/preschool .
13. A nurse is teaching a parent about the anterior fontanel. When should it close?
A) 2-3 months
B) 6-8 months
C) 12-18 months
D) 24-36 months
Answer: C) 12-18 months
Rationale: The anterior fontanel (soft spot) typically closes between 12-18 months of
age. The posterior fontanel closes earlier, by 2-3 months. A bulging fontanel may
indicate increased intracranial pressure, while a sunken fontanel may indicate
dehydration .
14. A nurse is assessing a newborn. Which reflex should be present?
