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ATI Pediatric Proctored Exam - Comprehensive
Study Guide
250 Randomized NGN-Style Multiple Choice
Questions -2026/2027 UPDATE-
1. A nurse in the emergency department is caring for a 2-year-old child who was
found by his parents crying and holding a container of toilet bowl cleaner. The
child's lips are edematous and inflamed, and he is drooling. Which of the
following is the priority action by the nurse?
A) Induce vomiting to remove the toxin
B) Administer activated charcoal
C) Check the child's respiratory status
D) Call poison control immediately
Correct Answer: C) Check the child's respiratory status
Rationale: Airway compromise is the greatest immediate threat in a child with
potential caustic ingestion. Edema and inflammation of the lips and drooling
indicate possible airway involvement, making respiratory assessment the
priority before any other intervention.
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2. A nurse is teaching a parent of a 12-month-old child about development
during the toddler years. Which of the following statements should the nurse
include?
A) "Your child should be able to walk up stairs with assistance at 18 months"
B) "Your child should be able to scribble spontaneously using a crayon at the
age of 15 months"
C) "Your child should be able to jump with both feet at 24 months"
D) "Your child should be able to feed themselves with a spoon at 12 months"
Correct Answer: B) "Your child should be able to scribble spontaneously using a
crayon at the age of 15 months"
Rationale: Fine motor development in toddlers includes the ability to scribble
spontaneously around 15 months of age. This demonstrates emerging hand-eye
coordination and fine motor control typical for this developmental stage.
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium
chloride 100 mL IV to infuse over 4 hr. The drop factor of the manual IV
tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how
many gtt/min? (Round the answer to the nearest whole number.)
A) 15 gtt/min
B) 20 gtt/min
C) 25 gtt/min
D) 30 gtt/min
Correct Answer: C) 25 gtt/min
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Rationale: Calculate using the formula: (Volume in mL × Drop factor) ÷ Time
in minutes = (100 mL × 60 gtt/mL) ÷ 240 minutes = 6000 ÷ 240 = 25 gtt/min.
This ensures accurate medication administration and prevents fluid overload or
underhydration.
4. A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which
of the following actions should the nurse take?
A) Begin the assessment by examining the ears first
B) Minimize physical contact with the child initially
C) Ask the child to undress completely before the examination
D) Perform the most invasive procedures first
Correct Answer: B) Minimize physical contact with the child initially
Rationale: Toddlers often experience stranger anxiety and fear of invasive
procedures. Minimizing initial physical contact allows the child to become
comfortable with the nurse and the environment, reducing anxiety and
promoting cooperation during the examination.
5. A nurse is caring for an 18-year-old adolescent who is up-to-date on
immunizations and is planning to attend college. The nurse should inform the
client that he should receive which of the following immunizations prior to
moving into a campus dormitory?
A) Hepatitis B vaccine
B) Meningococcal polysaccharide vaccine
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C) Human papillomavirus vaccine
D) Influenza vaccine
Correct Answer: B) Meningococcal polysaccharide vaccine
Rationale: College dormitories create environments where meningococcal
disease spreads more easily due to close quarters. The meningococcal vaccine is
specifically recommended for adolescents entering college, particularly those
living in dormitory settings, to prevent potentially fatal meningitis outbreaks.
6. A nurse is teaching the parent of a toddler about home safety. Which of the
following statements by the parent indicates an understanding of the teaching?
A) "I keep my medications on the kitchen counter for easy access"
B) "I lock my medications in the medicine cabinet"
C) "I store cleaning supplies under the bathroom sink"
D) "I leave poisonous plants in the living room"
Correct Answer: B) "I lock my medications in the medicine cabinet"
Rationale: Proper storage of medications in a locked cabinet prevents accidental
ingestion by curious toddlers. This is a crucial safety measure as medication
poisoning is a leading cause of injury in young children who explore their
environment through taste and touch.
7. A nurse is performing a physical assessment on a 6-month-old infant. Which
of the following reflexes should the nurse expect to find?
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A) Moro reflex
B) Babinski reflex
C) Stepping reflex
D) Rooting reflex
Correct Answer: B) Babinski reflex
Rationale: The Babinski reflex (toes fanning when sole is stroked) typically
persists until about 12 months of age. The Moro, stepping, and rooting reflexes
usually disappear by 4-6 months, making Babinski the expected finding at 6
months.
8. A nurse is teaching the parent of an infant about food allergens. Which of the
following foods should the nurse include as being the most common food allergy
in children?
A) Peanuts
B) Eggs
C) Cow's milk
D) Shellfish
Correct Answer: C) Cow's milk
Rationale: Cow's milk is the most common food allergy in children, affecting
approximately 2-3% of infants and young children. Symptoms can include
gastrointestinal distress, skin reactions, and respiratory issues, requiring careful
dietary management and avoidance.
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9. A nurse is preparing to administer recommended immunizations to a 2-
month-old infant. Which of the following immunizations should the nurse plan
to administer?
A) Measles, mumps, and rubella (MMR) and varicella
B) Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
C) Hepatitis A and rotavirus
D) Meningococcal and pneumococcal
Correct Answer: B) Haemophilus influenzae type B (Hib) and inactivated polio
virus (IPV)
Rationale: At 2 months of age, recommended immunizations include Hib, IPV,
DTaP, PCV, and rotavirus. MMR and varicella are not given until 12-15
months, while hepatitis A is typically given at 12-23 months, following
standard CDC immunization schedules.
10. A nurse is developing a plan of care for a school-age child who underwent a
surgical procedure that resulted in temporary loss of vision. Which of the
following interventions should the nurse include in the plan of care?
A) Keep the room brightly lit at all times
B) Explain sounds the child is hearing
C) Avoid touching the child to prevent startling
D) Move furniture frequently to stimulate the child
Correct Answer: B) Explain sounds the child is hearing
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Rationale: Children with temporary vision loss rely heavily on other senses.
Explaining environmental sounds helps the child understand their
surroundings, reduces anxiety, and promotes orientation to the environment,
enhancing their sense of safety and control.
11. A nurse is assessing a 3-year-old child who is 1 day postoperative following a
tonsillectomy. Which of the following methods should the nurse use to
determine if the child is experiencing pain?
A) Numeric rating scale
B) Use the FACES scale
C) Visual analog scale
D) Parental report only
Correct Answer: B) Use the FACES scale
Rationale: The FACES pain scale is developmentally appropriate for children as
young as 3 years old. It uses simple facial expressions that children can easily
understand and relate to, making it an effective tool for assessing pain in young
children who may not have the language skills to describe pain verbally.
12. A nurse is assessing a 6-month-old infant at a well-child visit. Which of the
following findings indicates the need for further assessment?
A) Legs remain crossed and extended when supine
B) Infant rolls from back to front
ATI Pediatric Proctored Exam - Comprehensive
Study Guide
250 Randomized NGN-Style Multiple Choice
Questions -2026/2027 UPDATE-
1. A nurse in the emergency department is caring for a 2-year-old child who was
found by his parents crying and holding a container of toilet bowl cleaner. The
child's lips are edematous and inflamed, and he is drooling. Which of the
following is the priority action by the nurse?
A) Induce vomiting to remove the toxin
B) Administer activated charcoal
C) Check the child's respiratory status
D) Call poison control immediately
Correct Answer: C) Check the child's respiratory status
Rationale: Airway compromise is the greatest immediate threat in a child with
potential caustic ingestion. Edema and inflammation of the lips and drooling
indicate possible airway involvement, making respiratory assessment the
priority before any other intervention.
,2|Page
2. A nurse is teaching a parent of a 12-month-old child about development
during the toddler years. Which of the following statements should the nurse
include?
A) "Your child should be able to walk up stairs with assistance at 18 months"
B) "Your child should be able to scribble spontaneously using a crayon at the
age of 15 months"
C) "Your child should be able to jump with both feet at 24 months"
D) "Your child should be able to feed themselves with a spoon at 12 months"
Correct Answer: B) "Your child should be able to scribble spontaneously using a
crayon at the age of 15 months"
Rationale: Fine motor development in toddlers includes the ability to scribble
spontaneously around 15 months of age. This demonstrates emerging hand-eye
coordination and fine motor control typical for this developmental stage.
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium
chloride 100 mL IV to infuse over 4 hr. The drop factor of the manual IV
tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how
many gtt/min? (Round the answer to the nearest whole number.)
A) 15 gtt/min
B) 20 gtt/min
C) 25 gtt/min
D) 30 gtt/min
Correct Answer: C) 25 gtt/min
,3|Page
Rationale: Calculate using the formula: (Volume in mL × Drop factor) ÷ Time
in minutes = (100 mL × 60 gtt/mL) ÷ 240 minutes = 6000 ÷ 240 = 25 gtt/min.
This ensures accurate medication administration and prevents fluid overload or
underhydration.
4. A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which
of the following actions should the nurse take?
A) Begin the assessment by examining the ears first
B) Minimize physical contact with the child initially
C) Ask the child to undress completely before the examination
D) Perform the most invasive procedures first
Correct Answer: B) Minimize physical contact with the child initially
Rationale: Toddlers often experience stranger anxiety and fear of invasive
procedures. Minimizing initial physical contact allows the child to become
comfortable with the nurse and the environment, reducing anxiety and
promoting cooperation during the examination.
5. A nurse is caring for an 18-year-old adolescent who is up-to-date on
immunizations and is planning to attend college. The nurse should inform the
client that he should receive which of the following immunizations prior to
moving into a campus dormitory?
A) Hepatitis B vaccine
B) Meningococcal polysaccharide vaccine
,4|Page
C) Human papillomavirus vaccine
D) Influenza vaccine
Correct Answer: B) Meningococcal polysaccharide vaccine
Rationale: College dormitories create environments where meningococcal
disease spreads more easily due to close quarters. The meningococcal vaccine is
specifically recommended for adolescents entering college, particularly those
living in dormitory settings, to prevent potentially fatal meningitis outbreaks.
6. A nurse is teaching the parent of a toddler about home safety. Which of the
following statements by the parent indicates an understanding of the teaching?
A) "I keep my medications on the kitchen counter for easy access"
B) "I lock my medications in the medicine cabinet"
C) "I store cleaning supplies under the bathroom sink"
D) "I leave poisonous plants in the living room"
Correct Answer: B) "I lock my medications in the medicine cabinet"
Rationale: Proper storage of medications in a locked cabinet prevents accidental
ingestion by curious toddlers. This is a crucial safety measure as medication
poisoning is a leading cause of injury in young children who explore their
environment through taste and touch.
7. A nurse is performing a physical assessment on a 6-month-old infant. Which
of the following reflexes should the nurse expect to find?
,5|Page
A) Moro reflex
B) Babinski reflex
C) Stepping reflex
D) Rooting reflex
Correct Answer: B) Babinski reflex
Rationale: The Babinski reflex (toes fanning when sole is stroked) typically
persists until about 12 months of age. The Moro, stepping, and rooting reflexes
usually disappear by 4-6 months, making Babinski the expected finding at 6
months.
8. A nurse is teaching the parent of an infant about food allergens. Which of the
following foods should the nurse include as being the most common food allergy
in children?
A) Peanuts
B) Eggs
C) Cow's milk
D) Shellfish
Correct Answer: C) Cow's milk
Rationale: Cow's milk is the most common food allergy in children, affecting
approximately 2-3% of infants and young children. Symptoms can include
gastrointestinal distress, skin reactions, and respiratory issues, requiring careful
dietary management and avoidance.
,6|Page
9. A nurse is preparing to administer recommended immunizations to a 2-
month-old infant. Which of the following immunizations should the nurse plan
to administer?
A) Measles, mumps, and rubella (MMR) and varicella
B) Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
C) Hepatitis A and rotavirus
D) Meningococcal and pneumococcal
Correct Answer: B) Haemophilus influenzae type B (Hib) and inactivated polio
virus (IPV)
Rationale: At 2 months of age, recommended immunizations include Hib, IPV,
DTaP, PCV, and rotavirus. MMR and varicella are not given until 12-15
months, while hepatitis A is typically given at 12-23 months, following
standard CDC immunization schedules.
10. A nurse is developing a plan of care for a school-age child who underwent a
surgical procedure that resulted in temporary loss of vision. Which of the
following interventions should the nurse include in the plan of care?
A) Keep the room brightly lit at all times
B) Explain sounds the child is hearing
C) Avoid touching the child to prevent startling
D) Move furniture frequently to stimulate the child
Correct Answer: B) Explain sounds the child is hearing
, 7|Page
Rationale: Children with temporary vision loss rely heavily on other senses.
Explaining environmental sounds helps the child understand their
surroundings, reduces anxiety, and promotes orientation to the environment,
enhancing their sense of safety and control.
11. A nurse is assessing a 3-year-old child who is 1 day postoperative following a
tonsillectomy. Which of the following methods should the nurse use to
determine if the child is experiencing pain?
A) Numeric rating scale
B) Use the FACES scale
C) Visual analog scale
D) Parental report only
Correct Answer: B) Use the FACES scale
Rationale: The FACES pain scale is developmentally appropriate for children as
young as 3 years old. It uses simple facial expressions that children can easily
understand and relate to, making it an effective tool for assessing pain in young
children who may not have the language skills to describe pain verbally.
12. A nurse is assessing a 6-month-old infant at a well-child visit. Which of the
following findings indicates the need for further assessment?
A) Legs remain crossed and extended when supine
B) Infant rolls from back to front
