ATI PN Pediatric Nursing Proctored Exam Page 1
ATI PN PEDIATRIC NURSING PROCTORED EXAM
2026 Updated | NGN Questions & Answers | 100% Correct
Actual Exam with Next Generation NCLEX (NGN) Clinical Judgment Questions
70 Questions | 4-Option Multiple Choice | 12 Sections | With Rationales
Section 1: Growth and Development Across Pediatric Age Groups (Q1-Q12)
Q1. A nurse is assessing a 4-month-old infant during a well-child visit. The mother asks which gross motor milestones she
should expect her infant to achieve by this age. Which response by the nurse is most appropriate?
A. The infant should be able to walk independently with support
B. The infant should be able to sit unsupported for brief periods
C. The infant should be able to hold the head steady and erect when supported in a sitting position **[CORRECT]**
D. The infant should be able to stand while holding onto furniture
Correct Answer: C
Rationale: By 4 months of age, an infant should have achieved good head control and be able to hold the head steady and erect when supported in a
sitting position, which is a critical gross motor milestone. Walking with support and standing while holding furniture are not expected until 9-12
months, and sitting unsupported typically emerges around 6-8 months. Head control is the foundational milestone that precedes all subsequent gross
motor development and reflects normal neurological maturation of the cervical and upper thoracic musculature.
Q2. A nurse is providing anticipatory guidance to the parents of a 2-year-old toddler. According to Erikson's
developmental theory, which psychosocial crisis is the toddler currently experiencing?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt **[CORRECT]**
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Correct Answer: B
Rationale: According to Erikson's psychosocial development theory, the toddler (1-3 years) is in the Autonomy vs. Shame and Doubt stage, during
which the child develops a sense of independence and self-control through activities such as feeding, dressing, and toilet training. Trust vs. Mistrust
applies to infancy (birth-1 year), Initiative vs. Guilt corresponds to the preschool period (3-5 years), and Industry vs. Inferiority is the school-age
stage (6-12 years). The toddler's drive for autonomy is why they frequently say 'no' and insist on doing things independently.
Q3. A nurse is performing a developmental assessment on a 9-month-old infant. Which fine motor milestone should the
nurse expect to find?
A. The infant uses a crude pincer grasp to pick up small objects
B. The infant builds a tower of two blocks
C. The infant scribbles with a crayon on paper
D. The infant transfers objects from one hand to the other **[CORRECT]**
Correct Answer: D
Rationale: At 9 months of age, the infant should be able to transfer objects from one hand to the other, which demonstrates bilateral coordination
and intentional hand use. The pincer grasp (using thumb and index finger) typically emerges around 9-12 months, but a crude pincer grasp may not
be fully refined until 10-12 months. Building a two-block tower and scribbling with a crayon are fine motor milestones expected in the toddler period
(12-15 months and 15-18 months, respectively). Transferring objects is a key 9-month milestone that precedes the more refined pincer grasp.
Q4. A nurse is assessing a 12-month-old infant and notes the anterior fontanel is closed. The mother is concerned whether
this is normal. Which response by the nurse is most accurate?
A. This is abnormal and requires immediate neurological evaluation
B. Premature closure of the anterior fontanel indicates craniosynostosis and requires surgical intervention
2026 Updated | NGN Questions & Answers | 100% Correct
,ATI PN Pediatric Nursing Proctored Exam Page 2
C. The anterior fontanel should remain open until 24 months of age
D. The anterior fontanel typically closes between 12 and 18 months, so this finding is within the expected range
**[CORRECT]**
Correct Answer: D
Rationale: The anterior fontanel typically closes between 12 and 18 months of age, so closure at 12 months is at the earliest end of the normal range
and is considered a normal finding. Closure before 6 months would be considered premature and may indicate craniosynostosis. The posterior
fontanel closes much earlier, between 2 and 3 months. The nurse should reassure the mother that this is a normal finding and continue routine
monitoring, while documenting it in the infant's growth record.
Q5. A nurse is counseling the parents of a 3-year-old child about play activities. Which type of play is most characteristic
of a child at this developmental stage according to Piaget's theory?
A. The child participates in parallel play, playing alongside but not directly with other children **[CORRECT]**
B. The child engages in cooperative play with shared goals and rules
C. The child engages in solitary play, showing no interest in other children
D. The child demonstrates formal operational thinking during pretend play
Correct Answer: A
Rationale: The preschool child (3-5 years) is in Piaget's preoperational stage and typically engages in associative and cooperative play, though
parallel play may still be observed. However, the hallmark of the preschool period is the emergence of associative and cooperative play with shared
goals. Parallel play is most characteristic of toddlers (1-3 years), and solitary play is seen in infants. Formal operational thinking does not emerge
until adolescence (12-18 years). The 3-year-old is beginning to engage with peers in a more interactive manner, which reflects advancing
social-cognitive development.
Q6. A nurse is evaluating the growth of a 6-month-old infant. The infant's birth weight was 3.5 kg. Which weight should
the nurse expect at this age?
A. 5.25 kg (birth weight + 50%)
B. 8.75 kg (birth weight + 150%)
C. 10.5 kg (triple the birth weight)
D. 7.0 kg (double the birth weight) **[CORRECT]**
Correct Answer: D
Rationale: An infant's weight typically doubles by 5-6 months of age and triples by 12 months. Therefore, a 6-month-old infant who weighed 3.5 kg
at birth should weigh approximately 7.0 kg (3.5 x 2). Weight tripling (10.5 kg) is not expected until approximately 12 months of age. The 50%
increase (5.25 kg) would be expected around 3-4 months, and the 150% increase does not represent a standard milestone. These growth patterns are
critical for evaluating nutritional status and overall health in infancy.
Q7. A school nurse is conducting a health assessment on a 10-year-old child. According to Erikson's developmental
theory, which psychosocial stage is this child experiencing?
A. Initiative vs. Guilt
B. Autonomy vs. Shame and Doubt
C. Industry vs. Inferiority **[CORRECT]**
D. Identity vs. Role Confusion
Correct Answer: C
Rationale: The school-age child (6-12 years) is in Erikson's Industry vs. Inferiority stage, in which the child develops competence and self-esteem
through academic achievement, skill development, and peer relationships. Initiative vs. Guilt is the preschool stage (3-5 years), Autonomy vs. Shame
and Doubt is the toddler stage (1-3 years), and Identity vs. Role Confusion is the adolescent stage (12-18 years). School-age children who successfully
navigate this stage develop a sense of competence, while those who struggle may develop feelings of inferiority that can affect their self-concept and
academic motivation.
Q8. A nurse is providing anticipatory guidance to the parents of a 15-month-old toddler. Which gross motor milestone
should the nurse discuss as expected for this age?
A. The child should be able to run smoothly and climb stairs with alternating feet
B. The child should be able to hop on one foot
C. The child should be able to ride a tricycle
2026 Updated | NGN Questions & Answers | 100% Correct
, ATI PN Pediatric Nursing Proctored Exam Page 3
D. The child should be able to walk independently without support **[CORRECT]**
Correct Answer: D
Rationale: Walking independently without support typically emerges between 12 and 15 months of age, making this the expected gross motor milestone
for a 15-month-old toddler. Running smoothly and climbing stairs with alternating feet are milestones expected around 2-3 years. Riding a tricycle
typically develops around age 3, and hopping on one foot is expected around age 4-5 years. The nurse should reassure parents that walking
independently is the appropriate milestone and encourage a safe environment for exploration and practice.
Q9. A nurse is assessing a 14-year-old adolescent who is exhibiting risk-taking behaviors. According to Erikson's theory,
which psychosocial crisis is this adolescent navigating?
A. Industry vs. Inferiority
B. Initiative vs. Guilt
C. Identity vs. Role Confusion **[CORRECT]**
D. Intimacy vs. Isolation
Correct Answer: C
Rationale: The adolescent (12-18 years) is in Erikson's Identity vs. Role Confusion stage, during which the teenager explores personal values, beliefs,
career goals, and sexual identity to form a coherent sense of self. Risk-taking behaviors are common during this stage as adolescents test boundaries
and explore different identities. Industry vs. Inferiority is the school-age stage (6-12 years), Initiative vs. Guilt is the preschool stage (3-5 years), and
Intimacy vs. Isolation is the young adult stage (18-40 years). Nurses should provide non-judgmental guidance and health education during this critical
developmental period.
Q10. A nurse is educating parents about the cognitive development of their 4-year-old preschooler using Piaget's theory.
Which cognitive characteristic is most appropriate for this developmental stage?
A. The child can think abstractly and reason hypothetically
B. The child demonstrates magical thinking and egocentrism **[CORRECT]**
C. The child understands conservation of mass and volume
D. The child can solve complex mathematical problems using formulas
Correct Answer: B
Rationale: The preschool child (3-5 years) is in Piaget's preoperational stage, characterized by magical thinking (believing thoughts can influence
events) and egocentrism (difficulty seeing others' perspectives). Abstract thinking and hypothetical reasoning emerge during the formal operational
stage (adolescence). Conservation understanding develops during the concrete operational stage (school-age, 6-12 years). Complex mathematical
problem-solving also requires concrete or formal operational thinking. These preoperational characteristics explain why preschoolers may believe they
caused a parent's illness through bad thoughts.
Q11. A nurse is assessing a newborn infant's reflexes. Which reflex, when elicited by stroking the sole of the foot from
heel to toe, causes the toes to fan and the great toe to dorsiflex?
A. Moro reflex
B. Babinski reflex **[CORRECT]**
C. Rooting reflex
D. Palmar grasp reflex
Correct Answer: B
Rationale: The Babinski reflex is elicited by stroking the lateral sole of the foot from heel to toe, causing the toes to fan and the great toe to dorsiflex.
This reflex is normal in infants up to approximately 12 months of age; persistence beyond this age may indicate upper motor neuron pathology. The
Moro reflex is a startle response to sudden movement or loud noise, the rooting reflex causes the infant to turn toward a stimulus touching the cheek,
and the palmar grasp reflex causes the infant to grasp an object placed in the palm. The Babinski reflex is a critical neurological assessment finding
in the newborn period.
Q12. A nurse is discussing developmental milestones with the parent of a 7-year-old child. According to Piaget's theory of
cognitive development, which stage is this child in?
A. Sensorimotor stage
B. Preoperational stage
C. Concrete operational stage **[CORRECT]**
D. Formal operational stage
2026 Updated | NGN Questions & Answers | 100% Correct
ATI PN PEDIATRIC NURSING PROCTORED EXAM
2026 Updated | NGN Questions & Answers | 100% Correct
Actual Exam with Next Generation NCLEX (NGN) Clinical Judgment Questions
70 Questions | 4-Option Multiple Choice | 12 Sections | With Rationales
Section 1: Growth and Development Across Pediatric Age Groups (Q1-Q12)
Q1. A nurse is assessing a 4-month-old infant during a well-child visit. The mother asks which gross motor milestones she
should expect her infant to achieve by this age. Which response by the nurse is most appropriate?
A. The infant should be able to walk independently with support
B. The infant should be able to sit unsupported for brief periods
C. The infant should be able to hold the head steady and erect when supported in a sitting position **[CORRECT]**
D. The infant should be able to stand while holding onto furniture
Correct Answer: C
Rationale: By 4 months of age, an infant should have achieved good head control and be able to hold the head steady and erect when supported in a
sitting position, which is a critical gross motor milestone. Walking with support and standing while holding furniture are not expected until 9-12
months, and sitting unsupported typically emerges around 6-8 months. Head control is the foundational milestone that precedes all subsequent gross
motor development and reflects normal neurological maturation of the cervical and upper thoracic musculature.
Q2. A nurse is providing anticipatory guidance to the parents of a 2-year-old toddler. According to Erikson's
developmental theory, which psychosocial crisis is the toddler currently experiencing?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt **[CORRECT]**
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Correct Answer: B
Rationale: According to Erikson's psychosocial development theory, the toddler (1-3 years) is in the Autonomy vs. Shame and Doubt stage, during
which the child develops a sense of independence and self-control through activities such as feeding, dressing, and toilet training. Trust vs. Mistrust
applies to infancy (birth-1 year), Initiative vs. Guilt corresponds to the preschool period (3-5 years), and Industry vs. Inferiority is the school-age
stage (6-12 years). The toddler's drive for autonomy is why they frequently say 'no' and insist on doing things independently.
Q3. A nurse is performing a developmental assessment on a 9-month-old infant. Which fine motor milestone should the
nurse expect to find?
A. The infant uses a crude pincer grasp to pick up small objects
B. The infant builds a tower of two blocks
C. The infant scribbles with a crayon on paper
D. The infant transfers objects from one hand to the other **[CORRECT]**
Correct Answer: D
Rationale: At 9 months of age, the infant should be able to transfer objects from one hand to the other, which demonstrates bilateral coordination
and intentional hand use. The pincer grasp (using thumb and index finger) typically emerges around 9-12 months, but a crude pincer grasp may not
be fully refined until 10-12 months. Building a two-block tower and scribbling with a crayon are fine motor milestones expected in the toddler period
(12-15 months and 15-18 months, respectively). Transferring objects is a key 9-month milestone that precedes the more refined pincer grasp.
Q4. A nurse is assessing a 12-month-old infant and notes the anterior fontanel is closed. The mother is concerned whether
this is normal. Which response by the nurse is most accurate?
A. This is abnormal and requires immediate neurological evaluation
B. Premature closure of the anterior fontanel indicates craniosynostosis and requires surgical intervention
2026 Updated | NGN Questions & Answers | 100% Correct
,ATI PN Pediatric Nursing Proctored Exam Page 2
C. The anterior fontanel should remain open until 24 months of age
D. The anterior fontanel typically closes between 12 and 18 months, so this finding is within the expected range
**[CORRECT]**
Correct Answer: D
Rationale: The anterior fontanel typically closes between 12 and 18 months of age, so closure at 12 months is at the earliest end of the normal range
and is considered a normal finding. Closure before 6 months would be considered premature and may indicate craniosynostosis. The posterior
fontanel closes much earlier, between 2 and 3 months. The nurse should reassure the mother that this is a normal finding and continue routine
monitoring, while documenting it in the infant's growth record.
Q5. A nurse is counseling the parents of a 3-year-old child about play activities. Which type of play is most characteristic
of a child at this developmental stage according to Piaget's theory?
A. The child participates in parallel play, playing alongside but not directly with other children **[CORRECT]**
B. The child engages in cooperative play with shared goals and rules
C. The child engages in solitary play, showing no interest in other children
D. The child demonstrates formal operational thinking during pretend play
Correct Answer: A
Rationale: The preschool child (3-5 years) is in Piaget's preoperational stage and typically engages in associative and cooperative play, though
parallel play may still be observed. However, the hallmark of the preschool period is the emergence of associative and cooperative play with shared
goals. Parallel play is most characteristic of toddlers (1-3 years), and solitary play is seen in infants. Formal operational thinking does not emerge
until adolescence (12-18 years). The 3-year-old is beginning to engage with peers in a more interactive manner, which reflects advancing
social-cognitive development.
Q6. A nurse is evaluating the growth of a 6-month-old infant. The infant's birth weight was 3.5 kg. Which weight should
the nurse expect at this age?
A. 5.25 kg (birth weight + 50%)
B. 8.75 kg (birth weight + 150%)
C. 10.5 kg (triple the birth weight)
D. 7.0 kg (double the birth weight) **[CORRECT]**
Correct Answer: D
Rationale: An infant's weight typically doubles by 5-6 months of age and triples by 12 months. Therefore, a 6-month-old infant who weighed 3.5 kg
at birth should weigh approximately 7.0 kg (3.5 x 2). Weight tripling (10.5 kg) is not expected until approximately 12 months of age. The 50%
increase (5.25 kg) would be expected around 3-4 months, and the 150% increase does not represent a standard milestone. These growth patterns are
critical for evaluating nutritional status and overall health in infancy.
Q7. A school nurse is conducting a health assessment on a 10-year-old child. According to Erikson's developmental
theory, which psychosocial stage is this child experiencing?
A. Initiative vs. Guilt
B. Autonomy vs. Shame and Doubt
C. Industry vs. Inferiority **[CORRECT]**
D. Identity vs. Role Confusion
Correct Answer: C
Rationale: The school-age child (6-12 years) is in Erikson's Industry vs. Inferiority stage, in which the child develops competence and self-esteem
through academic achievement, skill development, and peer relationships. Initiative vs. Guilt is the preschool stage (3-5 years), Autonomy vs. Shame
and Doubt is the toddler stage (1-3 years), and Identity vs. Role Confusion is the adolescent stage (12-18 years). School-age children who successfully
navigate this stage develop a sense of competence, while those who struggle may develop feelings of inferiority that can affect their self-concept and
academic motivation.
Q8. A nurse is providing anticipatory guidance to the parents of a 15-month-old toddler. Which gross motor milestone
should the nurse discuss as expected for this age?
A. The child should be able to run smoothly and climb stairs with alternating feet
B. The child should be able to hop on one foot
C. The child should be able to ride a tricycle
2026 Updated | NGN Questions & Answers | 100% Correct
, ATI PN Pediatric Nursing Proctored Exam Page 3
D. The child should be able to walk independently without support **[CORRECT]**
Correct Answer: D
Rationale: Walking independently without support typically emerges between 12 and 15 months of age, making this the expected gross motor milestone
for a 15-month-old toddler. Running smoothly and climbing stairs with alternating feet are milestones expected around 2-3 years. Riding a tricycle
typically develops around age 3, and hopping on one foot is expected around age 4-5 years. The nurse should reassure parents that walking
independently is the appropriate milestone and encourage a safe environment for exploration and practice.
Q9. A nurse is assessing a 14-year-old adolescent who is exhibiting risk-taking behaviors. According to Erikson's theory,
which psychosocial crisis is this adolescent navigating?
A. Industry vs. Inferiority
B. Initiative vs. Guilt
C. Identity vs. Role Confusion **[CORRECT]**
D. Intimacy vs. Isolation
Correct Answer: C
Rationale: The adolescent (12-18 years) is in Erikson's Identity vs. Role Confusion stage, during which the teenager explores personal values, beliefs,
career goals, and sexual identity to form a coherent sense of self. Risk-taking behaviors are common during this stage as adolescents test boundaries
and explore different identities. Industry vs. Inferiority is the school-age stage (6-12 years), Initiative vs. Guilt is the preschool stage (3-5 years), and
Intimacy vs. Isolation is the young adult stage (18-40 years). Nurses should provide non-judgmental guidance and health education during this critical
developmental period.
Q10. A nurse is educating parents about the cognitive development of their 4-year-old preschooler using Piaget's theory.
Which cognitive characteristic is most appropriate for this developmental stage?
A. The child can think abstractly and reason hypothetically
B. The child demonstrates magical thinking and egocentrism **[CORRECT]**
C. The child understands conservation of mass and volume
D. The child can solve complex mathematical problems using formulas
Correct Answer: B
Rationale: The preschool child (3-5 years) is in Piaget's preoperational stage, characterized by magical thinking (believing thoughts can influence
events) and egocentrism (difficulty seeing others' perspectives). Abstract thinking and hypothetical reasoning emerge during the formal operational
stage (adolescence). Conservation understanding develops during the concrete operational stage (school-age, 6-12 years). Complex mathematical
problem-solving also requires concrete or formal operational thinking. These preoperational characteristics explain why preschoolers may believe they
caused a parent's illness through bad thoughts.
Q11. A nurse is assessing a newborn infant's reflexes. Which reflex, when elicited by stroking the sole of the foot from
heel to toe, causes the toes to fan and the great toe to dorsiflex?
A. Moro reflex
B. Babinski reflex **[CORRECT]**
C. Rooting reflex
D. Palmar grasp reflex
Correct Answer: B
Rationale: The Babinski reflex is elicited by stroking the lateral sole of the foot from heel to toe, causing the toes to fan and the great toe to dorsiflex.
This reflex is normal in infants up to approximately 12 months of age; persistence beyond this age may indicate upper motor neuron pathology. The
Moro reflex is a startle response to sudden movement or loud noise, the rooting reflex causes the infant to turn toward a stimulus touching the cheek,
and the palmar grasp reflex causes the infant to grasp an object placed in the palm. The Babinski reflex is a critical neurological assessment finding
in the newborn period.
Q12. A nurse is discussing developmental milestones with the parent of a 7-year-old child. According to Piaget's theory of
cognitive development, which stage is this child in?
A. Sensorimotor stage
B. Preoperational stage
C. Concrete operational stage **[CORRECT]**
D. Formal operational stage
2026 Updated | NGN Questions & Answers | 100% Correct
