C O M P R E H E N S I V E P R A C T I C E E X A M I N AT I O N
ATI PEDIATRICS PROCTORED EXAM
COMPREHENSIVE PRACTICE – 2026/2027 EDITION
150 Questions 8 Content Sections Answers & Rationales 10 NGN-Style Case Studies
I M P O RTA N T N O T I C E
This is an original practice examination written in the style of pediatric nursing
proctored assessments. It is not an actual ATI assessment, is not affiliated with or
endorsed by ATI Nursing Education, and contains no proprietary exam items. It is intended
for self-study and preparation only.
Clinical content is aligned with widely accepted guidance as of August 2026 — the CDC
child/adolescent immunization schedule, AAP policy, and the current NCLEX-RN test plan.
Medication doses, schedules, and policies change: always verify against current official
sources and your program's references before clinical or classroom use.
HOW TO USE THIS EXAM
Work through each section sequentially. Correct answers are marked [CORRECT] with a
rationale after every question — cover the answer column or have a study partner quiz
you to convert this into a self-test. Sections 1–7 map to core content domains; Section 8
contains ten NGN-style case studies with related questions for clinical-judgment practice.
CONTENTS
1. Section 1 Growth & Development – Infancy through Adolescence (25 questions)
2. Section 2 Health Promotion & Disease Prevention – Immunizations, Nutrition,
Anticipatory Guidance (20 questions)
3. Section 3 Pediatric Acute Conditions – Respiratory, GI, ENT, Dermatologic (20
questions)
4. Section 4 Pediatric Chronic Conditions – Asthma, Diabetes, CF, Sickle Cell, CHD (20
questions)
5. Section 5 Pediatric Pharmacology – Calculations, Safety, Common Medications (15
questions)
6. Section 6 Assessment & Diagnostic Reasoning – Exam, Vitals, Milestones (15
questions)
7. Section 7 Special Populations – Neonatal, Adolescent, Special Needs (10 questions)
Page 1 of 42
, ATI Pediatrics Proctored Exam —Comprehensive Practice (2026/2027 Edition)
8. Section 8 Integrated Case Studies – Complex Pediatric Scenarios (25 questions)
Page 2 of 42
, ATI Pediatrics Proctored Exam —Comprehensive Practice (2026/2027 Edition)
Section 1: Growth & Development – Infancy through Adolescence
(25 questions)
Q1: A nurse is assessing a 6-month-old infant during a well-child visit. Which gross motor milestone
should the nurse expect to find?
A. Sits without support
B. Rolls from back to abdomen [CORRECT]
C. Pulls to a standing position
D. Creeps on hands and knees
Correct Answer: B
Rationale: At about 6 months, infants roll from back to abdomen and sit with support; unsupported
sitting occurs near 8 months, and pulling to stand and creeping near 9–10 months, making the other
findings too advanced for this age.
Q2: The parent of a 4-month-old asks the nurse when the infant will learn to roll over. Which response
is appropriate?
A. "Most infants first roll from the abdomen to the back at around this age." [CORRECT]
B. "Rolling is not expected until the infant can walk independently."
C. "Your infant should already be rolling from back to abdomen by now."
D. "Infants cannot roll purposefully until after the first birthday."
Correct Answer: A
Rationale: At about 4 months most infants roll from abdomen to back first; rolling from back to abdomen
follows around 6 months, so the other responses misstate the typical timeline.
Q3: Which fine motor skill is expected of a healthy 9-month-old infant?
A. Copies a circle
B. Scribbles spontaneously
C. Uses the thumb and fingers to pick up a small object [CORRECT]
D. Builds a tower of two blocks
Correct Answer: C
Rationale: A crude pincer grasp develops around 9 months; scribbling appears near 18 months, two-
block towers near 15 months, and circle copying during the preschool years.
Q4: A 9-month-old cries when the mother leaves the room and quiets when she returns. The nurse
explains this behavior is related to which cognitive development?
A. Conservation
B. Object permanence [CORRECT]
C. Magical thinking
D. Egocentrism
Correct Answer: B
Rationale: Object permanence develops around 9–10 months, so the infant now knows the mother exists
when out of sight; conservation, magical thinking, and egocentrism belong to older developmental
stages.
Page 3 of 42
, ATI Pediatrics Proctored Exam —Comprehensive Practice (2026/2027 Edition)
Q5: A nurse is teaching the parent of a 6-month-old about normal growth. By what age should the
nurse explain the anterior fontanelle is expected to close?
A. 3 months
B. 8 months
C. 14 months [CORRECT]
D. 36 months
Correct Answer: C
Rationale: The anterior fontanelle normally closes between 12 and 18 months; closure at 3 or 8 months
would be abnormally early, and persistence to 3 years would be abnormal.
Q6: A nurse plans care for an 18-month-old based on Erikson's stage of autonomy versus shame and
doubt. Which intervention supports this stage?
A. Allowing the child to choose which of two outfits to wear [CORRECT]
B. Restricting the child to the crib to conserve energy
C. Making all choices for the child to prevent frustration
D. Insisting the child remain quiet and still during meals
Correct Answer: A
Rationale: Toddlers build autonomy by making simple, safe choices; options B, C, and D remove control
and foster shame and doubt.
Q7: The parent of a 2-year-old reports the child says "no" to nearly every request. Which response by
the nurse is appropriate?
A. "This behavior requires immediate behavioral therapy."
B. "Punish the child consistently so the behavior stops quickly."
C. "This is normal and reflects the child's developing autonomy." [CORRECT]
D. "Most children this age are compliant and agreeable."
Correct Answer: C
Rationale: Negativism is an expected expression of toddler autonomy; it is not pathologic, punishment is
inappropriate, and typical toddlers are not uniformly compliant.
Q8: A 3-year-old has a temper tantrum in the clinic waiting room. Which guidance by the nurse is best?
A. "Give the child a treat to end the tantrum quickly."
B. "Make sure the child is safe, then ignore the tantrum behavior." [CORRECT]
C. "Reason with the child in detail while the tantrum continues."
D. "Tantrums at this age signal oppositional defiant disorder and need referral."
Correct Answer: B
Rationale: Tantrums are normal at this age; ensuring safety and ignoring the behavior avoids reinforcing
it, while rewards, lengthy reasoning, or labeling the child as disordered are inappropriate.
Page 4 of 42
ATI PEDIATRICS PROCTORED EXAM
COMPREHENSIVE PRACTICE – 2026/2027 EDITION
150 Questions 8 Content Sections Answers & Rationales 10 NGN-Style Case Studies
I M P O RTA N T N O T I C E
This is an original practice examination written in the style of pediatric nursing
proctored assessments. It is not an actual ATI assessment, is not affiliated with or
endorsed by ATI Nursing Education, and contains no proprietary exam items. It is intended
for self-study and preparation only.
Clinical content is aligned with widely accepted guidance as of August 2026 — the CDC
child/adolescent immunization schedule, AAP policy, and the current NCLEX-RN test plan.
Medication doses, schedules, and policies change: always verify against current official
sources and your program's references before clinical or classroom use.
HOW TO USE THIS EXAM
Work through each section sequentially. Correct answers are marked [CORRECT] with a
rationale after every question — cover the answer column or have a study partner quiz
you to convert this into a self-test. Sections 1–7 map to core content domains; Section 8
contains ten NGN-style case studies with related questions for clinical-judgment practice.
CONTENTS
1. Section 1 Growth & Development – Infancy through Adolescence (25 questions)
2. Section 2 Health Promotion & Disease Prevention – Immunizations, Nutrition,
Anticipatory Guidance (20 questions)
3. Section 3 Pediatric Acute Conditions – Respiratory, GI, ENT, Dermatologic (20
questions)
4. Section 4 Pediatric Chronic Conditions – Asthma, Diabetes, CF, Sickle Cell, CHD (20
questions)
5. Section 5 Pediatric Pharmacology – Calculations, Safety, Common Medications (15
questions)
6. Section 6 Assessment & Diagnostic Reasoning – Exam, Vitals, Milestones (15
questions)
7. Section 7 Special Populations – Neonatal, Adolescent, Special Needs (10 questions)
Page 1 of 42
, ATI Pediatrics Proctored Exam —Comprehensive Practice (2026/2027 Edition)
8. Section 8 Integrated Case Studies – Complex Pediatric Scenarios (25 questions)
Page 2 of 42
, ATI Pediatrics Proctored Exam —Comprehensive Practice (2026/2027 Edition)
Section 1: Growth & Development – Infancy through Adolescence
(25 questions)
Q1: A nurse is assessing a 6-month-old infant during a well-child visit. Which gross motor milestone
should the nurse expect to find?
A. Sits without support
B. Rolls from back to abdomen [CORRECT]
C. Pulls to a standing position
D. Creeps on hands and knees
Correct Answer: B
Rationale: At about 6 months, infants roll from back to abdomen and sit with support; unsupported
sitting occurs near 8 months, and pulling to stand and creeping near 9–10 months, making the other
findings too advanced for this age.
Q2: The parent of a 4-month-old asks the nurse when the infant will learn to roll over. Which response
is appropriate?
A. "Most infants first roll from the abdomen to the back at around this age." [CORRECT]
B. "Rolling is not expected until the infant can walk independently."
C. "Your infant should already be rolling from back to abdomen by now."
D. "Infants cannot roll purposefully until after the first birthday."
Correct Answer: A
Rationale: At about 4 months most infants roll from abdomen to back first; rolling from back to abdomen
follows around 6 months, so the other responses misstate the typical timeline.
Q3: Which fine motor skill is expected of a healthy 9-month-old infant?
A. Copies a circle
B. Scribbles spontaneously
C. Uses the thumb and fingers to pick up a small object [CORRECT]
D. Builds a tower of two blocks
Correct Answer: C
Rationale: A crude pincer grasp develops around 9 months; scribbling appears near 18 months, two-
block towers near 15 months, and circle copying during the preschool years.
Q4: A 9-month-old cries when the mother leaves the room and quiets when she returns. The nurse
explains this behavior is related to which cognitive development?
A. Conservation
B. Object permanence [CORRECT]
C. Magical thinking
D. Egocentrism
Correct Answer: B
Rationale: Object permanence develops around 9–10 months, so the infant now knows the mother exists
when out of sight; conservation, magical thinking, and egocentrism belong to older developmental
stages.
Page 3 of 42
, ATI Pediatrics Proctored Exam —Comprehensive Practice (2026/2027 Edition)
Q5: A nurse is teaching the parent of a 6-month-old about normal growth. By what age should the
nurse explain the anterior fontanelle is expected to close?
A. 3 months
B. 8 months
C. 14 months [CORRECT]
D. 36 months
Correct Answer: C
Rationale: The anterior fontanelle normally closes between 12 and 18 months; closure at 3 or 8 months
would be abnormally early, and persistence to 3 years would be abnormal.
Q6: A nurse plans care for an 18-month-old based on Erikson's stage of autonomy versus shame and
doubt. Which intervention supports this stage?
A. Allowing the child to choose which of two outfits to wear [CORRECT]
B. Restricting the child to the crib to conserve energy
C. Making all choices for the child to prevent frustration
D. Insisting the child remain quiet and still during meals
Correct Answer: A
Rationale: Toddlers build autonomy by making simple, safe choices; options B, C, and D remove control
and foster shame and doubt.
Q7: The parent of a 2-year-old reports the child says "no" to nearly every request. Which response by
the nurse is appropriate?
A. "This behavior requires immediate behavioral therapy."
B. "Punish the child consistently so the behavior stops quickly."
C. "This is normal and reflects the child's developing autonomy." [CORRECT]
D. "Most children this age are compliant and agreeable."
Correct Answer: C
Rationale: Negativism is an expected expression of toddler autonomy; it is not pathologic, punishment is
inappropriate, and typical toddlers are not uniformly compliant.
Q8: A 3-year-old has a temper tantrum in the clinic waiting room. Which guidance by the nurse is best?
A. "Give the child a treat to end the tantrum quickly."
B. "Make sure the child is safe, then ignore the tantrum behavior." [CORRECT]
C. "Reason with the child in detail while the tantrum continues."
D. "Tantrums at this age signal oppositional defiant disorder and need referral."
Correct Answer: B
Rationale: Tantrums are normal at this age; ensuring safety and ignoring the behavior avoids reinforcing
it, while rewards, lengthy reasoning, or labeling the child as disordered are inappropriate.
Page 4 of 42
