ATI PEDIATRICS PROCTORED EXAM 2023 RETAKE 150
QUESTIONS WITH CORRECT DETAILED ANSWERS &
RATIONALES | 2026 REVISED EDITION
Core Domains
• Growth & Development: Milestones, Erikson/Piaget Stages, Anticipatory Guidance
• Health Promotion & Disease Prevention: Immunizations, Safety, Nutrition
• Pediatric Emergencies & Airway Management: Respiratory Distress, Anaphylaxis, Ingestion
• Common Childhood Disorders: Respiratory, GI, Cardiac, Neurological, Infectious
• Pharmacological Interventions: Medication Administration, Dosage Calculation, Side Effects
• Chronic Conditions: Asthma, Diabetes, Sickle Cell, Cystic Fibrosis
• Family-Centered Care & Psychosocial Support
• Next Generation NCLEX (NGN): Case Studies, Bow-Tie, Prioritization
This comprehensive examination guide is designed for nursing students preparing for the ATI Pediatrics
Proctored Exam 2023 Retake, updated for the 2026/2027 academic year. The exam evaluates clinical
judgment, prioritization, and application of pediatric nursing concepts across growth and development,
health promotion, acute and chronic illness management, and pharmacological interventions. This
resource features 150 practice questions with verified answers and detailed rationales, aligned with
current ATI and NGN standards to ensure exam success .
SECTION 1: GROWTH & DEVELOPMENT (Questions 1-25)
Question 1
A nurse is performing a developmental screening on a 4-year-old child. Which milestone is appropriate
for the nurse to expect?
A. Ties shoelaces
B. Draws a circle
C. Uses a fork to eat independently
D. Rides a tricycle
Correct answer: B
RATIONALE: By age 4, a child should be able to copy a circle and draw a person with 2-4 body parts.
Tying shoelaces is a fine motor skill expected around age 5-6. Using a fork independently is typically seen
,by age 3-4, but drawing a circle is a more specific milestone for age 4. Riding a tricycle is expected at age
3.
Question 2
A nurse is providing car seat safety teaching for a 2-year-old weighing 25 lb. Which instruction is
correct?
A. "Turn the car seat forward-facing now."
B. "Keep the child rear-facing until age 2 or height/weight limit is reached."
C. "Use a booster seat with a lap belt only."
D. "Place the car seat in the front passenger seat."
Correct answer: B
RATIONALE: The AAP recommends keeping children rear-facing until age 2 or until they reach the
maximum height and weight limit for their rear-facing car seat. This provides the best protection for the
child's head, neck, and spine in a crash. Forward-facing is not recommended at 2 years if the child still
fits the rear-facing seat's limits .
Question 3
A nurse is teaching the parent of a 12-month-old about development during the toddler years. Which
statement should the nurse include?
A. "Your child should be referring to himself using the appropriate pronoun by 18 months of age."
B. "A toddler's interest in looking at pictures occurs at 20 months of age."
C. "A toddler should have daytime control of his bowel and bladder by 24 months of age."
D. "Your child should be able to scribble spontaneously using a crayon at the age of 15 months."
Correct answer: D
RATIONALE: At 15 months, the toddler should be able to scribble spontaneously. At 18 months, the
toddler should be able to make strokes imitatively. Bowel and bladder control is not typically achieved
until 30-36 months. Pronouns are not used correctly until later in toddlerhood .
Question 4
A nurse is performing a physical assessment on a 6-month-old infant. Which reflex should the nurse
expect to find?
A. Stepping
B. Babinski
C. Extrusion
D. Moro
, Correct answer: B
RATIONALE: The Babinski reflex should be present until age 1 year. The stepping reflex disappears
around 4-8 weeks. The extrusion reflex disappears around 4 months. The Moro reflex disappears around
3-6 months. Absence of neonatal reflexes might indicate neurological deficits .
Question 5
A nurse is providing anticipatory guidance to parents of a 12-month-old. Which statement by the parent
indicates a need for further teaching about injury prevention?
A. "I will keep my medications locked in a cabinet."
B. "I will turn pot handles to the back of the stove."
C. "I will place my child in a forward-facing car seat in the front seat."
D. "I will keep the Poison Control number on the refrigerator."
Correct answer: C
RATIONALE: Children under age 13 should ride in the back seat. Forward-facing is appropriate for
children over age 2 or who have outgrown their rear-facing seat, but the front seat is never safe due to
airbag risk. The other statements reflect correct injury prevention practices .
Question 6
A nurse is teaching parents about sleep patterns for a 6-month-old infant. Which statement indicates
understanding?
A. "My baby should sleep 20 hours per day."
B. "My baby may sleep 12-14 hours total with nighttime awakenings."
C. "My baby should not nap during the day."
D. "My baby will sleep through the night without waking."
Correct answer: B
RATIONALE: Infants around 6 months of age typically sleep about 12-14 hours total per day, and
nighttime awakenings are normal. Expecting a 6-month-old to sleep through the night without waking is
unrealistic. Napping is still essential at this age .
Question 7
A nurse is providing dental health teaching to parents of a 2-year-old. Which instruction is correct?
A. "Use fluoride toothpaste in a pea-sized amount."
B. "Use a smear (rice-sized) of fluoride toothpaste until age 3."
, C. "Your child can brush independently."
D. "Fluoride toothpaste is not recommended until age 6."
Correct answer: B
RATIONALE: For children under 3 years of age, a smear or rice-sized amount of fluoride toothpaste is
recommended. Pea-sized amounts are for ages 3-6. Children under 3 should not brush independently
without parental supervision to prevent excessive swallowing of toothpaste .
SECTION 2: PEDIATRIC EMERGENCIES & AIRWAY MANAGEMENT (Questions 8-25)
Question 8
A nurse in the emergency department is caring for a 2-year-old child who was found holding a container
of toilet bowl cleaner. The child's lips are edematous and inflamed, and he is drooling. What is the
priority action?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote.
D. Establish IV access.
Correct answer: B
RATIONALE: The priority is always Airway. Edematous lips and drooling indicate potential airway
compromise from a caustic ingestion. Using the ABC priority setting framework, airway is always the
highest priority because the airway must be clear and open for oxygen exchange to occur . Checking
respiratory status comes before removing clothing, administering antidotes, or establishing IV access.
Question 9
A nurse in the emergency department is assessing a toddler who has a burn to the right arm. Which
finding is the highest priority for the nurse to report?
A. The child is crying and pulling away from the nurse.
B. The burn area is estimated to be 15% of total body surface area (TBSA).
C. The burn is located on the palm of the hand.
D. The burn appears dry, brown, and leathery.
Correct answer: D
RATIONALE: A dry, brown, leathery appearance indicates a full-thickness (third-degree) burn. This is
the highest priority because full-thickness burns destroy all skin layers, require escharotomy potential,
and are at high risk for infection and complications. Crying and pulling away are expected pain
responses .
QUESTIONS WITH CORRECT DETAILED ANSWERS &
RATIONALES | 2026 REVISED EDITION
Core Domains
• Growth & Development: Milestones, Erikson/Piaget Stages, Anticipatory Guidance
• Health Promotion & Disease Prevention: Immunizations, Safety, Nutrition
• Pediatric Emergencies & Airway Management: Respiratory Distress, Anaphylaxis, Ingestion
• Common Childhood Disorders: Respiratory, GI, Cardiac, Neurological, Infectious
• Pharmacological Interventions: Medication Administration, Dosage Calculation, Side Effects
• Chronic Conditions: Asthma, Diabetes, Sickle Cell, Cystic Fibrosis
• Family-Centered Care & Psychosocial Support
• Next Generation NCLEX (NGN): Case Studies, Bow-Tie, Prioritization
This comprehensive examination guide is designed for nursing students preparing for the ATI Pediatrics
Proctored Exam 2023 Retake, updated for the 2026/2027 academic year. The exam evaluates clinical
judgment, prioritization, and application of pediatric nursing concepts across growth and development,
health promotion, acute and chronic illness management, and pharmacological interventions. This
resource features 150 practice questions with verified answers and detailed rationales, aligned with
current ATI and NGN standards to ensure exam success .
SECTION 1: GROWTH & DEVELOPMENT (Questions 1-25)
Question 1
A nurse is performing a developmental screening on a 4-year-old child. Which milestone is appropriate
for the nurse to expect?
A. Ties shoelaces
B. Draws a circle
C. Uses a fork to eat independently
D. Rides a tricycle
Correct answer: B
RATIONALE: By age 4, a child should be able to copy a circle and draw a person with 2-4 body parts.
Tying shoelaces is a fine motor skill expected around age 5-6. Using a fork independently is typically seen
,by age 3-4, but drawing a circle is a more specific milestone for age 4. Riding a tricycle is expected at age
3.
Question 2
A nurse is providing car seat safety teaching for a 2-year-old weighing 25 lb. Which instruction is
correct?
A. "Turn the car seat forward-facing now."
B. "Keep the child rear-facing until age 2 or height/weight limit is reached."
C. "Use a booster seat with a lap belt only."
D. "Place the car seat in the front passenger seat."
Correct answer: B
RATIONALE: The AAP recommends keeping children rear-facing until age 2 or until they reach the
maximum height and weight limit for their rear-facing car seat. This provides the best protection for the
child's head, neck, and spine in a crash. Forward-facing is not recommended at 2 years if the child still
fits the rear-facing seat's limits .
Question 3
A nurse is teaching the parent of a 12-month-old about development during the toddler years. Which
statement should the nurse include?
A. "Your child should be referring to himself using the appropriate pronoun by 18 months of age."
B. "A toddler's interest in looking at pictures occurs at 20 months of age."
C. "A toddler should have daytime control of his bowel and bladder by 24 months of age."
D. "Your child should be able to scribble spontaneously using a crayon at the age of 15 months."
Correct answer: D
RATIONALE: At 15 months, the toddler should be able to scribble spontaneously. At 18 months, the
toddler should be able to make strokes imitatively. Bowel and bladder control is not typically achieved
until 30-36 months. Pronouns are not used correctly until later in toddlerhood .
Question 4
A nurse is performing a physical assessment on a 6-month-old infant. Which reflex should the nurse
expect to find?
A. Stepping
B. Babinski
C. Extrusion
D. Moro
, Correct answer: B
RATIONALE: The Babinski reflex should be present until age 1 year. The stepping reflex disappears
around 4-8 weeks. The extrusion reflex disappears around 4 months. The Moro reflex disappears around
3-6 months. Absence of neonatal reflexes might indicate neurological deficits .
Question 5
A nurse is providing anticipatory guidance to parents of a 12-month-old. Which statement by the parent
indicates a need for further teaching about injury prevention?
A. "I will keep my medications locked in a cabinet."
B. "I will turn pot handles to the back of the stove."
C. "I will place my child in a forward-facing car seat in the front seat."
D. "I will keep the Poison Control number on the refrigerator."
Correct answer: C
RATIONALE: Children under age 13 should ride in the back seat. Forward-facing is appropriate for
children over age 2 or who have outgrown their rear-facing seat, but the front seat is never safe due to
airbag risk. The other statements reflect correct injury prevention practices .
Question 6
A nurse is teaching parents about sleep patterns for a 6-month-old infant. Which statement indicates
understanding?
A. "My baby should sleep 20 hours per day."
B. "My baby may sleep 12-14 hours total with nighttime awakenings."
C. "My baby should not nap during the day."
D. "My baby will sleep through the night without waking."
Correct answer: B
RATIONALE: Infants around 6 months of age typically sleep about 12-14 hours total per day, and
nighttime awakenings are normal. Expecting a 6-month-old to sleep through the night without waking is
unrealistic. Napping is still essential at this age .
Question 7
A nurse is providing dental health teaching to parents of a 2-year-old. Which instruction is correct?
A. "Use fluoride toothpaste in a pea-sized amount."
B. "Use a smear (rice-sized) of fluoride toothpaste until age 3."
, C. "Your child can brush independently."
D. "Fluoride toothpaste is not recommended until age 6."
Correct answer: B
RATIONALE: For children under 3 years of age, a smear or rice-sized amount of fluoride toothpaste is
recommended. Pea-sized amounts are for ages 3-6. Children under 3 should not brush independently
without parental supervision to prevent excessive swallowing of toothpaste .
SECTION 2: PEDIATRIC EMERGENCIES & AIRWAY MANAGEMENT (Questions 8-25)
Question 8
A nurse in the emergency department is caring for a 2-year-old child who was found holding a container
of toilet bowl cleaner. The child's lips are edematous and inflamed, and he is drooling. What is the
priority action?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote.
D. Establish IV access.
Correct answer: B
RATIONALE: The priority is always Airway. Edematous lips and drooling indicate potential airway
compromise from a caustic ingestion. Using the ABC priority setting framework, airway is always the
highest priority because the airway must be clear and open for oxygen exchange to occur . Checking
respiratory status comes before removing clothing, administering antidotes, or establishing IV access.
Question 9
A nurse in the emergency department is assessing a toddler who has a burn to the right arm. Which
finding is the highest priority for the nurse to report?
A. The child is crying and pulling away from the nurse.
B. The burn area is estimated to be 15% of total body surface area (TBSA).
C. The burn is located on the palm of the hand.
D. The burn appears dry, brown, and leathery.
Correct answer: D
RATIONALE: A dry, brown, leathery appearance indicates a full-thickness (third-degree) burn. This is
the highest priority because full-thickness burns destroy all skin layers, require escharotomy potential,
and are at high risk for infection and complications. Crying and pulling away are expected pain
responses .
