ATI RN Capstone Proctored Pediatric - 2026/2027 50 Actual Questions and Answers
ATI RN Capstone Proctored Pediatric
Comprehensive Pediatric Nursing Review
2026/2027 Updated - 50 Actual Questions and Answers
Exam Format: 50 multiple-choice questions across five integrated modules of pediatric nursing - Growth, Development, and
Health Promotion; Respiratory and Cardiovascular Disorders; Gastrointestinal, Genitourinary, and Endocrine Disorders;
Neurological, Musculoskeletal, and Hematologic Disorders; and Medication Administration, Safety, and Emergency Care.
Each question presents four options (A-D) with one best answer. Cognitive distribution: 25% recall, 55% application, 20%
analysis. Approximately 80% of items are scenario-based, integrating clinical judgment, growth and developmental
principles, family-centered care, and NCLEX Next Generation competencies. Each answer includes a comprehensive
ATI-specific rationale addressing pathophysiology, assessment, medication administration, safety considerations, and
developmental principles.
Section 1: Pediatric Growth, Development, and Health Promotion
Topics: Developmental Milestones, Immunizations, Nutrition, Anticipatory Guidance (Q1-Q10)
Q1. A mother brings her 6-month-old infant for a well-child visit. Which milestone should the infant be able to
perform at this age, according to Denver II developmental screening?
A. Sit unsupported for several minutes and bang two cubes together [CORRECT]
B. Crawl forward and pull to a standing position
C. Walk independently and use a spoon with spilling
D. Speak 2-4 word sentences and stack 4 blocks
Correct Answer: A
Rationale: By 6 months, infants typically sit with minimal support, transfer objects hand to hand, bang two cubes together,
babble consonant sounds, and show stranger anxiety. Crawling and pulling to stand emerge around 9 months; independent
walking occurs around 12-15 months; 2-4 word sentences develop around 24 months. Anticipatory guidance for the 6-month visit
includes introducing solid foods, fluoride supplementation if water is non-fluoridated, childproofing, and the 6-month vaccines.
Q2. A nurse is providing anticipatory guidance to the parents of a 4-month-old infant. Which statement by the
parent indicates a need for further teaching regarding injury prevention?
A. "I place my baby on her back to sleep on a firm mattress."
B. "I keep small objects, coins, and batteries out of reach."
C. "I have a baby walker so my baby can be upright and mobile." [CORRECT]
D. "I set the water heater thermostat to 120 degrees Fahrenheit."
Correct Answer: C
Rationale: Baby walkers are not recommended by the AAP due to the risk of falls down stairs, tip-overs, and accelerated
mobility that can lead to burns and poisoning. Back-to-sleep positioning, removing small objects (choking/aspiration), and
setting the water heater to 120°F (49°C) or below (scald prevention) are all correct anticipatory guidance. The nurse should
advise against baby walkers and recommend stationary activity centers instead.
RN Capstone Pediatric - NCLEX-Ready Clinical Judgment Page 1
,ATI RN Capstone Proctored Pediatric - 2026/2027 50 Actual Questions and Answers
Q3. According to Piaget's stages of cognitive development, a 7-year-old child is in which stage, and what is the
primary developmental task?
A. Preoperational stage - symbolic thinking and egocentrism
B. Concrete operational stage - logical thought about concrete objects and conservation [CORRECT]
C. Formal operational stage - abstract reasoning and hypothesis testing
D. Sensorimotor stage - object permanence
Correct Answer: B
Rationale: A 7-year-old is in Piaget's concrete operational stage (ages 7-11), characterized by logical thinking about concrete
objects, conservation (understanding that volume/number stays the same despite shape change), reversibility, and decreased
egocentrism. The preoperational stage spans 2-7 years (symbolic thinking, egocentrism); formal operational begins at 12+ years
(abstract reasoning); sensorimotor is 0-2 years (object permanence).
Q4. A nurse is preparing to administer vaccines to a 12-month-old infant. According to the CDC/ACIP
immunization schedule, which vaccines are routinely recommended at the 12-month well-child visit?
A. MMR, varicella, hepatitis A (first dose), and Hib (if not previously completed) [CORRECT]
B. HPV, Tdap, and meningococcal conjugate
C. Rotavirus, IPV, and PCV15 only
D. Hepatitis B series completion only
Correct Answer: A
Rationale: At 12 months, the CDC/ACIP schedule recommends MMR (measles, mumps, rubella), varicella, hepatitis A (first of
two doses), and Hib if not previously completed, plus the PCV15/PCV20 and any catch-up doses. HPV starts at age 9 (or 11-12);
Tdap is at 11-12 years; meningococcal conjugate at 11-12 years. Rotavirus is given only under 8 months and is completed by 8
months; IPV continues on schedule.
Q5. A mother of a 4-month-old exclusively breastfed infant asks when to introduce solid foods. What is the AAP
recommendation the nurse should communicate?
A. Introduce rice cereal at 2 months to help the baby sleep through the night
B. Introduce solid foods around 6 months, starting with iron-rich pureed foods, while continuing
breastfeeding for at least 12 months [CORRECT]
C. Stop breastfeeding at 4 months and switch to whole cow's milk
D. Introduce solid foods only after the first birthday
Correct Answer: B
Rationale: The AAP recommends exclusive breastfeeding for 6 months, with introduction of iron-rich complementary foods at
about 6 months and continued breastfeeding for at least 12 months or longer as mutually desired. Rice cereal at 2 months is not
recommended (rice contains arsenic, and 2 months is too early developmentally). Cow's milk should not be introduced until 12
months. Waiting past 6 months without solids risks iron deficiency.
RN Capstone Pediatric - NCLEX-Ready Clinical Judgment Page 2
, ATI RN Capstone Proctored Pediatric - 2026/2027 50 Actual Questions and Answers
Q6. A nurse is caring for a toddler according to Erikson's psychosocial theory. The toddler is 18 months old.
Which developmental stage is the toddler in, and what is the primary conflict the nurse should support?
A. Trust vs. Mistrust - consistent caregiving
B. Autonomy vs. Shame and Doubt - allowing safe choices and independence [CORRECT]
C. Initiative vs. Guilt - encouraging exploration and play
D. Industry vs. Inferiority - supporting academic success
Correct Answer: B
Rationale: Erikson's autonomy vs. shame and doubt stage spans 1-3 years (toddlerhood); the developmental task is asserting
independence through choices while maintaining safety. Nurses should offer limited, safe choices ("red shirt or blue shirt?") to
support autonomy. Trust vs. mistrust is infancy (0-1); initiative vs. guilt is preschool (3-6); industry vs. inferiority is school-age
(6-12).
Q7. A 2-year-old is brought to the clinic for a well-child visit. The parents ask about the appropriate car seat for
the child. Which response by the nurse is most accurate per AAP recommendations?
A. Use a forward-facing car seat with a harness until at least age 2, ideally longer until the child outgrows
the seat's height/weight limits [CORRECT]
B. Use a booster seat with the seatbelt only
C. Use the adult seatbelt alone
D. Place the child in the front passenger seat
Correct Answer: A
Rationale: The AAP recommends infants and toddlers ride rear-facing as long as possible until they reach the highest
weight/height allowed by the seat, at least until age 2. After outgrowing the rear-facing seat, the child should use a
forward-facing car seat with a harness until at least age 4 or outgrown. Booster seats start after age 4; the adult seatbelt alone
should not be used until the child is 4'9" (57 inches) tall, and children under 13 should always ride in the back seat.
Q8. A nurse is assessing a 3-year-old child's growth and development. Which gross motor milestone should the
child have achieved by this age?
A. Walks up and down stairs alternating feet, rides a tricycle, and stands on one foot briefly [CORRECT]
B. Skips using alternating feet and balances on each foot for 10 seconds
C. Walks backward heel-to-toe and hops on one foot
D. Jumps rope and rides a bicycle without training wheels
Correct Answer: A
Rationale: By 3 years of age, a child typically walks up and down stairs using alternating feet (not both feet on each step), rides
a tricycle, stands on one foot briefly, and runs well. Skipping, alternating-foot hopping, and walking backward heel-to-toe are
achieved around age 4-5; jumping rope and riding a bicycle without training wheels develop around age 5-6. Failure to achieve
3-year milestones warrants developmental screening.
RN Capstone Pediatric - NCLEX-Ready Clinical Judgment Page 3
ATI RN Capstone Proctored Pediatric
Comprehensive Pediatric Nursing Review
2026/2027 Updated - 50 Actual Questions and Answers
Exam Format: 50 multiple-choice questions across five integrated modules of pediatric nursing - Growth, Development, and
Health Promotion; Respiratory and Cardiovascular Disorders; Gastrointestinal, Genitourinary, and Endocrine Disorders;
Neurological, Musculoskeletal, and Hematologic Disorders; and Medication Administration, Safety, and Emergency Care.
Each question presents four options (A-D) with one best answer. Cognitive distribution: 25% recall, 55% application, 20%
analysis. Approximately 80% of items are scenario-based, integrating clinical judgment, growth and developmental
principles, family-centered care, and NCLEX Next Generation competencies. Each answer includes a comprehensive
ATI-specific rationale addressing pathophysiology, assessment, medication administration, safety considerations, and
developmental principles.
Section 1: Pediatric Growth, Development, and Health Promotion
Topics: Developmental Milestones, Immunizations, Nutrition, Anticipatory Guidance (Q1-Q10)
Q1. A mother brings her 6-month-old infant for a well-child visit. Which milestone should the infant be able to
perform at this age, according to Denver II developmental screening?
A. Sit unsupported for several minutes and bang two cubes together [CORRECT]
B. Crawl forward and pull to a standing position
C. Walk independently and use a spoon with spilling
D. Speak 2-4 word sentences and stack 4 blocks
Correct Answer: A
Rationale: By 6 months, infants typically sit with minimal support, transfer objects hand to hand, bang two cubes together,
babble consonant sounds, and show stranger anxiety. Crawling and pulling to stand emerge around 9 months; independent
walking occurs around 12-15 months; 2-4 word sentences develop around 24 months. Anticipatory guidance for the 6-month visit
includes introducing solid foods, fluoride supplementation if water is non-fluoridated, childproofing, and the 6-month vaccines.
Q2. A nurse is providing anticipatory guidance to the parents of a 4-month-old infant. Which statement by the
parent indicates a need for further teaching regarding injury prevention?
A. "I place my baby on her back to sleep on a firm mattress."
B. "I keep small objects, coins, and batteries out of reach."
C. "I have a baby walker so my baby can be upright and mobile." [CORRECT]
D. "I set the water heater thermostat to 120 degrees Fahrenheit."
Correct Answer: C
Rationale: Baby walkers are not recommended by the AAP due to the risk of falls down stairs, tip-overs, and accelerated
mobility that can lead to burns and poisoning. Back-to-sleep positioning, removing small objects (choking/aspiration), and
setting the water heater to 120°F (49°C) or below (scald prevention) are all correct anticipatory guidance. The nurse should
advise against baby walkers and recommend stationary activity centers instead.
RN Capstone Pediatric - NCLEX-Ready Clinical Judgment Page 1
,ATI RN Capstone Proctored Pediatric - 2026/2027 50 Actual Questions and Answers
Q3. According to Piaget's stages of cognitive development, a 7-year-old child is in which stage, and what is the
primary developmental task?
A. Preoperational stage - symbolic thinking and egocentrism
B. Concrete operational stage - logical thought about concrete objects and conservation [CORRECT]
C. Formal operational stage - abstract reasoning and hypothesis testing
D. Sensorimotor stage - object permanence
Correct Answer: B
Rationale: A 7-year-old is in Piaget's concrete operational stage (ages 7-11), characterized by logical thinking about concrete
objects, conservation (understanding that volume/number stays the same despite shape change), reversibility, and decreased
egocentrism. The preoperational stage spans 2-7 years (symbolic thinking, egocentrism); formal operational begins at 12+ years
(abstract reasoning); sensorimotor is 0-2 years (object permanence).
Q4. A nurse is preparing to administer vaccines to a 12-month-old infant. According to the CDC/ACIP
immunization schedule, which vaccines are routinely recommended at the 12-month well-child visit?
A. MMR, varicella, hepatitis A (first dose), and Hib (if not previously completed) [CORRECT]
B. HPV, Tdap, and meningococcal conjugate
C. Rotavirus, IPV, and PCV15 only
D. Hepatitis B series completion only
Correct Answer: A
Rationale: At 12 months, the CDC/ACIP schedule recommends MMR (measles, mumps, rubella), varicella, hepatitis A (first of
two doses), and Hib if not previously completed, plus the PCV15/PCV20 and any catch-up doses. HPV starts at age 9 (or 11-12);
Tdap is at 11-12 years; meningococcal conjugate at 11-12 years. Rotavirus is given only under 8 months and is completed by 8
months; IPV continues on schedule.
Q5. A mother of a 4-month-old exclusively breastfed infant asks when to introduce solid foods. What is the AAP
recommendation the nurse should communicate?
A. Introduce rice cereal at 2 months to help the baby sleep through the night
B. Introduce solid foods around 6 months, starting with iron-rich pureed foods, while continuing
breastfeeding for at least 12 months [CORRECT]
C. Stop breastfeeding at 4 months and switch to whole cow's milk
D. Introduce solid foods only after the first birthday
Correct Answer: B
Rationale: The AAP recommends exclusive breastfeeding for 6 months, with introduction of iron-rich complementary foods at
about 6 months and continued breastfeeding for at least 12 months or longer as mutually desired. Rice cereal at 2 months is not
recommended (rice contains arsenic, and 2 months is too early developmentally). Cow's milk should not be introduced until 12
months. Waiting past 6 months without solids risks iron deficiency.
RN Capstone Pediatric - NCLEX-Ready Clinical Judgment Page 2
, ATI RN Capstone Proctored Pediatric - 2026/2027 50 Actual Questions and Answers
Q6. A nurse is caring for a toddler according to Erikson's psychosocial theory. The toddler is 18 months old.
Which developmental stage is the toddler in, and what is the primary conflict the nurse should support?
A. Trust vs. Mistrust - consistent caregiving
B. Autonomy vs. Shame and Doubt - allowing safe choices and independence [CORRECT]
C. Initiative vs. Guilt - encouraging exploration and play
D. Industry vs. Inferiority - supporting academic success
Correct Answer: B
Rationale: Erikson's autonomy vs. shame and doubt stage spans 1-3 years (toddlerhood); the developmental task is asserting
independence through choices while maintaining safety. Nurses should offer limited, safe choices ("red shirt or blue shirt?") to
support autonomy. Trust vs. mistrust is infancy (0-1); initiative vs. guilt is preschool (3-6); industry vs. inferiority is school-age
(6-12).
Q7. A 2-year-old is brought to the clinic for a well-child visit. The parents ask about the appropriate car seat for
the child. Which response by the nurse is most accurate per AAP recommendations?
A. Use a forward-facing car seat with a harness until at least age 2, ideally longer until the child outgrows
the seat's height/weight limits [CORRECT]
B. Use a booster seat with the seatbelt only
C. Use the adult seatbelt alone
D. Place the child in the front passenger seat
Correct Answer: A
Rationale: The AAP recommends infants and toddlers ride rear-facing as long as possible until they reach the highest
weight/height allowed by the seat, at least until age 2. After outgrowing the rear-facing seat, the child should use a
forward-facing car seat with a harness until at least age 4 or outgrown. Booster seats start after age 4; the adult seatbelt alone
should not be used until the child is 4'9" (57 inches) tall, and children under 13 should always ride in the back seat.
Q8. A nurse is assessing a 3-year-old child's growth and development. Which gross motor milestone should the
child have achieved by this age?
A. Walks up and down stairs alternating feet, rides a tricycle, and stands on one foot briefly [CORRECT]
B. Skips using alternating feet and balances on each foot for 10 seconds
C. Walks backward heel-to-toe and hops on one foot
D. Jumps rope and rides a bicycle without training wheels
Correct Answer: A
Rationale: By 3 years of age, a child typically walks up and down stairs using alternating feet (not both feet on each step), rides
a tricycle, stands on one foot briefly, and runs well. Skipping, alternating-foot hopping, and walking backward heel-to-toe are
achieved around age 4-5; jumping rope and riding a bicycle without training wheels develop around age 5-6. Failure to achieve
3-year milestones warrants developmental screening.
RN Capstone Pediatric - NCLEX-Ready Clinical Judgment Page 3
