Exam Guide

ATI Pediatrics (Nursing Care of Children) Proctored Exam: What It Covers & How to Pass

The ATI Pediatrics proctored exam — officially ATI Nursing Care of Children — tests whether you can adapt nursing care to a client who is still growing. Every question has an age attached, and the "right" answer depends on it: the normal vital signs, the developmental stage, the way you explain a procedure, the dose you calculate and the safety risks you anticipate all change from infant to toddler to school-age child to adolescent.

This page explains what the exam covers, how it is scored, what makes it different from adult nursing exams, and how to study for it. For the general rules of ATI testing, see our main guide to ATI proctored exams.

What does the ATI Pediatrics proctored exam cover?

Growth and development — expected milestones by age, Erikson's and Piaget's stages, play and communication appropriate to each stage, and the red flags that indicate developmental delay.
Health promotion and safety — immunisation schedules and contraindications, anticipatory guidance, injury prevention by age (car seats, choking, drowning, poisoning, falls), nutrition and feeding across childhood.
Pediatric assessment and vital signs — normal ranges by age, pain assessment tools (FLACC, FACES, numeric), signs of dehydration and respiratory distress in children, and how to approach the physical exam at each stage.
Medication administration and dosing — mg/kg and mg/kg/day calculations, safe dose ranges, body surface area, routes and techniques for infants and children, and family teaching.
Common acute and chronic conditions — respiratory (bronchiolitis/RSV, croup, epiglottitis, asthma, cystic fibrosis), cardiac (congenital heart defects, Kawasaki disease, rheumatic fever), GI (pyloric stenosis, intussusception, Hirschsprung, cleft lip and palate, gastroenteritis and dehydration), renal (nephrotic syndrome, glomerulonephritis, UTI, Wilms tumour), neurological (seizures, meningitis, hydrocephalus, cerebral palsy), hematologic and oncologic (sickle cell disease, hemophilia, leukemia), endocrine (type 1 diabetes), musculoskeletal (fractures, scoliosis, hip dysplasia, clubfoot), and infectious diseases with their isolation precautions.
The hospitalised child and family — separation anxiety, family-centred care, therapeutic play, preparation for procedures, atraumatic care and end-of-life care.
Child maltreatment — recognition and mandatory reporting.

Select-all-that-apply items on developmental milestones and disease findings are common, as are dosage calculation items with fill-in-the-blank answers.

Format, length and scoring

The RN Nursing Care of Children proctored exam typically has around 60 scored items with about 60 minutes, though exact figures vary by version and program. Results come as a percentage and a proficiency level; level cut scores are set for this exam alone. Most programs expect a Level 2. Your course syllabus tells you how the result is used.

Why students find ATI Pediatrics tricky

Age changes the normal. A heart rate of 130 is tachycardia in a 10-year-old and normal in a 6-month-old. If you do not know the ranges by age, you cannot tell expected from concerning findings.
Developmental communication questions. "Which statement should the nurse make to a 4-year-old before an injection?" tests whether you know that preschoolers think magically, fear body mutilation and need simple, honest, immediate explanations — not a lecture and not a lie.
Weight-based dosing. Pounds to kilograms, mg/kg/day divided into doses, and checking against a safe range. One conversion error and the answer is wrong.
Look-alike respiratory conditions. Croup versus epiglottitis versus bronchiolitis versus asthma have distinct signs and very different priorities (for example, never inspect the throat of a child with suspected epiglottitis).

How to study for the ATI Pediatrics proctored exam

1. Make an age-band table first

Rows for infant, toddler, preschooler, school-age and adolescent. Columns for vital sign ranges, key milestones, Erikson stage, Piaget stage, biggest fears, best communication approach, top safety risks and nutrition notes. This single table answers a large share of the exam.

2. Learn the immunisation schedule

Know what is given at birth, 2, 4, 6, 12–15 months, 4–6 years and 11–12 years, plus the live vaccines and their contraindications. Expect at least a question or two.

3. Study conditions by "what makes it pediatric"

For each condition on the blueprint, ask: what is the hallmark sign, what is the priority intervention, and what do parents need to know? For example, intussusception — currant-jelly stools and sudden episodic pain; pyloric stenosis — projectile non-bilious vomiting and an olive-shaped mass; Kawasaki disease — strawberry tongue and the risk of coronary aneurysm.

4. Practise pediatric dosing daily

Convert weight, calculate mg/kg/day, divide by frequency, compare with the safe range, then work out the volume to draw up. Do one problem a day for three weeks. Our dosage calculation guide includes pediatric examples.

5. Do application questions and log by system and age

Twenty or more ATI-style pediatrics questions daily. Record the body system and the age group for each miss. Students often find a gap in one age group (commonly infants) rather than one disease.

6. Finish with timed sets

Two or three 60-in-60 sets in the last week, followed by full rationale review. The complete schedule is in how to study for ATI proctored exams.

Sample ATI Pediatrics question

A nurse is caring for a 3-year-old child who has a suspected diagnosis of epiglottitis. Which of the following actions should the nurse take?

Obtain a throat culture using a tongue blade.
Place the child in a supine position.
Keep emergency intubation equipment at the bedside.
Encourage the child to drink cool fluids.

Answer: C. Epiglottitis is a medical emergency with a high risk of sudden, complete airway obstruction; intubation and tracheostomy equipment must be immediately available. Inspecting the throat or inserting a tongue blade (A) can trigger laryngospasm and obstruction. The child should be allowed to sit upright, often in the "tripod" position, not laid flat (B). Oral intake is withheld because of the risk of aspiration and the likelihood of intubation (D).

ATI Pediatrics practice questions

Reading about pediatrics is not the same as answering pediatrics questions under time pressure. Work through the funnel in this order:

Free questions first. Try our free ATI-style Pediatrics practice questions — 99 original items, one at a time, with the rationale revealed after every answer. No account needed.
Structured review. The ATI RN Pediatrics Study Guide is a printable PDF that walks the blueprint in order with a full question bank and rationales.
Full-length practice. When your error log is thinning out, sit a timed set of 60 questions in one go to check pacing and stamina, then review every rationale — right and wrong.
Everything, all subjects. The Full Virtual Support Suite bundles every RN topic's complete question bank with structured lessons and full-length exams, if you are preparing for several proctored exams this term.

ATI Pediatrics proctored exam FAQ

Is "ATI Nursing Care of Children" the same as the ATI Pediatrics exam?

Yes. ATI's official name is Nursing Care of Children; most students and programs call it ATI Peds or ATI Pediatrics.

How many questions are on the ATI Pediatrics proctored exam?

Typically around 60 scored items in about 60 minutes. Confirm the version with your instructor.

What score do I need to pass?

Your program decides — most require at least a Level 2. The percentage for Level 2 is specific to this exam.

Does the exam include dosage calculations?

Yes; weight-based pediatric dosing is a core part of the blueprint. Expect fill-in-the-blank items and follow the rounding instructions precisely.

What should I focus on if I am running out of time?

Growth and development by age, immunisations, pediatric respiratory conditions, dehydration, and mg/kg dosing. Then practice questions with rationales.