The purpose of this study was to explore the ways elementary pre-service teachers responded to hypothetical student misconceptions about area measurement topics, framed in the context of their existing understanding and the Mathematical Knowledge for Teaching framework. Data collection consisted of written pre-assessments, followed by semi-structured interviews with 24 pre-service teachers enrolled in a geometry and measurement course. Findings included a frequent misattribution of area understanding to students, tendencies to provide alternate procedural strategies or re-explain concepts, and key differences in pedagogical strategies depending on initial content knowledge or apparent correctness of the student response. While there existed a tendency among some pre-service teachers to encourage procedural approaches, several others were able to leverage their own understanding towards conceptual, student-centered instructional responses. Such responses placed the student at the center of the instructional interaction, paving the way for exploration and mathematical discovery. Recommendations for supporting pre-service teachers in navigating the intersection between content and pedagogical knowledge in area measurement are discussed.