ATI PEDIATRICS/NURSING CARE OF CHILDREN EXAM – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
Core Domains
* Growth and Development
* Pediatric Pharmacotherapy
* Acute and Chronic Respiratory Conditions
* Cardiovascular Disorders
* Infectious and Communicable Diseases
* Gastrointestinal and Endocrine Disorders
* Musculoskeletal and Neurological Conditions
* Pediatric Safety and Injury Prevention
Introduction
*This comprehensive examination is designed to assess the student nurse's mastery of
pediatric nursing principles. The purpose is to evaluate clinical reasoning, safety standards,
and therapeutic interventions required for the care of infants, children, and adolescents.
Skills and knowledge assessed include developmental milestones, physiological assessment,
medication calculation, and evidence-based management of pediatric pathology. The exam
utilizes a multiple-choice and scenario-based structure to simulate clinical decision-making.
Emphasis is placed on real-world application, prioritizing safe, patient-centered care, and
legal/ethical compliance within the healthcare environment to ensure students are prepared
for both licensure examinations and professional practice.*
Section One: Questions 1–100
1. A nurse is assessing a 4-month-old infant. Which of the following developmental
milestones should the nurse expect to observe? A. Sitting without support B. Rolling
from front to back C. Holding head up when prone D. Using a pincer grasp
Explanation: At 4 months, infants typically demonstrate good head control and can lift
their head and chest when placed in a prone position.
2. A nurse is preparing to administer an intramuscular injection to a toddler. Which site
is the most appropriate for this age group? A. Vastus lateralis B. Dorsogluteal C.
Deltoid D. Ventrogluteal
, Explanation: The vastus lateralis is the preferred site for intramuscular injections in
infants and toddlers due to the muscle's size and lack of proximity to major nerves and blood
vessels.
3. Which finding in a child with asthma requires immediate nursing intervention? A.
Respiratory rate of 24 breaths/min B. Expiratory wheezing C. Oxygen saturation of
94% D. Silent chest on auscultation
Explanation: A silent chest indicates a lack of air movement and signifies a severe, life-
threatening asthma exacerbation that requires immediate medical attention.
4. A nurse is providing teaching to parents of a child with cystic fibrosis regarding
nutrition. Which dietary instruction is most appropriate? A. Restrict sodium intake
B. Provide a high-protein, high-calorie diet C. Encourage a low-fat diet D. Limit
intake of fat-soluble vitamins
Explanation: Children with cystic fibrosis have impaired fat absorption and increased
metabolic needs, requiring a high-protein, high-calorie diet and pancreatic enzyme
replacement therapy.
5. A nurse is assessing an infant with dehydration. Which of the following is an early
clinical manifestation? A. Tachycardia B. Bulging fontanel C. Bradycardia D.
Hypertension
Explanation: Tachycardia is an early compensatory mechanism in infants to maintain
cardiac output during episodes of dehydration.
6. A school-age child is admitted with suspected appendicitis. Which nursing action is
contraindicated? A. Assessing vital signs B. Maintaining NPO status C. Applying a
heating pad to the abdomen D. Preparing for abdominal ultrasound
Explanation: Applying heat to the abdomen in a patient with suspected appendicitis can
increase blood flow to the area and increase the risk of rupture.
7. Which assessment finding is expected in a child diagnosed with nephrotic syndrome?
A. Hematuria B. Periorbital edema C. Hypertension D. Dehydration
Explanation: Nephrotic syndrome is characterized by massive proteinuria leading to
hypoalbuminemia, which results in significant fluid shifts and edema, often first noted
around the eyes.
8. A nurse is caring for a child with Type 1 Diabetes Mellitus who is experiencing
hypoglycemia. Which snack is the best choice to provide? A. Peanut butter crackers
B. A glass of milk C. 4 ounces of orange juice D. A handful of almonds
, Explanation: A quick-acting carbohydrate, such as fruit juice, is the fastest way to raise
blood glucose levels during an acute hypoglycemic episode.
9. When assessing a child with suspected coarctation of the aorta, the nurse should
specifically check for: A. Increased blood pressure in the lower extremities B.
Discrepancy in blood pressure between upper and lower extremities C. Murmur at
the left upper sternal border D. Cyanosis of the nail beds
Explanation: Coarctation of the aorta causes narrowing, which leads to increased blood
pressure in the upper extremities and decreased blood pressure and pulses in the lower
extremities.
10. A nurse is educating parents on home safety for a 1-year-old child. Which instruction
should be included? A. Use a rear-facing car seat until age 5 B. Place covers on all
electrical outlets C. Keep cleaning supplies on low shelves D. Allow the child to play
with latex balloons
Explanation: Toddlers are at a high risk for electrical injury as they explore; placing safety
covers on outlets is a critical preventative measure.
11. A nurse is caring for a child with sickle cell anemia who is in a vaso-occlusive crisis.
What is the priority nursing intervention? A. Administering prophylactic antibiotics
B. Providing aggressive hydration C. Applying cold compresses to painful joints D.
Encouraging vigorous physical activity
Explanation: Aggressive hydration is essential to decrease blood viscosity and improve
perfusion during a vaso-occlusive crisis, alongside pain management.
12. A child is diagnosed with pediculosis capitis. Which instruction should the nurse
provide to the parents? A. The child can return to school immediately after the first
treatment B. All clothing and linens must be washed in hot water and dried on
high heat C. Over-the-counter shampoo is effective for a single use D. Hair should be
cut short to prevent reinfestation
Explanation: Treating pediculosis capitis involves killing lice and removing nits;
environmental management, including washing items in hot water and drying on high heat,
is vital to prevent reinfestation.
13. A nurse is assessing a child with suspected meningitis. Which clinical manifestation is
most characteristic of this condition? A. Hypotonia B. Nuchal rigidity C. Absent
deep tendon reflexes D. Periorbital edema
Explanation: Nuchal rigidity (stiff neck) is a hallmark sign of meningeal irritation and
inflammation in children.
, 14. Which position is most appropriate for a child who has just undergone a
tonsillectomy? A. Supine B. Trendelenburg C. Side-lying or prone D. High-Fowler's
Explanation: Positioning the child on their side or prone facilitates the drainage of
secretions and reduces the risk of aspiration following surgery.
15. A nurse is assessing a 2-year-old child. Which finding should be reported to the
provider? A. Negativism B. Parallel play C. Inability to speak in two-word
sentences D. Interest in a security object
Explanation: By age 2, a child is expected to be able to use two-word phrases to
communicate; failure to do so warrants evaluation for developmental delay.
16. A nurse is caring for an adolescent with scoliosis who is wearing a brace. What is the
priority teaching point? A. The brace should be worn only at night B. The brace
must be worn over a cotton t-shirt to protect the skin C. The brace can be removed
during school hours D. The brace will correct the curvature within two weeks
Explanation: Wearing a cotton t-shirt under the brace prevents skin breakdown and
irritation from the plastic material.
17. A nurse is caring for a child with Wilms tumor. Which action should the nurse avoid?
A. Monitoring blood pressure B. Palpating the abdomen C. Measuring abdominal
girth D. Monitoring intake and output
Explanation: Palpation of the abdomen is strictly contraindicated in children with Wilms
tumor because it can cause the tumor capsule to rupture and spread malignant cells.
18. A child is receiving an infusion of IV immune globulin (IVIG) for Kawasaki disease. The
nurse observes the child develop flushing and chest tightness. What is the priority
action? A. Slow the infusion rate B. Stop the infusion C. Administer
acetaminophen D. Document the finding as expected
Explanation: Flushing and chest tightness are signs of an infusion reaction. The nurse
must stop the infusion immediately to ensure patient safety.
19. A nurse is planning care for a child with cerebral palsy. Which goal is most
appropriate? A. Curing the underlying neurological deficit B. Maximizing the
child's level of independence in activities of daily living C. Eliminating all spastic
movements D. Preventing the need for physical therapy
Explanation: Cerebral palsy is a chronic condition; the focus of nursing care is to
maximize the child's function and independence through therapy and support.
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
Core Domains
* Growth and Development
* Pediatric Pharmacotherapy
* Acute and Chronic Respiratory Conditions
* Cardiovascular Disorders
* Infectious and Communicable Diseases
* Gastrointestinal and Endocrine Disorders
* Musculoskeletal and Neurological Conditions
* Pediatric Safety and Injury Prevention
Introduction
*This comprehensive examination is designed to assess the student nurse's mastery of
pediatric nursing principles. The purpose is to evaluate clinical reasoning, safety standards,
and therapeutic interventions required for the care of infants, children, and adolescents.
Skills and knowledge assessed include developmental milestones, physiological assessment,
medication calculation, and evidence-based management of pediatric pathology. The exam
utilizes a multiple-choice and scenario-based structure to simulate clinical decision-making.
Emphasis is placed on real-world application, prioritizing safe, patient-centered care, and
legal/ethical compliance within the healthcare environment to ensure students are prepared
for both licensure examinations and professional practice.*
Section One: Questions 1–100
1. A nurse is assessing a 4-month-old infant. Which of the following developmental
milestones should the nurse expect to observe? A. Sitting without support B. Rolling
from front to back C. Holding head up when prone D. Using a pincer grasp
Explanation: At 4 months, infants typically demonstrate good head control and can lift
their head and chest when placed in a prone position.
2. A nurse is preparing to administer an intramuscular injection to a toddler. Which site
is the most appropriate for this age group? A. Vastus lateralis B. Dorsogluteal C.
Deltoid D. Ventrogluteal
, Explanation: The vastus lateralis is the preferred site for intramuscular injections in
infants and toddlers due to the muscle's size and lack of proximity to major nerves and blood
vessels.
3. Which finding in a child with asthma requires immediate nursing intervention? A.
Respiratory rate of 24 breaths/min B. Expiratory wheezing C. Oxygen saturation of
94% D. Silent chest on auscultation
Explanation: A silent chest indicates a lack of air movement and signifies a severe, life-
threatening asthma exacerbation that requires immediate medical attention.
4. A nurse is providing teaching to parents of a child with cystic fibrosis regarding
nutrition. Which dietary instruction is most appropriate? A. Restrict sodium intake
B. Provide a high-protein, high-calorie diet C. Encourage a low-fat diet D. Limit
intake of fat-soluble vitamins
Explanation: Children with cystic fibrosis have impaired fat absorption and increased
metabolic needs, requiring a high-protein, high-calorie diet and pancreatic enzyme
replacement therapy.
5. A nurse is assessing an infant with dehydration. Which of the following is an early
clinical manifestation? A. Tachycardia B. Bulging fontanel C. Bradycardia D.
Hypertension
Explanation: Tachycardia is an early compensatory mechanism in infants to maintain
cardiac output during episodes of dehydration.
6. A school-age child is admitted with suspected appendicitis. Which nursing action is
contraindicated? A. Assessing vital signs B. Maintaining NPO status C. Applying a
heating pad to the abdomen D. Preparing for abdominal ultrasound
Explanation: Applying heat to the abdomen in a patient with suspected appendicitis can
increase blood flow to the area and increase the risk of rupture.
7. Which assessment finding is expected in a child diagnosed with nephrotic syndrome?
A. Hematuria B. Periorbital edema C. Hypertension D. Dehydration
Explanation: Nephrotic syndrome is characterized by massive proteinuria leading to
hypoalbuminemia, which results in significant fluid shifts and edema, often first noted
around the eyes.
8. A nurse is caring for a child with Type 1 Diabetes Mellitus who is experiencing
hypoglycemia. Which snack is the best choice to provide? A. Peanut butter crackers
B. A glass of milk C. 4 ounces of orange juice D. A handful of almonds
, Explanation: A quick-acting carbohydrate, such as fruit juice, is the fastest way to raise
blood glucose levels during an acute hypoglycemic episode.
9. When assessing a child with suspected coarctation of the aorta, the nurse should
specifically check for: A. Increased blood pressure in the lower extremities B.
Discrepancy in blood pressure between upper and lower extremities C. Murmur at
the left upper sternal border D. Cyanosis of the nail beds
Explanation: Coarctation of the aorta causes narrowing, which leads to increased blood
pressure in the upper extremities and decreased blood pressure and pulses in the lower
extremities.
10. A nurse is educating parents on home safety for a 1-year-old child. Which instruction
should be included? A. Use a rear-facing car seat until age 5 B. Place covers on all
electrical outlets C. Keep cleaning supplies on low shelves D. Allow the child to play
with latex balloons
Explanation: Toddlers are at a high risk for electrical injury as they explore; placing safety
covers on outlets is a critical preventative measure.
11. A nurse is caring for a child with sickle cell anemia who is in a vaso-occlusive crisis.
What is the priority nursing intervention? A. Administering prophylactic antibiotics
B. Providing aggressive hydration C. Applying cold compresses to painful joints D.
Encouraging vigorous physical activity
Explanation: Aggressive hydration is essential to decrease blood viscosity and improve
perfusion during a vaso-occlusive crisis, alongside pain management.
12. A child is diagnosed with pediculosis capitis. Which instruction should the nurse
provide to the parents? A. The child can return to school immediately after the first
treatment B. All clothing and linens must be washed in hot water and dried on
high heat C. Over-the-counter shampoo is effective for a single use D. Hair should be
cut short to prevent reinfestation
Explanation: Treating pediculosis capitis involves killing lice and removing nits;
environmental management, including washing items in hot water and drying on high heat,
is vital to prevent reinfestation.
13. A nurse is assessing a child with suspected meningitis. Which clinical manifestation is
most characteristic of this condition? A. Hypotonia B. Nuchal rigidity C. Absent
deep tendon reflexes D. Periorbital edema
Explanation: Nuchal rigidity (stiff neck) is a hallmark sign of meningeal irritation and
inflammation in children.
, 14. Which position is most appropriate for a child who has just undergone a
tonsillectomy? A. Supine B. Trendelenburg C. Side-lying or prone D. High-Fowler's
Explanation: Positioning the child on their side or prone facilitates the drainage of
secretions and reduces the risk of aspiration following surgery.
15. A nurse is assessing a 2-year-old child. Which finding should be reported to the
provider? A. Negativism B. Parallel play C. Inability to speak in two-word
sentences D. Interest in a security object
Explanation: By age 2, a child is expected to be able to use two-word phrases to
communicate; failure to do so warrants evaluation for developmental delay.
16. A nurse is caring for an adolescent with scoliosis who is wearing a brace. What is the
priority teaching point? A. The brace should be worn only at night B. The brace
must be worn over a cotton t-shirt to protect the skin C. The brace can be removed
during school hours D. The brace will correct the curvature within two weeks
Explanation: Wearing a cotton t-shirt under the brace prevents skin breakdown and
irritation from the plastic material.
17. A nurse is caring for a child with Wilms tumor. Which action should the nurse avoid?
A. Monitoring blood pressure B. Palpating the abdomen C. Measuring abdominal
girth D. Monitoring intake and output
Explanation: Palpation of the abdomen is strictly contraindicated in children with Wilms
tumor because it can cause the tumor capsule to rupture and spread malignant cells.
18. A child is receiving an infusion of IV immune globulin (IVIG) for Kawasaki disease. The
nurse observes the child develop flushing and chest tightness. What is the priority
action? A. Slow the infusion rate B. Stop the infusion C. Administer
acetaminophen D. Document the finding as expected
Explanation: Flushing and chest tightness are signs of an infusion reaction. The nurse
must stop the infusion immediately to ensure patient safety.
19. A nurse is planning care for a child with cerebral palsy. Which goal is most
appropriate? A. Curing the underlying neurological deficit B. Maximizing the
child's level of independence in activities of daily living C. Eliminating all spastic
movements D. Preventing the need for physical therapy
Explanation: Cerebral palsy is a chronic condition; the focus of nursing care is to
maximize the child's function and independence through therapy and support.
