** ATI RN PEDIATRICS PROCTORED EXAM 2023
QUESTION AND ANSWER**
---
**1.** A nurse is assessing a 4-month-old infant. Which finding should the nurse report to the provider?
A) Unable to roll over
B) Birth weight doubled
C) Anterior fontanel open
D) Moro reflex absent
💡 RATIONALE – Moro reflex should disappear by 3-4 months; persistence or absence at 4 months may
indicate neurologic impairment. Rolling over is a 5-6 month milestone.
✔️ **ANSWER – D) Moro reflex absent**
---
**2.** A nurse is providing discharge teaching to a parent of a child with a new diagnosis of epilepsy.
Which statement indicates understanding?
A) "I will place a spoon in my child's mouth during a seizure."
B) "I will restrain my child to prevent injury."
C) "I will turn my child on the side after the seizure ends."
D) "I will call 911 for any seizure lasting less than 2 minutes."
💡 RATIONALE – Side-lying after seizure prevents aspiration. Nothing in mouth, do not restrain. Call 911
for seizure >5 minutes or first-time seizure.
✔️ **ANSWER – C) "I will turn my child on the side after the seizure ends."**
---
,**3.** A 2-year-old is admitted with dehydration. Which assessment finding indicates severe
dehydration?
A) Capillary refill 2 seconds
B) Moist mucous membranes
C) Sunken eyes and tented skin turgor
D) Normal urine output
💡 RATIONALE – Sunken eyes, tented skin turgor, delayed capillary refill (>3 sec), and oliguria indicate
severe dehydration (≥10% fluid loss).
✔️ **ANSWER – C) Sunken eyes and tented skin turgor**
---
**4.** A nurse is reinforcing teaching with a parent of a 6-month-old about introduction of solid foods.
Which instruction is correct?
A) Introduce honey to prevent allergies
B) Start with iron-fortified rice cereal
C) Begin with whole cow's milk
D) Offer peanut butter as first food
💡 RATIONALE – Iron-fortified rice cereal is the recommended first solid food around 6 months. Honey
before 12 months risks botulism. Cow's milk after 12 months.
✔️ **ANSWER – B) Start with iron-fortified rice cereal**
---
**5.** A child with cystic fibrosis is prescribed pancreatic enzymes. When should the nurse administer
them?
A) 30 minutes before meals
,B) Immediately after meals
C) With meals and snacks
D) At bedtime only
💡 RATIONALE – Pancreatic enzymes must be taken with all meals and snacks to digest fats, proteins,
and carbohydrates.
✔️ **ANSWER – C) With meals and snacks**
---
**6.** A 5-year-old with nephrotic syndrome has 3+ proteinuria and periorbital edema. Which
intervention should the nurse prioritize?
A) Daily weight at same time
B) High-sodium diet
C) Restrict fluids to 500 mL/day
D) Encourage high-protein snacks
💡 RATIONALE – Daily weight is the most accurate indicator of fluid status in nephrotic syndrome. Low
sodium, fluid restriction if edema severe, normal protein.
✔️ **ANSWER – A) Daily weight at same time**
---
**7.** A 10-year-old with asthma has a peak flow reading of 55% of personal best. What action should
the nurse take first?
A) Administer rescue inhaler (albuterol)
B) Call the provider
C) Send child to emergency room
D) Repeat reading in 30 minutes
, 💡 RATIONALE – Yellow zone (50-80%) requires rescue inhaler; reassess after 15-20 minutes. Red zone
(<50%) is medical emergency.
✔️ **ANSWER – A) Administer rescue inhaler (albuterol)**
---
**8.** A 2-year-old is hospitalized. The parent must leave for work. The child screams "Don't go!" and
then becomes quiet and withdrawn. This behavior indicates:
A) Protest phase
B) Despair phase
C) Detachment phase
D) Regression
💡 RATIONALE – Despair phase: withdrawn, quiet, sad, no longer crying. Protest phase is initial
screaming/clinging.
✔️ **ANSWER – B) Despair phase**
---
**9.** A newborn is noted to have a continuous "machinery" murmur, bounding pulses, and wide pulse
pressure. The nurse suspects:
A) Ventricular septal defect (VSD)
B) Atrial septal defect (ASD)
C) Patent ductus arteriosus (PDA)
D) Tetralogy of Fallot (TOF)
💡 RATIONALE – PDA: continuous murmur (systolic & diastolic), bounding pulses, wide pulse pressure,
and possible heart failure.
✔️ **ANSWER – C) Patent ductus arteriosus (PDA)**
QUESTION AND ANSWER**
---
**1.** A nurse is assessing a 4-month-old infant. Which finding should the nurse report to the provider?
A) Unable to roll over
B) Birth weight doubled
C) Anterior fontanel open
D) Moro reflex absent
💡 RATIONALE – Moro reflex should disappear by 3-4 months; persistence or absence at 4 months may
indicate neurologic impairment. Rolling over is a 5-6 month milestone.
✔️ **ANSWER – D) Moro reflex absent**
---
**2.** A nurse is providing discharge teaching to a parent of a child with a new diagnosis of epilepsy.
Which statement indicates understanding?
A) "I will place a spoon in my child's mouth during a seizure."
B) "I will restrain my child to prevent injury."
C) "I will turn my child on the side after the seizure ends."
D) "I will call 911 for any seizure lasting less than 2 minutes."
💡 RATIONALE – Side-lying after seizure prevents aspiration. Nothing in mouth, do not restrain. Call 911
for seizure >5 minutes or first-time seizure.
✔️ **ANSWER – C) "I will turn my child on the side after the seizure ends."**
---
,**3.** A 2-year-old is admitted with dehydration. Which assessment finding indicates severe
dehydration?
A) Capillary refill 2 seconds
B) Moist mucous membranes
C) Sunken eyes and tented skin turgor
D) Normal urine output
💡 RATIONALE – Sunken eyes, tented skin turgor, delayed capillary refill (>3 sec), and oliguria indicate
severe dehydration (≥10% fluid loss).
✔️ **ANSWER – C) Sunken eyes and tented skin turgor**
---
**4.** A nurse is reinforcing teaching with a parent of a 6-month-old about introduction of solid foods.
Which instruction is correct?
A) Introduce honey to prevent allergies
B) Start with iron-fortified rice cereal
C) Begin with whole cow's milk
D) Offer peanut butter as first food
💡 RATIONALE – Iron-fortified rice cereal is the recommended first solid food around 6 months. Honey
before 12 months risks botulism. Cow's milk after 12 months.
✔️ **ANSWER – B) Start with iron-fortified rice cereal**
---
**5.** A child with cystic fibrosis is prescribed pancreatic enzymes. When should the nurse administer
them?
A) 30 minutes before meals
,B) Immediately after meals
C) With meals and snacks
D) At bedtime only
💡 RATIONALE – Pancreatic enzymes must be taken with all meals and snacks to digest fats, proteins,
and carbohydrates.
✔️ **ANSWER – C) With meals and snacks**
---
**6.** A 5-year-old with nephrotic syndrome has 3+ proteinuria and periorbital edema. Which
intervention should the nurse prioritize?
A) Daily weight at same time
B) High-sodium diet
C) Restrict fluids to 500 mL/day
D) Encourage high-protein snacks
💡 RATIONALE – Daily weight is the most accurate indicator of fluid status in nephrotic syndrome. Low
sodium, fluid restriction if edema severe, normal protein.
✔️ **ANSWER – A) Daily weight at same time**
---
**7.** A 10-year-old with asthma has a peak flow reading of 55% of personal best. What action should
the nurse take first?
A) Administer rescue inhaler (albuterol)
B) Call the provider
C) Send child to emergency room
D) Repeat reading in 30 minutes
, 💡 RATIONALE – Yellow zone (50-80%) requires rescue inhaler; reassess after 15-20 minutes. Red zone
(<50%) is medical emergency.
✔️ **ANSWER – A) Administer rescue inhaler (albuterol)**
---
**8.** A 2-year-old is hospitalized. The parent must leave for work. The child screams "Don't go!" and
then becomes quiet and withdrawn. This behavior indicates:
A) Protest phase
B) Despair phase
C) Detachment phase
D) Regression
💡 RATIONALE – Despair phase: withdrawn, quiet, sad, no longer crying. Protest phase is initial
screaming/clinging.
✔️ **ANSWER – B) Despair phase**
---
**9.** A newborn is noted to have a continuous "machinery" murmur, bounding pulses, and wide pulse
pressure. The nurse suspects:
A) Ventricular septal defect (VSD)
B) Atrial septal defect (ASD)
C) Patent ductus arteriosus (PDA)
D) Tetralogy of Fallot (TOF)
💡 RATIONALE – PDA: continuous murmur (systolic & diastolic), bounding pulses, wide pulse pressure,
and possible heart failure.
✔️ **ANSWER – C) Patent ductus arteriosus (PDA)**
