2024-2025-2026 ATI Pediatric CMS Proctored
Exam – Version 1 With Correct Detailed
Answers & Rationales, A+ Grade | Instant
Download PDF
CORE DOMAINS COVERED IN THIS EXAM
1. Growth and Development - Developmental milestones (infants, toddlers,
preschoolers, school-age, adolescents), developmental theories (Piaget,
Erikson, Freud), age-appropriate activities
2. Health Promotion and Maintenance - Immunizations, nutrition, safety,
injury prevention, anticipatory guidance, screening
3. Acute and Chronic Illnesses - Respiratory, gastrointestinal, cardiovascular,
neurologic, musculoskeletal, endocrine, hematologic, integumentary
disorders
4. Medication Administration and Pharmacology - Pediatric dosages,
medication calculations, adverse effects, contraindications, safe
administration
5. Nursing Care of the Hospitalized Child - Family-centered care,
developmental considerations, play therapy, pain management, preparation
for procedures
6. Pediatric Emergencies and Critical Care - Respiratory distress, shock,
seizures, trauma, burns, poisoning, child maltreatment
7. Fluid and Electrolyte Balance - Dehydration, fluid replacement, electrolyte
imbalances, IV therapy
8. Neurologic and Sensory Disorders - Seizures, hydrocephalus, meningitis,
head injuries, vision and hearing impairments
9. Mental Health and Behavioral Disorders - Autism spectrum disorder,
ADHD, depression, anxiety, eating disorders
, 10.Legal and Ethical Issues - Informed consent, assent, mandatory reporting,
child abuse and neglect, confidentiality
1. A nurse is caring for an adolescent following a lumbar puncture. Which of
the following actions should the nurse take?
A. Initiate NPO status for the adolescent
B. Place the adolescent in a supine position
C. Place a moist, warm pack on the adolescent's lower back
D. Apply a eutectic mixture of local anesthetics to the adolescent's puncture site
ANSWER: B. Place the adolescent in a supine position
RATIONALE: The nurse should place the adolescent in a supine position for
30 minutes to 1 hour following a lumbar puncture to decrease the risk of a post-
dural puncture headache.
2. A nurse is assessing a child who is receiving IV chemotherapy. Assessment
findings include extravasation of the tissues surrounding the IV insertion site.
In which order should the nurse take the following actions?
A. Remove IV line → Elevate the extremity → Stop the infusion → Notify the
provider
B. Stop the infusion → Elevate the extremity → Notify the provider → Remove
the IV line
C. Stop the infusion → Remove the IV line → Elevate the extremity → Notify the
provider
D. Elevate the extremity → Stop the infusion → Remove the IV line → Notify the
provider
ANSWER: C. Stop the infusion → Remove the IV line → Elevate the
extremity → Notify the provider
RATIONALE: In the event of extravasation of a vesicant chemotherapy
agent, the nurse should first stop the infusion, then remove the IV line, elevate the
extremity, and notify the provider. This sequence minimizes tissue damage and
promotes provider notification for further management.
,3. A nurse is discussing the causes of chronic diarrhea with a client. Which of
the following conditions is caused by malabsorption?
A. Celiac disease
B. Ulcerative colitis
C. Hirschsprung's disease
D. Crohn's disease
ANSWER: A. Celiac disease
RATIONALE: The nurse should recognize that celiac disease causes chronic
diarrhea due to malabsorption. Other malabsorption conditions include short bowel
syndrome, lactose intolerance, and congenital enzyme deficiency.
4. A nurse is caring for an 8-year-old child who has sickle cell anemia. Which
of the following actions should the nurse take?
A. Apply cool compresses to the painful area
B. Initiate contact isolation precautions
C. Give the child flavored popsicles
D. Administer phytonadione (vitamin K)
ANSWER: C. Give the child flavored popsicles
RATIONALE: Maintaining hydration in a child who has sickle cell anemia is
important to prevent sickling. Children often accept flavored popsicles as a source
of fluid. Hydration reduces blood viscosity and decreases the risk of vaso-
occlusive crisis.
5. A nurse is caring for a toddler who has a fever, a high-pitched cry,
irritability, and vomiting. Which of the following actions should the nurse
take?
A. Administer acetaminophen
B. Assess for nuchal rigidity
C. Place the toddler in a cool bath
D. Offer clear liquids
, ANSWER: B. Assess for nuchal rigidity
RATIONALE: A high-pitched cry, fever, irritability, and vomiting in a
toddler are signs of increased intracranial pressure and possible meningitis. The
nurse should assess for nuchal rigidity (neck stiffness) as part of the meningitis
assessment.
6. A nurse is preparing to administer immunizations to a 2-month-old infant.
Which of the following immunizations should the nurse administer?
A. MMR, DTaP, Hib, IPV
B. DTaP, Hib, IPV, PCV, HepB
C. MMR, Varicella, HepB, PCV
D. DTaP, Hib, IPV, MMR
ANSWER: B. DTaP, Hib, IPV, PCV, HepB
RATIONALE: At 2 months of age, the infant should receive DTaP, Hib, IPV,
PCV, and HepB. MMR and Varicella are not administered until 12-15 months of
age.
7. A nurse is assessing a 6-month-old infant during a well-child visit. Which of
the following developmental milestones should the nurse expect to observe?
A. Sits without support
B. Uses a pincer grasp
C. Says "mama" and "dada" specifically
D. Crawls
ANSWER: A. Sits without support
RATIONALE: By 6 months of age, an infant should be able to sit without
support briefly. The pincer grasp develops around 9 months, saying "mama" and
"dada" specifically around 12 months, and crawling around 8-10 months.
8. A nurse is caring for a child who has a diagnosis of acute epiglottitis. Which
of the following actions should the nurse take first?
Exam – Version 1 With Correct Detailed
Answers & Rationales, A+ Grade | Instant
Download PDF
CORE DOMAINS COVERED IN THIS EXAM
1. Growth and Development - Developmental milestones (infants, toddlers,
preschoolers, school-age, adolescents), developmental theories (Piaget,
Erikson, Freud), age-appropriate activities
2. Health Promotion and Maintenance - Immunizations, nutrition, safety,
injury prevention, anticipatory guidance, screening
3. Acute and Chronic Illnesses - Respiratory, gastrointestinal, cardiovascular,
neurologic, musculoskeletal, endocrine, hematologic, integumentary
disorders
4. Medication Administration and Pharmacology - Pediatric dosages,
medication calculations, adverse effects, contraindications, safe
administration
5. Nursing Care of the Hospitalized Child - Family-centered care,
developmental considerations, play therapy, pain management, preparation
for procedures
6. Pediatric Emergencies and Critical Care - Respiratory distress, shock,
seizures, trauma, burns, poisoning, child maltreatment
7. Fluid and Electrolyte Balance - Dehydration, fluid replacement, electrolyte
imbalances, IV therapy
8. Neurologic and Sensory Disorders - Seizures, hydrocephalus, meningitis,
head injuries, vision and hearing impairments
9. Mental Health and Behavioral Disorders - Autism spectrum disorder,
ADHD, depression, anxiety, eating disorders
, 10.Legal and Ethical Issues - Informed consent, assent, mandatory reporting,
child abuse and neglect, confidentiality
1. A nurse is caring for an adolescent following a lumbar puncture. Which of
the following actions should the nurse take?
A. Initiate NPO status for the adolescent
B. Place the adolescent in a supine position
C. Place a moist, warm pack on the adolescent's lower back
D. Apply a eutectic mixture of local anesthetics to the adolescent's puncture site
ANSWER: B. Place the adolescent in a supine position
RATIONALE: The nurse should place the adolescent in a supine position for
30 minutes to 1 hour following a lumbar puncture to decrease the risk of a post-
dural puncture headache.
2. A nurse is assessing a child who is receiving IV chemotherapy. Assessment
findings include extravasation of the tissues surrounding the IV insertion site.
In which order should the nurse take the following actions?
A. Remove IV line → Elevate the extremity → Stop the infusion → Notify the
provider
B. Stop the infusion → Elevate the extremity → Notify the provider → Remove
the IV line
C. Stop the infusion → Remove the IV line → Elevate the extremity → Notify the
provider
D. Elevate the extremity → Stop the infusion → Remove the IV line → Notify the
provider
ANSWER: C. Stop the infusion → Remove the IV line → Elevate the
extremity → Notify the provider
RATIONALE: In the event of extravasation of a vesicant chemotherapy
agent, the nurse should first stop the infusion, then remove the IV line, elevate the
extremity, and notify the provider. This sequence minimizes tissue damage and
promotes provider notification for further management.
,3. A nurse is discussing the causes of chronic diarrhea with a client. Which of
the following conditions is caused by malabsorption?
A. Celiac disease
B. Ulcerative colitis
C. Hirschsprung's disease
D. Crohn's disease
ANSWER: A. Celiac disease
RATIONALE: The nurse should recognize that celiac disease causes chronic
diarrhea due to malabsorption. Other malabsorption conditions include short bowel
syndrome, lactose intolerance, and congenital enzyme deficiency.
4. A nurse is caring for an 8-year-old child who has sickle cell anemia. Which
of the following actions should the nurse take?
A. Apply cool compresses to the painful area
B. Initiate contact isolation precautions
C. Give the child flavored popsicles
D. Administer phytonadione (vitamin K)
ANSWER: C. Give the child flavored popsicles
RATIONALE: Maintaining hydration in a child who has sickle cell anemia is
important to prevent sickling. Children often accept flavored popsicles as a source
of fluid. Hydration reduces blood viscosity and decreases the risk of vaso-
occlusive crisis.
5. A nurse is caring for a toddler who has a fever, a high-pitched cry,
irritability, and vomiting. Which of the following actions should the nurse
take?
A. Administer acetaminophen
B. Assess for nuchal rigidity
C. Place the toddler in a cool bath
D. Offer clear liquids
, ANSWER: B. Assess for nuchal rigidity
RATIONALE: A high-pitched cry, fever, irritability, and vomiting in a
toddler are signs of increased intracranial pressure and possible meningitis. The
nurse should assess for nuchal rigidity (neck stiffness) as part of the meningitis
assessment.
6. A nurse is preparing to administer immunizations to a 2-month-old infant.
Which of the following immunizations should the nurse administer?
A. MMR, DTaP, Hib, IPV
B. DTaP, Hib, IPV, PCV, HepB
C. MMR, Varicella, HepB, PCV
D. DTaP, Hib, IPV, MMR
ANSWER: B. DTaP, Hib, IPV, PCV, HepB
RATIONALE: At 2 months of age, the infant should receive DTaP, Hib, IPV,
PCV, and HepB. MMR and Varicella are not administered until 12-15 months of
age.
7. A nurse is assessing a 6-month-old infant during a well-child visit. Which of
the following developmental milestones should the nurse expect to observe?
A. Sits without support
B. Uses a pincer grasp
C. Says "mama" and "dada" specifically
D. Crawls
ANSWER: A. Sits without support
RATIONALE: By 6 months of age, an infant should be able to sit without
support briefly. The pincer grasp develops around 9 months, saying "mama" and
"dada" specifically around 12 months, and crawling around 8-10 months.
8. A nurse is caring for a child who has a diagnosis of acute epiglottitis. Which
of the following actions should the nurse take first?
