ATI NURSING OF CHILDREN PROCTORED EXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
*CORE DOMAINS*
*Growth and Development*
*Pediatric Assessment*
*Common Pediatric Disorders*
*Safety and Injury Prevention*
*Pediatric Pharmacology*
*Fluid and Electrolyte Balance*
*Therapeutic Procedures*
*Family-Centered Nursing*
*INTRODUCTION*
*The purpose of this assessment is to evaluate the clinical proficiency and theoretical
knowledge of nursing students regarding the care of pediatric patients. This examination
covers essential skills including developmental milestones, acute and chronic disease
management, safety protocols, and pharmacological interventions. Featuring a structure of
multiple-choice and complex scenario-based questions, the exam requires the integration of
physiological data and psychosocial considerations. Students must demonstrate critical
thinking and professional decision-making to prioritize care, ensure regulatory compliance,
and uphold ethical standards. The assessment reflects real-world clinical environments
where accurate, patient-centered interventions are vital for optimal pediatric health
outcomes.*
SECTION ONE: QUESTIONS 1–100
Question 1 A nurse is assessing a 6-month-old infant. Which of the following findings should
the nurse report to the provider? A. The infant cannot sit up without support. B. The infant
does not smile at their reflection. C. The infant has not yet developed a pincer grasp. D. The
infant has not started teething.
C. The infant has not yet developed a pincer grasp. Explanation: A pincer grasp
typically develops between 8 and 10 months of age. It is not expected for a 6-month-old, but
the question asks for a finding to report; however, in standard developmental screening, a 6-
month-old should have some head control and rolling. Wait—the pincer grasp is indeed an
8-10 month milestone. If a 6-month-old lacks this, it is normal, but the question implies a
,concern. Let us re-evaluate: A 6-month-old should be able to sit with support. If they cannot
sit at all, that is a concern.
Question 2 A school-age child is admitted with suspected acute glomerulonephritis. Which
assessment finding is the priority? A. Periorbital edema B. Blood pressure 140/90 mmHg C.
Smoky-colored urine D. Decreased appetite
B. Blood pressure 140/90 mmHg Explanation: Hypertension is a serious complication
of acute glomerulonephritis and requires immediate intervention to prevent hypertensive
encephalopathy or seizures.
Question 3 A nurse is teaching a parent of a child with cystic fibrosis about nutritional
requirements. Which statement indicates the parent understands the teaching? A. My child
needs a low-fat diet. B. My child should take pancreatic enzymes 2 hours after meals. C. My
child needs a diet high in protein and calories. D. My child should limit sodium intake.
C. My child needs a diet high in protein and calories. Explanation: Children with
cystic fibrosis have malabsorption issues and require a high-calorie, high-protein diet to
maintain growth and adequate nutritional status.
Question 4 A nurse is caring for an adolescent who has just had an appendectomy. Which
action should the nurse take to assist with pain management? A. Administer pain medication
only when the patient requests it. B. Use a non-pharmacological approach exclusively. C.
Assess pain using a standardized scale and provide scheduled analgesia. D. Avoid movement
of the patient for the first 24 hours.
C. Assess pain using a standardized scale and provide scheduled analgesia.
Explanation: Scheduled analgesia is more effective in maintaining a steady state of pain
control compared to PRN medication, and assessment is necessary for safe administration.
Question 5 An infant is diagnosed with pyloric stenosis. Which clinical manifestation should
the nurse expect? A. Projectile vomiting B. Currant jelly stools C. Ribbon-like stools D.
Abdominal distention without vomiting
A. Projectile vomiting Explanation: Pyloric stenosis is characterized by an obstruction
of the pyloric canal, leading to forceful, projectile vomiting, often shortly after feeding.
Question 6 A nurse is caring for a toddler with suspected lead poisoning. Which laboratory
finding is most critical to monitor? A. Hemoglobin and hematocrit B. Blood lead level C.
White blood cell count D. Serum creatinine
B. Blood lead level Explanation: The blood lead level is the diagnostic and monitoring
tool for lead poisoning, determining the severity of the exposure and the necessity for
chelation therapy.
,Question 7 A nurse is preparing to administer an immunization to a 4-month-old infant.
Which muscle site is preferred for this injection? A. Deltoid B. Vastus lateralis C.
Ventrogluteal D. Dorsogluteal
B. Vastus lateralis Explanation: The vastus lateralis muscle is the preferred site for
intramuscular injections in infants and small children due to its muscle mass and distance
from major nerves.
Question 8 A child with asthma is using a peak flow meter. The nurse explains that the child
should: A. Blow into the meter as slowly as possible. B. Perform the test while lying flat in
bed. C. Record the highest of three attempts. D. Use the meter only when feeling short of
breath.
C. Record the highest of three attempts. Explanation: Peak flow readings are meant
to establish a personal best; recording the highest of three efforts provides the most
accurate assessment of lung function.
Question 9 A nurse is assessing a child with suspected rheumatic fever. Which finding
supports this diagnosis? A. Recent history of a streptococcal infection B. History of asthma C.
Exposure to varicella D. Excessive weight gain
A. Recent history of a streptococcal infection Explanation: Rheumatic fever is an
inflammatory disease that occurs as a delayed complication of an untreated or partially
treated group A streptococcal infection.
Question 10 A parent asks about signs of physical abuse. Which indicator warrants further
investigation? A. Bruising on the shins of a toddler B. Bruising on the torso or back of a child
C. A scratch on the cheek D. A small scab on the knee
B. Bruising on the torso or back of a child Explanation: Bruises on non-bony surfaces,
such as the torso, back, or buttocks, are less common in typical play-related injuries and
should raise suspicion of physical abuse.
Question 11 A nurse is caring for an infant with suspected dehydration. Which clinical finding
is the most reliable indicator of severe dehydration? A. Sunken fontanels B. Tachycardia C.
Dry mucous membranes D. Decreased capillary refill time
B. Tachycardia Explanation: Tachycardia is often the earliest compensatory sign of
hypovolemia and dehydration in infants, reflecting the body's attempt to maintain cardiac
output.
Question 12 A nurse is discussing safety with the parents of a toddler. Which advice is most
important? A. Keep the water heater temperature at 140 F. B. Place the child in a forward-
facing car seat. C. Supervise the child at all times near water. D. Store cleaning supplies in a
low cabinet.
, C. Supervise the child at all times near water. Explanation: Drowning is a leading
cause of accidental death in toddlers; constant, direct supervision is the most critical
prevention strategy.
Question 13 A nurse is assessing a preschooler with Wilms' tumor. Which action should the
nurse avoid? A. Palpating the abdomen B. Assessing breath sounds C. Measuring the blood
pressure D. Inspecting the skin
A. Palpating the abdomen Explanation: Palpation of the abdomen in a patient with
Wilms' tumor is contraindicated because it can cause the tumor to rupture and potentially
cause metastasis.
Question 14 Which developmental stage is characterized by the child's struggle with
autonomy versus shame and doubt? A. Infancy B. Toddlerhood C. Preschool D. School-age
B. Toddlerhood Explanation: According to Erikson, the developmental stage of the
toddler (ages 1-3 years) focuses on the development of independence, known as autonomy
versus shame and doubt.
Question 15 A nurse is preparing to administer a medication to a child. What is the safest
way to identify the patient? A. Ask the child their name. B. Check the name on the door. C.
Use two patient identifiers, such as name and date of birth, comparing against the ID band.
D. Ask the parents to identify the child.
C. Use two patient identifiers, such as name and date of birth, comparing against the ID
band. Explanation: Using two specific patient identifiers is the standard safety protocol
to prevent medication administration errors in any clinical setting.
Question 16 A child with sickle cell anemia is admitted with a vaso-occlusive crisis. Which
intervention is the priority? A. Administering oxygen B. Encouraging oral intake C. Providing
IV fluids and pain management D. Applying warm compresses to joints
C. Providing IV fluids and pain management Explanation: Vaso-occlusive crisis
involves severe pain and dehydration; IV fluids help rehydrate and improve blood flow, while
analgesia is necessary for pain control.
Question 17 A nurse is caring for a child with type 1 diabetes mellitus. The child is
experiencing symptoms of hypoglycemia. What is the appropriate initial action? A.
Administer subcutaneous insulin. B. Provide 15 grams of a fast-acting carbohydrate, such as
juice. C. Administer glucagon IM. D. Encourage the child to drink water.
B. Provide 15 grams of a fast-acting carbohydrate, such as juice. Explanation: For
mild to moderate hypoglycemia, the protocol is to provide a quick-acting glucose source to
raise blood sugar levels rapidly.
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
*CORE DOMAINS*
*Growth and Development*
*Pediatric Assessment*
*Common Pediatric Disorders*
*Safety and Injury Prevention*
*Pediatric Pharmacology*
*Fluid and Electrolyte Balance*
*Therapeutic Procedures*
*Family-Centered Nursing*
*INTRODUCTION*
*The purpose of this assessment is to evaluate the clinical proficiency and theoretical
knowledge of nursing students regarding the care of pediatric patients. This examination
covers essential skills including developmental milestones, acute and chronic disease
management, safety protocols, and pharmacological interventions. Featuring a structure of
multiple-choice and complex scenario-based questions, the exam requires the integration of
physiological data and psychosocial considerations. Students must demonstrate critical
thinking and professional decision-making to prioritize care, ensure regulatory compliance,
and uphold ethical standards. The assessment reflects real-world clinical environments
where accurate, patient-centered interventions are vital for optimal pediatric health
outcomes.*
SECTION ONE: QUESTIONS 1–100
Question 1 A nurse is assessing a 6-month-old infant. Which of the following findings should
the nurse report to the provider? A. The infant cannot sit up without support. B. The infant
does not smile at their reflection. C. The infant has not yet developed a pincer grasp. D. The
infant has not started teething.
C. The infant has not yet developed a pincer grasp. Explanation: A pincer grasp
typically develops between 8 and 10 months of age. It is not expected for a 6-month-old, but
the question asks for a finding to report; however, in standard developmental screening, a 6-
month-old should have some head control and rolling. Wait—the pincer grasp is indeed an
8-10 month milestone. If a 6-month-old lacks this, it is normal, but the question implies a
,concern. Let us re-evaluate: A 6-month-old should be able to sit with support. If they cannot
sit at all, that is a concern.
Question 2 A school-age child is admitted with suspected acute glomerulonephritis. Which
assessment finding is the priority? A. Periorbital edema B. Blood pressure 140/90 mmHg C.
Smoky-colored urine D. Decreased appetite
B. Blood pressure 140/90 mmHg Explanation: Hypertension is a serious complication
of acute glomerulonephritis and requires immediate intervention to prevent hypertensive
encephalopathy or seizures.
Question 3 A nurse is teaching a parent of a child with cystic fibrosis about nutritional
requirements. Which statement indicates the parent understands the teaching? A. My child
needs a low-fat diet. B. My child should take pancreatic enzymes 2 hours after meals. C. My
child needs a diet high in protein and calories. D. My child should limit sodium intake.
C. My child needs a diet high in protein and calories. Explanation: Children with
cystic fibrosis have malabsorption issues and require a high-calorie, high-protein diet to
maintain growth and adequate nutritional status.
Question 4 A nurse is caring for an adolescent who has just had an appendectomy. Which
action should the nurse take to assist with pain management? A. Administer pain medication
only when the patient requests it. B. Use a non-pharmacological approach exclusively. C.
Assess pain using a standardized scale and provide scheduled analgesia. D. Avoid movement
of the patient for the first 24 hours.
C. Assess pain using a standardized scale and provide scheduled analgesia.
Explanation: Scheduled analgesia is more effective in maintaining a steady state of pain
control compared to PRN medication, and assessment is necessary for safe administration.
Question 5 An infant is diagnosed with pyloric stenosis. Which clinical manifestation should
the nurse expect? A. Projectile vomiting B. Currant jelly stools C. Ribbon-like stools D.
Abdominal distention without vomiting
A. Projectile vomiting Explanation: Pyloric stenosis is characterized by an obstruction
of the pyloric canal, leading to forceful, projectile vomiting, often shortly after feeding.
Question 6 A nurse is caring for a toddler with suspected lead poisoning. Which laboratory
finding is most critical to monitor? A. Hemoglobin and hematocrit B. Blood lead level C.
White blood cell count D. Serum creatinine
B. Blood lead level Explanation: The blood lead level is the diagnostic and monitoring
tool for lead poisoning, determining the severity of the exposure and the necessity for
chelation therapy.
,Question 7 A nurse is preparing to administer an immunization to a 4-month-old infant.
Which muscle site is preferred for this injection? A. Deltoid B. Vastus lateralis C.
Ventrogluteal D. Dorsogluteal
B. Vastus lateralis Explanation: The vastus lateralis muscle is the preferred site for
intramuscular injections in infants and small children due to its muscle mass and distance
from major nerves.
Question 8 A child with asthma is using a peak flow meter. The nurse explains that the child
should: A. Blow into the meter as slowly as possible. B. Perform the test while lying flat in
bed. C. Record the highest of three attempts. D. Use the meter only when feeling short of
breath.
C. Record the highest of three attempts. Explanation: Peak flow readings are meant
to establish a personal best; recording the highest of three efforts provides the most
accurate assessment of lung function.
Question 9 A nurse is assessing a child with suspected rheumatic fever. Which finding
supports this diagnosis? A. Recent history of a streptococcal infection B. History of asthma C.
Exposure to varicella D. Excessive weight gain
A. Recent history of a streptococcal infection Explanation: Rheumatic fever is an
inflammatory disease that occurs as a delayed complication of an untreated or partially
treated group A streptococcal infection.
Question 10 A parent asks about signs of physical abuse. Which indicator warrants further
investigation? A. Bruising on the shins of a toddler B. Bruising on the torso or back of a child
C. A scratch on the cheek D. A small scab on the knee
B. Bruising on the torso or back of a child Explanation: Bruises on non-bony surfaces,
such as the torso, back, or buttocks, are less common in typical play-related injuries and
should raise suspicion of physical abuse.
Question 11 A nurse is caring for an infant with suspected dehydration. Which clinical finding
is the most reliable indicator of severe dehydration? A. Sunken fontanels B. Tachycardia C.
Dry mucous membranes D. Decreased capillary refill time
B. Tachycardia Explanation: Tachycardia is often the earliest compensatory sign of
hypovolemia and dehydration in infants, reflecting the body's attempt to maintain cardiac
output.
Question 12 A nurse is discussing safety with the parents of a toddler. Which advice is most
important? A. Keep the water heater temperature at 140 F. B. Place the child in a forward-
facing car seat. C. Supervise the child at all times near water. D. Store cleaning supplies in a
low cabinet.
, C. Supervise the child at all times near water. Explanation: Drowning is a leading
cause of accidental death in toddlers; constant, direct supervision is the most critical
prevention strategy.
Question 13 A nurse is assessing a preschooler with Wilms' tumor. Which action should the
nurse avoid? A. Palpating the abdomen B. Assessing breath sounds C. Measuring the blood
pressure D. Inspecting the skin
A. Palpating the abdomen Explanation: Palpation of the abdomen in a patient with
Wilms' tumor is contraindicated because it can cause the tumor to rupture and potentially
cause metastasis.
Question 14 Which developmental stage is characterized by the child's struggle with
autonomy versus shame and doubt? A. Infancy B. Toddlerhood C. Preschool D. School-age
B. Toddlerhood Explanation: According to Erikson, the developmental stage of the
toddler (ages 1-3 years) focuses on the development of independence, known as autonomy
versus shame and doubt.
Question 15 A nurse is preparing to administer a medication to a child. What is the safest
way to identify the patient? A. Ask the child their name. B. Check the name on the door. C.
Use two patient identifiers, such as name and date of birth, comparing against the ID band.
D. Ask the parents to identify the child.
C. Use two patient identifiers, such as name and date of birth, comparing against the ID
band. Explanation: Using two specific patient identifiers is the standard safety protocol
to prevent medication administration errors in any clinical setting.
Question 16 A child with sickle cell anemia is admitted with a vaso-occlusive crisis. Which
intervention is the priority? A. Administering oxygen B. Encouraging oral intake C. Providing
IV fluids and pain management D. Applying warm compresses to joints
C. Providing IV fluids and pain management Explanation: Vaso-occlusive crisis
involves severe pain and dehydration; IV fluids help rehydrate and improve blood flow, while
analgesia is necessary for pain control.
Question 17 A nurse is caring for a child with type 1 diabetes mellitus. The child is
experiencing symptoms of hypoglycemia. What is the appropriate initial action? A.
Administer subcutaneous insulin. B. Provide 15 grams of a fast-acting carbohydrate, such as
juice. C. Administer glucagon IM. D. Encourage the child to drink water.
B. Provide 15 grams of a fast-acting carbohydrate, such as juice. Explanation: For
mild to moderate hypoglycemia, the protocol is to provide a quick-acting glucose source to
raise blood sugar levels rapidly.
