The Ultimate ATI PEDS CMS
Proctored Exam Study Guide: Practice
Questions with Answers & Detailed
Rationales
Question 1
A nurse in the emergency department is caring for a 2-year-old
child who was found by his parents crying and holding a container
of toilet bowl cleaner. The child's lips are edematous and
inflamed, and he is drooling. Which of the following is the priority
action by the nurse?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote to the child.
D. Establish IV access for the child.
Answer: B. Check the child's respiratory status.
Rationale: When applying the ABC (Airway, Breathing,
Circulation) priority-setting framework, airway is always the
highest priority. Edematous and inflamed lips with drooling
suggest airway compromise, and respiratory status must be
assessed immediately.
,Question 2
A nurse is teaching a parent of a 12-month-old child about
development during the toddler years. Which of the following
statements should the nurse include?
A. "Your child should be referring to himself using the appropriate
pronoun by 18 months of age."
B. "A toddler's interest in looking at pictures occurs at 20 months
of age."
C. "A toddler should have daytime control of his bowel and
bladder by 24 months of age."
D. "Your child should be able to scribble spontaneously using a
crayon at the age of 15 months."
Answer: D. "Your child should be able to scribble
spontaneously using a crayon at the age of 15 months."
Rationale: At 15 months, a toddler should be able to scribble
spontaneously. At 18 months, the toddler should be able to make
strokes imitatively. Bowel and bladder control typically occurs
later, around 2.5 to 3 years.
Question 3
A nurse is teaching school-aged child and his parents how to self-
administer insulin. Which of the following actions should the
nurse take first?
,A. Allow the parent to administer an injection to the nurse.
B. Have the child teach the injection technique to the parents.
C. Have a parent administer the insulin injection to the child.
D. Demonstrate the injection technique on an orange.
Answer: D. Demonstrate the injection technique on an
orange.
Rationale: The nurse should first demonstrate the technique on a
model (such as an orange) before having the child or parent
practice. This follows the "return demonstration" teaching
method.
Question 4
A nurse is teaching the guardian of an 18-month-old toddler
about otic medication administration. Which of the following
statements should the nurse make?
A. "Administer the drops immediately after removing the
medication from the refrigerator."
B. "Place the child in a seated position with the head tilted to the
side for administration."
C. "Gently pull the ear cartilage down and back when
administering the medication."
D. "Position the medication bottle so the drops do not touch the
side of the ear canal."
Answer: C. "Gently pull the ear cartilage down and back when
administering the medication."
, Rationale: For children under 3 years of age, the pinna should be
pulled down and back to straighten the ear canal. For children
over 3, pull up and back.
Question 5
A nurse is assessing a 1-week-old infant at a well-child visit. The
nurse should notify the provider about which of the following
assessment findings?
A. A flat, dark pink area between the eyes that blanches.
B. An area of deep blue pigmentation over the buttock.
C. A blue coloring of the sclera.
D. A patchy, red rash with raised centers.
Answer: C. A blue coloring of the sclera.
Rationale: Blue sclera can indicate osteogenesis imperfecta or
other connective tissue disorders and should be reported. A flat
pink area (salmon patch) and deep blue pigmentation (Mongolian
spot) are normal findings in newborns.
Question 6
A nurse is reviewing the lab results of an infant who is receiving
digoxin and furosemide for the treatment of heart failure. Which
of the following findings should the nurse report to the provider?
Proctored Exam Study Guide: Practice
Questions with Answers & Detailed
Rationales
Question 1
A nurse in the emergency department is caring for a 2-year-old
child who was found by his parents crying and holding a container
of toilet bowl cleaner. The child's lips are edematous and
inflamed, and he is drooling. Which of the following is the priority
action by the nurse?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote to the child.
D. Establish IV access for the child.
Answer: B. Check the child's respiratory status.
Rationale: When applying the ABC (Airway, Breathing,
Circulation) priority-setting framework, airway is always the
highest priority. Edematous and inflamed lips with drooling
suggest airway compromise, and respiratory status must be
assessed immediately.
,Question 2
A nurse is teaching a parent of a 12-month-old child about
development during the toddler years. Which of the following
statements should the nurse include?
A. "Your child should be referring to himself using the appropriate
pronoun by 18 months of age."
B. "A toddler's interest in looking at pictures occurs at 20 months
of age."
C. "A toddler should have daytime control of his bowel and
bladder by 24 months of age."
D. "Your child should be able to scribble spontaneously using a
crayon at the age of 15 months."
Answer: D. "Your child should be able to scribble
spontaneously using a crayon at the age of 15 months."
Rationale: At 15 months, a toddler should be able to scribble
spontaneously. At 18 months, the toddler should be able to make
strokes imitatively. Bowel and bladder control typically occurs
later, around 2.5 to 3 years.
Question 3
A nurse is teaching school-aged child and his parents how to self-
administer insulin. Which of the following actions should the
nurse take first?
,A. Allow the parent to administer an injection to the nurse.
B. Have the child teach the injection technique to the parents.
C. Have a parent administer the insulin injection to the child.
D. Demonstrate the injection technique on an orange.
Answer: D. Demonstrate the injection technique on an
orange.
Rationale: The nurse should first demonstrate the technique on a
model (such as an orange) before having the child or parent
practice. This follows the "return demonstration" teaching
method.
Question 4
A nurse is teaching the guardian of an 18-month-old toddler
about otic medication administration. Which of the following
statements should the nurse make?
A. "Administer the drops immediately after removing the
medication from the refrigerator."
B. "Place the child in a seated position with the head tilted to the
side for administration."
C. "Gently pull the ear cartilage down and back when
administering the medication."
D. "Position the medication bottle so the drops do not touch the
side of the ear canal."
Answer: C. "Gently pull the ear cartilage down and back when
administering the medication."
, Rationale: For children under 3 years of age, the pinna should be
pulled down and back to straighten the ear canal. For children
over 3, pull up and back.
Question 5
A nurse is assessing a 1-week-old infant at a well-child visit. The
nurse should notify the provider about which of the following
assessment findings?
A. A flat, dark pink area between the eyes that blanches.
B. An area of deep blue pigmentation over the buttock.
C. A blue coloring of the sclera.
D. A patchy, red rash with raised centers.
Answer: C. A blue coloring of the sclera.
Rationale: Blue sclera can indicate osteogenesis imperfecta or
other connective tissue disorders and should be reported. A flat
pink area (salmon patch) and deep blue pigmentation (Mongolian
spot) are normal findings in newborns.
Question 6
A nurse is reviewing the lab results of an infant who is receiving
digoxin and furosemide for the treatment of heart failure. Which
of the following findings should the nurse report to the provider?
