___________________________________________________________________
ATI Pediatric Medical-Surgical Practice
Exam 2026 | 100 Questions & Answers
with Detailed Rationales | Complete
Exam Prep & Study Guide
_________________________________
1. A nurse is assessing a child who has dehydration from gastroenteritis.
Which finding indicates moderate dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Decreased urine output
D. Increased skin turgor
Answer: Decreased urine output
Rationale: Reduced urine output is a common manifestation of dehydration in
children because the kidneys conserve fluid. Other findings can include dry
mucous membranes, tachycardia, and delayed capillary refill.
2. A nurse is caring for a child with cystic fibrosis. Which intervention is most
appropriate?
A. Restrict dietary fat
B. Limit fluid intake
C. Administer pancreatic enzymes with meals and snacks
D. Encourage a low-calorie diet
,Answer: Administer pancreatic enzymes with meals and snacks
Rationale: Children with cystic fibrosis commonly have pancreatic insufficiency
and require pancreatic enzyme replacement with meals and snacks to improve
digestion and nutrient absorption.
3. A child with asthma is experiencing acute wheezing and respiratory
distress. Which medication should the nurse expect to administer for rapid
relief?
A. Montelukast
B. Fluticasone
C. Albuterol
D. Cromolyn
Answer: Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist that produces
rapid bronchodilation during an acute asthma exacerbation.
4. A nurse is assessing a child with pneumonia. Which finding requires
immediate intervention?
A. Productive cough
B. Fever
C. Severe retractions and cyanosis
D. Decreased appetite
Answer: Severe retractions and cyanosis
Rationale: Severe retractions and cyanosis indicate significant respiratory
compromise and inadequate oxygenation. Immediate respiratory support is
required.
5. A child with type 1 diabetes mellitus is experiencing hypoglycemia. Which
finding should the nurse expect?
,A. Polyuria
B. Fruity breath
C. Diaphoresis and tremors
D. Kussmaul respirations
Answer: Diaphoresis and tremors
Rationale: Hypoglycemia activates the sympathetic nervous system, causing
sweating, tremors, tachycardia, hunger, irritability, and weakness.
6. A nurse is teaching the parents of a child with type 1 diabetes mellitus
about insulin administration. Which instruction is appropriate?
A. Store all insulin in direct sunlight
B. Shake insulin vigorously before administration
C. Rotate injection sites
D. Inject insulin into the muscle
Answer: Rotate injection sites
Rationale: Rotating insulin injection sites helps prevent lipodystrophy and
promotes predictable insulin absorption.
7. A child with sickle cell disease is experiencing a vaso-occlusive crisis. Which
intervention is appropriate?
A. Restrict fluids
B. Apply cold packs
C. Administer prescribed analgesics and encourage hydration
D. Encourage strenuous exercise
Answer: Administer prescribed analgesics and encourage hydration
Rationale: Hydration helps reduce blood viscosity, while adequate pain
management is essential during vaso-occlusive crises. Cold exposure and
dehydration can worsen sickling.
, 8. A nurse is caring for a child with sickle cell disease. Which finding is most
concerning?
A. Mild fatigue
B. Joint pain
C. Chest pain and respiratory distress
D. Decreased appetite
Answer: Chest pain and respiratory distress
Rationale: Chest pain, fever, cough, hypoxemia, and respiratory distress can
indicate acute chest syndrome, a life-threatening complication of sickle cell
disease.
9. A child with nephrotic syndrome has generalized edema. Which
intervention is appropriate?
A. Encourage a high-sodium diet
B. Restrict all protein
C. Monitor daily weight
D. Encourage excessive activity
Answer: Monitor daily weight
Rationale: Daily weight is an important indicator of fluid balance and helps
evaluate the progression or resolution of edema.
10.A nurse is assessing a child with acute glomerulonephritis. Which finding is
expected?
A. Increased urine output
B. Clear urine
C. Periorbital edema and hematuria
D. Severe dehydration
Answer: Periorbital edema and hematuria
ATI Pediatric Medical-Surgical Practice
Exam 2026 | 100 Questions & Answers
with Detailed Rationales | Complete
Exam Prep & Study Guide
_________________________________
1. A nurse is assessing a child who has dehydration from gastroenteritis.
Which finding indicates moderate dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Decreased urine output
D. Increased skin turgor
Answer: Decreased urine output
Rationale: Reduced urine output is a common manifestation of dehydration in
children because the kidneys conserve fluid. Other findings can include dry
mucous membranes, tachycardia, and delayed capillary refill.
2. A nurse is caring for a child with cystic fibrosis. Which intervention is most
appropriate?
A. Restrict dietary fat
B. Limit fluid intake
C. Administer pancreatic enzymes with meals and snacks
D. Encourage a low-calorie diet
,Answer: Administer pancreatic enzymes with meals and snacks
Rationale: Children with cystic fibrosis commonly have pancreatic insufficiency
and require pancreatic enzyme replacement with meals and snacks to improve
digestion and nutrient absorption.
3. A child with asthma is experiencing acute wheezing and respiratory
distress. Which medication should the nurse expect to administer for rapid
relief?
A. Montelukast
B. Fluticasone
C. Albuterol
D. Cromolyn
Answer: Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist that produces
rapid bronchodilation during an acute asthma exacerbation.
4. A nurse is assessing a child with pneumonia. Which finding requires
immediate intervention?
A. Productive cough
B. Fever
C. Severe retractions and cyanosis
D. Decreased appetite
Answer: Severe retractions and cyanosis
Rationale: Severe retractions and cyanosis indicate significant respiratory
compromise and inadequate oxygenation. Immediate respiratory support is
required.
5. A child with type 1 diabetes mellitus is experiencing hypoglycemia. Which
finding should the nurse expect?
,A. Polyuria
B. Fruity breath
C. Diaphoresis and tremors
D. Kussmaul respirations
Answer: Diaphoresis and tremors
Rationale: Hypoglycemia activates the sympathetic nervous system, causing
sweating, tremors, tachycardia, hunger, irritability, and weakness.
6. A nurse is teaching the parents of a child with type 1 diabetes mellitus
about insulin administration. Which instruction is appropriate?
A. Store all insulin in direct sunlight
B. Shake insulin vigorously before administration
C. Rotate injection sites
D. Inject insulin into the muscle
Answer: Rotate injection sites
Rationale: Rotating insulin injection sites helps prevent lipodystrophy and
promotes predictable insulin absorption.
7. A child with sickle cell disease is experiencing a vaso-occlusive crisis. Which
intervention is appropriate?
A. Restrict fluids
B. Apply cold packs
C. Administer prescribed analgesics and encourage hydration
D. Encourage strenuous exercise
Answer: Administer prescribed analgesics and encourage hydration
Rationale: Hydration helps reduce blood viscosity, while adequate pain
management is essential during vaso-occlusive crises. Cold exposure and
dehydration can worsen sickling.
, 8. A nurse is caring for a child with sickle cell disease. Which finding is most
concerning?
A. Mild fatigue
B. Joint pain
C. Chest pain and respiratory distress
D. Decreased appetite
Answer: Chest pain and respiratory distress
Rationale: Chest pain, fever, cough, hypoxemia, and respiratory distress can
indicate acute chest syndrome, a life-threatening complication of sickle cell
disease.
9. A child with nephrotic syndrome has generalized edema. Which
intervention is appropriate?
A. Encourage a high-sodium diet
B. Restrict all protein
C. Monitor daily weight
D. Encourage excessive activity
Answer: Monitor daily weight
Rationale: Daily weight is an important indicator of fluid balance and helps
evaluate the progression or resolution of edema.
10.A nurse is assessing a child with acute glomerulonephritis. Which finding is
expected?
A. Increased urine output
B. Clear urine
C. Periorbital edema and hematuria
D. Severe dehydration
Answer: Periorbital edema and hematuria
