ATI RN PEDIATRIC PROCTORED EXAM
2026/2027 | NGN PRACTICE QUESTIONS,
VERIFIED ANSWERS & DETAILED
RATIONALES | COMPLETE PEDIATRIC
NURSING STUDY GUIDE
ATI RN PEDIATRIC PROCTORED EXAM 2026/2027 - COMPLETE STUDY GUIDE
• This comprehensive study material contains 200 practice questions designed to
prepare you for the ATI RN Pediatric Proctored Exam with detailed rationales
explaining each correct answer and clinical reasoning behind it.
• Use this guide by completing questions daily, reviewing rationales thoroughly, and
focusing on areas where you score lowest to maximize retention and exam
readiness.
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QUESTION 1
A 2-year-old child is brought to the emergency department with a
temperature of 39.5°C, barky cough, and inspiratory stridor. The child has a
respiratory rate of 32 breaths per minute. Which of the following findings
would be most consistent with croup?
A) High fever, drooling, difficulty swallowing, tripod position
B) Barky seal-like cough, inspiratory stridor, low-grade fever
C) Wheezing, accessory muscle use, hyperinflation on chest X-ray
D) Cough with thick purulent sputum, consolidation on chest X-ray
E) Rapid onset of severe respiratory distress, epiglottitis appearance
CORRECT ANSWER: B) Barky seal-like cough, inspiratory stridor, low-grade
fever
Croup (laryngotracheobronchitis) is characterized by a distinctive barky, seal-like
cough with inspiratory stridor caused by subglottic edema. While fever can be
present, it is typically low-grade. Option A describes epiglottitis which presents with
,high fever, drooling, and dysphagia. Option C describes asthma or bronchiolitis with
wheezing. Option D suggests bacterial pneumonia. Option E describes severe
epiglottitis. The classic presentation of croup includes the pathognomonic barky
cough and inspiratory stridor.
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QUESTION 2
A 6-month-old infant is admitted with bronchiolitis. The infant has a
respiratory rate of 58 breaths per minute, intercostal and subcostal
retractions, and oxygen saturation of 88% on room air. What is the priority
nursing intervention?
A) Administer antipyretics to reduce fever and increase comfort
B) Initiate oxygen therapy to maintain oxygen saturation above 90%
C) Place the infant in a flat supine position to facilitate breathing
D) Restrict fluids to prevent pulmonary edema
E) Administer antibiotics immediately as ordered
CORRECT ANSWER: B) Initiate oxygen therapy to maintain oxygen saturation
above 90%
Bronchiolitis is a viral infection that causes bronchiolar inflammation and airway
obstruction. The priority intervention is to maintain adequate oxygenation as
evidenced by the low oxygen saturation of 88%. Oxygen therapy should be initiated
to keep saturation above 90%. While fever management is important, it is not the
priority. Positioning should be elevated, not flat. Fluids should be maintained for
hydration as infants with bronchiolitis are at risk for dehydration. Antibiotics are
not routinely used for viral bronchiolitis.
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QUESTION 3
,A 4-year-old child with asthma presents to the clinic with complaints of
frequent nighttime coughing and shortness of breath during play. The parent
reports this occurs about 2-3 times per week. How would you classify the
severity of this child's asthma?
A) Intermittent asthma
B) Mild persistent asthma
C) Moderate persistent asthma
D) Severe persistent asthma
E) Acute asthma exacerbation
CORRECT ANSWER: B) Mild persistent asthma
Asthma classification is based on frequency of symptoms and nighttime
awakenings. Mild persistent asthma occurs more than 2 days per week but not
daily, with nighttime symptoms 3-4 times per month. This child has symptoms 2-3
times per week with some nighttime symptoms, which is consistent with mild
persistent asthma. Intermittent asthma occurs less than 2 days per week with
minimal nighttime symptoms. Moderate persistent asthma occurs daily with
nighttime awakenings more than once per week. Severe persistent asthma occurs
throughout the day with frequent nighttime symptoms.
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QUESTION 4
A 7-year-old child is diagnosed with acute leukemia and presents with fever,
petechiae, and hepatosplenomegaly. The child's hemoglobin is 7 g/dL,
platelets are 15,000/mm³, and WBC is 150,000/mm³. Which of the following is
the primary concern for this child?
A) Infection due to leukopenia
B) Bleeding due to thrombocytopenia
C) Anemia-related fatigue and weakness
, D) Pain from splenomegaly
E) Hyperleukocytosis and leukostasis
CORRECT ANSWER: B) Bleeding due to thrombocytopenia
While all options present risks in leukemia, the critically low platelet count of
15,000/mm³ places this child at immediate risk for spontaneous bleeding. Platelet
counts below 20,000/mm³ significantly increase bleeding risk. Although the WBC is
markedly elevated, the presence of petechiae indicates active bleeding is already
occurring. While infection is a concern, the immediate life-threatening issue is
uncontrolled bleeding. Pain management and anemia treatment are important but
not the primary immediate concern.
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QUESTION 5
A 3-year-old child with sickle cell disease presents to the emergency
department with severe bone pain, fever of 38.9°C, and abdominal pain.
Which of the following is the most likely diagnosis?
A) Acute chest syndrome
B) Vaso-occlusive crisis
C) Splenic sequestration
D) Aplastic crisis
E) Priapism
CORRECT ANSWER: B) Vaso-occlusive crisis
Vaso-occlusive crisis is the most common acute complication of sickle cell disease,
characterized by severe bone pain, fever, and can include abdominal pain when
mesenteric vessels are occluded. The presentation of bone pain with fever is classic
for this crisis. Acute chest syndrome presents primarily with chest pain and
respiratory symptoms. Splenic sequestration occurs in younger children with rapid
2026/2027 | NGN PRACTICE QUESTIONS,
VERIFIED ANSWERS & DETAILED
RATIONALES | COMPLETE PEDIATRIC
NURSING STUDY GUIDE
ATI RN PEDIATRIC PROCTORED EXAM 2026/2027 - COMPLETE STUDY GUIDE
• This comprehensive study material contains 200 practice questions designed to
prepare you for the ATI RN Pediatric Proctored Exam with detailed rationales
explaining each correct answer and clinical reasoning behind it.
• Use this guide by completing questions daily, reviewing rationales thoroughly, and
focusing on areas where you score lowest to maximize retention and exam
readiness.
====================================================================
===========
QUESTION 1
A 2-year-old child is brought to the emergency department with a
temperature of 39.5°C, barky cough, and inspiratory stridor. The child has a
respiratory rate of 32 breaths per minute. Which of the following findings
would be most consistent with croup?
A) High fever, drooling, difficulty swallowing, tripod position
B) Barky seal-like cough, inspiratory stridor, low-grade fever
C) Wheezing, accessory muscle use, hyperinflation on chest X-ray
D) Cough with thick purulent sputum, consolidation on chest X-ray
E) Rapid onset of severe respiratory distress, epiglottitis appearance
CORRECT ANSWER: B) Barky seal-like cough, inspiratory stridor, low-grade
fever
Croup (laryngotracheobronchitis) is characterized by a distinctive barky, seal-like
cough with inspiratory stridor caused by subglottic edema. While fever can be
present, it is typically low-grade. Option A describes epiglottitis which presents with
,high fever, drooling, and dysphagia. Option C describes asthma or bronchiolitis with
wheezing. Option D suggests bacterial pneumonia. Option E describes severe
epiglottitis. The classic presentation of croup includes the pathognomonic barky
cough and inspiratory stridor.
====================================================================
===========
QUESTION 2
A 6-month-old infant is admitted with bronchiolitis. The infant has a
respiratory rate of 58 breaths per minute, intercostal and subcostal
retractions, and oxygen saturation of 88% on room air. What is the priority
nursing intervention?
A) Administer antipyretics to reduce fever and increase comfort
B) Initiate oxygen therapy to maintain oxygen saturation above 90%
C) Place the infant in a flat supine position to facilitate breathing
D) Restrict fluids to prevent pulmonary edema
E) Administer antibiotics immediately as ordered
CORRECT ANSWER: B) Initiate oxygen therapy to maintain oxygen saturation
above 90%
Bronchiolitis is a viral infection that causes bronchiolar inflammation and airway
obstruction. The priority intervention is to maintain adequate oxygenation as
evidenced by the low oxygen saturation of 88%. Oxygen therapy should be initiated
to keep saturation above 90%. While fever management is important, it is not the
priority. Positioning should be elevated, not flat. Fluids should be maintained for
hydration as infants with bronchiolitis are at risk for dehydration. Antibiotics are
not routinely used for viral bronchiolitis.
====================================================================
===========
QUESTION 3
,A 4-year-old child with asthma presents to the clinic with complaints of
frequent nighttime coughing and shortness of breath during play. The parent
reports this occurs about 2-3 times per week. How would you classify the
severity of this child's asthma?
A) Intermittent asthma
B) Mild persistent asthma
C) Moderate persistent asthma
D) Severe persistent asthma
E) Acute asthma exacerbation
CORRECT ANSWER: B) Mild persistent asthma
Asthma classification is based on frequency of symptoms and nighttime
awakenings. Mild persistent asthma occurs more than 2 days per week but not
daily, with nighttime symptoms 3-4 times per month. This child has symptoms 2-3
times per week with some nighttime symptoms, which is consistent with mild
persistent asthma. Intermittent asthma occurs less than 2 days per week with
minimal nighttime symptoms. Moderate persistent asthma occurs daily with
nighttime awakenings more than once per week. Severe persistent asthma occurs
throughout the day with frequent nighttime symptoms.
====================================================================
===========
QUESTION 4
A 7-year-old child is diagnosed with acute leukemia and presents with fever,
petechiae, and hepatosplenomegaly. The child's hemoglobin is 7 g/dL,
platelets are 15,000/mm³, and WBC is 150,000/mm³. Which of the following is
the primary concern for this child?
A) Infection due to leukopenia
B) Bleeding due to thrombocytopenia
C) Anemia-related fatigue and weakness
, D) Pain from splenomegaly
E) Hyperleukocytosis and leukostasis
CORRECT ANSWER: B) Bleeding due to thrombocytopenia
While all options present risks in leukemia, the critically low platelet count of
15,000/mm³ places this child at immediate risk for spontaneous bleeding. Platelet
counts below 20,000/mm³ significantly increase bleeding risk. Although the WBC is
markedly elevated, the presence of petechiae indicates active bleeding is already
occurring. While infection is a concern, the immediate life-threatening issue is
uncontrolled bleeding. Pain management and anemia treatment are important but
not the primary immediate concern.
====================================================================
===========
QUESTION 5
A 3-year-old child with sickle cell disease presents to the emergency
department with severe bone pain, fever of 38.9°C, and abdominal pain.
Which of the following is the most likely diagnosis?
A) Acute chest syndrome
B) Vaso-occlusive crisis
C) Splenic sequestration
D) Aplastic crisis
E) Priapism
CORRECT ANSWER: B) Vaso-occlusive crisis
Vaso-occlusive crisis is the most common acute complication of sickle cell disease,
characterized by severe bone pain, fever, and can include abdominal pain when
mesenteric vessels are occluded. The presentation of bone pain with fever is classic
for this crisis. Acute chest syndrome presents primarily with chest pain and
respiratory symptoms. Splenic sequestration occurs in younger children with rapid
