ATI RN PEDIATRIC NURSING ONLINE
PRACTICE 2026 B | QUESTIONS & ANSWERS
STUDY GUIDE
• This comprehensive 200-question study guide is designed to prepare you for the
ATI RN Pediatric Nursing Online Practice 2026 B exam through evidence-based,
high-yield questions covering all core pediatric nursing competencies.
• Study this material by working through questions systematically, reviewing
detailed rationales for both correct and incorrect answers to solidify clinical
knowledge and decision-making skills for pediatric patient care scenarios.
Question 1
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute
lymphoblastic leukemia (ALL). The mother asks the nurse what caused this disease.
What is the most appropriate response by the nurse?
A) Leukemia is caused by poor nutrition and lack of exercise in young children.
B) The cause of childhood leukemia is unknown, but it is not inherited from parents
and is not contagious.
C) Leukemia develops because of excessive sun exposure during infancy.
D) This condition results from untreated infections that were not managed during
early childhood.
E) Leukemia is caused by genetic mutations passed down from family members on
both sides.
✓ CORRECT ANSWER: B) The cause of childhood leukemia is unknown, but it is
not inherited from parents and is not contagious.
RATIONALE: The etiology of childhood leukemia remains largely unknown. Most
cases are not hereditary or contagious, and they cannot be prevented through
lifestyle modifications. While genetic factors may play a role in rare familial cases,
most acute lymphoblastic leukemia occurs sporadically. It is essential for nurses to
provide accurate information to reduce parental guilt and anxiety.
,Question 2
A 2-year-old toddler presents to the emergency department with severe
dehydration secondary to acute diarrhea. Which clinical manifestation would the
nurse expect to observe in a child with severe dehydration?
A) Moist mucous membranes and a blood pressure within normal limits for age.
B) Slightly delayed capillary refill, mild tachycardia, and dry mucous membranes.
C) Sunken fontanel, decreased urine output, and poor skin turgor with delayed
capillary refill greater than 2 seconds.
D) Normal skin turgor, alert mental status, and tears present when crying.
E) Bradycardia, hypertension, and cool extremities with bounding pulses.
✓ CORRECT ANSWER: C) Sunken fontanel, decreased urine output, and poor
skin turgor with delayed capillary refill greater than 2 seconds.
RATIONALE: Severe dehydration in a 2-year-old is characterized by significant fluid
loss resulting in multiple clinical signs. A sunken fontanel indicates significant fluid
loss in young children whose fontanels have not yet closed. Poor skin turgor (skin
tenting), decreased urine output, and capillary refill greater than 2 seconds are
classic indicators of severe dehydration. The child's mental status may also be
altered, and mucous membranes will be dry.
Question 3
A 6-year-old child with cystic fibrosis is scheduled for chest physiotherapy. The
nurse is explaining the procedure to the child. What is the primary purpose of chest
physiotherapy in a child with cystic fibrosis?
A) To provide pain relief and improve the child's comfort level during
hospitalization.
,B) To mobilize and drain secretions from the airways to prevent respiratory
complications and improve gas exchange.
C) To strengthen the child's cardiac muscle and improve cardiovascular function.
D) To replace the function of the pancreas and improve nutritional absorption.
E) To eliminate the genetic mutation that causes cystic fibrosis.
✓ CORRECT ANSWER: B) To mobilize and drain secretions from the airways to
prevent respiratory complications and improve gas exchange.
RATIONALE: Chest physiotherapy, including postural drainage, percussion, and
vibration, is a cornerstone of cystic fibrosis management. The primary goal is to
mobilize thick, tenacious secretions that accumulate in the airways due to
abnormal mucus production. By facilitating drainage of these secretions, chest
physiotherapy reduces airway obstruction, improves ventilation and gas exchange,
and helps prevent respiratory infections and complications. This must be
performed regularly as part of the child's care regimen.
Question 4
A nurse is caring for a 3-month-old infant with congenital heart disease who is
scheduled for cardiac catheterization. Which nursing action is most appropriate in
the immediate postprocedure period?
A) Encourage the infant to move freely and engage in vigorous play activities to
promote circulation.
B) Keep the infant on strict bed rest with the affected extremity immobilized to
prevent bleeding and ensure catheter site integrity.
C) Immediately feed the infant formula to restore energy and promote healing.
D) Administer aspirin to the infant to prevent blood clots at the catheter site.
E) Allow the infant to resume normal feeding and activities within one hour after
the procedure.
, ✓ CORRECT ANSWER: B) Keep the infant on strict bed rest with the affected
extremity immobilized to prevent bleeding and ensure catheter site integrity.
RATIONALE: Following cardiac catheterization, the child must remain on bed rest
with the affected extremity immobilized to prevent disruption of the catheter site
and subsequent bleeding complications. Vital signs must be monitored closely, and
the catheter site must be regularly assessed for signs of bleeding, hematoma
formation, or infection. The nurse should maintain the affected leg in full extension
and avoid bending at the hip or knee. Vigorous activity is contraindicated, and the
child should be kept calm to prevent increased cardiac workload.
Question 5
A 5-year-old child is admitted with suspected epiglottitis. Which assessment finding
would most concern the nurse and warrant immediate intervention?
A) Mild fever of 100.5°F (38.1°C) and a runny nose.
B) The child sitting upright in a tripod position, drooling, and appearing anxious
with stridor.
C) Complaints of a sore throat and intermittent coughing.
D) A red throat on visualization and difficulty swallowing clear liquids.
E) Nasal congestion and a productive cough with clear secretions.
✓ CORRECT ANSWER: B) The child sitting upright in a tripod position, drooling,
and appearing anxious with stridor.
RATIONALE: Epiglottitis is a medical emergency. The classic presentation includes
the child assuming a tripod position (sitting upright, leaning forward), drooling (due
to difficulty swallowing), and respiratory distress with stridor. The child typically
appears ill and anxious. This position allows maximum airway patency. The nurse
should never attempt to visualize the throat or take a tongue blade approach, as
this can precipitate complete airway obstruction. The child needs immediate airway
PRACTICE 2026 B | QUESTIONS & ANSWERS
STUDY GUIDE
• This comprehensive 200-question study guide is designed to prepare you for the
ATI RN Pediatric Nursing Online Practice 2026 B exam through evidence-based,
high-yield questions covering all core pediatric nursing competencies.
• Study this material by working through questions systematically, reviewing
detailed rationales for both correct and incorrect answers to solidify clinical
knowledge and decision-making skills for pediatric patient care scenarios.
Question 1
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute
lymphoblastic leukemia (ALL). The mother asks the nurse what caused this disease.
What is the most appropriate response by the nurse?
A) Leukemia is caused by poor nutrition and lack of exercise in young children.
B) The cause of childhood leukemia is unknown, but it is not inherited from parents
and is not contagious.
C) Leukemia develops because of excessive sun exposure during infancy.
D) This condition results from untreated infections that were not managed during
early childhood.
E) Leukemia is caused by genetic mutations passed down from family members on
both sides.
✓ CORRECT ANSWER: B) The cause of childhood leukemia is unknown, but it is
not inherited from parents and is not contagious.
RATIONALE: The etiology of childhood leukemia remains largely unknown. Most
cases are not hereditary or contagious, and they cannot be prevented through
lifestyle modifications. While genetic factors may play a role in rare familial cases,
most acute lymphoblastic leukemia occurs sporadically. It is essential for nurses to
provide accurate information to reduce parental guilt and anxiety.
,Question 2
A 2-year-old toddler presents to the emergency department with severe
dehydration secondary to acute diarrhea. Which clinical manifestation would the
nurse expect to observe in a child with severe dehydration?
A) Moist mucous membranes and a blood pressure within normal limits for age.
B) Slightly delayed capillary refill, mild tachycardia, and dry mucous membranes.
C) Sunken fontanel, decreased urine output, and poor skin turgor with delayed
capillary refill greater than 2 seconds.
D) Normal skin turgor, alert mental status, and tears present when crying.
E) Bradycardia, hypertension, and cool extremities with bounding pulses.
✓ CORRECT ANSWER: C) Sunken fontanel, decreased urine output, and poor
skin turgor with delayed capillary refill greater than 2 seconds.
RATIONALE: Severe dehydration in a 2-year-old is characterized by significant fluid
loss resulting in multiple clinical signs. A sunken fontanel indicates significant fluid
loss in young children whose fontanels have not yet closed. Poor skin turgor (skin
tenting), decreased urine output, and capillary refill greater than 2 seconds are
classic indicators of severe dehydration. The child's mental status may also be
altered, and mucous membranes will be dry.
Question 3
A 6-year-old child with cystic fibrosis is scheduled for chest physiotherapy. The
nurse is explaining the procedure to the child. What is the primary purpose of chest
physiotherapy in a child with cystic fibrosis?
A) To provide pain relief and improve the child's comfort level during
hospitalization.
,B) To mobilize and drain secretions from the airways to prevent respiratory
complications and improve gas exchange.
C) To strengthen the child's cardiac muscle and improve cardiovascular function.
D) To replace the function of the pancreas and improve nutritional absorption.
E) To eliminate the genetic mutation that causes cystic fibrosis.
✓ CORRECT ANSWER: B) To mobilize and drain secretions from the airways to
prevent respiratory complications and improve gas exchange.
RATIONALE: Chest physiotherapy, including postural drainage, percussion, and
vibration, is a cornerstone of cystic fibrosis management. The primary goal is to
mobilize thick, tenacious secretions that accumulate in the airways due to
abnormal mucus production. By facilitating drainage of these secretions, chest
physiotherapy reduces airway obstruction, improves ventilation and gas exchange,
and helps prevent respiratory infections and complications. This must be
performed regularly as part of the child's care regimen.
Question 4
A nurse is caring for a 3-month-old infant with congenital heart disease who is
scheduled for cardiac catheterization. Which nursing action is most appropriate in
the immediate postprocedure period?
A) Encourage the infant to move freely and engage in vigorous play activities to
promote circulation.
B) Keep the infant on strict bed rest with the affected extremity immobilized to
prevent bleeding and ensure catheter site integrity.
C) Immediately feed the infant formula to restore energy and promote healing.
D) Administer aspirin to the infant to prevent blood clots at the catheter site.
E) Allow the infant to resume normal feeding and activities within one hour after
the procedure.
, ✓ CORRECT ANSWER: B) Keep the infant on strict bed rest with the affected
extremity immobilized to prevent bleeding and ensure catheter site integrity.
RATIONALE: Following cardiac catheterization, the child must remain on bed rest
with the affected extremity immobilized to prevent disruption of the catheter site
and subsequent bleeding complications. Vital signs must be monitored closely, and
the catheter site must be regularly assessed for signs of bleeding, hematoma
formation, or infection. The nurse should maintain the affected leg in full extension
and avoid bending at the hip or knee. Vigorous activity is contraindicated, and the
child should be kept calm to prevent increased cardiac workload.
Question 5
A 5-year-old child is admitted with suspected epiglottitis. Which assessment finding
would most concern the nurse and warrant immediate intervention?
A) Mild fever of 100.5°F (38.1°C) and a runny nose.
B) The child sitting upright in a tripod position, drooling, and appearing anxious
with stridor.
C) Complaints of a sore throat and intermittent coughing.
D) A red throat on visualization and difficulty swallowing clear liquids.
E) Nasal congestion and a productive cough with clear secretions.
✓ CORRECT ANSWER: B) The child sitting upright in a tripod position, drooling,
and appearing anxious with stridor.
RATIONALE: Epiglottitis is a medical emergency. The classic presentation includes
the child assuming a tripod position (sitting upright, leaning forward), drooling (due
to difficulty swallowing), and respiratory distress with stridor. The child typically
appears ill and anxious. This position allows maximum airway patency. The nurse
should never attempt to visualize the throat or take a tongue blade approach, as
this can precipitate complete airway obstruction. The child needs immediate airway
