2026 ATI PEDIATRICS ACTUAL EXAM 121 QUESTION AND
CORRECT DETAILED ANSWERS WITH RATIONALES RATED A
GRADE.
A nurse in a provider's office is preparing to administer immunizations to a
toddler during a well-child visit. Which of the following actions should the
nurse plan to take?
A. Withhold the MMR vaccine.
B. Administer the MMR vaccine.
C. Administer the varicella vaccine.
D. Withhold the DTaP vaccine.
Correct Answer: A. Withhold the MMR vaccine.
Rationale
The MMR (measles, mumps, rubella) vaccine may be withheld if the toddler
has a severe allergy to gelatin or neomycin, is immunocompromised, or has a
moderate to severe acute illness. The nurse should verify that there are no
contraindications before administering any vaccine. The varicella vaccine is
typically administered at 12-15 months of age, and DTaP is also administered
during the toddler years.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
A nurse is teaching the parent of an infant who has a Pavlik harness for the
treatment of developmental dysplasia of the hip. The nurse should identify
that which of the following statements by the parents indicates an
understanding of the teaching?
A. "I will place my infant's diapers under the harness straps."
B. "I will place my infant's diapers over the harness straps."
,C. "I will remove the harness for 2 hours each day."
D. "I will place the harness over a single layer of clothing."
Correct Answer: A. "I will place my infant's diapers under the harness straps."
Rationale
Diapers should be placed under the harness straps to prevent skin breakdown
and soiling of the harness. The harness should be worn continuously and
should not be removed without provider instruction. It should be applied
directly to the skin or over a thin layer of clothing to prevent skin irritation.
DIF: Cognitive Level: Evaluate (Evaluation)
TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
A nurse is planning care for a toddler who has a serum lead level of 4 mcg/dL.
Which of the following actions should the nurse plan to take?
A. Schedule the toddler for a yearly rescreening.
B. Initiate chelation therapy.
C. Refer the family to social services.
D. Admit the toddler to the hospital.
Correct Answer: A. Schedule the toddler for a yearly rescreening.
Rationale
A serum lead level of 4 mcg/dL is below the Centers for Disease Control and
Prevention (CDC) reference level of 5 mcg/dL. The recommended action is to
schedule the child for yearly rescreening and provide education on lead
poisoning prevention. Chelation therapy is not indicated at this level.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
,After reviewing the information in the child's medical record, which of the
following findings should the nurse report to the provider? Select 4.
A. Arterial blood gases
B. WBC count
C. Oxygen saturation
D. Respiratory assessment
E. Heart rate
F. Temperature
Correct Answer: A, B, C, D
Rationale
Arterial blood gases, WBC count, oxygen saturation, and respiratory
assessment are critical findings that may indicate respiratory compromise or
infection. These findings should be reported to the provider for further
evaluation and intervention.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A nurse is caring for a 15-year-old client who is married and is scheduled for a
surgical procedure. The client asks, "Who should sign my surgical consent?"
Which of the following responses should the nurse make?
A. "You can sign the consent form because you are married."
B. "Your parents need to sign the consent form."
C. "Your spouse needs to sign the consent form."
D. "The provider will sign the consent form."
Correct Answer: A. "You can sign the consent form because you are married."
Rationale
Emancipated minors, including married adolescents, have the legal right to
consent to their own medical treatment. The client can sign the surgical
consent form without parental or spousal consent.
, DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
A nurse is teaching a school-age child who has a new diagnosis of type 1
diabetes mellitus. Which of the following statements by the child indicates an
understanding of the teaching?
A. "I will give myself a shot of regular insulin 30 minutes before I eat breakfast."
B. "I will give myself a shot of regular insulin immediately after I eat breakfast."
C. "I will give myself a shot of NPH insulin 30 minutes before I eat breakfast."
D. "I will give myself a shot of NPH insulin immediately after I eat breakfast."
Correct Answer: A. "I will give myself a shot of regular insulin 30 minutes
before I eat breakfast."
Rationale
Regular insulin should be administered 30 minutes before meals to align with
the onset of action and prevent hyperglycemia. NPH insulin is typically given
with breakfast and dinner, but the timing differs from regular insulin.
DIF: Cognitive Level: Evaluate (Evaluation)
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
A charge nurse in an emergency department is preparing an inservice for a
group of newly licensed nurses about the manifestations of child
maltreatment. Which of the following manifestations should the charge nurse
include as a potential indication of physical abuse?
A. Symmetric burns of the lower extremities
B. Abrasions on the knees
C. Bruises on the shins
D. A single bruise on the forehead
CORRECT DETAILED ANSWERS WITH RATIONALES RATED A
GRADE.
A nurse in a provider's office is preparing to administer immunizations to a
toddler during a well-child visit. Which of the following actions should the
nurse plan to take?
A. Withhold the MMR vaccine.
B. Administer the MMR vaccine.
C. Administer the varicella vaccine.
D. Withhold the DTaP vaccine.
Correct Answer: A. Withhold the MMR vaccine.
Rationale
The MMR (measles, mumps, rubella) vaccine may be withheld if the toddler
has a severe allergy to gelatin or neomycin, is immunocompromised, or has a
moderate to severe acute illness. The nurse should verify that there are no
contraindications before administering any vaccine. The varicella vaccine is
typically administered at 12-15 months of age, and DTaP is also administered
during the toddler years.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
A nurse is teaching the parent of an infant who has a Pavlik harness for the
treatment of developmental dysplasia of the hip. The nurse should identify
that which of the following statements by the parents indicates an
understanding of the teaching?
A. "I will place my infant's diapers under the harness straps."
B. "I will place my infant's diapers over the harness straps."
,C. "I will remove the harness for 2 hours each day."
D. "I will place the harness over a single layer of clothing."
Correct Answer: A. "I will place my infant's diapers under the harness straps."
Rationale
Diapers should be placed under the harness straps to prevent skin breakdown
and soiling of the harness. The harness should be worn continuously and
should not be removed without provider instruction. It should be applied
directly to the skin or over a thin layer of clothing to prevent skin irritation.
DIF: Cognitive Level: Evaluate (Evaluation)
TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
A nurse is planning care for a toddler who has a serum lead level of 4 mcg/dL.
Which of the following actions should the nurse plan to take?
A. Schedule the toddler for a yearly rescreening.
B. Initiate chelation therapy.
C. Refer the family to social services.
D. Admit the toddler to the hospital.
Correct Answer: A. Schedule the toddler for a yearly rescreening.
Rationale
A serum lead level of 4 mcg/dL is below the Centers for Disease Control and
Prevention (CDC) reference level of 5 mcg/dL. The recommended action is to
schedule the child for yearly rescreening and provide education on lead
poisoning prevention. Chelation therapy is not indicated at this level.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
,After reviewing the information in the child's medical record, which of the
following findings should the nurse report to the provider? Select 4.
A. Arterial blood gases
B. WBC count
C. Oxygen saturation
D. Respiratory assessment
E. Heart rate
F. Temperature
Correct Answer: A, B, C, D
Rationale
Arterial blood gases, WBC count, oxygen saturation, and respiratory
assessment are critical findings that may indicate respiratory compromise or
infection. These findings should be reported to the provider for further
evaluation and intervention.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A nurse is caring for a 15-year-old client who is married and is scheduled for a
surgical procedure. The client asks, "Who should sign my surgical consent?"
Which of the following responses should the nurse make?
A. "You can sign the consent form because you are married."
B. "Your parents need to sign the consent form."
C. "Your spouse needs to sign the consent form."
D. "The provider will sign the consent form."
Correct Answer: A. "You can sign the consent form because you are married."
Rationale
Emancipated minors, including married adolescents, have the legal right to
consent to their own medical treatment. The client can sign the surgical
consent form without parental or spousal consent.
, DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
A nurse is teaching a school-age child who has a new diagnosis of type 1
diabetes mellitus. Which of the following statements by the child indicates an
understanding of the teaching?
A. "I will give myself a shot of regular insulin 30 minutes before I eat breakfast."
B. "I will give myself a shot of regular insulin immediately after I eat breakfast."
C. "I will give myself a shot of NPH insulin 30 minutes before I eat breakfast."
D. "I will give myself a shot of NPH insulin immediately after I eat breakfast."
Correct Answer: A. "I will give myself a shot of regular insulin 30 minutes
before I eat breakfast."
Rationale
Regular insulin should be administered 30 minutes before meals to align with
the onset of action and prevent hyperglycemia. NPH insulin is typically given
with breakfast and dinner, but the timing differs from regular insulin.
DIF: Cognitive Level: Evaluate (Evaluation)
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
A charge nurse in an emergency department is preparing an inservice for a
group of newly licensed nurses about the manifestations of child
maltreatment. Which of the following manifestations should the charge nurse
include as a potential indication of physical abuse?
A. Symmetric burns of the lower extremities
B. Abrasions on the knees
C. Bruises on the shins
D. A single bruise on the forehead
