ATI Care of Children RN 2026/2027 Proctored Exam - Level 3!. Peds
2026/2027. All 70 Questions with the Answers Higlighted
EXAM
1. During a high-priority assessment, the practitioner must select the best answer. A child with
suspected appendicitis reports increasing right-lower-quadrant pain; which nursing action is
most appropriate?
A. apply repeated deep abdominal massage
B. provide a large meal
✓ C. keep the child NPO and prepare for further evaluation
D. encourage vigorous exercise
Rationale: NPO status supports preparation for possible surgery or procedures, while deep palpation can
increase discomfort and is inappropriate.
2. During a high-priority assessment, careful prioritization is required. A child receives an oral
medication and vomits immediately afterward; what should the nurse do first?
A. discard the medication record
B. double the next scheduled dose
✓ C. determine the medication, timing, amount vomited, and specific redosing instructions
D. automatically repeat every dose
Rationale: Redosing depends on the drug, formulation, timing, and amount retained, so assessment is needed
before repeating it.
3. During a high-priority assessment, a child with type 1 diabetes becomes sweaty, shaky, and
confused; which problem should the nurse suspect first?
✓ A. hypoglycemia
B. appendicitis
C. dehydration only
, D. hypercalcemia
Rationale: Shakiness, sweating, and altered mental status are common manifestations of hypoglycemia and
require prompt treatment.
4. During a high-priority assessment, the practitioner must select the best answer. A child with
asthma develops wheezing and increased work of breathing; which assessment finding
indicates worsening respiratory distress?
A. normal activity tolerance
B. quiet comfortable breathing
✓ C. retractions with difficulty speaking in complete sentences
D. clear speech without dyspnea
Rationale: Retractions and impaired speech indicate increased respiratory effort and potentially severe airway
obstruction.
5. During a high-priority assessment, careful prioritization is required. A parent asks how to
reduce medication errors at home; which instruction is safest?
A. use kitchen spoons for all liquid medications
B. estimate doses by eye
✓ C. use an oral syringe and verify the dose each time using the prescribed concentration
D. combine medicines into one unlabeled container
Rationale: An oral syringe improves dose accuracy, and concentration should be verified because liquid
medications may have different strengths.
6. During a high-priority assessment, a child with sickle cell disease has severe pain during a
vaso-occlusive episode; which intervention is appropriate?
✓ A. provide prescribed analgesia, hydration, oxygen when indicated, and rest
B. encourage strenuous exercise
C. restrict fluids routinely
D. withhold pain medication until discharge
,Rationale: Vaso-occlusive episodes require prompt pain management and supportive care, including hydration
and oxygen when clinically indicated.
7. During a high-priority assessment, the practitioner must select the best answer. A child with
bacterial meningitis is receiving treatment; which finding requires urgent reassessment?
✓ A. new seizure activity or declining level of consciousness
B. normal sleep
C. improved appetite
D. stable temperature with improved behavior
Rationale: Seizures and declining consciousness can signal serious neurologic complications and require
immediate reassessment.
8. During a high-priority assessment, careful prioritization is required. A child with croup has a
barking cough and inspiratory stridor; which action is most appropriate?
A. encourage crying
B. force the child to lie flat
C. inspect the throat repeatedly
✓ D. keep the child calm and provide prescribed airway-supportive treatment
Rationale: Agitation can worsen upper-airway obstruction, so maintaining calm and providing appropriate
treatment are priorities.
9. During a high-priority assessment, a child with acute gastroenteritis has reduced urine
output and dry mucous membranes; which finding best indicates worsening dehydration?
✓ A. increasing lethargy with weak peripheral pulses
B. normal urine output
C. increased tears
D. moist oral mucosa
Rationale: Lethargy and weak pulses indicate worsening volume depletion and possible circulatory compromise.
, 10. During a high-priority assessment, the practitioner must select the best answer. A child with
nephrotic syndrome develops generalized edema; which mechanism best explains the edema?
✓ A. loss of plasma protein in urine lowers oncotic pressure
B. increased bone density
C. isolated airway inflammation
D. excess red-cell production
Rationale: Protein loss in nephrotic syndrome reduces plasma oncotic pressure, promoting movement of fluid
into tissues.
11. A clinician is reviewing a new case when careful prioritization is required. A parent asks how
to reduce medication errors at home; which instruction is safest?
A. use kitchen spoons for all liquid medications
B. combine medicines into one unlabeled container
C. estimate doses by eye
✓ D. use an oral syringe and verify the dose each time using the prescribed concentration
Rationale: An oral syringe improves dose accuracy, and concentration should be verified because liquid
medications may have different strengths.
12. A clinician is reviewing a new case when a child with sickle cell disease has severe pain
during a vaso-occlusive episode; which intervention is appropriate?
✓ A. provide prescribed analgesia, hydration, oxygen when indicated, and rest
B. withhold pain medication until discharge
C. restrict fluids routinely
D. encourage strenuous exercise
Rationale: Vaso-occlusive episodes require prompt pain management and supportive care, including hydration
and oxygen when clinically indicated.
13. A clinician is reviewing a new case when the practitioner must select the best answer. A
child with acute gastroenteritis has reduced urine output and dry mucous membranes; which
finding best indicates worsening dehydration?
2026/2027. All 70 Questions with the Answers Higlighted
EXAM
1. During a high-priority assessment, the practitioner must select the best answer. A child with
suspected appendicitis reports increasing right-lower-quadrant pain; which nursing action is
most appropriate?
A. apply repeated deep abdominal massage
B. provide a large meal
✓ C. keep the child NPO and prepare for further evaluation
D. encourage vigorous exercise
Rationale: NPO status supports preparation for possible surgery or procedures, while deep palpation can
increase discomfort and is inappropriate.
2. During a high-priority assessment, careful prioritization is required. A child receives an oral
medication and vomits immediately afterward; what should the nurse do first?
A. discard the medication record
B. double the next scheduled dose
✓ C. determine the medication, timing, amount vomited, and specific redosing instructions
D. automatically repeat every dose
Rationale: Redosing depends on the drug, formulation, timing, and amount retained, so assessment is needed
before repeating it.
3. During a high-priority assessment, a child with type 1 diabetes becomes sweaty, shaky, and
confused; which problem should the nurse suspect first?
✓ A. hypoglycemia
B. appendicitis
C. dehydration only
, D. hypercalcemia
Rationale: Shakiness, sweating, and altered mental status are common manifestations of hypoglycemia and
require prompt treatment.
4. During a high-priority assessment, the practitioner must select the best answer. A child with
asthma develops wheezing and increased work of breathing; which assessment finding
indicates worsening respiratory distress?
A. normal activity tolerance
B. quiet comfortable breathing
✓ C. retractions with difficulty speaking in complete sentences
D. clear speech without dyspnea
Rationale: Retractions and impaired speech indicate increased respiratory effort and potentially severe airway
obstruction.
5. During a high-priority assessment, careful prioritization is required. A parent asks how to
reduce medication errors at home; which instruction is safest?
A. use kitchen spoons for all liquid medications
B. estimate doses by eye
✓ C. use an oral syringe and verify the dose each time using the prescribed concentration
D. combine medicines into one unlabeled container
Rationale: An oral syringe improves dose accuracy, and concentration should be verified because liquid
medications may have different strengths.
6. During a high-priority assessment, a child with sickle cell disease has severe pain during a
vaso-occlusive episode; which intervention is appropriate?
✓ A. provide prescribed analgesia, hydration, oxygen when indicated, and rest
B. encourage strenuous exercise
C. restrict fluids routinely
D. withhold pain medication until discharge
,Rationale: Vaso-occlusive episodes require prompt pain management and supportive care, including hydration
and oxygen when clinically indicated.
7. During a high-priority assessment, the practitioner must select the best answer. A child with
bacterial meningitis is receiving treatment; which finding requires urgent reassessment?
✓ A. new seizure activity or declining level of consciousness
B. normal sleep
C. improved appetite
D. stable temperature with improved behavior
Rationale: Seizures and declining consciousness can signal serious neurologic complications and require
immediate reassessment.
8. During a high-priority assessment, careful prioritization is required. A child with croup has a
barking cough and inspiratory stridor; which action is most appropriate?
A. encourage crying
B. force the child to lie flat
C. inspect the throat repeatedly
✓ D. keep the child calm and provide prescribed airway-supportive treatment
Rationale: Agitation can worsen upper-airway obstruction, so maintaining calm and providing appropriate
treatment are priorities.
9. During a high-priority assessment, a child with acute gastroenteritis has reduced urine
output and dry mucous membranes; which finding best indicates worsening dehydration?
✓ A. increasing lethargy with weak peripheral pulses
B. normal urine output
C. increased tears
D. moist oral mucosa
Rationale: Lethargy and weak pulses indicate worsening volume depletion and possible circulatory compromise.
, 10. During a high-priority assessment, the practitioner must select the best answer. A child with
nephrotic syndrome develops generalized edema; which mechanism best explains the edema?
✓ A. loss of plasma protein in urine lowers oncotic pressure
B. increased bone density
C. isolated airway inflammation
D. excess red-cell production
Rationale: Protein loss in nephrotic syndrome reduces plasma oncotic pressure, promoting movement of fluid
into tissues.
11. A clinician is reviewing a new case when careful prioritization is required. A parent asks how
to reduce medication errors at home; which instruction is safest?
A. use kitchen spoons for all liquid medications
B. combine medicines into one unlabeled container
C. estimate doses by eye
✓ D. use an oral syringe and verify the dose each time using the prescribed concentration
Rationale: An oral syringe improves dose accuracy, and concentration should be verified because liquid
medications may have different strengths.
12. A clinician is reviewing a new case when a child with sickle cell disease has severe pain
during a vaso-occlusive episode; which intervention is appropriate?
✓ A. provide prescribed analgesia, hydration, oxygen when indicated, and rest
B. withhold pain medication until discharge
C. restrict fluids routinely
D. encourage strenuous exercise
Rationale: Vaso-occlusive episodes require prompt pain management and supportive care, including hydration
and oxygen when clinically indicated.
13. A clinician is reviewing a new case when the practitioner must select the best answer. A
child with acute gastroenteritis has reduced urine output and dry mucous membranes; which
finding best indicates worsening dehydration?
