ORIGINAL ATI RN Pediatric Nursing 2026 Proctored Exam
ATI RN Pediatric Nursing 2026 Proctored Exam
A comprehensive 70-question practice test designed to mirror
the proctored exam format with detailed answer rationales.
Question 1 of 70
A nurse is providing teaching to the parents of a school-age child who has asthma. Which of
the following instructions should the nurse include in the teaching?
• Use a peak flow meter daily to monitor respiratory status.
• Administer the prescribed rescue inhaler 30 minutes before exercise.
• Withhold the daily inhaled corticosteroid when the child is feeling well.
• Encourage the child to take cough suppressants at night.
Correct Answer: Use a peak flow meter daily to monitor respiratory status.
Detailed Rationale:
• Correct Option: A peak flow meter measures the peak expiratory flow rate (PEFR), which
helps monitor airway function and identifies early signs of bronchoconstriction before
symptoms worsen. It is a crucial tool for managing asthma at home.
1
,ORIGINAL ATI RN Pediatric Nursing 2026 Proctored Exam
• Incorrect Options:
o Administer the prescribed rescue inhaler 30 minutes before exercise: A short-
acting beta-agonist (rescue inhaler) should be administered 15 to 20 minutes
prior to exercise, not 30 minutes, to prevent exercise-induced bronchospasm.
o Withhold the daily inhaled corticosteroid when the child is feeling well: Inhaled
corticosteroids are long-term controller medications. They must be administered
daily, even when the child is asymptomatic, to reduce airway inflammation and
prevent acute exacerbations.
o Encourage the child to take cough suppressants at night: Coughing is a protective
reflex that helps clear airways. Cough suppressants are generally contraindicated
in children with asthma because suppressing the cough can lead to mucus
plugging and worsening respiratory status.
Question 2 of 70
A nurse is planning care for a school-age child who has acute glomerulonephritis. Which of the
following interventions should the nurse include?
• Collect and strain all urine for sediment.
• Monitor blood pressure every 4 hr.
• Implement a protein-restricted diet.
• Increase fluid consumption.
Correct Answer: Monitor blood pressure every 4 hr.
Detailed Rationale:
• Correct Option: Acute glomerulonephritis causes fluid retention and sodium intravascular
accumulation due to decreased glomerular filtration, leading to hypertension. Frequent
monitoring of vital signs (especially blood pressure every 4 to 6 hours) is critical to detect
and manage hypertensive encephalopathy and cardiovascular complications.
2
,ORIGINAL ATI RN Pediatric Nursing 2026 Proctored Exam
• Incorrect Options:
o Collect and strain all urine for sediment: Straining urine for sediment is indicated
for suspected nephrolithiasis (kidney stones), not for glomerulonephritis.
o Implement a protein-restricted diet: Protein restriction is not recommended
unless the child has severe azotemia. Children require protein for growth and
tissue repair. Dietary management focuses on sodium and fluid restriction.
o Increase fluid consumption: Increasing fluids can exacerbate fluid retention,
hypertension, and edema. Fluids are typically restricted based on urine output
and insensible losses.
Question 3 of 70
A nurse is caring for a child who has a prescription for fluticasone and has developed white
patches and sores in his mouth. Which of the following is an appropriate action for the nurse
to take?
• Encourage the use of a spacer.
• Obtain a prescription for oral prednisone.
• Withhold the medication until the lesions heal.
• Collect a culture from the lesions.
Correct Answer: Encourage the use of a spacer.
Detailed Rationale:
• Correct Option: Fluticasone is an inhaled corticosteroid that can cause oral candidiasis
(thrush) as a side effect due to localized immunosuppression in the mouth. Using a spacer
reduces drug deposition in the oral cavity by directing more of the medication directly
into the lungs. The nurse should also teach the child to rinse the mouth thoroughly with
water after each use.
3
, ORIGINAL ATI RN Pediatric Nursing 2026 Proctored Exam
• Incorrect Options:
o Obtain a prescription for oral prednisone: Prednisone is a systemic corticosteroid
and would not treat the localized fungal infection; it could worsen the
immunosuppression.
o Withhold the medication until the lesions heal: Withholding the inhaled
corticosteroid could lead to an acute asthma exacerbation. The medication should
be continued while the thrush is treated with a topical antifungal.
o Collect a culture from the lesions: The visual presentation of white patches in a
child on inhaled corticosteroids is a classic sign of candidiasis. A culture is not the
immediate priority; implementing preventative measures (spacer, mouth rinsing)
and obtaining an antifungal prescription is.
Question 4 of 70
A nurse is planning care for a preschooler who has neutropenia. Which of the following
interventions should the nurse include in the plan?
• Bathe the child every other day.
• Obtain the child's rectal temperature once daily.
• Administer vaccines prior to discharge.
• Avoid raw fruits and vegetables in the child's diet.
Correct Answer: Avoid raw fruits and vegetables in the child's diet.
Detailed Rationale:
• Correct Option: Preschoolers with neutropenia have a severely suppressed immune
system, placing them at high risk for opportunistic infections. Raw fruits and vegetables
can harbor bacteria, molds, and parasites that cannot be entirely washed away;
therefore, a low-microbial (neutropenic) diet requiring all foods to be cooked is
recommended.
4
ATI RN Pediatric Nursing 2026 Proctored Exam
A comprehensive 70-question practice test designed to mirror
the proctored exam format with detailed answer rationales.
Question 1 of 70
A nurse is providing teaching to the parents of a school-age child who has asthma. Which of
the following instructions should the nurse include in the teaching?
• Use a peak flow meter daily to monitor respiratory status.
• Administer the prescribed rescue inhaler 30 minutes before exercise.
• Withhold the daily inhaled corticosteroid when the child is feeling well.
• Encourage the child to take cough suppressants at night.
Correct Answer: Use a peak flow meter daily to monitor respiratory status.
Detailed Rationale:
• Correct Option: A peak flow meter measures the peak expiratory flow rate (PEFR), which
helps monitor airway function and identifies early signs of bronchoconstriction before
symptoms worsen. It is a crucial tool for managing asthma at home.
1
,ORIGINAL ATI RN Pediatric Nursing 2026 Proctored Exam
• Incorrect Options:
o Administer the prescribed rescue inhaler 30 minutes before exercise: A short-
acting beta-agonist (rescue inhaler) should be administered 15 to 20 minutes
prior to exercise, not 30 minutes, to prevent exercise-induced bronchospasm.
o Withhold the daily inhaled corticosteroid when the child is feeling well: Inhaled
corticosteroids are long-term controller medications. They must be administered
daily, even when the child is asymptomatic, to reduce airway inflammation and
prevent acute exacerbations.
o Encourage the child to take cough suppressants at night: Coughing is a protective
reflex that helps clear airways. Cough suppressants are generally contraindicated
in children with asthma because suppressing the cough can lead to mucus
plugging and worsening respiratory status.
Question 2 of 70
A nurse is planning care for a school-age child who has acute glomerulonephritis. Which of the
following interventions should the nurse include?
• Collect and strain all urine for sediment.
• Monitor blood pressure every 4 hr.
• Implement a protein-restricted diet.
• Increase fluid consumption.
Correct Answer: Monitor blood pressure every 4 hr.
Detailed Rationale:
• Correct Option: Acute glomerulonephritis causes fluid retention and sodium intravascular
accumulation due to decreased glomerular filtration, leading to hypertension. Frequent
monitoring of vital signs (especially blood pressure every 4 to 6 hours) is critical to detect
and manage hypertensive encephalopathy and cardiovascular complications.
2
,ORIGINAL ATI RN Pediatric Nursing 2026 Proctored Exam
• Incorrect Options:
o Collect and strain all urine for sediment: Straining urine for sediment is indicated
for suspected nephrolithiasis (kidney stones), not for glomerulonephritis.
o Implement a protein-restricted diet: Protein restriction is not recommended
unless the child has severe azotemia. Children require protein for growth and
tissue repair. Dietary management focuses on sodium and fluid restriction.
o Increase fluid consumption: Increasing fluids can exacerbate fluid retention,
hypertension, and edema. Fluids are typically restricted based on urine output
and insensible losses.
Question 3 of 70
A nurse is caring for a child who has a prescription for fluticasone and has developed white
patches and sores in his mouth. Which of the following is an appropriate action for the nurse
to take?
• Encourage the use of a spacer.
• Obtain a prescription for oral prednisone.
• Withhold the medication until the lesions heal.
• Collect a culture from the lesions.
Correct Answer: Encourage the use of a spacer.
Detailed Rationale:
• Correct Option: Fluticasone is an inhaled corticosteroid that can cause oral candidiasis
(thrush) as a side effect due to localized immunosuppression in the mouth. Using a spacer
reduces drug deposition in the oral cavity by directing more of the medication directly
into the lungs. The nurse should also teach the child to rinse the mouth thoroughly with
water after each use.
3
, ORIGINAL ATI RN Pediatric Nursing 2026 Proctored Exam
• Incorrect Options:
o Obtain a prescription for oral prednisone: Prednisone is a systemic corticosteroid
and would not treat the localized fungal infection; it could worsen the
immunosuppression.
o Withhold the medication until the lesions heal: Withholding the inhaled
corticosteroid could lead to an acute asthma exacerbation. The medication should
be continued while the thrush is treated with a topical antifungal.
o Collect a culture from the lesions: The visual presentation of white patches in a
child on inhaled corticosteroids is a classic sign of candidiasis. A culture is not the
immediate priority; implementing preventative measures (spacer, mouth rinsing)
and obtaining an antifungal prescription is.
Question 4 of 70
A nurse is planning care for a preschooler who has neutropenia. Which of the following
interventions should the nurse include in the plan?
• Bathe the child every other day.
• Obtain the child's rectal temperature once daily.
• Administer vaccines prior to discharge.
• Avoid raw fruits and vegetables in the child's diet.
Correct Answer: Avoid raw fruits and vegetables in the child's diet.
Detailed Rationale:
• Correct Option: Preschoolers with neutropenia have a severely suppressed immune
system, placing them at high risk for opportunistic infections. Raw fruits and vegetables
can harbor bacteria, molds, and parasites that cannot be entirely washed away;
therefore, a low-microbial (neutropenic) diet requiring all foods to be cooked is
recommended.
4
