ATI RN PEDIATRIC NURSING 2026
PROCTORED EXAM STUDY GUIDE
Question 1
A nurse is assessing a 6-month-old infant. Which finding should the nurse
recognize as an expected developmental milestone?
A. Walks independently
B. Uses a pincer grasp
C. Rolls from abdomen to back
D. Uses two-word phrases
Answer: _C. Rolls from abdomen to back_
Rationale: Rolling is an expected gross-motor milestone during infancy.
Independent walking, a pincer grasp, and two-word phrases generally occur later
in development.
Question 2
A nurse is providing teaching to the parents of a child with iron-deficiency anemia.
Which food should the nurse recommend as a good source of dietary iron?
A. Applesauce
B. White rice
C. Lean beef
D. Whole milk
Answer: _C. Lean beef_
Rationale: Lean meats provide heme iron, which is absorbed more efficiently than
nonheme iron found in plant-based foods.
Question 3
A nurse is caring for a child who has suspected epiglottitis. Which action should
the nurse take?
,A. Inspect the child's throat with a tongue blade
B. Obtain a throat culture immediately
C. Keep the child calm and prepare for airway management
D. Place the child in a supine position
Answer: _C. Keep the child calm and prepare for airway management_
Rationale: Epiglottitis can cause rapid airway obstruction. The child should be
kept calm, and equipment and personnel for emergency airway management
should be readily available. Throat manipulation can precipitate complete airway
obstruction.
Question 4
A nurse is teaching the parent of a child who has asthma about using a metered-
dose inhaler with a spacer. Which instruction should the nurse include?
A. Inhale rapidly after activating the inhaler
B. Exhale immediately after inhaling the medication
C. Shake the inhaler before administering the medication
D. Take several puffs simultaneously
Answer: _C. Shake the inhaler before administering the medication_
Rationale: The inhaler should be shaken before use to properly mix the
medication. The child should inhale slowly and deeply through the spacer and
follow the prescribed interval between puffs.
Question 5
A nurse is assessing a child with dehydration. Which finding should the nurse
expect?
A. Bounding peripheral pulses
B. Increased urine output
C. Dry mucous membranes
D. Increased skin turgor
Answer: _C. Dry mucous membranes_
,Rationale: Dehydration commonly causes dry mucous membranes, decreased
urine output, poor skin turgor, tachycardia, and other signs of reduced circulating
volume.
Question 6
A nurse is caring for a child with nephrotic syndrome. Which finding should the
nurse expect?
A. Generalized edema
B. Hemoptysis
C. Severe hypertension in every case
D. Increased serum albumin
Answer: _A. Generalized edema**_
Rationale: Nephrotic syndrome causes significant protein loss through the kidneys,
resulting in hypoalbuminemia and edema. Proteinuria is a characteristic finding.
Question 7
A nurse is providing discharge teaching to the parents of a child with bacterial
meningitis. Which instruction is most important?
A. Restrict all fluids
B. Complete the prescribed antimicrobial therapy
C. Encourage strenuous exercise
D. Stop medications when the fever resolves
Answer: _B. Complete the prescribed antimicrobial therapy**_
Rationale: Bacterial meningitis requires prompt and complete antimicrobial
treatment. Stopping therapy prematurely can contribute to treatment failure and
complications.
Question 8
A nurse is caring for a toddler who has gastroenteritis. Which intervention is
appropriate?
, A. Offer large amounts of water at once
B. Provide oral rehydration solution in small, frequent amounts
C. Withhold fluids until vomiting stops completely
D. Give carbonated beverages frequently
Answer: _B. Provide oral rehydration solution in small, frequent amounts**_
Rationale: Small, frequent amounts of an appropriate oral rehydration solution
help replace water and electrolytes while reducing the likelihood of triggering
additional vomiting.
Question 9
A nurse is assessing a child who has tetralogy of Fallot and develops a
hypercyanotic episode. Which position should the nurse place the child in?
A. Supine
B. Trendelenburg
C. Knee-chest
D. Prone
Answer: _C. Knee-chest**_
Rationale: The knee-chest position increases systemic vascular resistance and can
reduce right-to-left shunting, improving pulmonary blood flow and oxygenation
during a hypercyanotic episode.
Question 10
A nurse is administering digoxin to an infant. Which finding should cause the
nurse to withhold the medication and notify the provider?
A. Heart rate below the prescribed pediatric parameter
B. Respiratory rate of 30/min
C. Temperature of 37°C (98.6°F)
D. Blood pressure within the expected range
Answer: _A. Heart rate below the prescribed pediatric parameter**_
PROCTORED EXAM STUDY GUIDE
Question 1
A nurse is assessing a 6-month-old infant. Which finding should the nurse
recognize as an expected developmental milestone?
A. Walks independently
B. Uses a pincer grasp
C. Rolls from abdomen to back
D. Uses two-word phrases
Answer: _C. Rolls from abdomen to back_
Rationale: Rolling is an expected gross-motor milestone during infancy.
Independent walking, a pincer grasp, and two-word phrases generally occur later
in development.
Question 2
A nurse is providing teaching to the parents of a child with iron-deficiency anemia.
Which food should the nurse recommend as a good source of dietary iron?
A. Applesauce
B. White rice
C. Lean beef
D. Whole milk
Answer: _C. Lean beef_
Rationale: Lean meats provide heme iron, which is absorbed more efficiently than
nonheme iron found in plant-based foods.
Question 3
A nurse is caring for a child who has suspected epiglottitis. Which action should
the nurse take?
,A. Inspect the child's throat with a tongue blade
B. Obtain a throat culture immediately
C. Keep the child calm and prepare for airway management
D. Place the child in a supine position
Answer: _C. Keep the child calm and prepare for airway management_
Rationale: Epiglottitis can cause rapid airway obstruction. The child should be
kept calm, and equipment and personnel for emergency airway management
should be readily available. Throat manipulation can precipitate complete airway
obstruction.
Question 4
A nurse is teaching the parent of a child who has asthma about using a metered-
dose inhaler with a spacer. Which instruction should the nurse include?
A. Inhale rapidly after activating the inhaler
B. Exhale immediately after inhaling the medication
C. Shake the inhaler before administering the medication
D. Take several puffs simultaneously
Answer: _C. Shake the inhaler before administering the medication_
Rationale: The inhaler should be shaken before use to properly mix the
medication. The child should inhale slowly and deeply through the spacer and
follow the prescribed interval between puffs.
Question 5
A nurse is assessing a child with dehydration. Which finding should the nurse
expect?
A. Bounding peripheral pulses
B. Increased urine output
C. Dry mucous membranes
D. Increased skin turgor
Answer: _C. Dry mucous membranes_
,Rationale: Dehydration commonly causes dry mucous membranes, decreased
urine output, poor skin turgor, tachycardia, and other signs of reduced circulating
volume.
Question 6
A nurse is caring for a child with nephrotic syndrome. Which finding should the
nurse expect?
A. Generalized edema
B. Hemoptysis
C. Severe hypertension in every case
D. Increased serum albumin
Answer: _A. Generalized edema**_
Rationale: Nephrotic syndrome causes significant protein loss through the kidneys,
resulting in hypoalbuminemia and edema. Proteinuria is a characteristic finding.
Question 7
A nurse is providing discharge teaching to the parents of a child with bacterial
meningitis. Which instruction is most important?
A. Restrict all fluids
B. Complete the prescribed antimicrobial therapy
C. Encourage strenuous exercise
D. Stop medications when the fever resolves
Answer: _B. Complete the prescribed antimicrobial therapy**_
Rationale: Bacterial meningitis requires prompt and complete antimicrobial
treatment. Stopping therapy prematurely can contribute to treatment failure and
complications.
Question 8
A nurse is caring for a toddler who has gastroenteritis. Which intervention is
appropriate?
, A. Offer large amounts of water at once
B. Provide oral rehydration solution in small, frequent amounts
C. Withhold fluids until vomiting stops completely
D. Give carbonated beverages frequently
Answer: _B. Provide oral rehydration solution in small, frequent amounts**_
Rationale: Small, frequent amounts of an appropriate oral rehydration solution
help replace water and electrolytes while reducing the likelihood of triggering
additional vomiting.
Question 9
A nurse is assessing a child who has tetralogy of Fallot and develops a
hypercyanotic episode. Which position should the nurse place the child in?
A. Supine
B. Trendelenburg
C. Knee-chest
D. Prone
Answer: _C. Knee-chest**_
Rationale: The knee-chest position increases systemic vascular resistance and can
reduce right-to-left shunting, improving pulmonary blood flow and oxygenation
during a hypercyanotic episode.
Question 10
A nurse is administering digoxin to an infant. Which finding should cause the
nurse to withhold the medication and notify the provider?
A. Heart rate below the prescribed pediatric parameter
B. Respiratory rate of 30/min
C. Temperature of 37°C (98.6°F)
D. Blood pressure within the expected range
Answer: _A. Heart rate below the prescribed pediatric parameter**_
