ATI PEDS FINAL EXAM QUESTIONS AND
CORRECT ANSWERS 2023/2026 | GRADED A+
Core Domains
1. Growth and Development Milestones
2. Pediatric Assessment and Health Promotion
3. Respiratory Disorders and Oxygenation
4. Cardiovascular and Hematologic Disorders
5. Gastrointestinal and Genitourinary Disorders
6. Endocrine and Metabolic Disorders
7. Neurologic, Musculoskeletal, and Sensory Disorders
8. Pharmacology and Medication Administration
9. Safety, Injury Prevention, and Infection Control
10. Family-Centered Care and Prioritization
Introduction
The ATI Pediatrics Final Examination is the comprehensive assessment designed to evaluate the
nursing student's mastery of pediatric nursing care across the continuum from infancy through
adolescence. This exam assesses the application of the nursing process in caring for children
with acute and chronic health conditions, with emphasis on growth and development, family-
centered care, and clinical judgment. The multiple-choice and scenario-based format requires
candidates to demonstrate critical thinking in prioritization, medication calculation, patient
education, and recognition of complications. This examination ensures students are prepared to
deliver safe, developmentally appropriate, and family-centered pediatric nursing care in diverse
clinical settings.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has a
current blood glucose level of 250 mg/dL. Which of the following actions should the nurse
take?
A. Administer 5% Dextrose in 0.9% sodium chloride by continuous IV infusion
B. Give potassium as rapid IV bolus
C. Administer 3 units of ultralente insulin subcutaneously
D. Obtain an HbA1c level stat
Correct Answer: A
RATIONALE: When a child with DKA reaches a blood glucose level of approximately 250
,mg/dL, the provider typically orders the addition of dextrose to the IV fluids to prevent
hypoglycemia while continuing insulin therapy to close the anion gap.
2. A nurse is caring for a child who has epistaxis. Which of the following actions should the
nurse take?
A. Apply a warm cloth to the bridge of the child's nose
B. Tilt the child's head back
C. Apply continuous pressure to the child's nose for at least 10 minutes
D. Administer aspirin for the child's pain
Correct Answer: C
RATIONALE: For epistaxis, the nurse should apply continuous pressure to the nose for at
least 10 minutes to promote clot formation. The child should sit upright and lean forward, not
tilt the head back.
3. A nurse is teaching the parents of a 3-year-old who has persistent otitis media about
prevention. Which of the following statements by the parents indicates an understanding of
the teaching?
A. "My child should not play around others who have ear infections."
B. "We should not smoke around our child."
C. "My child should not swim this summer."
D. "I will encourage my child to blow his nose forcefully when he has a cold."
Correct Answer: B
RATIONALE: Exposure to secondhand smoke is a major risk factor for otitis media.
Eliminating smoke exposure is an essential preventive measure.
4. A nurse is assessing the pain level of a 3-year-old who is postoperative following abdominal
surgery. Which of the following pain scales should the nurse use?
A. Word graphic rating scale
B. Color tool
C. FACES pain rating scale
D. Numeric scale
Correct Answer: C
RATIONALE: The FACES pain rating scale is appropriate for children ages 3 years and older. It
uses pictures of faces to help children describe their pain level.
,5. A nurse is caring for a child who has acute glomerulonephritis. Which of the following
actions should the nurse take?
A. Maintain the child on strict bed rest
B. Check the child's blood pressure every 4 hours
C. Administer albumin to the child every 8 hours
D. Provide the child with a low-carbohydrate diet
Correct Answer: B
RATIONALE: Acute glomerulonephritis can cause hypertension due to fluid retention. Blood
pressure should be monitored frequently to detect and manage hypertension.
6. A nurse on the pediatric unit is caring for a group of clients. Which of the following findings
should be the nurse's priority?
A. A child who has asthma and a pulse oximetry of 94%
B. A child who has nephrotic syndrome and 1+ protein on urine dipstick
C. A child who has sickle cell anemia and a urine specific gravity of 1.030
D. A child who has insulin-dependent diabetes mellitus and a fingerstick glucose reading of 110
mg/dL
Correct Answer: C
RATIONALE: A urine specific gravity of 1.030 indicates concentrated urine and possible
dehydration, which can precipitate a sickle cell crisis. This finding requires immediate
intervention.
7. A nurse is caring for a preschool-age child who has mucosal ulceration after receiving
chemotherapy. Which of the following actions should the nurse take?
A. Place viscous lidocaine on the child's oral lesions
B. Instruct the child to use a soft-sponge toothbrush when brushing her teeth
C. Encourage the child to rinse her mouth with hydrogen peroxide every 2-4 hours
D. Give the child lemon glycerin swabs to use after each meal
Correct Answer: B
RATIONALE: A soft-sponge toothbrush minimizes trauma to the oral mucosa. Viscous
lidocaine is not recommended for children due to risk of aspiration and systemic absorption.
8. A nurse is assessing an infant who develops respiratory distress, absence of breath sounds
on one side, and deviation of the trachea away from the affected side. Based on these
manifestations, which of the following conditions is the infant experiencing?
, A. Tension pneumothorax
B. Atelectasis
C. Pneumonia
D. Pleural effusion
Correct Answer: A
RATIONALE: Tension pneumothorax presents with respiratory distress, absent breath sounds
on the affected side, and tracheal deviation away from the affected side. This is a medical
emergency.
9. A nurse is planning care for an infant with an unrepaired myelomeningocele. Which of the
following actions should the nurse take?
A. Palpate the abdomen for bladder distension
B. Place the infant in a prone position
C. Apply a sterile, moist dressing to the sac
D. Perform range-of-motion exercises on the lower extremities
Correct Answer: A
RATIONALE: Infants with myelomeningocele often have neurogenic bladder and are at risk
for urinary retention. Palpating for bladder distension helps monitor for this complication.
10. A nurse is caring for a child who has a tracheostomy. Which of the following techniques
should the nurse use to suction the child's tracheostomy?
A. Remove the catheter while applying intermittent suction
B. Insert the catheter while applying continuous suction
C. Apply suction for no more than 15 seconds
D. Instill 5 mL of normal saline before suctioning
Correct Answer: A
RATIONALE: The nurse should remove the catheter while applying intermittent suction to
minimize mucosal trauma and hypoxia. Suction should be limited to 5-10 seconds.
11. A nurse is performing a physical assessment on a 6-month-old infant. Which of the
following reflexes should the nurse expect to find?
A. Babinski
B. Moro
C. Stepping
D. Tonic neck
CORRECT ANSWERS 2023/2026 | GRADED A+
Core Domains
1. Growth and Development Milestones
2. Pediatric Assessment and Health Promotion
3. Respiratory Disorders and Oxygenation
4. Cardiovascular and Hematologic Disorders
5. Gastrointestinal and Genitourinary Disorders
6. Endocrine and Metabolic Disorders
7. Neurologic, Musculoskeletal, and Sensory Disorders
8. Pharmacology and Medication Administration
9. Safety, Injury Prevention, and Infection Control
10. Family-Centered Care and Prioritization
Introduction
The ATI Pediatrics Final Examination is the comprehensive assessment designed to evaluate the
nursing student's mastery of pediatric nursing care across the continuum from infancy through
adolescence. This exam assesses the application of the nursing process in caring for children
with acute and chronic health conditions, with emphasis on growth and development, family-
centered care, and clinical judgment. The multiple-choice and scenario-based format requires
candidates to demonstrate critical thinking in prioritization, medication calculation, patient
education, and recognition of complications. This examination ensures students are prepared to
deliver safe, developmentally appropriate, and family-centered pediatric nursing care in diverse
clinical settings.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has a
current blood glucose level of 250 mg/dL. Which of the following actions should the nurse
take?
A. Administer 5% Dextrose in 0.9% sodium chloride by continuous IV infusion
B. Give potassium as rapid IV bolus
C. Administer 3 units of ultralente insulin subcutaneously
D. Obtain an HbA1c level stat
Correct Answer: A
RATIONALE: When a child with DKA reaches a blood glucose level of approximately 250
,mg/dL, the provider typically orders the addition of dextrose to the IV fluids to prevent
hypoglycemia while continuing insulin therapy to close the anion gap.
2. A nurse is caring for a child who has epistaxis. Which of the following actions should the
nurse take?
A. Apply a warm cloth to the bridge of the child's nose
B. Tilt the child's head back
C. Apply continuous pressure to the child's nose for at least 10 minutes
D. Administer aspirin for the child's pain
Correct Answer: C
RATIONALE: For epistaxis, the nurse should apply continuous pressure to the nose for at
least 10 minutes to promote clot formation. The child should sit upright and lean forward, not
tilt the head back.
3. A nurse is teaching the parents of a 3-year-old who has persistent otitis media about
prevention. Which of the following statements by the parents indicates an understanding of
the teaching?
A. "My child should not play around others who have ear infections."
B. "We should not smoke around our child."
C. "My child should not swim this summer."
D. "I will encourage my child to blow his nose forcefully when he has a cold."
Correct Answer: B
RATIONALE: Exposure to secondhand smoke is a major risk factor for otitis media.
Eliminating smoke exposure is an essential preventive measure.
4. A nurse is assessing the pain level of a 3-year-old who is postoperative following abdominal
surgery. Which of the following pain scales should the nurse use?
A. Word graphic rating scale
B. Color tool
C. FACES pain rating scale
D. Numeric scale
Correct Answer: C
RATIONALE: The FACES pain rating scale is appropriate for children ages 3 years and older. It
uses pictures of faces to help children describe their pain level.
,5. A nurse is caring for a child who has acute glomerulonephritis. Which of the following
actions should the nurse take?
A. Maintain the child on strict bed rest
B. Check the child's blood pressure every 4 hours
C. Administer albumin to the child every 8 hours
D. Provide the child with a low-carbohydrate diet
Correct Answer: B
RATIONALE: Acute glomerulonephritis can cause hypertension due to fluid retention. Blood
pressure should be monitored frequently to detect and manage hypertension.
6. A nurse on the pediatric unit is caring for a group of clients. Which of the following findings
should be the nurse's priority?
A. A child who has asthma and a pulse oximetry of 94%
B. A child who has nephrotic syndrome and 1+ protein on urine dipstick
C. A child who has sickle cell anemia and a urine specific gravity of 1.030
D. A child who has insulin-dependent diabetes mellitus and a fingerstick glucose reading of 110
mg/dL
Correct Answer: C
RATIONALE: A urine specific gravity of 1.030 indicates concentrated urine and possible
dehydration, which can precipitate a sickle cell crisis. This finding requires immediate
intervention.
7. A nurse is caring for a preschool-age child who has mucosal ulceration after receiving
chemotherapy. Which of the following actions should the nurse take?
A. Place viscous lidocaine on the child's oral lesions
B. Instruct the child to use a soft-sponge toothbrush when brushing her teeth
C. Encourage the child to rinse her mouth with hydrogen peroxide every 2-4 hours
D. Give the child lemon glycerin swabs to use after each meal
Correct Answer: B
RATIONALE: A soft-sponge toothbrush minimizes trauma to the oral mucosa. Viscous
lidocaine is not recommended for children due to risk of aspiration and systemic absorption.
8. A nurse is assessing an infant who develops respiratory distress, absence of breath sounds
on one side, and deviation of the trachea away from the affected side. Based on these
manifestations, which of the following conditions is the infant experiencing?
, A. Tension pneumothorax
B. Atelectasis
C. Pneumonia
D. Pleural effusion
Correct Answer: A
RATIONALE: Tension pneumothorax presents with respiratory distress, absent breath sounds
on the affected side, and tracheal deviation away from the affected side. This is a medical
emergency.
9. A nurse is planning care for an infant with an unrepaired myelomeningocele. Which of the
following actions should the nurse take?
A. Palpate the abdomen for bladder distension
B. Place the infant in a prone position
C. Apply a sterile, moist dressing to the sac
D. Perform range-of-motion exercises on the lower extremities
Correct Answer: A
RATIONALE: Infants with myelomeningocele often have neurogenic bladder and are at risk
for urinary retention. Palpating for bladder distension helps monitor for this complication.
10. A nurse is caring for a child who has a tracheostomy. Which of the following techniques
should the nurse use to suction the child's tracheostomy?
A. Remove the catheter while applying intermittent suction
B. Insert the catheter while applying continuous suction
C. Apply suction for no more than 15 seconds
D. Instill 5 mL of normal saline before suctioning
Correct Answer: A
RATIONALE: The nurse should remove the catheter while applying intermittent suction to
minimize mucosal trauma and hypoxia. Suction should be limited to 5-10 seconds.
11. A nurse is performing a physical assessment on a 6-month-old infant. Which of the
following reflexes should the nurse expect to find?
A. Babinski
B. Moro
C. Stepping
D. Tonic neck
