ATI PEDS FINAL. QUESTIONS AND ANSWERS
2023/2026. GRADED A+
Core Domains
1. Growth and Development Milestones (Infancy through Adolescence)
2. Health Promotion, Immunizations, and Preventive Care
3. Pediatric Assessment and Physical Examination
4. Pediatric Respiratory Disorders
5. Pediatric Cardiovascular Disorders
6. Pediatric Gastrointestinal and Genitourinary Disorders
7. Pediatric Neurological and Musculoskeletal Disorders
8. Pediatric Endocrine and Hematologic Disorders
9. Pediatric Pharmacology and Medication Safety
10. Safety, Injury Prevention, and Family-Centered Care
Introduction
This comprehensive examination assesses the clinical knowledge and decision-making skills
of nursing students preparing for the ATI Pediatric Nursing Final Proctored Assessment.
The assessment evaluates proficiency in growth and development, pediatric assessment,
respiratory and cardiovascular disorders, gastrointestinal and genitourinary conditions,
neurological and musculoskeletal care, and medication safety. Multiple-choice and scenario-
based questions emphasize real-world application, critical thinking, and safe clinical
judgment essential for professional pediatric nursing practice. Content aligns with the ATI
RN Nursing Care of Children test blueprint and NCLEX-PN test plan, ensuring rigorous
preparation for contemporary clinical challenges.
SECTION ONE: QUESTIONS 1–100
1. 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. Pneumonia
,B. Tension pneumothorax
C. Atelectasis
D. Pleural effusion
B. Tension pneumothorax
RATIONALE: Absence of breath sounds on one side with tracheal deviation away from
the affected side is the classic presentation of tension pneumothorax, a life-threatening
emergency requiring immediate chest decompression.
2. 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 warm compress to the sac
D. Perform range-of-motion exercises to the lower extremities
A. Palpate the abdomen for bladder distension
RATIONALE: Infants with myelomeningocele are at risk for neurogenic bladder and
urinary retention. Palpating the abdomen for bladder distension helps detect this
complication.
3. 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. Insert the catheter until resistance is met, then pull back 1 cm
B. Apply suction continuously while inserting the catheter
C. Remove the catheter while applying intermittent suction
D. Hyperoxygenate with 100% oxygen for 5 minutes before suctioning
C. Remove the catheter while applying intermittent suction
RATIONALE: Suction should be applied intermittently only while withdrawing the
catheter to minimize mucosal trauma and hypoxia.
4. 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. Moro reflex
B. Babinski reflex
C. Stepping reflex
D. Tonic neck reflex
B. Babinski reflex
RATIONALE: The Babinski reflex is normally present until approximately 12 months of
age. The Moro, stepping, and tonic neck reflexes typically disappear by 3–4 months.
5. A nurse is providing teaching to an adolescent who has a fiberglass arm cast.
Which of the following instructions should the nurse include in the teaching?
A. Place a plastic bag over the cast when showering
B. Use a cotton swab to scratch inside the cast
C. Apply powder to the skin around the cast edges
D. Remove the cast at night to allow the skin to breathe
A. Place a plastic bag over the cast when showering
RATIONALE: A plastic bag protects the cast from moisture during showering. Nothing
should be placed inside the cast, and the cast must remain in place continuously.
6. A nurse is teaching a group of parents and guardians about otitis media. Which
of the following should the nurse identify as a risk factor for this illness?
A. Breastfeeding
B. Passive smoking
C. Immunizations
D. Frequent hand washing
B. Passive smoking
RATIONALE: Exposure to secondhand smoke is a significant risk factor for otitis media
due to impaired Eustachian tube function and increased susceptibility to infection.
7. A nurse is providing teaching about immunizations to the parents of a severely
immunocompromised child who has human immunodeficiency virus (HIV). Which
of the following statements should the nurse include in the teaching?
, A. "Your child should not receive any vaccines."
B. "The pneumococcal and influenza vaccines are recommended for your child."
C. "Live attenuated vaccines are safe for your child."
D. "Your child should receive the MMR vaccine immediately."
B. "The pneumococcal and influenza vaccines are recommended for your child."
RATIONALE: Inactivated vaccines such as pneumococcal and influenza vaccines are
safe and recommended for immunocompromised children. Live vaccines are
contraindicated.
8. A nurse in an emergency department is assessing an infant who has
laryngotracheobronchitis. Which of the following findings should the nurse report
as an indication of impending airway obstruction?
A. Barking cough
B. Nasal flaring
C. Low-grade fever
D. Hoarse voice
B. Nasal flaring
RATIONALE: Nasal flaring is an early sign of respiratory distress and impending airway
obstruction in infants with croup.
9. A nurse is assessing a 6-year-old child who is immediately postoperative
following a tonsillectomy. Which of the following findings should the nurse report
to the provider?
A. The child is swallowing frequently
B. The child reports mild throat pain
C. The child has a heart rate of 100/min
D. The child is drowsy but arousable
A. The child is swallowing frequently
RATIONALE: Frequent swallowing is a sign of bleeding at the surgical site. The nurse
should report this immediately.
2023/2026. GRADED A+
Core Domains
1. Growth and Development Milestones (Infancy through Adolescence)
2. Health Promotion, Immunizations, and Preventive Care
3. Pediatric Assessment and Physical Examination
4. Pediatric Respiratory Disorders
5. Pediatric Cardiovascular Disorders
6. Pediatric Gastrointestinal and Genitourinary Disorders
7. Pediatric Neurological and Musculoskeletal Disorders
8. Pediatric Endocrine and Hematologic Disorders
9. Pediatric Pharmacology and Medication Safety
10. Safety, Injury Prevention, and Family-Centered Care
Introduction
This comprehensive examination assesses the clinical knowledge and decision-making skills
of nursing students preparing for the ATI Pediatric Nursing Final Proctored Assessment.
The assessment evaluates proficiency in growth and development, pediatric assessment,
respiratory and cardiovascular disorders, gastrointestinal and genitourinary conditions,
neurological and musculoskeletal care, and medication safety. Multiple-choice and scenario-
based questions emphasize real-world application, critical thinking, and safe clinical
judgment essential for professional pediatric nursing practice. Content aligns with the ATI
RN Nursing Care of Children test blueprint and NCLEX-PN test plan, ensuring rigorous
preparation for contemporary clinical challenges.
SECTION ONE: QUESTIONS 1–100
1. 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. Pneumonia
,B. Tension pneumothorax
C. Atelectasis
D. Pleural effusion
B. Tension pneumothorax
RATIONALE: Absence of breath sounds on one side with tracheal deviation away from
the affected side is the classic presentation of tension pneumothorax, a life-threatening
emergency requiring immediate chest decompression.
2. 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 warm compress to the sac
D. Perform range-of-motion exercises to the lower extremities
A. Palpate the abdomen for bladder distension
RATIONALE: Infants with myelomeningocele are at risk for neurogenic bladder and
urinary retention. Palpating the abdomen for bladder distension helps detect this
complication.
3. 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. Insert the catheter until resistance is met, then pull back 1 cm
B. Apply suction continuously while inserting the catheter
C. Remove the catheter while applying intermittent suction
D. Hyperoxygenate with 100% oxygen for 5 minutes before suctioning
C. Remove the catheter while applying intermittent suction
RATIONALE: Suction should be applied intermittently only while withdrawing the
catheter to minimize mucosal trauma and hypoxia.
4. 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. Moro reflex
B. Babinski reflex
C. Stepping reflex
D. Tonic neck reflex
B. Babinski reflex
RATIONALE: The Babinski reflex is normally present until approximately 12 months of
age. The Moro, stepping, and tonic neck reflexes typically disappear by 3–4 months.
5. A nurse is providing teaching to an adolescent who has a fiberglass arm cast.
Which of the following instructions should the nurse include in the teaching?
A. Place a plastic bag over the cast when showering
B. Use a cotton swab to scratch inside the cast
C. Apply powder to the skin around the cast edges
D. Remove the cast at night to allow the skin to breathe
A. Place a plastic bag over the cast when showering
RATIONALE: A plastic bag protects the cast from moisture during showering. Nothing
should be placed inside the cast, and the cast must remain in place continuously.
6. A nurse is teaching a group of parents and guardians about otitis media. Which
of the following should the nurse identify as a risk factor for this illness?
A. Breastfeeding
B. Passive smoking
C. Immunizations
D. Frequent hand washing
B. Passive smoking
RATIONALE: Exposure to secondhand smoke is a significant risk factor for otitis media
due to impaired Eustachian tube function and increased susceptibility to infection.
7. A nurse is providing teaching about immunizations to the parents of a severely
immunocompromised child who has human immunodeficiency virus (HIV). Which
of the following statements should the nurse include in the teaching?
, A. "Your child should not receive any vaccines."
B. "The pneumococcal and influenza vaccines are recommended for your child."
C. "Live attenuated vaccines are safe for your child."
D. "Your child should receive the MMR vaccine immediately."
B. "The pneumococcal and influenza vaccines are recommended for your child."
RATIONALE: Inactivated vaccines such as pneumococcal and influenza vaccines are
safe and recommended for immunocompromised children. Live vaccines are
contraindicated.
8. A nurse in an emergency department is assessing an infant who has
laryngotracheobronchitis. Which of the following findings should the nurse report
as an indication of impending airway obstruction?
A. Barking cough
B. Nasal flaring
C. Low-grade fever
D. Hoarse voice
B. Nasal flaring
RATIONALE: Nasal flaring is an early sign of respiratory distress and impending airway
obstruction in infants with croup.
9. A nurse is assessing a 6-year-old child who is immediately postoperative
following a tonsillectomy. Which of the following findings should the nurse report
to the provider?
A. The child is swallowing frequently
B. The child reports mild throat pain
C. The child has a heart rate of 100/min
D. The child is drowsy but arousable
A. The child is swallowing frequently
RATIONALE: Frequent swallowing is a sign of bleeding at the surgical site. The nurse
should report this immediately.
