NR 328: ATI Pediatrics Proctored Exam Prep 2026/2027
with Detailed Rationales
Course Code: NR 328
Course Name: Pediatric Nursing
Topic: Comprehensive Pediatric Care, Safe Dosage, and Congenital Pathologies
Academic Year: 2026/2027
1. A nurse is completing an admission assessment on an adolescent child who
is a vegetarian. He eats milk products but does not like beans. Which of the
following items should the nurse suggest the client order for lunch to provide
nutrients most likely to be lacking in his diet?
A. Grilled Cheese Sandwich
B. Peanut Butter and Jelly Sandwich
C. Vegetable Salad with French Dressing
D. White Rice and Steamed Broccoli
CORRECT ANSWER: B
RATIONALE: A peanut butter and jelly sandwich provides a complete
combination of plant-based protein, caloric density, and essential amino acids that
are frequently deficient in a vegetarian diet that excludes legumes. Peanuts serve as
an excellent alternative source of protein, zinc, and iron for growing adolescents
who dislike beans or refuse meat. The alternative menu options fail to deliver a
substantive amount of protein to support adolescent growth milestones.
2. A nurse is caring for a 1-month-old infant who weighs 3540 g and is
prescribed a dose of cefazolin 50 mg/kg IV bolus TID. How many mg should
the nurse administer per dose?
A. 50 mg
B. 177 mg
C. 531 mg
D. 1770 mg
CORRECT ANSWER: B
RATIONALE: To calculate the accurate individual dose, first convert the
infant's weight from grams to kilograms: 3540 g = 3.54 kg. Next, multiply the
,calculated weight by the prescribed individual dose parameter: 3.54 kg × 50 mg/kg
= 177 mg per dose. While the "TID" frequency modifier dictates that this
medication will be given three times per day, the precise mass administered during
a single bolus event is 177 mg.
3. A nurse is performing a pre-college assessment on an adolescent. Which of
the following immunizations should the nurse anticipate administering?
A. Pneumococcal conjugate vaccine
B. Meningococcal polysaccharide vaccine
C. Rotavirus vaccine
D. Inactivated poliovirus vaccine
CORRECT ANSWER: B
RATIONALE: The meningococcal polysaccharide or conjugate vaccine is
highly recommended and routinely mandated for older adolescents transitioning
into high-density communal living environments like college dormitories, where
the transmission rate of Neisseria meningitidis is elevated. Pneumococcal and polio
series are completed during early childhood, and the rotavirus vaccine series is
strictly restricted to infants younger than 8 months of age.
4. A nurse is assessing a client who has left-sided heart failure. Which of the
following findings should the nurse expect?
A. Jugular venous distention
B. Nocturia at night
C. Hepatomegaly
D. Splenomegaly
CORRECT ANSWER: B
RATIONALE: Nocturia occurs in left-sided heart failure because when the
client assumes a recumbent position at night, fluid accumulated in the lower
extremities fluidly shifts back into the central circulatory system. This increases
renal perfusion and subsequent urine production. Conversely, jugular venous
distention, hepatomegaly, and splenomegaly are systemic congestion indicators
unique to right-sided heart failure.
5. A nurse is caring for a client who has active TB and is to be started on IV
rifampin therapy. The nurse should instruct the client that this medication
can cause which of the following adverse effects?
, A. Permanent hearing loss
B. Peripheral neuropathy
C. Body secretions turning a red-orange color
D. Severe muscle cramping
CORRECT ANSWER: C
RATIONALE: Rifampin characteristically causes a benign but potentially
alarming side effect where body secretions (including urine, saliva, tears, and
sweat) turn a red-orange color. The nurse must proactively educate the client
about this effect to prevent unnecessary panic. Aminoglycosides cause ototoxicity,
and isoniazid (INH) is primarily linked to peripheral neuropathy.
6. A nurse is caring for a 6-week-old infant who has pyloric stenosis. Which of
the following manifestations should the nurse expect?
A. Bile-stained vomitus
B. Projectile vomiting
C. Chronic diarrhea
D. Absent bowel sounds
CORRECT ANSWER: B
RATIONALE: The classic clinical hallmark of pyloric stenosis is projectile
vomiting, which occurs forcefully and immediately after feedings due to severe
muscular hypertrophy blocking food passage into the small intestine. This vomitus
is explicitly non-bilious (lacks bile) because the structural obstruction is proximal
to the ampulla of Vater where bile enters the gastrointestinal tract.
7. A nurse receives a call from a parent of a child who has von Willebrand
disease and is having a nosebleed. Which of the following instructions should
the nurse give to the parents?
A. "Have your child lie flat on her back with a warm cloth on her forehead."
B. "Have your child sit with her head tilted forward and hold pressure on her
nose for 10 minutes."
C. "Tilt your child's head backward and pack the nostrils with cotton gauze."
D. "Instruct your child to blow her nose vigorously to clear out any blood clots."
CORRECT ANSWER: B
RATIONALE: For a child with an underlying bleeding diathesis like von
Willebrand disease experiencing epistaxis, the parent must have the child sit
with Detailed Rationales
Course Code: NR 328
Course Name: Pediatric Nursing
Topic: Comprehensive Pediatric Care, Safe Dosage, and Congenital Pathologies
Academic Year: 2026/2027
1. A nurse is completing an admission assessment on an adolescent child who
is a vegetarian. He eats milk products but does not like beans. Which of the
following items should the nurse suggest the client order for lunch to provide
nutrients most likely to be lacking in his diet?
A. Grilled Cheese Sandwich
B. Peanut Butter and Jelly Sandwich
C. Vegetable Salad with French Dressing
D. White Rice and Steamed Broccoli
CORRECT ANSWER: B
RATIONALE: A peanut butter and jelly sandwich provides a complete
combination of plant-based protein, caloric density, and essential amino acids that
are frequently deficient in a vegetarian diet that excludes legumes. Peanuts serve as
an excellent alternative source of protein, zinc, and iron for growing adolescents
who dislike beans or refuse meat. The alternative menu options fail to deliver a
substantive amount of protein to support adolescent growth milestones.
2. A nurse is caring for a 1-month-old infant who weighs 3540 g and is
prescribed a dose of cefazolin 50 mg/kg IV bolus TID. How many mg should
the nurse administer per dose?
A. 50 mg
B. 177 mg
C. 531 mg
D. 1770 mg
CORRECT ANSWER: B
RATIONALE: To calculate the accurate individual dose, first convert the
infant's weight from grams to kilograms: 3540 g = 3.54 kg. Next, multiply the
,calculated weight by the prescribed individual dose parameter: 3.54 kg × 50 mg/kg
= 177 mg per dose. While the "TID" frequency modifier dictates that this
medication will be given three times per day, the precise mass administered during
a single bolus event is 177 mg.
3. A nurse is performing a pre-college assessment on an adolescent. Which of
the following immunizations should the nurse anticipate administering?
A. Pneumococcal conjugate vaccine
B. Meningococcal polysaccharide vaccine
C. Rotavirus vaccine
D. Inactivated poliovirus vaccine
CORRECT ANSWER: B
RATIONALE: The meningococcal polysaccharide or conjugate vaccine is
highly recommended and routinely mandated for older adolescents transitioning
into high-density communal living environments like college dormitories, where
the transmission rate of Neisseria meningitidis is elevated. Pneumococcal and polio
series are completed during early childhood, and the rotavirus vaccine series is
strictly restricted to infants younger than 8 months of age.
4. A nurse is assessing a client who has left-sided heart failure. Which of the
following findings should the nurse expect?
A. Jugular venous distention
B. Nocturia at night
C. Hepatomegaly
D. Splenomegaly
CORRECT ANSWER: B
RATIONALE: Nocturia occurs in left-sided heart failure because when the
client assumes a recumbent position at night, fluid accumulated in the lower
extremities fluidly shifts back into the central circulatory system. This increases
renal perfusion and subsequent urine production. Conversely, jugular venous
distention, hepatomegaly, and splenomegaly are systemic congestion indicators
unique to right-sided heart failure.
5. A nurse is caring for a client who has active TB and is to be started on IV
rifampin therapy. The nurse should instruct the client that this medication
can cause which of the following adverse effects?
, A. Permanent hearing loss
B. Peripheral neuropathy
C. Body secretions turning a red-orange color
D. Severe muscle cramping
CORRECT ANSWER: C
RATIONALE: Rifampin characteristically causes a benign but potentially
alarming side effect where body secretions (including urine, saliva, tears, and
sweat) turn a red-orange color. The nurse must proactively educate the client
about this effect to prevent unnecessary panic. Aminoglycosides cause ototoxicity,
and isoniazid (INH) is primarily linked to peripheral neuropathy.
6. A nurse is caring for a 6-week-old infant who has pyloric stenosis. Which of
the following manifestations should the nurse expect?
A. Bile-stained vomitus
B. Projectile vomiting
C. Chronic diarrhea
D. Absent bowel sounds
CORRECT ANSWER: B
RATIONALE: The classic clinical hallmark of pyloric stenosis is projectile
vomiting, which occurs forcefully and immediately after feedings due to severe
muscular hypertrophy blocking food passage into the small intestine. This vomitus
is explicitly non-bilious (lacks bile) because the structural obstruction is proximal
to the ampulla of Vater where bile enters the gastrointestinal tract.
7. A nurse receives a call from a parent of a child who has von Willebrand
disease and is having a nosebleed. Which of the following instructions should
the nurse give to the parents?
A. "Have your child lie flat on her back with a warm cloth on her forehead."
B. "Have your child sit with her head tilted forward and hold pressure on her
nose for 10 minutes."
C. "Tilt your child's head backward and pack the nostrils with cotton gauze."
D. "Instruct your child to blow her nose vigorously to clear out any blood clots."
CORRECT ANSWER: B
RATIONALE: For a child with an underlying bleeding diathesis like von
Willebrand disease experiencing epistaxis, the parent must have the child sit
