RN ATI PEDIATRIC ASSESSMENT
EXAM 2025 NGN QUESTIONS AND
ANSWERS WITH RATIONALE
LATEST VERSION
5 year old child presents to the ER with a fever of 103 with no other symptoms, what
should be on your differential? - ANSWER-UTI
bc peds pts often have no sx besides fever
adolescents - ANSWER-12-18 years
all medication for pediatrics is - ANSWER-weight-based dosing!!
,can get reasonable hx from patients in this age group - ANSWER-school-aged child (3-
12)
caregiver fatigue is a risk factor for - ANSWER-nonaccidental trauma
cause of viral croup - ANSWER-parainfluenza virus
causes of stridor < 6 months - ANSWER-Laryngotrachiomalacia
Vocal cord paralysis
Subglottic Stenosis
Airway Hemangioma
Vascular Ring
(anatomical / hereditary stuff)
causes of stridor > 6 months - ANSWER-Croup
Epiglotitis
Bacterial Tracheitis
Foreign body aspiration
Retropharyngeal abscess
(Infectious / accidental stuff)
chloride requirements per day for peds pts - ANSWER-5 mEq / kg / day
clinical features of bacteremia/sepsis - ANSWER-Febrile, Tachycardic, Hypotensive,
Lethargic, Toxic appearance
clinical features of meningitis - ANSWER-●Fever
●altered mental status / lethargy
●Headache
●nuchal rigidity
●petechial skin rash
●toxic appearance
Seizures
common causes of GI bowel obstructions in peds - ANSWER-volvulus, intussuseption,
pyloric stenosis
common organisms causing bacteremia/sepsis - ANSWER-group B strep, listeria, E.
coli
CSF analysis in bacterial meningitis - ANSWER-●White blood cells HIGH
(>10cells/mm3 in children, >30cells/mm3 in neonates)
●Gram Stain : + organisms seen
, ●Protein : HIGH (>80mg/dL)
●Glucose : LOW (less reliable indicator, however)
currant jelly stool is associated with what peds GI issue? - ANSWER-intussusception
daily fluid dosing for peds pt less than or equal to 10 kg - ANSWER-100 ml/kg
daily fluid dosing for peds pt more than 10 kg, but less than 20 kg - ANSWER-1000 ml +
50mL/(total weight - 10) kg/day
daily fluid dosing for peds pt more than 20 kg - ANSWER-1500 ml + 20 ml/total weight-
20)kg/day
diagnosis of FBA? - ANSWER-plain radiographs
bronchoscopy can be used if you don't find anything on XRs
diagnosis of Intussusception - ANSWER-- Plain film xray may show a mass or filling
defect in RLQ.
- Abdominal Ultrasound is highly sensitive and specific.
- Air pressure or barium enema is highly diagnostic.
diagnosis of otitis media - ANSWER-1. acute onset of symptoms < 48 hrs
2. middle ear effusion
3. middle ear inflammation
diagnosis of pna in peds - ANSWER-●Your careful History & Physical exam
●nasopharyngeal viral assays for RSV and Influenza- if they are positive you could
avoid exposing a non-toxic child to radiation.
●Chest Xray if needed to help narrow your differential diagnosis.
●Sputum and blood cultures- can help future care, but do not help in the emergency
setting.
diagnosis of pyloric stenosis - ANSWER-Observe child eating to confirm projectile
nature of vomiting. Ultrasound the abdomen and observe hypertrophic pylorus.
diagnostic studies for appendicitis in peds - ANSWER-U/S can be used to rule in
CT is most diagnostic
diagnostic studies for bacteremia/sepsis - ANSWER-blood cultures
Target approach to identifying source (UTI, Pneumonia, etc)
diagnostic studies for malrotation/volvulus - ANSWER-X-ray can show air fluid levels /
obstruction. CT scan is more diagnostic.
diagnostic studies for UTI in peds - ANSWER-urinalysis- leuk esterase + nitrates
urine culture ALWAYS
EXAM 2025 NGN QUESTIONS AND
ANSWERS WITH RATIONALE
LATEST VERSION
5 year old child presents to the ER with a fever of 103 with no other symptoms, what
should be on your differential? - ANSWER-UTI
bc peds pts often have no sx besides fever
adolescents - ANSWER-12-18 years
all medication for pediatrics is - ANSWER-weight-based dosing!!
,can get reasonable hx from patients in this age group - ANSWER-school-aged child (3-
12)
caregiver fatigue is a risk factor for - ANSWER-nonaccidental trauma
cause of viral croup - ANSWER-parainfluenza virus
causes of stridor < 6 months - ANSWER-Laryngotrachiomalacia
Vocal cord paralysis
Subglottic Stenosis
Airway Hemangioma
Vascular Ring
(anatomical / hereditary stuff)
causes of stridor > 6 months - ANSWER-Croup
Epiglotitis
Bacterial Tracheitis
Foreign body aspiration
Retropharyngeal abscess
(Infectious / accidental stuff)
chloride requirements per day for peds pts - ANSWER-5 mEq / kg / day
clinical features of bacteremia/sepsis - ANSWER-Febrile, Tachycardic, Hypotensive,
Lethargic, Toxic appearance
clinical features of meningitis - ANSWER-●Fever
●altered mental status / lethargy
●Headache
●nuchal rigidity
●petechial skin rash
●toxic appearance
Seizures
common causes of GI bowel obstructions in peds - ANSWER-volvulus, intussuseption,
pyloric stenosis
common organisms causing bacteremia/sepsis - ANSWER-group B strep, listeria, E.
coli
CSF analysis in bacterial meningitis - ANSWER-●White blood cells HIGH
(>10cells/mm3 in children, >30cells/mm3 in neonates)
●Gram Stain : + organisms seen
, ●Protein : HIGH (>80mg/dL)
●Glucose : LOW (less reliable indicator, however)
currant jelly stool is associated with what peds GI issue? - ANSWER-intussusception
daily fluid dosing for peds pt less than or equal to 10 kg - ANSWER-100 ml/kg
daily fluid dosing for peds pt more than 10 kg, but less than 20 kg - ANSWER-1000 ml +
50mL/(total weight - 10) kg/day
daily fluid dosing for peds pt more than 20 kg - ANSWER-1500 ml + 20 ml/total weight-
20)kg/day
diagnosis of FBA? - ANSWER-plain radiographs
bronchoscopy can be used if you don't find anything on XRs
diagnosis of Intussusception - ANSWER-- Plain film xray may show a mass or filling
defect in RLQ.
- Abdominal Ultrasound is highly sensitive and specific.
- Air pressure or barium enema is highly diagnostic.
diagnosis of otitis media - ANSWER-1. acute onset of symptoms < 48 hrs
2. middle ear effusion
3. middle ear inflammation
diagnosis of pna in peds - ANSWER-●Your careful History & Physical exam
●nasopharyngeal viral assays for RSV and Influenza- if they are positive you could
avoid exposing a non-toxic child to radiation.
●Chest Xray if needed to help narrow your differential diagnosis.
●Sputum and blood cultures- can help future care, but do not help in the emergency
setting.
diagnosis of pyloric stenosis - ANSWER-Observe child eating to confirm projectile
nature of vomiting. Ultrasound the abdomen and observe hypertrophic pylorus.
diagnostic studies for appendicitis in peds - ANSWER-U/S can be used to rule in
CT is most diagnostic
diagnostic studies for bacteremia/sepsis - ANSWER-blood cultures
Target approach to identifying source (UTI, Pneumonia, etc)
diagnostic studies for malrotation/volvulus - ANSWER-X-ray can show air fluid levels /
obstruction. CT scan is more diagnostic.
diagnostic studies for UTI in peds - ANSWER-urinalysis- leuk esterase + nitrates
urine culture ALWAYS
