2025/2026 ATI Pediatrics Proctored Exam
QUESTIONS AND ANSWERS/Actual Exam/ TESTED
GRADE A+
1. A nurse is assessing a 4-month-old infant during a well-child visit. Which finding
should the nurse report to the provider?
A. The infant has not yet rolled from stomach to back
B. The infant is unable to support weight on forearms while prone
C. The infant responds to voices by turning toward sound
D. The infant grasps objects placed in hand
Correct Answer: B
Rationale: By 3 months, infants should be able to bear weight on forearms in the prone
position. Inability at 4 months may indicate a developmental delay. Rolling from stomach
to back typically occurs closer to 5–6 months.
2. A school-age child with sickle cell anemia arrives at the ED during a vaso-
occlusive crisis. Which intervention is the priority?
A. Apply cold packs to painful areas
B. Initiate IV fluids
C. Begin range-of-motion exercises
D. Administer high-calorie snacks
Correct Answer: B
Rationale: Hydration is critical to reduce blood viscosity and promote circulation. Cold
therapy increases vasoconstriction and should be avoided.
3. A nurse is teaching the parent of a toddler with iron-deficiency anemia. Which
statement indicates understanding?
A. “I will give the iron medication with milk.”
B. “I should expect my child’s stools to turn a dark color.”
C. “I will mix the iron medication into a bottle of formula."
D. “I will stop the supplement once my child’s energy improves.”
,Correct Answer: B
Rationale: Iron supplements commonly cause dark stools. They should be given with
vitamin C–rich liquids, not milk, and therapy continues for several months after levels
normalize.
4. A nurse is caring for a preschooler scheduled for a tonsillectomy. Which
preoperative teaching approach is appropriate?
A. Provide detailed, scientific explanations
B. Use short, simple words and visual aids
C. Explain the surgery the day before the procedure
D. Allow the child to handle real surgical equipment
Correct Answer: B
Rationale: Preschoolers learn best with simple explanations, pictures, and
demonstrations using non-threatening equipment such as dolls.
5. A nurse is caring for an adolescent receiving isotretinoin for severe acne. Which
assessment is the priority?
A. Sleep patterns
B. Dietary intake
C. Pregnancy status
D. Skin hydration
Correct Answer: C
Rationale: Isotretinoin is teratogenic. A pregnancy test is required before starting and
throughout therapy.
6. A nurse is assessing a toddler who has acute gastroenteritis. Which finding
indicates the child is experiencing moderate dehydration?
A. Absence of tears when crying
B. Sunken fontanels
C. Decreased urine output and slightly increased heart rate
D. Capillary refill greater than 4 seconds
Correct Answer: C
Rationale: Moderate dehydration often presents with tachycardia and decreased urine
output. Absence of tears and >4 second cap refill suggest severe dehydration.
,7. A nurse is caring for a school-age child who has asthma and is experiencing an
acute exacerbation. Which intervention should the nurse perform first?
A. Administer a short-acting beta agonist
B. Obtain a peak expiratory flow rate
C. Apply humidified oxygen by mask
D. Start IV access for corticosteroid administration
Correct Answer: A
Rationale: Immediate bronchodilation with a short-acting beta agonist (albuterol) is the
priority during an acute asthma attack.
8. A child receiving chemotherapy has a platelet count of 30,000/mm³. Which
instruction should the nurse give the parents?
A. Allow the child to use a soft-bristle toothbrush
B. Encourage high-impact physical play
C. Increase intake of high-protein foods
D. Administer acetaminophen every 4 hours
Correct Answer: A
Rationale: A soft toothbrush prevents gum bleeding in thrombocytopenia. High-impact
play is unsafe.
9. A nurse is providing teaching to the parent of a preschooler newly diagnosed with
celiac disease. Which food choice indicates understanding of the teaching?
A. Macaroni and cheese
B. Wheat toast with butter
C. Grilled chicken and steamed vegetables
D. Oatmeal with honey
Correct Answer: C
Rationale: Celiac disease requires a gluten-free diet. Wheat, barley, and rye products
must be avoided.
, 10. A nurse is caring for a 2-month-old infant receiving routine immunizations.
Which finding is an expected response to the DTaP vaccine?
A. Persistent high-pitched cry for 3 days
B. Localized swelling at the injection site
C. Rash on the trunk and face
D. Vomiting after feeding
Correct Answer: B
Rationale: Mild localized swelling, redness, and irritability are common after DTaP.
High-pitched prolonged crying is abnormal.
11. A nurse is reviewing safety precautions with the parent of a 6-month-old infant.
Which statement indicates the parent needs further teaching?
A. “I will lower the crib mattress as soon as my baby can sit.”
B. “I will keep small toys out of reach.”
C. “I will place pillows in the crib to keep my baby comfortable.”
D. “I will always check bath water temperature before putting the baby in.”
Correct Answer: C
Rationale: Pillows, blankets, and plush items increase the risk of suffocation and should
not be placed in the infant’s sleep area.
12. A nurse is caring for a child diagnosed with bacterial meningitis. Which finding
requires immediate intervention?
A. Nuchal rigidity
B. Petechial rash on the trunk
C. Headache
D. Photophobia
Correct Answer: B
Rationale: A petechial or purpuric rash can indicate meningococcemia and rapid
deterioration; urgent action is required.
13. A nurse is teaching an adolescent who has type 1 diabetes about managing blood
glucose during exercise. Which statement shows understanding?
QUESTIONS AND ANSWERS/Actual Exam/ TESTED
GRADE A+
1. A nurse is assessing a 4-month-old infant during a well-child visit. Which finding
should the nurse report to the provider?
A. The infant has not yet rolled from stomach to back
B. The infant is unable to support weight on forearms while prone
C. The infant responds to voices by turning toward sound
D. The infant grasps objects placed in hand
Correct Answer: B
Rationale: By 3 months, infants should be able to bear weight on forearms in the prone
position. Inability at 4 months may indicate a developmental delay. Rolling from stomach
to back typically occurs closer to 5–6 months.
2. A school-age child with sickle cell anemia arrives at the ED during a vaso-
occlusive crisis. Which intervention is the priority?
A. Apply cold packs to painful areas
B. Initiate IV fluids
C. Begin range-of-motion exercises
D. Administer high-calorie snacks
Correct Answer: B
Rationale: Hydration is critical to reduce blood viscosity and promote circulation. Cold
therapy increases vasoconstriction and should be avoided.
3. A nurse is teaching the parent of a toddler with iron-deficiency anemia. Which
statement indicates understanding?
A. “I will give the iron medication with milk.”
B. “I should expect my child’s stools to turn a dark color.”
C. “I will mix the iron medication into a bottle of formula."
D. “I will stop the supplement once my child’s energy improves.”
,Correct Answer: B
Rationale: Iron supplements commonly cause dark stools. They should be given with
vitamin C–rich liquids, not milk, and therapy continues for several months after levels
normalize.
4. A nurse is caring for a preschooler scheduled for a tonsillectomy. Which
preoperative teaching approach is appropriate?
A. Provide detailed, scientific explanations
B. Use short, simple words and visual aids
C. Explain the surgery the day before the procedure
D. Allow the child to handle real surgical equipment
Correct Answer: B
Rationale: Preschoolers learn best with simple explanations, pictures, and
demonstrations using non-threatening equipment such as dolls.
5. A nurse is caring for an adolescent receiving isotretinoin for severe acne. Which
assessment is the priority?
A. Sleep patterns
B. Dietary intake
C. Pregnancy status
D. Skin hydration
Correct Answer: C
Rationale: Isotretinoin is teratogenic. A pregnancy test is required before starting and
throughout therapy.
6. A nurse is assessing a toddler who has acute gastroenteritis. Which finding
indicates the child is experiencing moderate dehydration?
A. Absence of tears when crying
B. Sunken fontanels
C. Decreased urine output and slightly increased heart rate
D. Capillary refill greater than 4 seconds
Correct Answer: C
Rationale: Moderate dehydration often presents with tachycardia and decreased urine
output. Absence of tears and >4 second cap refill suggest severe dehydration.
,7. A nurse is caring for a school-age child who has asthma and is experiencing an
acute exacerbation. Which intervention should the nurse perform first?
A. Administer a short-acting beta agonist
B. Obtain a peak expiratory flow rate
C. Apply humidified oxygen by mask
D. Start IV access for corticosteroid administration
Correct Answer: A
Rationale: Immediate bronchodilation with a short-acting beta agonist (albuterol) is the
priority during an acute asthma attack.
8. A child receiving chemotherapy has a platelet count of 30,000/mm³. Which
instruction should the nurse give the parents?
A. Allow the child to use a soft-bristle toothbrush
B. Encourage high-impact physical play
C. Increase intake of high-protein foods
D. Administer acetaminophen every 4 hours
Correct Answer: A
Rationale: A soft toothbrush prevents gum bleeding in thrombocytopenia. High-impact
play is unsafe.
9. A nurse is providing teaching to the parent of a preschooler newly diagnosed with
celiac disease. Which food choice indicates understanding of the teaching?
A. Macaroni and cheese
B. Wheat toast with butter
C. Grilled chicken and steamed vegetables
D. Oatmeal with honey
Correct Answer: C
Rationale: Celiac disease requires a gluten-free diet. Wheat, barley, and rye products
must be avoided.
, 10. A nurse is caring for a 2-month-old infant receiving routine immunizations.
Which finding is an expected response to the DTaP vaccine?
A. Persistent high-pitched cry for 3 days
B. Localized swelling at the injection site
C. Rash on the trunk and face
D. Vomiting after feeding
Correct Answer: B
Rationale: Mild localized swelling, redness, and irritability are common after DTaP.
High-pitched prolonged crying is abnormal.
11. A nurse is reviewing safety precautions with the parent of a 6-month-old infant.
Which statement indicates the parent needs further teaching?
A. “I will lower the crib mattress as soon as my baby can sit.”
B. “I will keep small toys out of reach.”
C. “I will place pillows in the crib to keep my baby comfortable.”
D. “I will always check bath water temperature before putting the baby in.”
Correct Answer: C
Rationale: Pillows, blankets, and plush items increase the risk of suffocation and should
not be placed in the infant’s sleep area.
12. A nurse is caring for a child diagnosed with bacterial meningitis. Which finding
requires immediate intervention?
A. Nuchal rigidity
B. Petechial rash on the trunk
C. Headache
D. Photophobia
Correct Answer: B
Rationale: A petechial or purpuric rash can indicate meningococcemia and rapid
deterioration; urgent action is required.
13. A nurse is teaching an adolescent who has type 1 diabetes about managing blood
glucose during exercise. Which statement shows understanding?
