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RN ATI Capstone Nursing Care of Children Proctored
ACTUAL EXAM 2026/2027 | Version 1 | Multiple
Formats | Verified Questions and Answers | Just
Released - Pass Guaranteed - A+ Graded
EXAM INSTRUCTIONS:
• This is a comprehensive assessment containing 80 questions.
• Read each question carefully and select the best answer.
• For Multiple Response questions, select ALL that apply.
• Time allowed: 2 hours
• Passing standard: Level 2 proficiency
QUESTIONS 1-80: PROCTORED EXAM
Question 1 A 6-month-old infant is admitted with bronchiolitis and moderate respiratory
distress. The nurse notes nasal flaring, intercostal retractions, and a respiratory rate of 62
breaths/min. Which action should the nurse take first?
A. Administer prescribed albuterol nebulizer treatment
B. Position the infant in a semi-Fowler's position with head elevated
C. Apply oxygen via nasal cannula at 2 L/min
D. Suction the nares with a bulb syringe
Correct Answer: B
Detailed Rationale: Positioning is the priority intervention for a child in respiratory distress.
The semi-Fowler's position with the head elevated facilitates diaphragmatic excursion and
reduces work of breathing. This non-invasive intervention should be implemented immediately
while preparing for other treatments. While oxygen administration (C) is important, positioning
must occur first to optimize respiratory mechanics. Albuterol (A) may be prescribed but
,2
positioning takes precedence. Nasal suctioning (D) may help but is not the first priority when the
infant is showing signs of significant respiratory distress.
Key Learning Point: In pediatric respiratory emergencies, positioning to optimize airway and
breathing always comes before pharmacological interventions.
Question 2 A nurse is caring for a 4-year-old with newly diagnosed Type 1 diabetes mellitus.
The child's parents are tearful and state, "We don't know how we're going to manage all these
insulin shots." Which response by the nurse demonstrates family-centered care?
A. "Don't worry, most parents feel this way at first, but you'll get used to it."
B. "Let me connect you with another family whose child has diabetes so you can talk to them."
C. "I understand this feels overwhelming. Let's identify your specific concerns and develop a
plan together."
D. "Your child needs these shots to live, so you'll have to find a way to cope."
Correct Answer: C
Detailed Rationale: Family-centered care recognizes the family as the constant in the child's life
and partners with them in care. Option C validates the parents' feelings, acknowledges their
emotional state, and engages them collaboratively in problem-solving. Option A minimizes their
concerns. Option B, while potentially helpful later, deflects from immediate therapeutic
communication. Option D is dismissive and threatening.
Key Learning Point: Family-centered care involves acknowledging emotions, validating
concerns, and collaborating with families as partners in the child's care.
Question 3 A nurse is supervising a newly licensed nurse caring for a 2-year-old with
dehydration. Which statement by the newly licensed nurse indicates a need for further teaching?
A. "I'll monitor the child's urine output and specific gravity every 4 hours."
B. "I should expect the child to have tears when crying if hydration is improving."
B. "I'll assess the child's fontanels since they should still be open at this age."
D. "I'll check the child's mucous membranes and skin turgor regularly."
Correct Answer: C
Detailed Rationale: By age 2 years, the anterior fontanel should be closed (typically closes
between 12-18 months). The posterior fontanel closes even earlier (2-3 months). Assessing
fontanels in a 2-year-old is inappropriate and indicates a developmental knowledge gap. Options
A, B, and D are all appropriate assessments for dehydration in a toddler.
,3
Key Learning Point: Understanding age-appropriate anatomy is crucial. Fontanels are not
reliable assessment indicators after 18 months of age.
Question 4 A school nurse is conducting scoliosis screenings. Which finding requires immediate
referral to a healthcare provider?
A. A 12-year-old with a 5-degree curvature noted on forward bend test
B. A 14-year-old with one shoulder slightly higher than the other
C. A 10-year-old with asymmetrical waistline and rib hump on forward bend
D. A 16-year-old with mild postural rounding that corrects when lying down
Correct Answer: C
Detailed Rationale: Asymmetrical waistline with a rib hump on forward bend (Adam's test)
indicates structural scoliosis requiring immediate evaluation. This finding suggests rotation of
the vertebrae, which is more significant than simple postural asymmetry. Option A (5 degrees) is
within normal limits. Option B could indicate mild scoliosis but requires further assessment.
Option D describes postural kyphosis, which is benign and corrects with positioning.
Key Learning Point: The forward bend test revealing a rib hump is the hallmark screening
finding for structural scoliosis requiring orthopedic referral.
Question 5 A nurse is caring for an 8-year-old with sickle cell anemia who is experiencing a
vaso-occlusive crisis. Which intervention should the nurse prioritize?
A. Administer prophylactic antibiotics as prescribed
B. Apply warm compresses to painful joints
C. Ensure aggressive hydration with IV fluids
D. Provide meperidine for pain management
Correct Answer: C
Detailed Rationale: Aggressive hydration is the priority intervention during a vaso-occlusive
crisis. Hydration reduces blood viscosity, improves circulation, and helps prevent further
sickling. While pain management is important, hydration takes precedence to address the
underlying pathophysiology. Warm compresses (B) may provide comfort but are secondary.
Meperidine (D) is contraindicated in sickle cell patients due to risk of normeperidine toxicity and
seizures.
Key Learning Point: The "HHH" approach to sickle cell crisis: Hydration, Heat (warmth), and
Hematology monitoring. Hydration is always the foundation.
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Question 6 A nurse is teaching parents of a 15-month-old about car seat safety. Which statement
by the parents indicates understanding of current guidelines?
A. "We can turn the car seat forward-facing now since our baby is over 1 year old."
B. "We'll keep our child rear-facing until she reaches the maximum height or weight limit for our
convertible seat."
C. "Once our child weighs 20 pounds, we can use a forward-facing seat with a harness."
D. "We should move our child to a booster seat when she turns 3 years old."
Correct Answer: B
Detailed Rationale: Current AAP guidelines (2026/2027) recommend children remain rear-
facing until they reach the maximum height or weight limit of their convertible car seat, typically
around age 2-4 years. Option A reflects outdated information. Option C is incorrect (20 lbs was
an old minimum). Option D is premature (booster seats are for children who have outgrown
forward-facing harness seats, typically around age 5-6 years).
Key Learning Point: Rear-facing is safest and should be maintained as long as possible within
the seat's limits, not based on age alone.
Question 7 A pediatric nurse is delegating care for a group of patients. Which task is appropriate
to delegate to an unlicensed assistive personnel (UAP)?
A. Feeding a 3-year-old with cerebral palsy who has dysphagia and requires thickened liquids
B. Obtaining a finger-stick blood glucose on a 10-year-old with Type 1 diabetes
C. Assisting a 6-year-old post-tonsillectomy with oral intake and monitoring for bleeding
D. Helping a 12-year-old with asthma use a peak flow meter
Correct Answer: B
Detailed Rationale: Obtaining a finger-stick blood glucose is a standardized procedure that
UAPs can be trained to perform with a stable patient. Option A requires specialized knowledge
of swallowing precautions and aspiration risk. Option C requires assessment skills to identify
bleeding, which is beyond UAP scope. Option D requires teaching and interpretation of results,
which is a nursing function.
Key Learning Point: Delegation to UAP requires predictable, stable conditions without need for
assessment, judgment, or teaching.
Question 8 A nurse is caring for a newborn with a suspected congenital heart defect. Which
assessment finding is most consistent with a left-to-right shunt (acyanotic) lesion?
RN ATI Capstone Nursing Care of Children Proctored
ACTUAL EXAM 2026/2027 | Version 1 | Multiple
Formats | Verified Questions and Answers | Just
Released - Pass Guaranteed - A+ Graded
EXAM INSTRUCTIONS:
• This is a comprehensive assessment containing 80 questions.
• Read each question carefully and select the best answer.
• For Multiple Response questions, select ALL that apply.
• Time allowed: 2 hours
• Passing standard: Level 2 proficiency
QUESTIONS 1-80: PROCTORED EXAM
Question 1 A 6-month-old infant is admitted with bronchiolitis and moderate respiratory
distress. The nurse notes nasal flaring, intercostal retractions, and a respiratory rate of 62
breaths/min. Which action should the nurse take first?
A. Administer prescribed albuterol nebulizer treatment
B. Position the infant in a semi-Fowler's position with head elevated
C. Apply oxygen via nasal cannula at 2 L/min
D. Suction the nares with a bulb syringe
Correct Answer: B
Detailed Rationale: Positioning is the priority intervention for a child in respiratory distress.
The semi-Fowler's position with the head elevated facilitates diaphragmatic excursion and
reduces work of breathing. This non-invasive intervention should be implemented immediately
while preparing for other treatments. While oxygen administration (C) is important, positioning
must occur first to optimize respiratory mechanics. Albuterol (A) may be prescribed but
,2
positioning takes precedence. Nasal suctioning (D) may help but is not the first priority when the
infant is showing signs of significant respiratory distress.
Key Learning Point: In pediatric respiratory emergencies, positioning to optimize airway and
breathing always comes before pharmacological interventions.
Question 2 A nurse is caring for a 4-year-old with newly diagnosed Type 1 diabetes mellitus.
The child's parents are tearful and state, "We don't know how we're going to manage all these
insulin shots." Which response by the nurse demonstrates family-centered care?
A. "Don't worry, most parents feel this way at first, but you'll get used to it."
B. "Let me connect you with another family whose child has diabetes so you can talk to them."
C. "I understand this feels overwhelming. Let's identify your specific concerns and develop a
plan together."
D. "Your child needs these shots to live, so you'll have to find a way to cope."
Correct Answer: C
Detailed Rationale: Family-centered care recognizes the family as the constant in the child's life
and partners with them in care. Option C validates the parents' feelings, acknowledges their
emotional state, and engages them collaboratively in problem-solving. Option A minimizes their
concerns. Option B, while potentially helpful later, deflects from immediate therapeutic
communication. Option D is dismissive and threatening.
Key Learning Point: Family-centered care involves acknowledging emotions, validating
concerns, and collaborating with families as partners in the child's care.
Question 3 A nurse is supervising a newly licensed nurse caring for a 2-year-old with
dehydration. Which statement by the newly licensed nurse indicates a need for further teaching?
A. "I'll monitor the child's urine output and specific gravity every 4 hours."
B. "I should expect the child to have tears when crying if hydration is improving."
B. "I'll assess the child's fontanels since they should still be open at this age."
D. "I'll check the child's mucous membranes and skin turgor regularly."
Correct Answer: C
Detailed Rationale: By age 2 years, the anterior fontanel should be closed (typically closes
between 12-18 months). The posterior fontanel closes even earlier (2-3 months). Assessing
fontanels in a 2-year-old is inappropriate and indicates a developmental knowledge gap. Options
A, B, and D are all appropriate assessments for dehydration in a toddler.
,3
Key Learning Point: Understanding age-appropriate anatomy is crucial. Fontanels are not
reliable assessment indicators after 18 months of age.
Question 4 A school nurse is conducting scoliosis screenings. Which finding requires immediate
referral to a healthcare provider?
A. A 12-year-old with a 5-degree curvature noted on forward bend test
B. A 14-year-old with one shoulder slightly higher than the other
C. A 10-year-old with asymmetrical waistline and rib hump on forward bend
D. A 16-year-old with mild postural rounding that corrects when lying down
Correct Answer: C
Detailed Rationale: Asymmetrical waistline with a rib hump on forward bend (Adam's test)
indicates structural scoliosis requiring immediate evaluation. This finding suggests rotation of
the vertebrae, which is more significant than simple postural asymmetry. Option A (5 degrees) is
within normal limits. Option B could indicate mild scoliosis but requires further assessment.
Option D describes postural kyphosis, which is benign and corrects with positioning.
Key Learning Point: The forward bend test revealing a rib hump is the hallmark screening
finding for structural scoliosis requiring orthopedic referral.
Question 5 A nurse is caring for an 8-year-old with sickle cell anemia who is experiencing a
vaso-occlusive crisis. Which intervention should the nurse prioritize?
A. Administer prophylactic antibiotics as prescribed
B. Apply warm compresses to painful joints
C. Ensure aggressive hydration with IV fluids
D. Provide meperidine for pain management
Correct Answer: C
Detailed Rationale: Aggressive hydration is the priority intervention during a vaso-occlusive
crisis. Hydration reduces blood viscosity, improves circulation, and helps prevent further
sickling. While pain management is important, hydration takes precedence to address the
underlying pathophysiology. Warm compresses (B) may provide comfort but are secondary.
Meperidine (D) is contraindicated in sickle cell patients due to risk of normeperidine toxicity and
seizures.
Key Learning Point: The "HHH" approach to sickle cell crisis: Hydration, Heat (warmth), and
Hematology monitoring. Hydration is always the foundation.
, 4
Question 6 A nurse is teaching parents of a 15-month-old about car seat safety. Which statement
by the parents indicates understanding of current guidelines?
A. "We can turn the car seat forward-facing now since our baby is over 1 year old."
B. "We'll keep our child rear-facing until she reaches the maximum height or weight limit for our
convertible seat."
C. "Once our child weighs 20 pounds, we can use a forward-facing seat with a harness."
D. "We should move our child to a booster seat when she turns 3 years old."
Correct Answer: B
Detailed Rationale: Current AAP guidelines (2026/2027) recommend children remain rear-
facing until they reach the maximum height or weight limit of their convertible car seat, typically
around age 2-4 years. Option A reflects outdated information. Option C is incorrect (20 lbs was
an old minimum). Option D is premature (booster seats are for children who have outgrown
forward-facing harness seats, typically around age 5-6 years).
Key Learning Point: Rear-facing is safest and should be maintained as long as possible within
the seat's limits, not based on age alone.
Question 7 A pediatric nurse is delegating care for a group of patients. Which task is appropriate
to delegate to an unlicensed assistive personnel (UAP)?
A. Feeding a 3-year-old with cerebral palsy who has dysphagia and requires thickened liquids
B. Obtaining a finger-stick blood glucose on a 10-year-old with Type 1 diabetes
C. Assisting a 6-year-old post-tonsillectomy with oral intake and monitoring for bleeding
D. Helping a 12-year-old with asthma use a peak flow meter
Correct Answer: B
Detailed Rationale: Obtaining a finger-stick blood glucose is a standardized procedure that
UAPs can be trained to perform with a stable patient. Option A requires specialized knowledge
of swallowing precautions and aspiration risk. Option C requires assessment skills to identify
bleeding, which is beyond UAP scope. Option D requires teaching and interpretation of results,
which is a nursing function.
Key Learning Point: Delegation to UAP requires predictable, stable conditions without need for
assessment, judgment, or teaching.
Question 8 A nurse is caring for a newborn with a suspected congenital heart defect. Which
assessment finding is most consistent with a left-to-right shunt (acyanotic) lesion?
