ATI PEDIATRIC NURSING ASSESSMENT ACTUAL QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
*Core Domains:*
*- Growth and Development*
*- Pediatric Pharmacology and Medication Administration*
*- Cardiovascular and Respiratory Disorders*
*- Gastrointestinal and Genitourinary Alterations*
*- Neurological and Musculoskeletal Conditions*
*- Hematology and Oncology*
*- Immunology and Infectious Diseases*
*- Fluid, Electrolyte, and Acid-Base Balance*
*- Psychosocial and Mental Health Health Alterations*
*Introduction:*
*The purpose of this comprehensive assessment is to evaluate the clinical competence, critical thinking, and decision-making s
Section One: Questions 1–100
Question 1
A nurse is assessing a 12-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider as a
potential developmental delay?
A. The infant cannot stand alone without support.
B. The infant is unable to transfer objects from one hand to the other.
C. The infant says two recognizable words besides "mama" and "dada."
D. The infant exhibits a fear of strangers.
🟢 Correct answer: B. The infant is unable to transfer objects from one hand to the other.
🔴 RATIONALE: Infants typically develop the ability to transfer objects from one hand to the other by 7 months of age. Inability to perform
this task at 12 months is a significant gross/fine motor delay that requires further evaluation. Standing alone without support is a skill that
,develops around 12 months, but not achieving it is not yet diagnostic of a delay. Saying a few words and exhibiting stranger anxiety are
expected developmental milestones for a 12-month-old.
Question 2
A nurse is caring for an 8-year-old child who is post-operative following an appendectomy. Which of the following pain assessment tools is
most appropriate for the nurse to use?
A. FLACC Scale
B. CRIES Pain Scale
C. FACES Pain Rating Scale
D. Numeric Rating Scale
🟢 Correct answer: C. FACES Pain Rating Scale
🔴 RATIONALE: The Wong-Baker FACES Pain Rating Scale is appropriate for children as young as 3 to 4 years old and remains highly
effective for school-age children up to 8 years old who can point to a face that matches their pain level. The FLACC and CRIES scales are
observational tools intended for infants and non-verbal patients. While some 8-year-olds can use a numeric 0-10 scale, the FACES scale
provides a more reliable developmental fit for immediate post-operative evaluation in this age group.
Question 3
A nurse is preparing to administer an intramuscular (IM) injection to a 4-month-old infant. Which of the following muscle sites should the nurse
select?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
🟢 Correct answer: C. Vastus lateralis
🔴 RATIONALE: The vastus lateralis muscle is the preferred and safest site for intramuscular injections in infants under 12 months of age
because it is the largest, most developed muscle mass available and lacks proximity to major nerves or blood vessels. The deltoid muscle is
too small in an infant, the ventrogluteal site is not fully developed until walking occurs, and the dorsogluteal site is avoided in pediatrics due to
the high risk of sciatic nerve injury.
Question 4
A nurse is providing discharge teaching to the parents of a toddler who has a new prescription for liquid ferrous sulfate. Which of the following
instructions should the nurse include?
A. Administer the medication with a glass of milk to prevent gastric upset.
B. Give the medication through a straw or dropper placed toward the back of the mouth.
C. Expect the toddler's stools to become light yellow and clay-colored.
D. Stop the medication immediately if the child develops a mild cough.
🟢 Correct answer: B. Give the medication through a straw or dropper placed toward the back of the mouth.
🔴 RATIONALE: Liquid iron preparations can stain a child's teeth. Administering the medication through a straw or placing a dropper toward
the back of the mouth minimizes contact with the teeth. Iron should be given on an empty stomach or with vitamin C (juice) to enhance
,absorption; milk inhibits iron absorption. Iron causes stools to become dark green or black, not light yellow, and a mild cough is unrelated to
iron therapy.
Question 5
A nurse is caring for a 5-year-old child who has a prescription for a continuous intravenous infusion. Which of the following actions should the
nurse take to ensure safety and prevent fluid overload?
A. Check the IV site and volume infused every 4 hours.
B. Utilize an electronic infusion pump with a microdrip tubing system and a buretrol.
C. Allow the child to adjust the infusion pump buttons under direct supervision.
D. Increase the infusion rate if the line becomes sluggish to catch up on missed volume.
🟢 Correct answer: B. Utilize an electronic infusion pump with a microdrip tubing system and a buretrol.
🔴 RATIONALE: Pediatric patients are at a high risk for fluid volume overload. Using an electronic infusion pump along with a volume-control
device (buretrol) limits the maximum amount of fluid that can accidentally infuse into the child if the pump malfunctions. IV sites in pediatrics
should be checked at least every 1 hour, not every 4 hours. Children should never manipulate infusion equipment, and catching up on fluids
by increasing rates is strictly contraindicated.
Question 6
A nurse is performing a physical assessment on a 2-year-old toddler. Which of the following strategies should the nurse use to promote
cooperation?
A. Examine the toddler's throat and ears first to get the unpleasant parts over with.
B. Perform the assessment while the child sits on the parent's lap.
C. Ask the child for permission before starting every step of the examination.
D. Remove all the child's clothing at the beginning of the assessment.
🟢 Correct answer: B. Perform the assessment while the child sits on the parent's lap.
🔴 RATIONALE: Conducting the physical exam while the toddler stays on the parent's lap reduces stranger anxiety and helps the child feel
secure, which dramatically increases cooperation. Invasive procedures like examining the ears and throat should always be done last.
Toddlers are naturally negative; asking for permission gives them an opportunity to say "no," so options should be framed as choices instead.
Removing all clothing at once can cause distress and hypothermia.
Question 7
A nurse is evaluating a 6-month-old infant for a suspected diagnosis of intussusception. Which of the following clinical manifestations should
the nurse expect to find?
A. Persistent projectile vomiting after every feeding
B. Chronic ribbon-like, foul-smelling stools
C. Severe episodic abdominal pain and jelly-like stools
D. Absolute absence of bowel sounds with a rigid, board-like abdomen
🟢 Correct answer: C. Severe episodic abdominal pain and jelly-like stools
🔴 RATIONALE: Intussusception is characterized by the telescoping of one portion of the intestine into another, causing lymphatic and
venous obstruction. This leads to severe, intermittent colicky abdominal pain (manifested by screaming and drawing knees to chest) and the
, passage of "currant jelly" stools containing blood and mucus. Projectile vomiting points to pyloric stenosis. Ribbon-like stools indicate
Hirschsprung's disease. A rigid, board-like abdomen indicates peritonitis.
Question 8
A nurse is admitting an infant who has RSV bronchiolitis. Which of the following isolation precautions must the nurse implement?
A. Airborne precautions
B. Contact and droplet precautions
C. Protective isolation precautions
D. Standard precautions only
🟢 Correct answer: B. Contact and droplet precautions
🔴 RATIONALE: Respiratory Syncytial Virus (RSV) is primarily transmitted through direct contact with respiratory secretions and large
droplets generated by coughing or sneezing. Therefore, a combination of contact and droplet precautions is required to prevent nosocomial
transmission. Airborne precautions are reserved for pathogens like measles or varicella. Protective isolation is used for severely
immunocompromised patients.
Question 9
A nurse is planning care for a 4-year-old child who is scheduled for a cardiac catheterization. Which of the following interventions is
appropriate to prepare the child psychologically?
A. Provide a detailed, technical seminar using anatomical models 2 weeks in advance.
B. Limit therapeutic play and explanations to the day of the procedure to prevent anxiety.
C. Use a doll to demonstrate the procedure using simple, concrete terms a day before.
D. Inform the child that the procedure will not cause any discomfort or pain.
🟢 Correct answer: C. Use a doll to demonstrate the procedure using simple, concrete terms a day before.
🔴 RATIONALE: Preschool-age children (3 to 5 years) learn best through therapeutic play and concrete, sensory explanations tailored to
their developmental level, completed shortly before the procedure (usually the day before). Explaining things too far in advance can cause
prolonged anxiety due to their active imaginations. False reassurances that something will not hurt destroy trust; instead, the nurse should
explain what sensations to expect.
Question 10
A nurse is assessing a child who has tetralogy of Fallot and notes the child is experiencing a hypercyanotic spell ("tet spell"). Which of the
following actions should the nurse take first?
A. Administer a high-dose IV bolus of morphine sulfate.
B. Place the child in a knee-chest position.
C. Apply a non-rebreather oxygen mask at 10 L/min.
D. Prepare for immediate endotracheal intubation.
🟢 Correct answer: B. Place the child in a knee-chest position.
🔴 RATIONALE: Placing the child in a knee-chest position is the immediate priority action. This position increases systemic vascular
resistance, which decreases the right-to-left shunt across the ventricular septal defect and improves pulmonary blood flow, thereby relieving
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
*Core Domains:*
*- Growth and Development*
*- Pediatric Pharmacology and Medication Administration*
*- Cardiovascular and Respiratory Disorders*
*- Gastrointestinal and Genitourinary Alterations*
*- Neurological and Musculoskeletal Conditions*
*- Hematology and Oncology*
*- Immunology and Infectious Diseases*
*- Fluid, Electrolyte, and Acid-Base Balance*
*- Psychosocial and Mental Health Health Alterations*
*Introduction:*
*The purpose of this comprehensive assessment is to evaluate the clinical competence, critical thinking, and decision-making s
Section One: Questions 1–100
Question 1
A nurse is assessing a 12-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider as a
potential developmental delay?
A. The infant cannot stand alone without support.
B. The infant is unable to transfer objects from one hand to the other.
C. The infant says two recognizable words besides "mama" and "dada."
D. The infant exhibits a fear of strangers.
🟢 Correct answer: B. The infant is unable to transfer objects from one hand to the other.
🔴 RATIONALE: Infants typically develop the ability to transfer objects from one hand to the other by 7 months of age. Inability to perform
this task at 12 months is a significant gross/fine motor delay that requires further evaluation. Standing alone without support is a skill that
,develops around 12 months, but not achieving it is not yet diagnostic of a delay. Saying a few words and exhibiting stranger anxiety are
expected developmental milestones for a 12-month-old.
Question 2
A nurse is caring for an 8-year-old child who is post-operative following an appendectomy. Which of the following pain assessment tools is
most appropriate for the nurse to use?
A. FLACC Scale
B. CRIES Pain Scale
C. FACES Pain Rating Scale
D. Numeric Rating Scale
🟢 Correct answer: C. FACES Pain Rating Scale
🔴 RATIONALE: The Wong-Baker FACES Pain Rating Scale is appropriate for children as young as 3 to 4 years old and remains highly
effective for school-age children up to 8 years old who can point to a face that matches their pain level. The FLACC and CRIES scales are
observational tools intended for infants and non-verbal patients. While some 8-year-olds can use a numeric 0-10 scale, the FACES scale
provides a more reliable developmental fit for immediate post-operative evaluation in this age group.
Question 3
A nurse is preparing to administer an intramuscular (IM) injection to a 4-month-old infant. Which of the following muscle sites should the nurse
select?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
🟢 Correct answer: C. Vastus lateralis
🔴 RATIONALE: The vastus lateralis muscle is the preferred and safest site for intramuscular injections in infants under 12 months of age
because it is the largest, most developed muscle mass available and lacks proximity to major nerves or blood vessels. The deltoid muscle is
too small in an infant, the ventrogluteal site is not fully developed until walking occurs, and the dorsogluteal site is avoided in pediatrics due to
the high risk of sciatic nerve injury.
Question 4
A nurse is providing discharge teaching to the parents of a toddler who has a new prescription for liquid ferrous sulfate. Which of the following
instructions should the nurse include?
A. Administer the medication with a glass of milk to prevent gastric upset.
B. Give the medication through a straw or dropper placed toward the back of the mouth.
C. Expect the toddler's stools to become light yellow and clay-colored.
D. Stop the medication immediately if the child develops a mild cough.
🟢 Correct answer: B. Give the medication through a straw or dropper placed toward the back of the mouth.
🔴 RATIONALE: Liquid iron preparations can stain a child's teeth. Administering the medication through a straw or placing a dropper toward
the back of the mouth minimizes contact with the teeth. Iron should be given on an empty stomach or with vitamin C (juice) to enhance
,absorption; milk inhibits iron absorption. Iron causes stools to become dark green or black, not light yellow, and a mild cough is unrelated to
iron therapy.
Question 5
A nurse is caring for a 5-year-old child who has a prescription for a continuous intravenous infusion. Which of the following actions should the
nurse take to ensure safety and prevent fluid overload?
A. Check the IV site and volume infused every 4 hours.
B. Utilize an electronic infusion pump with a microdrip tubing system and a buretrol.
C. Allow the child to adjust the infusion pump buttons under direct supervision.
D. Increase the infusion rate if the line becomes sluggish to catch up on missed volume.
🟢 Correct answer: B. Utilize an electronic infusion pump with a microdrip tubing system and a buretrol.
🔴 RATIONALE: Pediatric patients are at a high risk for fluid volume overload. Using an electronic infusion pump along with a volume-control
device (buretrol) limits the maximum amount of fluid that can accidentally infuse into the child if the pump malfunctions. IV sites in pediatrics
should be checked at least every 1 hour, not every 4 hours. Children should never manipulate infusion equipment, and catching up on fluids
by increasing rates is strictly contraindicated.
Question 6
A nurse is performing a physical assessment on a 2-year-old toddler. Which of the following strategies should the nurse use to promote
cooperation?
A. Examine the toddler's throat and ears first to get the unpleasant parts over with.
B. Perform the assessment while the child sits on the parent's lap.
C. Ask the child for permission before starting every step of the examination.
D. Remove all the child's clothing at the beginning of the assessment.
🟢 Correct answer: B. Perform the assessment while the child sits on the parent's lap.
🔴 RATIONALE: Conducting the physical exam while the toddler stays on the parent's lap reduces stranger anxiety and helps the child feel
secure, which dramatically increases cooperation. Invasive procedures like examining the ears and throat should always be done last.
Toddlers are naturally negative; asking for permission gives them an opportunity to say "no," so options should be framed as choices instead.
Removing all clothing at once can cause distress and hypothermia.
Question 7
A nurse is evaluating a 6-month-old infant for a suspected diagnosis of intussusception. Which of the following clinical manifestations should
the nurse expect to find?
A. Persistent projectile vomiting after every feeding
B. Chronic ribbon-like, foul-smelling stools
C. Severe episodic abdominal pain and jelly-like stools
D. Absolute absence of bowel sounds with a rigid, board-like abdomen
🟢 Correct answer: C. Severe episodic abdominal pain and jelly-like stools
🔴 RATIONALE: Intussusception is characterized by the telescoping of one portion of the intestine into another, causing lymphatic and
venous obstruction. This leads to severe, intermittent colicky abdominal pain (manifested by screaming and drawing knees to chest) and the
, passage of "currant jelly" stools containing blood and mucus. Projectile vomiting points to pyloric stenosis. Ribbon-like stools indicate
Hirschsprung's disease. A rigid, board-like abdomen indicates peritonitis.
Question 8
A nurse is admitting an infant who has RSV bronchiolitis. Which of the following isolation precautions must the nurse implement?
A. Airborne precautions
B. Contact and droplet precautions
C. Protective isolation precautions
D. Standard precautions only
🟢 Correct answer: B. Contact and droplet precautions
🔴 RATIONALE: Respiratory Syncytial Virus (RSV) is primarily transmitted through direct contact with respiratory secretions and large
droplets generated by coughing or sneezing. Therefore, a combination of contact and droplet precautions is required to prevent nosocomial
transmission. Airborne precautions are reserved for pathogens like measles or varicella. Protective isolation is used for severely
immunocompromised patients.
Question 9
A nurse is planning care for a 4-year-old child who is scheduled for a cardiac catheterization. Which of the following interventions is
appropriate to prepare the child psychologically?
A. Provide a detailed, technical seminar using anatomical models 2 weeks in advance.
B. Limit therapeutic play and explanations to the day of the procedure to prevent anxiety.
C. Use a doll to demonstrate the procedure using simple, concrete terms a day before.
D. Inform the child that the procedure will not cause any discomfort or pain.
🟢 Correct answer: C. Use a doll to demonstrate the procedure using simple, concrete terms a day before.
🔴 RATIONALE: Preschool-age children (3 to 5 years) learn best through therapeutic play and concrete, sensory explanations tailored to
their developmental level, completed shortly before the procedure (usually the day before). Explaining things too far in advance can cause
prolonged anxiety due to their active imaginations. False reassurances that something will not hurt destroy trust; instead, the nurse should
explain what sensations to expect.
Question 10
A nurse is assessing a child who has tetralogy of Fallot and notes the child is experiencing a hypercyanotic spell ("tet spell"). Which of the
following actions should the nurse take first?
A. Administer a high-dose IV bolus of morphine sulfate.
B. Place the child in a knee-chest position.
C. Apply a non-rebreather oxygen mask at 10 L/min.
D. Prepare for immediate endotracheal intubation.
🟢 Correct answer: B. Place the child in a knee-chest position.
🔴 RATIONALE: Placing the child in a knee-chest position is the immediate priority action. This position increases systemic vascular
resistance, which decreases the right-to-left shunt across the ventricular septal defect and improves pulmonary blood flow, thereby relieving
