ATI PEDIATRICS PROCTORED EXAM 2023 | RN NURSING
COMPREHENSIVE TEST BANK 2026/2027
INSTRUCTIONS:
Select the single best answer for each question.
1. A nurse is assessing a 4-year-old child. Which of the following findings should
the nurse identify as a potential developmental delay?
A. The child cannot hop on one foot.
B. The child cannot skip using alternate feet.
C. The child cannot draw a circle.
D. The child cannot identify four colors.
Answer: B
Rationale: A 4-year-old is expected to hop on one foot, draw a circle, and identify some
colors. Skipping using alternate feet is a gross motor skill typically achieved by a 5-year-
old child. Therefore, a 4-year-old not being able to skip is not a delay, but an inability to
hop on one foot or draw a circle at age 4 would be a concern for a developmental delay.
2. A nurse is providing anticipatory guidance to the parents of a 6-month-old
infant. Which of the following safety measures should the nurse prioritize?
A. Installing a car seat in a forward-facing position.
B. Keeping the side rails of the crib up.
C. Placing the infant on their stomach for sleep.
D. Keeping small objects out of reach.
Answer: D
Rationale: At 6 months, infants develop the pincer grasp and begin to explore objects by
putting them in their mouths, significantly increasing the risk of choking and aspiration.
Placing small objects out of reach is the primary safety priority. Infants should be placed
on their backs to sleep, and car seats should remain rear-facing until at least age 2. Side
rails of cribs should be up, but this is a standard safety practice from birth, not a new
priority specific to this age.
3. A nurse is calculating the maintenance fluid requirements for a child who
weighs 22 kg. Using the Holliday-Segar method, what is the child's daily
maintenance fluid requirement?
A. 1000 mL/day
,B. 1500 mL/day
C. 1600 mL/day
D. 2200 mL/day
Answer: C
Rationale: The Holliday-Segar method calculates maintenance fluids as 100 mL/kg for the
first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each additional kg. For a 22 kg
child: (10 kg x 100 mL) + (10 kg x 50 mL) + (2 kg x 20 mL) = 1000 mL + 500 mL + 40 mL
= 1540 mL/day. This is rounded to the closest option, 1600 mL/day.
4. A nurse is assessing a 2-week-old infant and notes a continuous, machinery-like
murmur. The nurse should suspect which of the following congenital cardiac
defects?
A. Ventricular Septal Defect (VSD)
B. Atrial Septal Defect (ASD)
C. Patent Ductus Arteriosus (PDA)
D. Coarctation of the Aorta
Answer: C
Rationale: A patent ductus arteriosus (PDA) is characterized by a continuous, machinery-
like murmur due to the constant flow of blood from the high-pressure aorta to the low-
pressure pulmonary artery throughout the cardiac cycle. A VSD is a holosystolic murmur,
an ASD is a systolic ejection murmur, and coarctation of the aorta is characterized by
hypertension in the upper extremities and weak or absent femoral pulses.
5. A nurse is caring for a child with acute glomerulonephritis. Which of the
following dietary restrictions is most appropriate for this child?
A. Increased potassium intake.
B. Increased calcium intake.
C. Sodium restriction.
D. High-protein diet.
Answer: C
Rationale: Acute glomerulonephritis involves inflammation of the glomeruli, leading to
decreased glomerular filtration rate (GFR) and fluid retention, which manifests as edema
and hypertension. Sodium restriction is crucial to help manage fluid overload and
hypertension. Protein may be moderately restricted in severe cases, and potassium may be
restricted if hyperkalemia is present.
6. A nurse is preparing to administer a vaccine to a 2-month-old infant. Which of
the following vaccines should the nurse plan to administer?
A. MMR (Measles, Mumps, Rubella)
,B. Varicella
C. DTaP (Diphtheria, Tetanus, Pertussis)
D. Hepatitis A
Answer: C
Rationale: The recommended immunization schedule for a 2-month-old infant includes
the first dose of DTaP, IPV (inactivated poliovirus), Hib (Haemophilus influenzae type b),
PCV (pneumococcal conjugate), and RV (rotavirus). MMR and Varicella are typically
administered at 12-15 months, and Hepatitis A is given at 12 months.
7. A nurse is assessing a toddler who has just been diagnosed with iron-deficiency
anemia. Which of the following findings is consistent with this diagnosis?
A. Polycythemia
B. Hyperactivity
C. Pica
D. Bradycardia
Answer: C
Rationale: Pica, the craving and ingestion of nonfood items such as dirt or ice, is a classic
behavioral manifestation of iron-deficiency anemia in children. Other findings include
pallor, fatigue, tachycardia, and systolic murmurs.
8. A nurse is caring for a child in sickle cell crisis who is experiencing severe pain.
What is the priority nursing intervention?
A. Administering oxygen via nasal cannula.
B. Applying cold compresses to painful joints.
C. Restricting oral fluid intake.
D. Administering pain medication as prescribed.
Answer: D
Rationale: While oxygen and hydration are crucial components of care, pain management
is the priority for a child in a sickle cell crisis. Pain is often severe and requires prompt
administration of analgesics, usually opioids. Cold compresses should be avoided as they
can cause vasoconstriction; warm compresses are preferred.
9. A nurse is providing discharge teaching to the parents of a 6-month-old infant
who has just had a cleft lip repair. Which of the following statements indicates the
parents understand the teaching?
A. "We will use a soft-bristled toothbrush to clean the suture line."
B. "We will apply antibiotic ointment to the suture line as prescribed."
C. "We will use a straw to feed our baby."
D. "We will keep the baby in a prone position to prevent aspiration."
, Answer: B
Rationale: After cleft lip repair, the suture line must be kept clean and moist. Applying
antibiotic ointment as prescribed helps prevent infection and keeps the tissue moist. A
soft-bristled toothbrush can disrupt the sutures; a straw can create negative pressure on
the suture line, and the infant should be positioned on their side or back to prevent
rubbing the suture line on the mattress.
10. A nurse is assessing a child with suspected meningitis. Which of the following
signs is a positive indicator of meningeal irritation?
A. Brudzinski's sign
B. Kernig's sign
C. Babinski's sign
D. Both A and B
Answer: D
Rationale: Both Brudzinski's sign (flexion of the hips and knees when the neck is flexed)
and Kernig's sign (pain and resistance with knee extension when the hip is flexed) are
classic indicators of meningeal irritation, which is a hallmark of meningitis. Babinski's sign
is indicative of an upper motor neuron lesion, not specific to meningitis.
11. A nurse is caring for a child with a fever. What is the primary purpose of
administering antipyretics like acetaminophen or ibuprofen?
A. To eliminate the infection causing the fever.
B. To provide comfort and reduce metabolic demands.
C. To induce sleep and promote rest.
D. To prevent febrile seizures in all children.
Answer: B
Rationale: Antipyretics do not treat the underlying cause of the fever (infection); they are
administered to reduce fever and promote comfort. Lowering the body temperature also
reduces the metabolic rate, which can be beneficial in a sick child. While they are used to
prevent febrile seizures in some high-risk cases, this is not their primary purpose for every
child with a fever.
12. A nurse is assessing a 10-year-old child who has type 1 diabetes mellitus. The
child is drowsy, has flushed skin, and has a fruity odor to their breath. Which of
the following conditions should the nurse suspect?
A. Hypoglycemia
B. Diabetic Ketoacidosis (DKA)
C. Hyperglycemic Hyperosmolar State (HHS)
D. Insulin Shock
COMPREHENSIVE TEST BANK 2026/2027
INSTRUCTIONS:
Select the single best answer for each question.
1. A nurse is assessing a 4-year-old child. Which of the following findings should
the nurse identify as a potential developmental delay?
A. The child cannot hop on one foot.
B. The child cannot skip using alternate feet.
C. The child cannot draw a circle.
D. The child cannot identify four colors.
Answer: B
Rationale: A 4-year-old is expected to hop on one foot, draw a circle, and identify some
colors. Skipping using alternate feet is a gross motor skill typically achieved by a 5-year-
old child. Therefore, a 4-year-old not being able to skip is not a delay, but an inability to
hop on one foot or draw a circle at age 4 would be a concern for a developmental delay.
2. A nurse is providing anticipatory guidance to the parents of a 6-month-old
infant. Which of the following safety measures should the nurse prioritize?
A. Installing a car seat in a forward-facing position.
B. Keeping the side rails of the crib up.
C. Placing the infant on their stomach for sleep.
D. Keeping small objects out of reach.
Answer: D
Rationale: At 6 months, infants develop the pincer grasp and begin to explore objects by
putting them in their mouths, significantly increasing the risk of choking and aspiration.
Placing small objects out of reach is the primary safety priority. Infants should be placed
on their backs to sleep, and car seats should remain rear-facing until at least age 2. Side
rails of cribs should be up, but this is a standard safety practice from birth, not a new
priority specific to this age.
3. A nurse is calculating the maintenance fluid requirements for a child who
weighs 22 kg. Using the Holliday-Segar method, what is the child's daily
maintenance fluid requirement?
A. 1000 mL/day
,B. 1500 mL/day
C. 1600 mL/day
D. 2200 mL/day
Answer: C
Rationale: The Holliday-Segar method calculates maintenance fluids as 100 mL/kg for the
first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each additional kg. For a 22 kg
child: (10 kg x 100 mL) + (10 kg x 50 mL) + (2 kg x 20 mL) = 1000 mL + 500 mL + 40 mL
= 1540 mL/day. This is rounded to the closest option, 1600 mL/day.
4. A nurse is assessing a 2-week-old infant and notes a continuous, machinery-like
murmur. The nurse should suspect which of the following congenital cardiac
defects?
A. Ventricular Septal Defect (VSD)
B. Atrial Septal Defect (ASD)
C. Patent Ductus Arteriosus (PDA)
D. Coarctation of the Aorta
Answer: C
Rationale: A patent ductus arteriosus (PDA) is characterized by a continuous, machinery-
like murmur due to the constant flow of blood from the high-pressure aorta to the low-
pressure pulmonary artery throughout the cardiac cycle. A VSD is a holosystolic murmur,
an ASD is a systolic ejection murmur, and coarctation of the aorta is characterized by
hypertension in the upper extremities and weak or absent femoral pulses.
5. A nurse is caring for a child with acute glomerulonephritis. Which of the
following dietary restrictions is most appropriate for this child?
A. Increased potassium intake.
B. Increased calcium intake.
C. Sodium restriction.
D. High-protein diet.
Answer: C
Rationale: Acute glomerulonephritis involves inflammation of the glomeruli, leading to
decreased glomerular filtration rate (GFR) and fluid retention, which manifests as edema
and hypertension. Sodium restriction is crucial to help manage fluid overload and
hypertension. Protein may be moderately restricted in severe cases, and potassium may be
restricted if hyperkalemia is present.
6. A nurse is preparing to administer a vaccine to a 2-month-old infant. Which of
the following vaccines should the nurse plan to administer?
A. MMR (Measles, Mumps, Rubella)
,B. Varicella
C. DTaP (Diphtheria, Tetanus, Pertussis)
D. Hepatitis A
Answer: C
Rationale: The recommended immunization schedule for a 2-month-old infant includes
the first dose of DTaP, IPV (inactivated poliovirus), Hib (Haemophilus influenzae type b),
PCV (pneumococcal conjugate), and RV (rotavirus). MMR and Varicella are typically
administered at 12-15 months, and Hepatitis A is given at 12 months.
7. A nurse is assessing a toddler who has just been diagnosed with iron-deficiency
anemia. Which of the following findings is consistent with this diagnosis?
A. Polycythemia
B. Hyperactivity
C. Pica
D. Bradycardia
Answer: C
Rationale: Pica, the craving and ingestion of nonfood items such as dirt or ice, is a classic
behavioral manifestation of iron-deficiency anemia in children. Other findings include
pallor, fatigue, tachycardia, and systolic murmurs.
8. A nurse is caring for a child in sickle cell crisis who is experiencing severe pain.
What is the priority nursing intervention?
A. Administering oxygen via nasal cannula.
B. Applying cold compresses to painful joints.
C. Restricting oral fluid intake.
D. Administering pain medication as prescribed.
Answer: D
Rationale: While oxygen and hydration are crucial components of care, pain management
is the priority for a child in a sickle cell crisis. Pain is often severe and requires prompt
administration of analgesics, usually opioids. Cold compresses should be avoided as they
can cause vasoconstriction; warm compresses are preferred.
9. A nurse is providing discharge teaching to the parents of a 6-month-old infant
who has just had a cleft lip repair. Which of the following statements indicates the
parents understand the teaching?
A. "We will use a soft-bristled toothbrush to clean the suture line."
B. "We will apply antibiotic ointment to the suture line as prescribed."
C. "We will use a straw to feed our baby."
D. "We will keep the baby in a prone position to prevent aspiration."
, Answer: B
Rationale: After cleft lip repair, the suture line must be kept clean and moist. Applying
antibiotic ointment as prescribed helps prevent infection and keeps the tissue moist. A
soft-bristled toothbrush can disrupt the sutures; a straw can create negative pressure on
the suture line, and the infant should be positioned on their side or back to prevent
rubbing the suture line on the mattress.
10. A nurse is assessing a child with suspected meningitis. Which of the following
signs is a positive indicator of meningeal irritation?
A. Brudzinski's sign
B. Kernig's sign
C. Babinski's sign
D. Both A and B
Answer: D
Rationale: Both Brudzinski's sign (flexion of the hips and knees when the neck is flexed)
and Kernig's sign (pain and resistance with knee extension when the hip is flexed) are
classic indicators of meningeal irritation, which is a hallmark of meningitis. Babinski's sign
is indicative of an upper motor neuron lesion, not specific to meningitis.
11. A nurse is caring for a child with a fever. What is the primary purpose of
administering antipyretics like acetaminophen or ibuprofen?
A. To eliminate the infection causing the fever.
B. To provide comfort and reduce metabolic demands.
C. To induce sleep and promote rest.
D. To prevent febrile seizures in all children.
Answer: B
Rationale: Antipyretics do not treat the underlying cause of the fever (infection); they are
administered to reduce fever and promote comfort. Lowering the body temperature also
reduces the metabolic rate, which can be beneficial in a sick child. While they are used to
prevent febrile seizures in some high-risk cases, this is not their primary purpose for every
child with a fever.
12. A nurse is assessing a 10-year-old child who has type 1 diabetes mellitus. The
child is drowsy, has flushed skin, and has a fruity odor to their breath. Which of
the following conditions should the nurse suspect?
A. Hypoglycemia
B. Diabetic Ketoacidosis (DKA)
C. Hyperglycemic Hyperosmolar State (HHS)
D. Insulin Shock
