ATI PEDIATRICS PROCTORED EXAM 2023
RN NURSING COMPREHENSIVE TEST BANK 2026/2027
Instructions:
Choose the best answer for each question.
1. A nurse is assessing a 2-year-old toddler. Which of the following developmental
milestones should the nurse expect to observe?
A. Rides a tricycle
B. Builds a tower of 6-7 blocks
C. Uses a spoon effectively
D. Walks up and down stairs independently
Answer: C
Rationale: A 2-year-old typically has the fine motor skills to use a spoon effectively,
though with some spilling. Riding a tricycle and building a 6-7 block tower are skills of a
3-year-old. Walking up and down stairs independently is usually achieved by a 3-year-old,
while a 2-year-old can usually walk up and down stairs with assistance.
2. A nurse is caring for a 6-month-old infant with a diagnosis of bronchiolitis.
Which of the following assessment findings should the nurse report to the
provider immediately?
A. Respiratory rate of 40 breaths/min
B. Nasal flaring
C. Apnea episode lasting 20 seconds
D. Oxygen saturation of 92%
Answer: C
Rationale: Apnea (cessation of breathing for 20 seconds or longer) is a critical finding in an
infant and indicates severe respiratory distress or failure. It requires immediate
intervention. Nasal flaring and a respiratory rate of 40 are signs of respiratory distress but
,are expected in bronchiolitis. An oxygen saturation of 92% requires intervention like
supplemental oxygen but is not as immediately life-threatening as an apneic episode.
3. A nurse is preparing to administer a vaccine to a 4-year-old child. Which of the
following is a contraindication for receiving the Measles, Mumps, Rubella (MMR)
vaccine?
A. A mild upper respiratory infection
B. A history of an anaphylactic reaction to gelatin
C. A temperature of 37.2°C (99.0°F)
D. Recent exposure to varicella
Answer: B
Rationale: A severe allergic reaction (anaphylaxis) to a previous vaccine dose or a vaccine
component (like gelatin or neomycin) is an absolute contraindication to receiving the
MMR vaccine. Mild illnesses with or without fever are not contraindications. Recent
exposure to varicella is not a contraindication to receiving the MMR vaccine.
4. A nurse is providing teaching to the parents of a child who has iron-deficiency
anemia. Which of the following dietary instructions should the nurse include?
A. "Encourage your child to drink milk with meals."
B. "Feed your child foods like apricots and raisins."
C. "Increase your child's intake of whole grain bread."
D. "Offer your child a glass of orange juice with iron supplements."
Answer: D
Rationale: Vitamin C (ascorbic acid) enhances the absorption of iron. Orange juice is a
good source of Vitamin C and should be given with iron supplements. Milk interferes with
iron absorption. Whole grains and raisins are good sources of iron, but the instruction
about orange juice is specifically about increasing absorption of the supplement, making it
the most important teaching point.
,5. A nurse is assessing a newborn for congenital hip dysplasia. Which of the
following findings should the nurse expect?
A. Negative Ortolani sign
B. Positive Barlow sign
C. Symmetrical gluteal folds
D. Full range of motion in the hips
Answer: B
Rationale: A positive Barlow sign (the hip dislocates when adducted and pushed
posteriorly) indicates congenital hip dysplasia. A positive Ortolani sign (the hip reduces
when abducted) is also a positive finding. Asymmetrical gluteal folds and limited range of
motion are also findings associated with hip dysplasia. A negative Ortolani sign is a
normal finding.
6. A nurse is planning care for a child with a diagnosis of acute glomerulonephritis.
Which of the following interventions should be included in the plan of care?
A. Monitor intake and output.
B. Encourage a high-protein diet.
C. Administer diuretics as prescribed.
D. Restrict fluids.
Answer: A
Rationale: Monitoring intake and output is essential in acute glomerulonephritis to assess
renal function and fluid balance. A low-protein, low-sodium, and potassium-restricted diet
is recommended. Diuretics are not typically used in the acute phase as they can further
compromise renal perfusion. Fluid restriction is necessary only if the child has significant
edema or hypertension.
7. A nurse is providing teaching to the parents of a child with a new diagnosis of
type 1 diabetes mellitus. Which of the following statements by the parents
indicates an understanding of the teaching?
A. "We will give insulin after our child eats."
B. "We will check our child's urine for ketones if their blood sugar is high."
C. "We will use a sliding scale for insulin based on our child's activity level."
D. "We will give our child a snack before physical activity."
, Answer: D
Rationale: Giving a snack before physical activity helps prevent hypoglycemia (low blood
sugar). Insulin should be given before meals, not after. Urine ketone testing is not as
accurate or timely as blood ketone testing. A sliding scale is based on blood glucose levels,
not activity level.
8. A nurse is assessing a 3-year-old child who has been hospitalized. Which of the
following behaviors is a common reaction to hospitalization in this age group?
A. Regression (e.g., thumb-sucking, bed-wetting)
B. Fear of bodily injury
C. Belief that hospitalization is a punishment
D. Withdrawal from the environment
Answer: A
Rationale: Regression to an earlier stage of development is a common defense mechanism
for a toddler/preschooler who is hospitalized. Fear of bodily injury is more common in
school-age children. Belief that hospitalization is a punishment is seen in the school-age
child who has magical thinking. Withdrawal is a reaction more commonly seen in
adolescents.
9. A nurse is caring for a child who has a seizure disorder and is prescribed
phenytoin. Which of the following adverse effects should the nurse monitor for?
A. Gingival hyperplasia
B. Weight gain
C. Urinary retention
D. Bradycardia
Answer: A
Rationale: Gingival hyperplasia (overgrowth of the gums) is a well-known adverse effect of
phenytoin. Proper oral hygiene can help minimize this effect. Weight gain is associated
with valproic acid. Urinary retention is associated with anticholinergic medications.
Bradycardia is a side effect of beta-blockers or digoxin.
RN NURSING COMPREHENSIVE TEST BANK 2026/2027
Instructions:
Choose the best answer for each question.
1. A nurse is assessing a 2-year-old toddler. Which of the following developmental
milestones should the nurse expect to observe?
A. Rides a tricycle
B. Builds a tower of 6-7 blocks
C. Uses a spoon effectively
D. Walks up and down stairs independently
Answer: C
Rationale: A 2-year-old typically has the fine motor skills to use a spoon effectively,
though with some spilling. Riding a tricycle and building a 6-7 block tower are skills of a
3-year-old. Walking up and down stairs independently is usually achieved by a 3-year-old,
while a 2-year-old can usually walk up and down stairs with assistance.
2. A nurse is caring for a 6-month-old infant with a diagnosis of bronchiolitis.
Which of the following assessment findings should the nurse report to the
provider immediately?
A. Respiratory rate of 40 breaths/min
B. Nasal flaring
C. Apnea episode lasting 20 seconds
D. Oxygen saturation of 92%
Answer: C
Rationale: Apnea (cessation of breathing for 20 seconds or longer) is a critical finding in an
infant and indicates severe respiratory distress or failure. It requires immediate
intervention. Nasal flaring and a respiratory rate of 40 are signs of respiratory distress but
,are expected in bronchiolitis. An oxygen saturation of 92% requires intervention like
supplemental oxygen but is not as immediately life-threatening as an apneic episode.
3. A nurse is preparing to administer a vaccine to a 4-year-old child. Which of the
following is a contraindication for receiving the Measles, Mumps, Rubella (MMR)
vaccine?
A. A mild upper respiratory infection
B. A history of an anaphylactic reaction to gelatin
C. A temperature of 37.2°C (99.0°F)
D. Recent exposure to varicella
Answer: B
Rationale: A severe allergic reaction (anaphylaxis) to a previous vaccine dose or a vaccine
component (like gelatin or neomycin) is an absolute contraindication to receiving the
MMR vaccine. Mild illnesses with or without fever are not contraindications. Recent
exposure to varicella is not a contraindication to receiving the MMR vaccine.
4. A nurse is providing teaching to the parents of a child who has iron-deficiency
anemia. Which of the following dietary instructions should the nurse include?
A. "Encourage your child to drink milk with meals."
B. "Feed your child foods like apricots and raisins."
C. "Increase your child's intake of whole grain bread."
D. "Offer your child a glass of orange juice with iron supplements."
Answer: D
Rationale: Vitamin C (ascorbic acid) enhances the absorption of iron. Orange juice is a
good source of Vitamin C and should be given with iron supplements. Milk interferes with
iron absorption. Whole grains and raisins are good sources of iron, but the instruction
about orange juice is specifically about increasing absorption of the supplement, making it
the most important teaching point.
,5. A nurse is assessing a newborn for congenital hip dysplasia. Which of the
following findings should the nurse expect?
A. Negative Ortolani sign
B. Positive Barlow sign
C. Symmetrical gluteal folds
D. Full range of motion in the hips
Answer: B
Rationale: A positive Barlow sign (the hip dislocates when adducted and pushed
posteriorly) indicates congenital hip dysplasia. A positive Ortolani sign (the hip reduces
when abducted) is also a positive finding. Asymmetrical gluteal folds and limited range of
motion are also findings associated with hip dysplasia. A negative Ortolani sign is a
normal finding.
6. A nurse is planning care for a child with a diagnosis of acute glomerulonephritis.
Which of the following interventions should be included in the plan of care?
A. Monitor intake and output.
B. Encourage a high-protein diet.
C. Administer diuretics as prescribed.
D. Restrict fluids.
Answer: A
Rationale: Monitoring intake and output is essential in acute glomerulonephritis to assess
renal function and fluid balance. A low-protein, low-sodium, and potassium-restricted diet
is recommended. Diuretics are not typically used in the acute phase as they can further
compromise renal perfusion. Fluid restriction is necessary only if the child has significant
edema or hypertension.
7. A nurse is providing teaching to the parents of a child with a new diagnosis of
type 1 diabetes mellitus. Which of the following statements by the parents
indicates an understanding of the teaching?
A. "We will give insulin after our child eats."
B. "We will check our child's urine for ketones if their blood sugar is high."
C. "We will use a sliding scale for insulin based on our child's activity level."
D. "We will give our child a snack before physical activity."
, Answer: D
Rationale: Giving a snack before physical activity helps prevent hypoglycemia (low blood
sugar). Insulin should be given before meals, not after. Urine ketone testing is not as
accurate or timely as blood ketone testing. A sliding scale is based on blood glucose levels,
not activity level.
8. A nurse is assessing a 3-year-old child who has been hospitalized. Which of the
following behaviors is a common reaction to hospitalization in this age group?
A. Regression (e.g., thumb-sucking, bed-wetting)
B. Fear of bodily injury
C. Belief that hospitalization is a punishment
D. Withdrawal from the environment
Answer: A
Rationale: Regression to an earlier stage of development is a common defense mechanism
for a toddler/preschooler who is hospitalized. Fear of bodily injury is more common in
school-age children. Belief that hospitalization is a punishment is seen in the school-age
child who has magical thinking. Withdrawal is a reaction more commonly seen in
adolescents.
9. A nurse is caring for a child who has a seizure disorder and is prescribed
phenytoin. Which of the following adverse effects should the nurse monitor for?
A. Gingival hyperplasia
B. Weight gain
C. Urinary retention
D. Bradycardia
Answer: A
Rationale: Gingival hyperplasia (overgrowth of the gums) is a well-known adverse effect of
phenytoin. Proper oral hygiene can help minimize this effect. Weight gain is associated
with valproic acid. Urinary retention is associated with anticholinergic medications.
Bradycardia is a side effect of beta-blockers or digoxin.
