RN ATI Pediatric Nursing Exam
RN Pediatric Nursing 2023 | 70 Questions | Comprehensive Review
Question 44 of 70 Image-Based
A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first?
■ A. An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10.
■ B. A toddler who has a partial-thickness burn on their right hand and requires a dressing change.
■ C. A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillin.
✔ D. An adolescent who has sickle cell anemia and slurred speech.
■ CORRECT ANSWER & RATIONALE
Answer: D. An adolescent who has sickle cell anemia and slurred speech.
Slurred speech in a child with sickle cell anemia may indicate a stroke (cerebrovascular accident), which is a life-
threatening emergency requiring immediate assessment. Neurological changes always take priority using the ABC framework
and Maslow's hierarchy.
,A nurse is teaching a parent of a preschool-age child about management of sleep terrors. Which of the
following instructions should the nurse include?
✔ A. Remain uninvolved until the child awakens.
■ B. Allow the child to fall asleep with the television on.
■ C. Schedule professional counseling for the child.
■ D. Take the child to the parent's bed to resume sleep.
■ CORRECT ANSWER & RATIONALE
Answer: A. Remain uninvolved until the child awakens.
Sleep terrors are a normal developmental occurrence in preschoolers. The best intervention is to remain calm and uninvolved until
the episode ends, as waking the child can cause confusion and prolong the episode.
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Question 60 of 70 Image-Based
A nurse is caring for a 10-year-old child who is dying and has refused pain medication. The child's
guardians ask the nurse about nonpharmacological alternatives. Which of the following actions
should the nurse take?
■ A. Increase lighting in the child's room.
■ B. Administer oxygen therapy to the child via facemask.
■ C. Provide the child with sucrose-containing liquids.
✔ D. Teach guided imagery exercises to the child.
■ CORRECT ANSWER & RATIONALE
Answer: D. Teach guided imagery exercises to the child.
Guided imagery is an age-appropriate nonpharmacological pain management technique for school-age children. Sucrose
solutions are appropriate for infants, not 10-year-olds.
,A nurse is providing teaching to the parent of a 10-month-old infant who is having difficulty eating.
The parent is feeding their infant goat milk. Which of the following instructions should the nurse
include?
■ A. Reinitiate breast feeding.
✔ B. Offer commercially prepared formula.
■ C. Warm the goat's milk before feeding.
■ D. Switch to soy milk.
■ CORRECT ANSWER & RATIONALE
Answer: B. Offer commercially prepared formula.
Goat's milk lacks adequate folate, iron, and vitamin D and is not appropriate for infants under 12 months. Commercially
prepared infant formula is nutritionally complete for infants.
, classmerit.com — The Marketplace to Buy and Sell Study Materials
Question 56 of 70 Image-Based
A nurse is providing teaching to the parent of a toddler who is scheduled for an
electrocardiogram. Which of the following statements should the nurse make?
■ A. "Leads will be placed on your child's back prior to the procedure."
✔ B. "Your child can rest on your lap during the procedure."
■ C. "This procedure will take at least 30 minutes to complete."
■ D. "An alarm will sound if your child has an abnormal heart rhythm."
■ CORRECT ANSWER & RATIONALE
Answer: B. "Your child can rest on your lap during the procedure."
Allowing a toddler to sit on the parent's lap during an ECG reduces anxiety and promotes cooperation. ECG leads are placed
on the chest and limbs, not the back. An ECG typically takes 5-10 minutes.
,A nurse is planning care for a child who has a prescription to transfuse 2 units of packed RBCs. Which
of the following interventions should the nurse include?
■ A. Administer RBCs using non-filtered IV tubing.
✔ B. Infuse each unit of blood within 4 hr.
■ C. Store the second unit of blood at room temperature for up to 2 hr.
■ D. Infuse dextrose 5% in water during the infusion of packed RBCs.
■ CORRECT ANSWER & RATIONALE
Answer: B. Infuse each unit of blood within 4 hr.
Each unit of packed RBCs must be infused within 4 hours to prevent bacterial growth and hemolysis. Blood must always be
administered through filtered tubing.
, classmerit.com — The Marketplace to Buy and Sell Study Materials
Question 39 of 70 Image-Based
A nurse is caring for an infant who weighs 7.8 kg (17.2 lb) and was admitted yesterday for treatment
of moderate dehydration. Which of the following findings indicates the infant's condition is
improving?
■ A. Dry mucous membranes
✔ B. Fontanel is level and soft.
■ C. Capillary refill is greater than 3 seconds.
■ D. Respiratory rate 70/min
■ CORRECT ANSWER & RATIONALE
Answer: B. Fontanel is level and soft.
A level and soft fontanel indicates normal intracranial pressure and adequate hydration. In dehydration, the fontanel becomes
sunken. Dry mucous membranes, prolonged capillary refill, and tachypnea are signs of continued dehydration.
,A nurse is planning care for an infant who has failure to thrive. Which of the following
interventions should the nurse include?
■ A. Ensure that the infant has a variety of caregivers.
■ B. Obtain and record the infant's weight weekly.
✔ C. Initiate formula that is 24 kcal/oz for the infant.
■ D. Administer 5 mL of megestrol to the infant with feedings.
■ CORRECT ANSWER & RATIONALE
Answer: C. Initiate formula that is 24 kcal/oz for the infant.
A 24 kcal/oz formula provides increased caloric density to promote weight gain in infants with failure to thrive. Weight
should be measured daily, not weekly.
, classmerit.com — The Marketplace to Buy and Sell Study Materials
Question 28 of 70 Image-Based
A nurse is admitting a 3-year-old child to the pediatric unit. Select the 5 findings that require
immediate follow-up.
■ A. Glucose, Hemoglobin, Neurologic assessment, Pain assessment, Temperature
✔ B. Neurologic assessment, Temperature, WBC, Peripheral pulses, Pain assessment
■ C. Abdominal assessment, WBC, Pain assessment, Temperature, Neurologic assessment
■ D. Hemoglobin, WBC, Peripheral pulses, Temperature, Neurologic assessment
■ CORRECT ANSWER & RATIONALE
Answer: B. Neurologic assessment, Temperature, WBC, Peripheral pulses, Pain assessment
For a child with signs suggesting meningitis, the priority findings requiring immediate follow-up are: neurologic assessment
(nuchal rigidity), temperature (fever), WBC (infection marker), peripheral pulses (circulation), and pain assessment.
, A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the
dressing is saturated with blood. Which of the following actions should the nurse take first?
■ A. Monitor the pulse distal to the insertion site.
■ B. Obtain vital signs.
✔ C. Apply pressure just above the insertion site.
■ D. Reinforce the dressing.
■ CORRECT ANSWER & RATIONALE
Answer: C. Apply pressure just above the insertion site.
Applying direct pressure above the femoral insertion site is the priority to control bleeding and prevent hemorrhage after
cardiac catheterization.
RN Pediatric Nursing 2023 | 70 Questions | Comprehensive Review
Question 44 of 70 Image-Based
A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first?
■ A. An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10.
■ B. A toddler who has a partial-thickness burn on their right hand and requires a dressing change.
■ C. A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillin.
✔ D. An adolescent who has sickle cell anemia and slurred speech.
■ CORRECT ANSWER & RATIONALE
Answer: D. An adolescent who has sickle cell anemia and slurred speech.
Slurred speech in a child with sickle cell anemia may indicate a stroke (cerebrovascular accident), which is a life-
threatening emergency requiring immediate assessment. Neurological changes always take priority using the ABC framework
and Maslow's hierarchy.
,A nurse is teaching a parent of a preschool-age child about management of sleep terrors. Which of the
following instructions should the nurse include?
✔ A. Remain uninvolved until the child awakens.
■ B. Allow the child to fall asleep with the television on.
■ C. Schedule professional counseling for the child.
■ D. Take the child to the parent's bed to resume sleep.
■ CORRECT ANSWER & RATIONALE
Answer: A. Remain uninvolved until the child awakens.
Sleep terrors are a normal developmental occurrence in preschoolers. The best intervention is to remain calm and uninvolved until
the episode ends, as waking the child can cause confusion and prolong the episode.
, classmerit.com — The Marketplace to Buy and Sell Study Materials
Question 60 of 70 Image-Based
A nurse is caring for a 10-year-old child who is dying and has refused pain medication. The child's
guardians ask the nurse about nonpharmacological alternatives. Which of the following actions
should the nurse take?
■ A. Increase lighting in the child's room.
■ B. Administer oxygen therapy to the child via facemask.
■ C. Provide the child with sucrose-containing liquids.
✔ D. Teach guided imagery exercises to the child.
■ CORRECT ANSWER & RATIONALE
Answer: D. Teach guided imagery exercises to the child.
Guided imagery is an age-appropriate nonpharmacological pain management technique for school-age children. Sucrose
solutions are appropriate for infants, not 10-year-olds.
,A nurse is providing teaching to the parent of a 10-month-old infant who is having difficulty eating.
The parent is feeding their infant goat milk. Which of the following instructions should the nurse
include?
■ A. Reinitiate breast feeding.
✔ B. Offer commercially prepared formula.
■ C. Warm the goat's milk before feeding.
■ D. Switch to soy milk.
■ CORRECT ANSWER & RATIONALE
Answer: B. Offer commercially prepared formula.
Goat's milk lacks adequate folate, iron, and vitamin D and is not appropriate for infants under 12 months. Commercially
prepared infant formula is nutritionally complete for infants.
, classmerit.com — The Marketplace to Buy and Sell Study Materials
Question 56 of 70 Image-Based
A nurse is providing teaching to the parent of a toddler who is scheduled for an
electrocardiogram. Which of the following statements should the nurse make?
■ A. "Leads will be placed on your child's back prior to the procedure."
✔ B. "Your child can rest on your lap during the procedure."
■ C. "This procedure will take at least 30 minutes to complete."
■ D. "An alarm will sound if your child has an abnormal heart rhythm."
■ CORRECT ANSWER & RATIONALE
Answer: B. "Your child can rest on your lap during the procedure."
Allowing a toddler to sit on the parent's lap during an ECG reduces anxiety and promotes cooperation. ECG leads are placed
on the chest and limbs, not the back. An ECG typically takes 5-10 minutes.
,A nurse is planning care for a child who has a prescription to transfuse 2 units of packed RBCs. Which
of the following interventions should the nurse include?
■ A. Administer RBCs using non-filtered IV tubing.
✔ B. Infuse each unit of blood within 4 hr.
■ C. Store the second unit of blood at room temperature for up to 2 hr.
■ D. Infuse dextrose 5% in water during the infusion of packed RBCs.
■ CORRECT ANSWER & RATIONALE
Answer: B. Infuse each unit of blood within 4 hr.
Each unit of packed RBCs must be infused within 4 hours to prevent bacterial growth and hemolysis. Blood must always be
administered through filtered tubing.
, classmerit.com — The Marketplace to Buy and Sell Study Materials
Question 39 of 70 Image-Based
A nurse is caring for an infant who weighs 7.8 kg (17.2 lb) and was admitted yesterday for treatment
of moderate dehydration. Which of the following findings indicates the infant's condition is
improving?
■ A. Dry mucous membranes
✔ B. Fontanel is level and soft.
■ C. Capillary refill is greater than 3 seconds.
■ D. Respiratory rate 70/min
■ CORRECT ANSWER & RATIONALE
Answer: B. Fontanel is level and soft.
A level and soft fontanel indicates normal intracranial pressure and adequate hydration. In dehydration, the fontanel becomes
sunken. Dry mucous membranes, prolonged capillary refill, and tachypnea are signs of continued dehydration.
,A nurse is planning care for an infant who has failure to thrive. Which of the following
interventions should the nurse include?
■ A. Ensure that the infant has a variety of caregivers.
■ B. Obtain and record the infant's weight weekly.
✔ C. Initiate formula that is 24 kcal/oz for the infant.
■ D. Administer 5 mL of megestrol to the infant with feedings.
■ CORRECT ANSWER & RATIONALE
Answer: C. Initiate formula that is 24 kcal/oz for the infant.
A 24 kcal/oz formula provides increased caloric density to promote weight gain in infants with failure to thrive. Weight
should be measured daily, not weekly.
, classmerit.com — The Marketplace to Buy and Sell Study Materials
Question 28 of 70 Image-Based
A nurse is admitting a 3-year-old child to the pediatric unit. Select the 5 findings that require
immediate follow-up.
■ A. Glucose, Hemoglobin, Neurologic assessment, Pain assessment, Temperature
✔ B. Neurologic assessment, Temperature, WBC, Peripheral pulses, Pain assessment
■ C. Abdominal assessment, WBC, Pain assessment, Temperature, Neurologic assessment
■ D. Hemoglobin, WBC, Peripheral pulses, Temperature, Neurologic assessment
■ CORRECT ANSWER & RATIONALE
Answer: B. Neurologic assessment, Temperature, WBC, Peripheral pulses, Pain assessment
For a child with signs suggesting meningitis, the priority findings requiring immediate follow-up are: neurologic assessment
(nuchal rigidity), temperature (fever), WBC (infection marker), peripheral pulses (circulation), and pain assessment.
, A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the
dressing is saturated with blood. Which of the following actions should the nurse take first?
■ A. Monitor the pulse distal to the insertion site.
■ B. Obtain vital signs.
✔ C. Apply pressure just above the insertion site.
■ D. Reinforce the dressing.
■ CORRECT ANSWER & RATIONALE
Answer: C. Apply pressure just above the insertion site.
Applying direct pressure above the femoral insertion site is the priority to control bleeding and prevent hemorrhage after
cardiac catheterization.
