ATI PN Pediatric Proctored Exam Version 2
Case Scenarios Questions and Answers
Case Scenario 1: Respiratory Distress
A 4-year-old child presents to the ER with nasal flaring, intercostal retractions, and
oxygen saturation of 88% on room air.
Question: What is the nurse’s priority action?
A. Administer albuterol inhaler
B. Apply oxygen via non-rebreather mask
C. Notify respiratory therapy
D. Encourage slow deep breathing
Answer: B. Apply oxygen via non-rebreather mask (Airway and oxygenation are
priority.)
Case Scenario 2: Dehydration
A toddler with gastroenteritis has sunken eyes, dry mucous membranes, and
capillary refill >3 seconds.
Question: Which IV fluid is most appropriate for initial rehydration?
A. 0.9% Normal saline
B. D5W
C. 0.45% Normal saline
D. Lactated Ringer’s with dextrose
Answer: A. 0.9% Normal saline (Isotonic fluids are used for initial rehydration.)
Case Scenario 3: Pain Management
A 6-year-old post-tonsillectomy patient reports throat pain rated 8/10.
Question: Which intervention should the nurse implement first?
A. Offer ice chips
B. Administer prescribed acetaminophen
C. Encourage coughing and deep breathing
D. Provide warm fluids
Answer: B. Administer prescribed acetaminophen (Pharmacologic pain relief is
priority.)
Case Scenario 4: Immunizations
A 12-month-old is scheduled for routine vaccines.
Question: Which vaccines should the nurse anticipate administering?
A. MMR, Varicella, Hepatitis A
B. DTaP, Hib, IPV
C. Influenza (nasal spray), HPV
D. Pneumococcal, Rotavirus
Answer: A. MMR, Varicella, Hepatitis A (These are due at 12 months.)
,Case Scenario 5: Diabetes Management
A school-age child with Type 1 diabetes presents with blood glucose of 45 mg/dL,
sweating, and irritability.
Question: What is the nurse’s immediate action?
A. Administer IV insulin
B. Provide 4 oz of orange juice
C. Call the provider
D. Encourage physical activity
Answer: B. Provide 4 oz of orange juice (Treat hypoglycemia with fast-acting
carbs.)
Case Scenario 6: Seizure Precautions
A child with epilepsy is admitted for observation.
Question: Which intervention should be included in the plan of care?
A. Keep suction equipment at bedside
B. Insert padded tongue blade
C. Place child in high Fowler’s position
D. Restrict fluids
Answer: A. Keep suction equipment at bedside (Maintain airway during seizures.)
Case Scenario 7: Growth & Development
A nurse is assessing a 2-year-old child.
Question: Which developmental milestone is expected?
A. Copies a circle
B. Rides a tricycle
C. Uses 2-word sentences
D. Ties shoelaces
Answer: C. Uses 2-word sentences (Language development at age 2.)
Case Scenario 8: Asthma Exacerbation
A 7-year-old with asthma is wheezing and has an O₂ saturation of 91%.
Question: Which medication should the nurse administer first?
A. Montelukast
B. Albuterol
C. Prednisone
D. Salmeterol
Answer: B. Albuterol (Short-acting bronchodilator for acute relief.)
Case Scenario 9: Cystic Fibrosis
A child with cystic fibrosis is admitted with thick sputum and frequent cough.
Question: Which intervention is most important?
A. Encourage fluid restriction
, B. Perform chest physiotherapy
C. Administer antitussives
D. Limit physical activity
Answer: B. Perform chest physiotherapy (Helps mobilize secretions.)
Case Scenario 10: Otitis Media
A toddler with otitis media is prescribed amoxicillin.
Question: What teaching should the nurse provide to the parent?
A. Complete the full course of antibiotics
B. Stop medication once fever resolves
C. Avoid giving fluids during treatment
D. Expect permanent hearing loss
Answer: A. Complete the full course of antibiotics
Case Scenario 11: Sickle Cell Crisis
A child with sickle cell anemia presents with severe pain.
Question: Which intervention is priority?
A. Administer oxygen
B. Provide IV fluids
C. Apply cold compresses
D. Encourage ambulation
Answer: B. Provide IV fluids (Hydration reduces sickling.)
Case Scenario 12: Rheumatic Fever
A child with rheumatic fever has a new heart murmur.
Question: Which diagnostic test is most appropriate?
A. Chest X-ray
B. Echocardiogram
C. CT scan
D. EEG
Answer: B. Echocardiogram (Assesses cardiac involvement.)
Case Scenario 13: Appendicitis
A 10-year-old presents with RLQ pain and rebound tenderness.
Question: Which action should the nurse avoid?
A. Keep NPO
B. Administer IV fluids
C. Apply heat to abdomen
D. Prepare for surgery
Answer: C. Apply heat to abdomen (Heat may worsen inflammation.)
Case Scenario 14: Kawasaki Disease
A child with Kawasaki disease is receiving IV immunoglobulin.
Case Scenarios Questions and Answers
Case Scenario 1: Respiratory Distress
A 4-year-old child presents to the ER with nasal flaring, intercostal retractions, and
oxygen saturation of 88% on room air.
Question: What is the nurse’s priority action?
A. Administer albuterol inhaler
B. Apply oxygen via non-rebreather mask
C. Notify respiratory therapy
D. Encourage slow deep breathing
Answer: B. Apply oxygen via non-rebreather mask (Airway and oxygenation are
priority.)
Case Scenario 2: Dehydration
A toddler with gastroenteritis has sunken eyes, dry mucous membranes, and
capillary refill >3 seconds.
Question: Which IV fluid is most appropriate for initial rehydration?
A. 0.9% Normal saline
B. D5W
C. 0.45% Normal saline
D. Lactated Ringer’s with dextrose
Answer: A. 0.9% Normal saline (Isotonic fluids are used for initial rehydration.)
Case Scenario 3: Pain Management
A 6-year-old post-tonsillectomy patient reports throat pain rated 8/10.
Question: Which intervention should the nurse implement first?
A. Offer ice chips
B. Administer prescribed acetaminophen
C. Encourage coughing and deep breathing
D. Provide warm fluids
Answer: B. Administer prescribed acetaminophen (Pharmacologic pain relief is
priority.)
Case Scenario 4: Immunizations
A 12-month-old is scheduled for routine vaccines.
Question: Which vaccines should the nurse anticipate administering?
A. MMR, Varicella, Hepatitis A
B. DTaP, Hib, IPV
C. Influenza (nasal spray), HPV
D. Pneumococcal, Rotavirus
Answer: A. MMR, Varicella, Hepatitis A (These are due at 12 months.)
,Case Scenario 5: Diabetes Management
A school-age child with Type 1 diabetes presents with blood glucose of 45 mg/dL,
sweating, and irritability.
Question: What is the nurse’s immediate action?
A. Administer IV insulin
B. Provide 4 oz of orange juice
C. Call the provider
D. Encourage physical activity
Answer: B. Provide 4 oz of orange juice (Treat hypoglycemia with fast-acting
carbs.)
Case Scenario 6: Seizure Precautions
A child with epilepsy is admitted for observation.
Question: Which intervention should be included in the plan of care?
A. Keep suction equipment at bedside
B. Insert padded tongue blade
C. Place child in high Fowler’s position
D. Restrict fluids
Answer: A. Keep suction equipment at bedside (Maintain airway during seizures.)
Case Scenario 7: Growth & Development
A nurse is assessing a 2-year-old child.
Question: Which developmental milestone is expected?
A. Copies a circle
B. Rides a tricycle
C. Uses 2-word sentences
D. Ties shoelaces
Answer: C. Uses 2-word sentences (Language development at age 2.)
Case Scenario 8: Asthma Exacerbation
A 7-year-old with asthma is wheezing and has an O₂ saturation of 91%.
Question: Which medication should the nurse administer first?
A. Montelukast
B. Albuterol
C. Prednisone
D. Salmeterol
Answer: B. Albuterol (Short-acting bronchodilator for acute relief.)
Case Scenario 9: Cystic Fibrosis
A child with cystic fibrosis is admitted with thick sputum and frequent cough.
Question: Which intervention is most important?
A. Encourage fluid restriction
, B. Perform chest physiotherapy
C. Administer antitussives
D. Limit physical activity
Answer: B. Perform chest physiotherapy (Helps mobilize secretions.)
Case Scenario 10: Otitis Media
A toddler with otitis media is prescribed amoxicillin.
Question: What teaching should the nurse provide to the parent?
A. Complete the full course of antibiotics
B. Stop medication once fever resolves
C. Avoid giving fluids during treatment
D. Expect permanent hearing loss
Answer: A. Complete the full course of antibiotics
Case Scenario 11: Sickle Cell Crisis
A child with sickle cell anemia presents with severe pain.
Question: Which intervention is priority?
A. Administer oxygen
B. Provide IV fluids
C. Apply cold compresses
D. Encourage ambulation
Answer: B. Provide IV fluids (Hydration reduces sickling.)
Case Scenario 12: Rheumatic Fever
A child with rheumatic fever has a new heart murmur.
Question: Which diagnostic test is most appropriate?
A. Chest X-ray
B. Echocardiogram
C. CT scan
D. EEG
Answer: B. Echocardiogram (Assesses cardiac involvement.)
Case Scenario 13: Appendicitis
A 10-year-old presents with RLQ pain and rebound tenderness.
Question: Which action should the nurse avoid?
A. Keep NPO
B. Administer IV fluids
C. Apply heat to abdomen
D. Prepare for surgery
Answer: C. Apply heat to abdomen (Heat may worsen inflammation.)
Case Scenario 14: Kawasaki Disease
A child with Kawasaki disease is receiving IV immunoglobulin.
