ATI NCLEX Pediatric Nursing Questions, Answers, and
Rationales |Very Comprehensive | Latest 2025-2026 |
1. Question: A nurse is providing teaching to the parents of a school-aged child
who has ADHD. Which of the following instructions should the nurse include?
Answer: a. Place the child’s daily activities on an organizational chart
Rationale: Children with ADHD benefit from structured routines to manage
impulsivity and inattention. An organizational chart visually outlines daily tasks,
promoting consistency and reducing overwhelm. This tool helps the child
anticipate activities, improving focus and time management. Other options, like
rewarding positive behavior, are useful but less specific to daily structure. The
chart directly addresses the need for predictability, a key strategy in ADHD
management, as it aligns with evidence-based behavioral interventions for
school-aged children.
2. Question: A nurse is completing an admission assessment on an adolescent
child who is a vegetarian. He eats milk products but does not like beans. Which
of the following items should the nurse suggest the client order for lunch to
provide nutrients most likely to be lacking in his diet?
Answer: a. Peanut butter and jelly sandwich
1|Page
,Rationale: A vegetarian adolescent who consumes milk but avoids beans may
lack protein and iron. A peanut butter and jelly sandwich provides plant-based
protein and some iron, addressing these deficiencies. Milk products supply
calcium and vitamin D, but protein sources are limited without beans. This
choice supports nutritional balance, aligning with pediatric dietary guidelines
for vegetarians to ensure adequate growth and development.
3. Question: A nurse is caring for a child who has sickle cell anemia. Which of
the following findings is a priority for the nurse to report to the provider?
Answer: a. Facial twitching
Rationale: Facial twitching in a child with sickle cell anemia may indicate a
neurological complication, such as a stroke, due to vaso-occlusion in cerebral
blood vessels. This is a medical emergency requiring immediate reporting to
the provider. Other findings, like pain or fever, are common but less urgent
unless severe. Stroke risk is significant in sickle cell disease, and early
intervention can prevent long-term damage, making facial twitching the priority
finding to address promptly.
2|Page
,4. Question: A nurse is caring for a 1-month-old infant who weighs 3540 g and
is prescribed a dose of cefazolin 50 mg/kg IV bolus TID. How many mg should
the nurse administer per dose?
Answer: 177 mg
Rationale: To calculate the dose, multiply the infant’s weight (3540 g = 3.54 kg)
by the prescribed dose (50 mg/kg): 3.54 kg × 50 mg/kg = 177 mg per dose.
This ensures the infant receives the correct antibiotic amount for effective
treatment while avoiding toxicity. Accurate weight-based dosing is critical in
pediatric care to account for rapid growth and metabolism, aligning with
pharmacological safety standards.
5. Question: A nurse in the PACU is caring for a school-aged child immediately
after a tonsillectomy. Which of the following actions should the nurse take?
Answer: a. Place the child in a side-lying position
Rationale: After a tonsillectomy, placing the child in a side-lying position
promotes drainage of oral secretions and prevents aspiration, a critical concern
due to postoperative bleeding risk. This position also maintains airway patency.
3|Page
, Other actions, like encouraging swallowing, may increase bleeding risk. The
side-lying position aligns with postoperative care standards to ensure safety
and comfort while minimizing complications in the immediate recovery period
for pediatric patients.
6. Question: A nurse is performing a pre-college assessment on an adolescent.
Which of the following immunizations should the nurse anticipate
administering?
Answer: a. Meningococcal polysaccharide vaccine
Rationale: Adolescents require the meningococcal vaccine (MCV4) before
college due to increased risk of meningococcal disease in communal settings
like dormitories. This vaccine is typically administered at ages 11–12 with a
booster at 16–18, aligning with pre-college assessments. Other vaccines, like
Tdap, may also be given, but MCV4 is a priority. This aligns with CDC
immunization schedules to prevent outbreaks in high-risk settings.
4|Page
Rationales |Very Comprehensive | Latest 2025-2026 |
1. Question: A nurse is providing teaching to the parents of a school-aged child
who has ADHD. Which of the following instructions should the nurse include?
Answer: a. Place the child’s daily activities on an organizational chart
Rationale: Children with ADHD benefit from structured routines to manage
impulsivity and inattention. An organizational chart visually outlines daily tasks,
promoting consistency and reducing overwhelm. This tool helps the child
anticipate activities, improving focus and time management. Other options, like
rewarding positive behavior, are useful but less specific to daily structure. The
chart directly addresses the need for predictability, a key strategy in ADHD
management, as it aligns with evidence-based behavioral interventions for
school-aged children.
2. Question: A nurse is completing an admission assessment on an adolescent
child who is a vegetarian. He eats milk products but does not like beans. Which
of the following items should the nurse suggest the client order for lunch to
provide nutrients most likely to be lacking in his diet?
Answer: a. Peanut butter and jelly sandwich
1|Page
,Rationale: A vegetarian adolescent who consumes milk but avoids beans may
lack protein and iron. A peanut butter and jelly sandwich provides plant-based
protein and some iron, addressing these deficiencies. Milk products supply
calcium and vitamin D, but protein sources are limited without beans. This
choice supports nutritional balance, aligning with pediatric dietary guidelines
for vegetarians to ensure adequate growth and development.
3. Question: A nurse is caring for a child who has sickle cell anemia. Which of
the following findings is a priority for the nurse to report to the provider?
Answer: a. Facial twitching
Rationale: Facial twitching in a child with sickle cell anemia may indicate a
neurological complication, such as a stroke, due to vaso-occlusion in cerebral
blood vessels. This is a medical emergency requiring immediate reporting to
the provider. Other findings, like pain or fever, are common but less urgent
unless severe. Stroke risk is significant in sickle cell disease, and early
intervention can prevent long-term damage, making facial twitching the priority
finding to address promptly.
2|Page
,4. Question: A nurse is caring for a 1-month-old infant who weighs 3540 g and
is prescribed a dose of cefazolin 50 mg/kg IV bolus TID. How many mg should
the nurse administer per dose?
Answer: 177 mg
Rationale: To calculate the dose, multiply the infant’s weight (3540 g = 3.54 kg)
by the prescribed dose (50 mg/kg): 3.54 kg × 50 mg/kg = 177 mg per dose.
This ensures the infant receives the correct antibiotic amount for effective
treatment while avoiding toxicity. Accurate weight-based dosing is critical in
pediatric care to account for rapid growth and metabolism, aligning with
pharmacological safety standards.
5. Question: A nurse in the PACU is caring for a school-aged child immediately
after a tonsillectomy. Which of the following actions should the nurse take?
Answer: a. Place the child in a side-lying position
Rationale: After a tonsillectomy, placing the child in a side-lying position
promotes drainage of oral secretions and prevents aspiration, a critical concern
due to postoperative bleeding risk. This position also maintains airway patency.
3|Page
, Other actions, like encouraging swallowing, may increase bleeding risk. The
side-lying position aligns with postoperative care standards to ensure safety
and comfort while minimizing complications in the immediate recovery period
for pediatric patients.
6. Question: A nurse is performing a pre-college assessment on an adolescent.
Which of the following immunizations should the nurse anticipate
administering?
Answer: a. Meningococcal polysaccharide vaccine
Rationale: Adolescents require the meningococcal vaccine (MCV4) before
college due to increased risk of meningococcal disease in communal settings
like dormitories. This vaccine is typically administered at ages 11–12 with a
booster at 16–18, aligning with pre-college assessments. Other vaccines, like
Tdap, may also be given, but MCV4 is a priority. This aligns with CDC
immunization schedules to prevent outbreaks in high-risk settings.
4|Page
