❖ ATI Pediatrics Proctored Exam Updated 2026 |
220+ Practice Questions & Verified Answers |
Comprehensive Study Guide, Exam Prep Test
Bank, Growth & Development, Pediatric
Assessment, Neonatal Care, Pediatric
Pharmacology, Childhood Disorders,
Immunizations, Medication Safety, Clinical
Judgment, ATI RN & NCLEX-RN Review
Question 1: A 2-day-old newborn, born at 39 weeks gestation via spontaneous
vaginal delivery, is being evaluated for a shallow, irregular breathing pattern
with brief pauses of 5 seconds followed by rapid breaths. The infant is pink,
with a heart rate of 140 bpm and oxygen saturation of 97% on room air. Which
of the following is the most appropriate nursing action?
A. Administer supplemental oxygen via nasal cannula at 2 L/min.
B. Prepare for immediate endotracheal intubation.
C. Document this as periodic breathing and continue routine monitoring.
D. Notify the neonatal intensive care unit (NICU) provider for an emergent consult.
CORRECT ANSWER: C. Document this as periodic breathing and continue
routine monitoring.
Rationale:Periodic breathing, characterized by pauses in respiration lasting 5 to 10
seconds followed by a series of rapid breaths, is a common and benign finding in
preterm and some term newborns. It does not cause cyanosis, bradycardia, or oxygen
desaturation. The infant is hemodynamically stable, so the most appropriate action is to
document the finding and continue routine monitoring.
Question 2: The parent of a 6-month-old infant reports that the infant cries
intensely and draws their legs up to the abdomen during feeding. The parent
notes that the infant has had several episodes of "currant jelly" stools in the
past 4 hours. Which of the following interventions should the nurse anticipate?
A. Administration of oral rehydration solution.
B. Preparation for a barium enema.
C. Initiation of broad-spectrum antibiotics.
D. Surgical resection of the bowel.
CORRECT ANSWER: B. Preparation for a barium enema.
Rationale:The presentation of sudden, severe paroxysmal abdominal pain, drawing up
of the legs, and "currant jelly" stools is classic for intussusception. The initial diagnostic
and often therapeutic procedure for intussusception is a barium or air-contrast enema,
which can reduce the intussusception in many cases. Surgery is reserved for cases
where the enema is unsuccessful or if there are signs of perforation or peritonitis.
,Question 3: A 10-year-old child with cystic fibrosis is admitted with a
pulmonary exacerbation. The child's morning laboratory results show a serum
potassium of 3.2 mEq/L. Which of the following findings is most consistent
with this electrolyte imbalance?
A. Prolonged PR interval on electrocardiogram.
B. Flattened T waves on electrocardiogram.
C. Peaked, narrow T waves on electrocardiogram.
D. Widened QRS complex on electrocardiogram.
CORRECT ANSWER: B. Flattened T waves on electrocardiogram.
Rationale:Hypokalemia (serum potassium < 3.5 mEq/L) is a common complication in
cystic fibrosis due to excessive potassium loss in sweat. Classic electrocardiogram (ECG)
changes associated with hypokalemia include flattened or inverted T waves and the
presence of a U wave. Peaked T waves are characteristic of hyperkalemia.
Question 4: The nurse is preparing to administer immunizations to a 4-year-
old child. Which of the following vaccines should the nurse anticipate
administering at this visit?
A. Hepatitis B (HepB) and Inactivated Poliovirus (IPV).
B. MMR, Varicella, and DTaP.
C. MMR and Varicella only.
D. DTaP, IPV, MMR, and Varicella.
CORRECT ANSWER: D. DTaP, IPV, MMR, and Varicella.
Rationale:According to the CDC's recommended immunization schedule for children 4-
6 years of age, the following vaccines are routinely administered at the 4-year visit:
Diphtheria, Tetanus, and acellular Pertussis (DTaP), Inactivated Poliovirus (IPV),
Measles, Mumps, Rubella (MMR), and Varicella. Hepatitis B is typically given at birth, 1-
2 months, and 6-18 months.
Question 5: An 8-month-old infant is being evaluated for failure to thrive. The
mother reports that the infant has been exclusively breastfed but now seems
uninterested in feeding and is not sitting without support. Which of the
following is the priority nursing assessment?
A. Developmental milestones for a 6-month-old.
B. Assessment of the mother's milk supply and feeding technique.
C. Detailed 24-hour dietary recall and feeding history.
D. Serum albumin and prealbumin levels.
CORRECT ANSWER: C. Detailed 24-hour dietary recall and feeding history.
,Rationale:When evaluating an infant for failure to thrive (FTT), the priority is a
thorough history, including a detailed dietary recall, feeding patterns, and the parent-
infant interaction during feeding. This provides the most direct information about caloric
intake and possible feeding issues. While growth parameters and milestones are
important, the history is the foundational step to identify the cause.
Question 6: A 3-year-old child with sickle cell anemia is admitted with a vaso-
occlusive crisis. The child is in significant pain and has a temperature of
38.5°C. Which of the following interventions is most important for the nurse to
implement first?
A. Administer morphine sulfate as prescribed for pain.
B. Apply cold compresses to the affected joints.
C. Obtain blood cultures and administer antibiotics.
D. Encourage increased oral fluid intake.
CORRECT ANSWER: C. Obtain blood cultures and administer antibiotics.
Rationale:Children with sickle cell anemia are at high risk for sepsis, particularly due to
functional asplenia. Fever is a medical emergency in these patients, as it can be the first
sign of a life-threatening infection. The priority is to obtain blood cultures and initiate
broad-spectrum antibiotics promptly, even before the source of infection is identified.
Pain management and hydration are also crucial but secondary to ruling out and
treating sepsis.
Question 7: A 15-year-old adolescent reports experiencing a sudden onset of
palpitations, chest pain, and shortness of breath while at rest. The adolescent
is thin, tall, and has long fingers. Which of the following findings is most likely
to be noted on a cardiac assessment?
A. A midsystolic click and a late systolic murmur.
B. A continuous, machine-like murmur.
C. An early diastolic decrescendo murmur.
D. A harsh systolic ejection murmur at the left sternal border.
CORRECT ANSWER: A. A midsystolic click and a late systolic murmur.
Rationale:The adolescent's physical characteristics (tall, thin, long fingers) and
symptoms suggest Marfan syndrome, which is associated with mitral valve prolapse
(MVP). MVP is characterized by a midsystolic click, often followed by a late systolic
murmur due to mitral regurgitation. This is a classic cardiac finding in this patient
population.
, Question 8: The nurse is caring for a 2-day-old newborn who is noted to have a
single, palpable umbilical artery. The healthcare provider orders a renal
ultrasound. What is the primary rationale for this diagnostic test?
A. To rule out a congenital diaphragmatic hernia.
B. To evaluate for renal anomalies.
C. To assess for a patent ductus arteriosus.
D. To confirm the diagnosis of omphalocele.
CORRECT ANSWER: B. To evaluate for renal anomalies.
Rationale:A single umbilical artery (SUA) is present in about 1% of pregnancies and is
associated with a higher incidence of congenital anomalies, particularly of the renal and
urinary tract systems. Therefore, a renal ultrasound is typically recommended to screen
for renal abnormalities such as renal agenesis, cystic kidney disease, or hydronephrosis.
Question 9: A school nurse is teaching a group of adolescents about the
prevention of sexually transmitted infections (STIs). Which of the following
statements made by an adolescent indicates a need for further teaching
regarding the use of condoms?
A. "I should use a new condom for each sexual act."
B. "I should use oil-based lubricants with latex condoms."
C. "I should hold the condom at the rim when withdrawing."
D. "I should check the expiration date on the condom package."
CORRECT ANSWER: B. "I should use oil-based lubricants with latex condoms."
Rationale:Oil-based lubricants (e.g., Vaseline, baby oil, lotion) can degrade latex and
cause the condom to break. Water-based or silicone-based lubricants are safe to use
with latex condoms. All other statements are correct and indicate proper understanding
of condom use.
Question 10: A 5-year-old child with acute lymphoblastic leukemia (ALL) is
receiving induction chemotherapy. The child's absolute neutrophil count (ANC)
is 200/mm³. Which of the following clinical manifestations should the nurse
monitor for as a priority?
A. Mucositis and mouth ulcers.
B. Pallor and fatigue.
C. Fever and sepsis.
D. Prolonged bleeding from venipuncture sites.
CORRECT ANSWER: C. Fever and sepsis.
Rationale:An ANC of < 500/mm³ indicates severe neutropenia, placing the child at a
significantly high risk for life-threatening infections. The priority is to monitor for early
220+ Practice Questions & Verified Answers |
Comprehensive Study Guide, Exam Prep Test
Bank, Growth & Development, Pediatric
Assessment, Neonatal Care, Pediatric
Pharmacology, Childhood Disorders,
Immunizations, Medication Safety, Clinical
Judgment, ATI RN & NCLEX-RN Review
Question 1: A 2-day-old newborn, born at 39 weeks gestation via spontaneous
vaginal delivery, is being evaluated for a shallow, irregular breathing pattern
with brief pauses of 5 seconds followed by rapid breaths. The infant is pink,
with a heart rate of 140 bpm and oxygen saturation of 97% on room air. Which
of the following is the most appropriate nursing action?
A. Administer supplemental oxygen via nasal cannula at 2 L/min.
B. Prepare for immediate endotracheal intubation.
C. Document this as periodic breathing and continue routine monitoring.
D. Notify the neonatal intensive care unit (NICU) provider for an emergent consult.
CORRECT ANSWER: C. Document this as periodic breathing and continue
routine monitoring.
Rationale:Periodic breathing, characterized by pauses in respiration lasting 5 to 10
seconds followed by a series of rapid breaths, is a common and benign finding in
preterm and some term newborns. It does not cause cyanosis, bradycardia, or oxygen
desaturation. The infant is hemodynamically stable, so the most appropriate action is to
document the finding and continue routine monitoring.
Question 2: The parent of a 6-month-old infant reports that the infant cries
intensely and draws their legs up to the abdomen during feeding. The parent
notes that the infant has had several episodes of "currant jelly" stools in the
past 4 hours. Which of the following interventions should the nurse anticipate?
A. Administration of oral rehydration solution.
B. Preparation for a barium enema.
C. Initiation of broad-spectrum antibiotics.
D. Surgical resection of the bowel.
CORRECT ANSWER: B. Preparation for a barium enema.
Rationale:The presentation of sudden, severe paroxysmal abdominal pain, drawing up
of the legs, and "currant jelly" stools is classic for intussusception. The initial diagnostic
and often therapeutic procedure for intussusception is a barium or air-contrast enema,
which can reduce the intussusception in many cases. Surgery is reserved for cases
where the enema is unsuccessful or if there are signs of perforation or peritonitis.
,Question 3: A 10-year-old child with cystic fibrosis is admitted with a
pulmonary exacerbation. The child's morning laboratory results show a serum
potassium of 3.2 mEq/L. Which of the following findings is most consistent
with this electrolyte imbalance?
A. Prolonged PR interval on electrocardiogram.
B. Flattened T waves on electrocardiogram.
C. Peaked, narrow T waves on electrocardiogram.
D. Widened QRS complex on electrocardiogram.
CORRECT ANSWER: B. Flattened T waves on electrocardiogram.
Rationale:Hypokalemia (serum potassium < 3.5 mEq/L) is a common complication in
cystic fibrosis due to excessive potassium loss in sweat. Classic electrocardiogram (ECG)
changes associated with hypokalemia include flattened or inverted T waves and the
presence of a U wave. Peaked T waves are characteristic of hyperkalemia.
Question 4: The nurse is preparing to administer immunizations to a 4-year-
old child. Which of the following vaccines should the nurse anticipate
administering at this visit?
A. Hepatitis B (HepB) and Inactivated Poliovirus (IPV).
B. MMR, Varicella, and DTaP.
C. MMR and Varicella only.
D. DTaP, IPV, MMR, and Varicella.
CORRECT ANSWER: D. DTaP, IPV, MMR, and Varicella.
Rationale:According to the CDC's recommended immunization schedule for children 4-
6 years of age, the following vaccines are routinely administered at the 4-year visit:
Diphtheria, Tetanus, and acellular Pertussis (DTaP), Inactivated Poliovirus (IPV),
Measles, Mumps, Rubella (MMR), and Varicella. Hepatitis B is typically given at birth, 1-
2 months, and 6-18 months.
Question 5: An 8-month-old infant is being evaluated for failure to thrive. The
mother reports that the infant has been exclusively breastfed but now seems
uninterested in feeding and is not sitting without support. Which of the
following is the priority nursing assessment?
A. Developmental milestones for a 6-month-old.
B. Assessment of the mother's milk supply and feeding technique.
C. Detailed 24-hour dietary recall and feeding history.
D. Serum albumin and prealbumin levels.
CORRECT ANSWER: C. Detailed 24-hour dietary recall and feeding history.
,Rationale:When evaluating an infant for failure to thrive (FTT), the priority is a
thorough history, including a detailed dietary recall, feeding patterns, and the parent-
infant interaction during feeding. This provides the most direct information about caloric
intake and possible feeding issues. While growth parameters and milestones are
important, the history is the foundational step to identify the cause.
Question 6: A 3-year-old child with sickle cell anemia is admitted with a vaso-
occlusive crisis. The child is in significant pain and has a temperature of
38.5°C. Which of the following interventions is most important for the nurse to
implement first?
A. Administer morphine sulfate as prescribed for pain.
B. Apply cold compresses to the affected joints.
C. Obtain blood cultures and administer antibiotics.
D. Encourage increased oral fluid intake.
CORRECT ANSWER: C. Obtain blood cultures and administer antibiotics.
Rationale:Children with sickle cell anemia are at high risk for sepsis, particularly due to
functional asplenia. Fever is a medical emergency in these patients, as it can be the first
sign of a life-threatening infection. The priority is to obtain blood cultures and initiate
broad-spectrum antibiotics promptly, even before the source of infection is identified.
Pain management and hydration are also crucial but secondary to ruling out and
treating sepsis.
Question 7: A 15-year-old adolescent reports experiencing a sudden onset of
palpitations, chest pain, and shortness of breath while at rest. The adolescent
is thin, tall, and has long fingers. Which of the following findings is most likely
to be noted on a cardiac assessment?
A. A midsystolic click and a late systolic murmur.
B. A continuous, machine-like murmur.
C. An early diastolic decrescendo murmur.
D. A harsh systolic ejection murmur at the left sternal border.
CORRECT ANSWER: A. A midsystolic click and a late systolic murmur.
Rationale:The adolescent's physical characteristics (tall, thin, long fingers) and
symptoms suggest Marfan syndrome, which is associated with mitral valve prolapse
(MVP). MVP is characterized by a midsystolic click, often followed by a late systolic
murmur due to mitral regurgitation. This is a classic cardiac finding in this patient
population.
, Question 8: The nurse is caring for a 2-day-old newborn who is noted to have a
single, palpable umbilical artery. The healthcare provider orders a renal
ultrasound. What is the primary rationale for this diagnostic test?
A. To rule out a congenital diaphragmatic hernia.
B. To evaluate for renal anomalies.
C. To assess for a patent ductus arteriosus.
D. To confirm the diagnosis of omphalocele.
CORRECT ANSWER: B. To evaluate for renal anomalies.
Rationale:A single umbilical artery (SUA) is present in about 1% of pregnancies and is
associated with a higher incidence of congenital anomalies, particularly of the renal and
urinary tract systems. Therefore, a renal ultrasound is typically recommended to screen
for renal abnormalities such as renal agenesis, cystic kidney disease, or hydronephrosis.
Question 9: A school nurse is teaching a group of adolescents about the
prevention of sexually transmitted infections (STIs). Which of the following
statements made by an adolescent indicates a need for further teaching
regarding the use of condoms?
A. "I should use a new condom for each sexual act."
B. "I should use oil-based lubricants with latex condoms."
C. "I should hold the condom at the rim when withdrawing."
D. "I should check the expiration date on the condom package."
CORRECT ANSWER: B. "I should use oil-based lubricants with latex condoms."
Rationale:Oil-based lubricants (e.g., Vaseline, baby oil, lotion) can degrade latex and
cause the condom to break. Water-based or silicone-based lubricants are safe to use
with latex condoms. All other statements are correct and indicate proper understanding
of condom use.
Question 10: A 5-year-old child with acute lymphoblastic leukemia (ALL) is
receiving induction chemotherapy. The child's absolute neutrophil count (ANC)
is 200/mm³. Which of the following clinical manifestations should the nurse
monitor for as a priority?
A. Mucositis and mouth ulcers.
B. Pallor and fatigue.
C. Fever and sepsis.
D. Prolonged bleeding from venipuncture sites.
CORRECT ANSWER: C. Fever and sepsis.
Rationale:An ANC of < 500/mm³ indicates severe neutropenia, placing the child at a
significantly high risk for life-threatening infections. The priority is to monitor for early
