❖ ATI Pediatrics Proctored Exam Updated 2026 |
250+ Practice Questions & Answers |
Comprehensive Study Guide, Exam Prep Test
Bank, Pediatric Assessment, Growth &
Development, Family-Centered Care, Neonatal &
Infant Nursing, Pediatric Pharmacology, Childhood
Disorders, Immunizations, Medication
Administration, Clinical Judgment, Detailed
Rationales, ATI RN & NCLEX-RN Success
Question 1: A nurse is assessing a 2-year-old child who has had a fever for the past 24
hours. Which of the following findings should the nurse identify as an early sign of
respiratory distress?
A. Bradycardia
B. Nasal flaring
C. Decreased respiratory rate
D. Cyanosis of the nail beds
CORRECT ANSWER: B. Nasal flaring
Rationale:Nasal flaring is an early compensatory mechanism in children to decrease airway
resistance and increase air intake. Bradycardia and decreased respiratory rate are late signs of
respiratory failure, while cyanosis is a late sign of hypoxia.
Question 2: A nurse is planning care for a 6-month-old infant who is hospitalized with
bronchiolitis. Which of the following interventions should the nurse include to
maintain the infant's airway patency?
A. Place the infant in a prone position
B. Administer cough syrup as prescribed
C. Suction the nares with a bulb syringe
D. Offer clear fluids every hour
CORRECT ANSWER: C. Suction the nares with a bulb syringe
Rationale:Infants are obligate nose breathers. Suctioning the nares clears secretions and
maintains airway patency. Prone positioning increases the risk of SIDS, cough syrup is not
recommended for infants, and fluids do not directly maintain airway patency.
Question 3: A nurse is providing discharge teaching to the parents of a child with a
new diagnosis of asthma. Which of the following statements by a parent indicates an
understanding of the teaching regarding the use of a peak expiratory flow meter?
A. "I will have my child use the meter after taking medication."
B. "I will record the average of three readings."
C. "I will use the same meter for all family members."
D. "I will have my child use the meter when symptoms are severe."
CORRECT ANSWER: B. "I will record the average of three readings."
,Rationale:The best of three readings should be recorded, not the average. The meter should be
used before medication and is patient-specific. It is used daily for monitoring, not just during
severe symptoms.
Question 4: A nurse is caring for a 4-year-old child who is postoperative following a
tonsillectomy. Which of the following findings should the nurse report to the provider
immediately?
A. Frequent swallowing
B. Refusal to eat solid foods
C. A hoarse voice
D. Ear pain
CORRECT ANSWER: A. Frequent swallowing
Rationale:Frequent swallowing is a sign of bleeding in the throat post-tonsillectomy.
Hoarseness, ear pain (referred pain), and refusal to eat are expected findings.
Question 5: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. Grunting respirations
B. Axillary temperature of 36.5°C (97.7°F)
C. Heart rate of 150/min
D. Acrocyanosis
CORRECT ANSWER: A. Grunting respirations
Rationale:Grunting is a sign of respiratory distress in a newborn, indicating the body is trying to
keep alveoli open. Acrocyanosis, a heart rate of 150/min, and a temperature of 36.5°C are within
normal limits for a newborn.
Question 6: A nurse is preparing to administer immunizations to a 2-month-old infant.
Which of the following vaccines should the nurse plan to administer?
A. MMR and Varicella
B. DTaP, IPV, and Hib
C. Tdap and HPV
D. Influenza and Hepatitis A
CORRECT ANSWER: B. DTaP, IPV, and Hib
Rationale:At 2 months, the recommended vaccines include DTaP, IPV, Hib, PCV, and RV. MMR
and Varicella are given at 12-15 months. Tdap is for older children/adolescents.
Question 7: A nurse is teaching the parents of an infant with gastroesophageal reflux
about feeding. Which of the following instructions should the nurse include?
A. Place the infant in a prone position after feeding
B. Feed the infant larger volumes less frequently
C. Thicken the formula with rice cereal
D. Administer feedings via a continuous pump
CORRECT ANSWER: C. Thicken the formula with rice cereal
,Rationale:Thickening formula helps decrease regurgitation. Infants should be placed upright
after feeding, not prone. Smaller, more frequent feedings are recommended.
Question 8: A nurse is assessing a 7-year-old child who has cystic fibrosis. Which of
the following findings is the nurse most likely to observe?
A. Constipation
B. Bulky, greasy stools
C. Hard, pellet-like stools
D. Bloody stools
CORRECT ANSWER: B. Bulky, greasy stools
Rationale:Cystic fibrosis causes malabsorption due to pancreatic insufficiency, leading to
steatorrhea (bulky, greasy stools). Constipation is less common.
Question 9: A nurse is caring for a child with a diagnosis of Kawasaki disease. Which
of the following findings should the nurse expect?
A. Hypotension
B. Decreased platelet count
C. Strawberry tongue
D. Polyarthritis
CORRECT ANSWER: C. Strawberry tongue
Rationale:Strawberry tongue is a classic finding in Kawasaki disease. Other symptoms include
fever, conjunctivitis, and rash. It is a vasculitis, not primarily arthritis.
Question 10: A nurse is calculating the maintenance fluid requirement for a 10 kg
child. Using the 100/50/20 rule, what is the daily maintenance fluid requirement?
A. 800 mL
B. 1000 mL
C. 1200 mL
D. 1400 mL
CORRECT ANSWER: B. 1000 mL
Rationale:For the first 10 kg: 100 mL/kg/day. 10 kg x 100 mL/kg = 1000 mL/day.
Question 11: A nurse is assessing a newborn for neonatal abstinence syndrome.
Which of the following findings is a manifestation of this condition?
A. Hypoactive bowel sounds
B. Prolonged sleeping
C. Hyperactive Moro reflex
D. Decreased muscle tone
CORRECT ANSWER: C. Hyperactive Moro reflex
Rationale:Neonatal abstinence syndrome presents with central nervous system irritability,
including a hyperactive Moro reflex. Hypoactivity, decreased tone, and sleeping are signs of
sedation, not withdrawal.
, Question 12: A nurse is providing dietary teaching to the mother of a 10-month-old
infant. Which of the following foods should the nurse instruct the mother to avoid due
to risk of choking?
A. Cooked carrots
B. Whole grapes
C. Soft cheese
D. Mashed potatoes
CORRECT ANSWER: B. Whole grapes
Rationale:Whole grapes are a round, firm food that poses a high choking risk for infants and
toddlers. They should be cut into small pieces.
Question 13: A nurse is preparing a child for a lumbar puncture. Which of the
following actions should the nurse take?
A. Place the child in a knee-chest position
B. Apply a topical anesthetic 5 minutes prior
C. Ensure the child is upright
D. Restrict fluids for 4 hours
CORRECT ANSWER: A. Place the child in a knee-chest position
Rationale:The knee-chest or fetal position flexes the spine, widening the intervertebral spaces.
Topical anesthetic should be applied 30-60 minutes prior.
Question 14: A nurse is assessing a school-age child who has a urinary tract infection.
Which of the following findings should the nurse expect?
A. Increased appetite
B. Polyuria
C. Flank pain
D. Hypertension
CORRECT ANSWER: C. Flank pain
Rationale:Flank pain is a classic sign of pyelonephritis/upper UTI. Appetite is usually
decreased. Polyuria is not a primary symptom.
Question 15: A nurse is caring for an adolescent with a new diagnosis of type 1
diabetes mellitus. Which of the following psychosocial concerns is most common in
this age group?
A. Fear of needles
B. Body image disturbance
C. Separation anxiety
D. Regression to infantile behaviors
CORRECT ANSWER: B. Body image disturbance
Rationale:Adolescents are highly concerned with peer acceptance and body image. A chronic
illness like diabetes requires dietary changes and insulin injections, impacting body image.
Question 16: A nurse is assessing a 3-year-old child. Which of the following
developmental milestones should the nurse expect the child to achieve?
250+ Practice Questions & Answers |
Comprehensive Study Guide, Exam Prep Test
Bank, Pediatric Assessment, Growth &
Development, Family-Centered Care, Neonatal &
Infant Nursing, Pediatric Pharmacology, Childhood
Disorders, Immunizations, Medication
Administration, Clinical Judgment, Detailed
Rationales, ATI RN & NCLEX-RN Success
Question 1: A nurse is assessing a 2-year-old child who has had a fever for the past 24
hours. Which of the following findings should the nurse identify as an early sign of
respiratory distress?
A. Bradycardia
B. Nasal flaring
C. Decreased respiratory rate
D. Cyanosis of the nail beds
CORRECT ANSWER: B. Nasal flaring
Rationale:Nasal flaring is an early compensatory mechanism in children to decrease airway
resistance and increase air intake. Bradycardia and decreased respiratory rate are late signs of
respiratory failure, while cyanosis is a late sign of hypoxia.
Question 2: A nurse is planning care for a 6-month-old infant who is hospitalized with
bronchiolitis. Which of the following interventions should the nurse include to
maintain the infant's airway patency?
A. Place the infant in a prone position
B. Administer cough syrup as prescribed
C. Suction the nares with a bulb syringe
D. Offer clear fluids every hour
CORRECT ANSWER: C. Suction the nares with a bulb syringe
Rationale:Infants are obligate nose breathers. Suctioning the nares clears secretions and
maintains airway patency. Prone positioning increases the risk of SIDS, cough syrup is not
recommended for infants, and fluids do not directly maintain airway patency.
Question 3: A nurse is providing discharge teaching to the parents of a child with a
new diagnosis of asthma. Which of the following statements by a parent indicates an
understanding of the teaching regarding the use of a peak expiratory flow meter?
A. "I will have my child use the meter after taking medication."
B. "I will record the average of three readings."
C. "I will use the same meter for all family members."
D. "I will have my child use the meter when symptoms are severe."
CORRECT ANSWER: B. "I will record the average of three readings."
,Rationale:The best of three readings should be recorded, not the average. The meter should be
used before medication and is patient-specific. It is used daily for monitoring, not just during
severe symptoms.
Question 4: A nurse is caring for a 4-year-old child who is postoperative following a
tonsillectomy. Which of the following findings should the nurse report to the provider
immediately?
A. Frequent swallowing
B. Refusal to eat solid foods
C. A hoarse voice
D. Ear pain
CORRECT ANSWER: A. Frequent swallowing
Rationale:Frequent swallowing is a sign of bleeding in the throat post-tonsillectomy.
Hoarseness, ear pain (referred pain), and refusal to eat are expected findings.
Question 5: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. Grunting respirations
B. Axillary temperature of 36.5°C (97.7°F)
C. Heart rate of 150/min
D. Acrocyanosis
CORRECT ANSWER: A. Grunting respirations
Rationale:Grunting is a sign of respiratory distress in a newborn, indicating the body is trying to
keep alveoli open. Acrocyanosis, a heart rate of 150/min, and a temperature of 36.5°C are within
normal limits for a newborn.
Question 6: A nurse is preparing to administer immunizations to a 2-month-old infant.
Which of the following vaccines should the nurse plan to administer?
A. MMR and Varicella
B. DTaP, IPV, and Hib
C. Tdap and HPV
D. Influenza and Hepatitis A
CORRECT ANSWER: B. DTaP, IPV, and Hib
Rationale:At 2 months, the recommended vaccines include DTaP, IPV, Hib, PCV, and RV. MMR
and Varicella are given at 12-15 months. Tdap is for older children/adolescents.
Question 7: A nurse is teaching the parents of an infant with gastroesophageal reflux
about feeding. Which of the following instructions should the nurse include?
A. Place the infant in a prone position after feeding
B. Feed the infant larger volumes less frequently
C. Thicken the formula with rice cereal
D. Administer feedings via a continuous pump
CORRECT ANSWER: C. Thicken the formula with rice cereal
,Rationale:Thickening formula helps decrease regurgitation. Infants should be placed upright
after feeding, not prone. Smaller, more frequent feedings are recommended.
Question 8: A nurse is assessing a 7-year-old child who has cystic fibrosis. Which of
the following findings is the nurse most likely to observe?
A. Constipation
B. Bulky, greasy stools
C. Hard, pellet-like stools
D. Bloody stools
CORRECT ANSWER: B. Bulky, greasy stools
Rationale:Cystic fibrosis causes malabsorption due to pancreatic insufficiency, leading to
steatorrhea (bulky, greasy stools). Constipation is less common.
Question 9: A nurse is caring for a child with a diagnosis of Kawasaki disease. Which
of the following findings should the nurse expect?
A. Hypotension
B. Decreased platelet count
C. Strawberry tongue
D. Polyarthritis
CORRECT ANSWER: C. Strawberry tongue
Rationale:Strawberry tongue is a classic finding in Kawasaki disease. Other symptoms include
fever, conjunctivitis, and rash. It is a vasculitis, not primarily arthritis.
Question 10: A nurse is calculating the maintenance fluid requirement for a 10 kg
child. Using the 100/50/20 rule, what is the daily maintenance fluid requirement?
A. 800 mL
B. 1000 mL
C. 1200 mL
D. 1400 mL
CORRECT ANSWER: B. 1000 mL
Rationale:For the first 10 kg: 100 mL/kg/day. 10 kg x 100 mL/kg = 1000 mL/day.
Question 11: A nurse is assessing a newborn for neonatal abstinence syndrome.
Which of the following findings is a manifestation of this condition?
A. Hypoactive bowel sounds
B. Prolonged sleeping
C. Hyperactive Moro reflex
D. Decreased muscle tone
CORRECT ANSWER: C. Hyperactive Moro reflex
Rationale:Neonatal abstinence syndrome presents with central nervous system irritability,
including a hyperactive Moro reflex. Hypoactivity, decreased tone, and sleeping are signs of
sedation, not withdrawal.
, Question 12: A nurse is providing dietary teaching to the mother of a 10-month-old
infant. Which of the following foods should the nurse instruct the mother to avoid due
to risk of choking?
A. Cooked carrots
B. Whole grapes
C. Soft cheese
D. Mashed potatoes
CORRECT ANSWER: B. Whole grapes
Rationale:Whole grapes are a round, firm food that poses a high choking risk for infants and
toddlers. They should be cut into small pieces.
Question 13: A nurse is preparing a child for a lumbar puncture. Which of the
following actions should the nurse take?
A. Place the child in a knee-chest position
B. Apply a topical anesthetic 5 minutes prior
C. Ensure the child is upright
D. Restrict fluids for 4 hours
CORRECT ANSWER: A. Place the child in a knee-chest position
Rationale:The knee-chest or fetal position flexes the spine, widening the intervertebral spaces.
Topical anesthetic should be applied 30-60 minutes prior.
Question 14: A nurse is assessing a school-age child who has a urinary tract infection.
Which of the following findings should the nurse expect?
A. Increased appetite
B. Polyuria
C. Flank pain
D. Hypertension
CORRECT ANSWER: C. Flank pain
Rationale:Flank pain is a classic sign of pyelonephritis/upper UTI. Appetite is usually
decreased. Polyuria is not a primary symptom.
Question 15: A nurse is caring for an adolescent with a new diagnosis of type 1
diabetes mellitus. Which of the following psychosocial concerns is most common in
this age group?
A. Fear of needles
B. Body image disturbance
C. Separation anxiety
D. Regression to infantile behaviors
CORRECT ANSWER: B. Body image disturbance
Rationale:Adolescents are highly concerned with peer acceptance and body image. A chronic
illness like diabetes requires dietary changes and insulin injections, impacting body image.
Question 16: A nurse is assessing a 3-year-old child. Which of the following
developmental milestones should the nurse expect the child to achieve?
