ATI RN PEDIATRICS PROCTORED EXAM
Comprehensive Study Guide • 60+ Questions with Answer Keys & Rationales
Question 1 CLINICAL SCENARIO /
NGN
Nurses' Notes (0900): Toddler brought to clinic with a persistent cough and recurring respiratory infections. Coughing for
several weeks with wheezing starting overnight. S1 and S2 present, no murmur. Labored respirations, rhonchi present,
nasal congestion. Child is lethargic and irritable. Guardian states: "often sweaty, and when I kiss them, it tastes salty."
Eating well prior but failing to gain weight. Loose, fatty stool in diaper.
Vitals (0900): Temp 37.4°C (99.3°F), HR 150/min, RR 40/min, BP 82/42 mmHg, SaO2 92% on room air.
Labs (1200): Sodium 128 mEq/L (136-145 mEq/L).
Analyze the findings to determine the most likely condition, appropriate actions, and parameters to monitor.
Correct Answer:
• Potential Condition: Cystic Fibrosis
• Actions to Take: Educate guardian about sweat chloride testing; Prepare toddler for chest physiotherapy.
• Parameters to Monitor: Oxygen saturation level; Stools.
Rationale: The child presents with classic manifestations of cystic fibrosis, including recurrent pulmonary infections,
wheezing, tachypnea, tachycardia, decreased SaO2, failure to thrive/weight loss despite good appetite, steatorrhea (loose
fatty stools), salty sweat, and hyponatremia. Sweat chloride testing is the diagnostic gold standard, and chest physiotherapy
helps mobilize viscous secretions. Monitoring SaO2 and stools evaluates respiratory status and gastrointestinal absorption
efficacy.
Question 2 PHARMACOLOGY
A nurse is caring for a school-age child receiving Cefazolin via intermittent IV bolus. The child suddenly
develops diffuse flushing of the skin and angioedema. After discontinuing the infusion, which medication
should the nurse administer first?
A) Prednisone
B) Epinephrine
C) Diphenhydramine
D) Albuterol
Correct Answer: B (Epinephrine)
Rationale: The child is demonstrating manifestations of an acute anaphylactic reaction. According to evidence-based
emergency protocols, Epinephrine is the first-line medication. Epinephrine acts as a beta-adrenergic agonist that causes
bronchodilation, vasoconstriction to raise blood pressure, and reduction of vascular permeability and mucosal edema.
ATI RN Pediatric Proctored Exam Study Guide Page 1 of 21
, Question 3 DERMATOLOGY / HOME
CARE
A nurse in a provider's office is caring for a preschooler with a skin condition. Which of the following
statements by the guardian indicate effective discharge teaching? (Select All That Apply)
A) "We should apply a skin emollient immediately after bathing our child."
B) "We should keep our child's fingernails trimmed short."
C) "We should rub the sores vigorously to remove scabs."
D) "We should allow our child to take a bubble bath prior to bed."
E) "We should use a mild detergent for our laundry."
F) "We should apply a large amount of the ointment to the sores."
Correct Answers: A, B, E
Rationale: Applying emollients immediately after bathing traps moisture in damp skin. Trimming fingernails prevents skin
breakdown and secondary bacterial infections from scratching. Mild laundry detergents reduce contact allergens and itching.
Bubble baths and vigorous rubbing cause severe irritation and skin injury.
Question 4 RESPIRATORY
A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent
asthma. Which of the following instructions should the nurse include?
A) "You should give your child their salmeterol inhaler every 4 hours during acute wheezing."
B) "You should monitor your child's weight weekly while receiving inhaled corticosteroids."
C) "Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to
therapy."
D) "When using the peak expiratory flow meter, record your child's average of three readings."
Correct Answer: C
Rationale: Baseline and periodic pulmonary function testing (PFTs) every 12 to 24 months evaluates lung mechanics and
treatment efficiency as the child grows. Salmeterol is a long-acting bronchodilator, NOT a fast-acting rescue inhaler. Peak
expiratory flow meter tracking requires recording the highest of three readings, not the average.
ATI RN Pediatric Proctored Exam Study Guide Page 2 of 21
, Question 5 INFANT CARE /
DIAGNOSTICS
A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure
the sensor to which area on the infant?
A) Wrist
B) Great toe
C) Index finger
D) Heel
Correct Answer: B (Great toe)
Rationale: In infants, pulse oximeter probes are best secured to the great toe (or foot) with a snug sock over it to minimize
motion artifact and preserve circulation checks.
Question 6 PEDIATRIC ASTHMA /
NGN
A nurse on a pediatric unit is caring for a school-age child with asthma. Which 4 findings should the nurse
report to the provider?
A) Arterial blood gases
B) Cardiovascular assessment
C) WBC count
D) Hemoglobin
E) Oxygen saturation level
F) Respiratory assessment
Correct Answers: A, C, E, F
Rationale: ABGs show respiratory alkalosis (or uncompensated fatigue/hypoxia), WBC count is elevated indicating infection,
SaO2 is dropping despite oxygen, and respiratory assessment reflects severe distress (retractions, tachypnea, elevated
wheezing).
Question 7 DOSAGE CALCULATION
A school nurse is preparing to administer Atomoxetine 1.2 mg/kg/day PO to a school-age child weighing 75 lb.
Available is Atomoxetine 40 mg/capsule. How many capsules should the nurse administer per day? (Round to
nearest whole number).
Correct Answer: 1 capsule
Calculation Steps:
1. Convert weight: 75 lb ÷ 2.2 = 34.09 kg
2. Calculate total mg needed: 34.09 kg × 1.2 mg/kg = 40.91 mg/day
3. Calculate capsules: 40.91 mg ÷ 40 mg/capsule = 1.02 capsules
4. Rounded to nearest whole number = 1 capsule.
ATI RN Pediatric Proctored Exam Study Guide Page 3 of 21
Comprehensive Study Guide • 60+ Questions with Answer Keys & Rationales
Question 1 CLINICAL SCENARIO /
NGN
Nurses' Notes (0900): Toddler brought to clinic with a persistent cough and recurring respiratory infections. Coughing for
several weeks with wheezing starting overnight. S1 and S2 present, no murmur. Labored respirations, rhonchi present,
nasal congestion. Child is lethargic and irritable. Guardian states: "often sweaty, and when I kiss them, it tastes salty."
Eating well prior but failing to gain weight. Loose, fatty stool in diaper.
Vitals (0900): Temp 37.4°C (99.3°F), HR 150/min, RR 40/min, BP 82/42 mmHg, SaO2 92% on room air.
Labs (1200): Sodium 128 mEq/L (136-145 mEq/L).
Analyze the findings to determine the most likely condition, appropriate actions, and parameters to monitor.
Correct Answer:
• Potential Condition: Cystic Fibrosis
• Actions to Take: Educate guardian about sweat chloride testing; Prepare toddler for chest physiotherapy.
• Parameters to Monitor: Oxygen saturation level; Stools.
Rationale: The child presents with classic manifestations of cystic fibrosis, including recurrent pulmonary infections,
wheezing, tachypnea, tachycardia, decreased SaO2, failure to thrive/weight loss despite good appetite, steatorrhea (loose
fatty stools), salty sweat, and hyponatremia. Sweat chloride testing is the diagnostic gold standard, and chest physiotherapy
helps mobilize viscous secretions. Monitoring SaO2 and stools evaluates respiratory status and gastrointestinal absorption
efficacy.
Question 2 PHARMACOLOGY
A nurse is caring for a school-age child receiving Cefazolin via intermittent IV bolus. The child suddenly
develops diffuse flushing of the skin and angioedema. After discontinuing the infusion, which medication
should the nurse administer first?
A) Prednisone
B) Epinephrine
C) Diphenhydramine
D) Albuterol
Correct Answer: B (Epinephrine)
Rationale: The child is demonstrating manifestations of an acute anaphylactic reaction. According to evidence-based
emergency protocols, Epinephrine is the first-line medication. Epinephrine acts as a beta-adrenergic agonist that causes
bronchodilation, vasoconstriction to raise blood pressure, and reduction of vascular permeability and mucosal edema.
ATI RN Pediatric Proctored Exam Study Guide Page 1 of 21
, Question 3 DERMATOLOGY / HOME
CARE
A nurse in a provider's office is caring for a preschooler with a skin condition. Which of the following
statements by the guardian indicate effective discharge teaching? (Select All That Apply)
A) "We should apply a skin emollient immediately after bathing our child."
B) "We should keep our child's fingernails trimmed short."
C) "We should rub the sores vigorously to remove scabs."
D) "We should allow our child to take a bubble bath prior to bed."
E) "We should use a mild detergent for our laundry."
F) "We should apply a large amount of the ointment to the sores."
Correct Answers: A, B, E
Rationale: Applying emollients immediately after bathing traps moisture in damp skin. Trimming fingernails prevents skin
breakdown and secondary bacterial infections from scratching. Mild laundry detergents reduce contact allergens and itching.
Bubble baths and vigorous rubbing cause severe irritation and skin injury.
Question 4 RESPIRATORY
A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent
asthma. Which of the following instructions should the nurse include?
A) "You should give your child their salmeterol inhaler every 4 hours during acute wheezing."
B) "You should monitor your child's weight weekly while receiving inhaled corticosteroids."
C) "Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to
therapy."
D) "When using the peak expiratory flow meter, record your child's average of three readings."
Correct Answer: C
Rationale: Baseline and periodic pulmonary function testing (PFTs) every 12 to 24 months evaluates lung mechanics and
treatment efficiency as the child grows. Salmeterol is a long-acting bronchodilator, NOT a fast-acting rescue inhaler. Peak
expiratory flow meter tracking requires recording the highest of three readings, not the average.
ATI RN Pediatric Proctored Exam Study Guide Page 2 of 21
, Question 5 INFANT CARE /
DIAGNOSTICS
A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure
the sensor to which area on the infant?
A) Wrist
B) Great toe
C) Index finger
D) Heel
Correct Answer: B (Great toe)
Rationale: In infants, pulse oximeter probes are best secured to the great toe (or foot) with a snug sock over it to minimize
motion artifact and preserve circulation checks.
Question 6 PEDIATRIC ASTHMA /
NGN
A nurse on a pediatric unit is caring for a school-age child with asthma. Which 4 findings should the nurse
report to the provider?
A) Arterial blood gases
B) Cardiovascular assessment
C) WBC count
D) Hemoglobin
E) Oxygen saturation level
F) Respiratory assessment
Correct Answers: A, C, E, F
Rationale: ABGs show respiratory alkalosis (or uncompensated fatigue/hypoxia), WBC count is elevated indicating infection,
SaO2 is dropping despite oxygen, and respiratory assessment reflects severe distress (retractions, tachypnea, elevated
wheezing).
Question 7 DOSAGE CALCULATION
A school nurse is preparing to administer Atomoxetine 1.2 mg/kg/day PO to a school-age child weighing 75 lb.
Available is Atomoxetine 40 mg/capsule. How many capsules should the nurse administer per day? (Round to
nearest whole number).
Correct Answer: 1 capsule
Calculation Steps:
1. Convert weight: 75 lb ÷ 2.2 = 34.09 kg
2. Calculate total mg needed: 34.09 kg × 1.2 mg/kg = 40.91 mg/day
3. Calculate capsules: 40.91 mg ÷ 40 mg/capsule = 1.02 capsules
4. Rounded to nearest whole number = 1 capsule.
ATI RN Pediatric Proctored Exam Study Guide Page 3 of 21
