ATI RN Pediatric (Peds) Proctored Exam
Questions 1 - 100
Advanced / Hard / Mixed Difficulty
1. A nurse is caring for a 2-year-old child who is admitted with dehydration. The
child's parent asks why the intravenous (IV) line is being placed in the scalp.
Which of the following responses by the nurse is most appropriate?
A. "The scalp veins are less likely to cause infection."
B. "The scalp veins are easier to visualize and access in young children."
C. "The scalp veins are the preferred site because they cause less pain."
D. "The scalp veins have a lower risk of infiltration."
Exact answer:B
Explanation: In infants and young toddlers, scalp veins are superficial and
prominent, making them easier to visualize and cannulate. They are often used
when other sites (e.g., hands, feet) are difficult to access. Infection risk, pain, and
infiltration risk are not inherently lower in scalp veins compared to other sites.
2. A nurse is assessing a 6-month-old infant who has been diagnosed with
respiratory syncytial virus (RSV) bronchiolitis. Which of the following findings is
an early sign of respiratory distress?
A. Cyanosis of the lips and nail beds
B. Nasal flaring and grunting
C. Bradypnea with periods of apnea
D. Use of accessory muscles with retractions
Exact answer:B
Explanation: Nasal flaring, grunting, and tachypnea are early compensatory signs
of respiratory distress in infants. Cyanosis is a late sign indicating severe hypoxia.
Bradypnea is a sign of impending respiratory failure, not early distress. Accessory
,muscle use and retractions are also significant signs but often appear after nasal
flaring and grunting in the progression of distress.
3. A nurse is teaching a parent about the administration of oral iron drops for a
9-month-old infant with iron deficiency anemia. Which of the following
instructions should the nurse include?
A. "Administer the drops with milk to improve absorption."
B. "Place the drops in the back of the mouth to avoid staining the teeth."
C. "Give the drops with orange juice to enhance absorption."
D. "Stop the drops once the infant's hemoglobin level returns to normal."
Exact answer:C
Explanation: Vitamin C (ascorbic acid), found in orange juice, enhances the
absorption of iron. Iron should not be given with milk, as calcium interferes with
absorption. Drops should be placed in the back of the mouth, but the primary
reason is to prevent staining of the teeth. Treatment should continue for at least 3
months after the anemia is corrected to replenish iron stores.
4. A nurse is caring for a 3-year-old child who is prescribed digoxin for heart
failure. Which of the following findings indicates potential digoxin toxicity?
A. Heart rate of 120 beats per minute
B. Vomiting and diarrhea
C. Increased urine output
D. Blood pressure of 110/70 mmHg
Exact answer:B
Explanation: Vomiting, diarrhea, anorexia, and bradycardia are classic signs of
digoxin toxicity in children. A heart rate of 120 bpm is elevated and not typical for
toxicity. Increased urine output is a desired effect of improved cardiac output. The
blood pressure is within normal limits for a 3-year-old.
,5. A nurse is assessing a 10-year-old child with suspected acute
glomerulonephritis. Which of the following findings is consistent with this
diagnosis?
A. Polyuria and polydipsia
B. Periorbital edema and dark-colored urine
C. Hypotension and tachycardia
D. High fever and flank pain
Exact answer:B
Explanation: Acute glomerulonephritis typically presents with periorbital edema,
dark, smoky (tea-colored) urine due to hematuria, and hypertension. Polyuria and
polydipsia are associated with diabetes. Hypotension is not a typical finding;
hypertension is common. Fever and flank pain may indicate pyelonephritis.
6. A nurse is preparing to administer the measles, mumps, rubella (MMR)
vaccine to a 12-month-old infant. Which of the following is a contraindication to
administering this vaccine?
A. A recent mild upper respiratory infection
B. A documented allergy to eggs
C. A history of anaphylactic reaction to neomycin
D. A temperature of 37.5°C (99.5°F)
Exact answer:C
Explanation: A severe allergic reaction (anaphylaxis) to a vaccine component, such
as neomycin or gelatin, is a contraindication to the MMR vaccine. A mild illness
without fever is not a contraindication. Egg allergy is no longer considered a
contraindication to MMR, as the vaccine is grown in chick embryo fibroblasts, not
egg protein.
7. A nurse is assessing a 5-year-old child with a diagnosis of bacterial meningitis.
Which of the following findings is a classic early manifestation of this condition?
A. Nuchal rigidity and positive Kernig's sign
B. High-pitched cry and bulging fontanel
, C. Severe headache and photophobia
D. Lethargy and irritability
Exact answer:D
Explanation: Early signs of meningitis in children include fever, severe headache,
photophobia, lethargy, and irritability. Nuchal rigidity and positive Kernig's and
Brudzinski's signs are classic later signs in older children. High-pitched cry and
bulging fontanel are more specific to infants with open fontanels.
8. A nurse is providing discharge teaching to the parent of a child who has a new
diagnosis of type 1 diabetes mellitus. Which of the following statements by the
parent indicates a need for further teaching?
A. "I will check my child's blood glucose before meals and at bedtime."
B. "I will rotate the injection sites to prevent lipodystrophy."
C. "I will give my child a snack before playing soccer."
D. "I will administer insulin after my child has finished eating."
Exact answer:D
Explanation: Insulin should be administered 15-30 minutes before meals to align
with the peak action of rapid-acting insulin and to prevent postprandial
hyperglycemia. Administering it after eating would lead to elevated blood glucose
levels. The other statements are correct: blood glucose checks, site rotation, and
providing a snack before exercise are key components of diabetes management.
9. A nurse is caring for a 14-year-old adolescent with scoliosis who is prescribed
a Boston brace. Which of the following statements by the adolescent indicates
an understanding of the treatment regimen?
A. "I can remove the brace while I sleep at night."
B. "I should wear a tight-fitting t-shirt under the brace."
C. "I can take the brace off for sports and swimming."
D. "I will wear the brace for 16 hours a day, and then can take it off."
Exact answer:B
Explanation: A tight-fitting cotton t-shirt should be worn under the brace to
Questions 1 - 100
Advanced / Hard / Mixed Difficulty
1. A nurse is caring for a 2-year-old child who is admitted with dehydration. The
child's parent asks why the intravenous (IV) line is being placed in the scalp.
Which of the following responses by the nurse is most appropriate?
A. "The scalp veins are less likely to cause infection."
B. "The scalp veins are easier to visualize and access in young children."
C. "The scalp veins are the preferred site because they cause less pain."
D. "The scalp veins have a lower risk of infiltration."
Exact answer:B
Explanation: In infants and young toddlers, scalp veins are superficial and
prominent, making them easier to visualize and cannulate. They are often used
when other sites (e.g., hands, feet) are difficult to access. Infection risk, pain, and
infiltration risk are not inherently lower in scalp veins compared to other sites.
2. A nurse is assessing a 6-month-old infant who has been diagnosed with
respiratory syncytial virus (RSV) bronchiolitis. Which of the following findings is
an early sign of respiratory distress?
A. Cyanosis of the lips and nail beds
B. Nasal flaring and grunting
C. Bradypnea with periods of apnea
D. Use of accessory muscles with retractions
Exact answer:B
Explanation: Nasal flaring, grunting, and tachypnea are early compensatory signs
of respiratory distress in infants. Cyanosis is a late sign indicating severe hypoxia.
Bradypnea is a sign of impending respiratory failure, not early distress. Accessory
,muscle use and retractions are also significant signs but often appear after nasal
flaring and grunting in the progression of distress.
3. A nurse is teaching a parent about the administration of oral iron drops for a
9-month-old infant with iron deficiency anemia. Which of the following
instructions should the nurse include?
A. "Administer the drops with milk to improve absorption."
B. "Place the drops in the back of the mouth to avoid staining the teeth."
C. "Give the drops with orange juice to enhance absorption."
D. "Stop the drops once the infant's hemoglobin level returns to normal."
Exact answer:C
Explanation: Vitamin C (ascorbic acid), found in orange juice, enhances the
absorption of iron. Iron should not be given with milk, as calcium interferes with
absorption. Drops should be placed in the back of the mouth, but the primary
reason is to prevent staining of the teeth. Treatment should continue for at least 3
months after the anemia is corrected to replenish iron stores.
4. A nurse is caring for a 3-year-old child who is prescribed digoxin for heart
failure. Which of the following findings indicates potential digoxin toxicity?
A. Heart rate of 120 beats per minute
B. Vomiting and diarrhea
C. Increased urine output
D. Blood pressure of 110/70 mmHg
Exact answer:B
Explanation: Vomiting, diarrhea, anorexia, and bradycardia are classic signs of
digoxin toxicity in children. A heart rate of 120 bpm is elevated and not typical for
toxicity. Increased urine output is a desired effect of improved cardiac output. The
blood pressure is within normal limits for a 3-year-old.
,5. A nurse is assessing a 10-year-old child with suspected acute
glomerulonephritis. Which of the following findings is consistent with this
diagnosis?
A. Polyuria and polydipsia
B. Periorbital edema and dark-colored urine
C. Hypotension and tachycardia
D. High fever and flank pain
Exact answer:B
Explanation: Acute glomerulonephritis typically presents with periorbital edema,
dark, smoky (tea-colored) urine due to hematuria, and hypertension. Polyuria and
polydipsia are associated with diabetes. Hypotension is not a typical finding;
hypertension is common. Fever and flank pain may indicate pyelonephritis.
6. A nurse is preparing to administer the measles, mumps, rubella (MMR)
vaccine to a 12-month-old infant. Which of the following is a contraindication to
administering this vaccine?
A. A recent mild upper respiratory infection
B. A documented allergy to eggs
C. A history of anaphylactic reaction to neomycin
D. A temperature of 37.5°C (99.5°F)
Exact answer:C
Explanation: A severe allergic reaction (anaphylaxis) to a vaccine component, such
as neomycin or gelatin, is a contraindication to the MMR vaccine. A mild illness
without fever is not a contraindication. Egg allergy is no longer considered a
contraindication to MMR, as the vaccine is grown in chick embryo fibroblasts, not
egg protein.
7. A nurse is assessing a 5-year-old child with a diagnosis of bacterial meningitis.
Which of the following findings is a classic early manifestation of this condition?
A. Nuchal rigidity and positive Kernig's sign
B. High-pitched cry and bulging fontanel
, C. Severe headache and photophobia
D. Lethargy and irritability
Exact answer:D
Explanation: Early signs of meningitis in children include fever, severe headache,
photophobia, lethargy, and irritability. Nuchal rigidity and positive Kernig's and
Brudzinski's signs are classic later signs in older children. High-pitched cry and
bulging fontanel are more specific to infants with open fontanels.
8. A nurse is providing discharge teaching to the parent of a child who has a new
diagnosis of type 1 diabetes mellitus. Which of the following statements by the
parent indicates a need for further teaching?
A. "I will check my child's blood glucose before meals and at bedtime."
B. "I will rotate the injection sites to prevent lipodystrophy."
C. "I will give my child a snack before playing soccer."
D. "I will administer insulin after my child has finished eating."
Exact answer:D
Explanation: Insulin should be administered 15-30 minutes before meals to align
with the peak action of rapid-acting insulin and to prevent postprandial
hyperglycemia. Administering it after eating would lead to elevated blood glucose
levels. The other statements are correct: blood glucose checks, site rotation, and
providing a snack before exercise are key components of diabetes management.
9. A nurse is caring for a 14-year-old adolescent with scoliosis who is prescribed
a Boston brace. Which of the following statements by the adolescent indicates
an understanding of the treatment regimen?
A. "I can remove the brace while I sleep at night."
B. "I should wear a tight-fitting t-shirt under the brace."
C. "I can take the brace off for sports and swimming."
D. "I will wear the brace for 16 hours a day, and then can take it off."
Exact answer:B
Explanation: A tight-fitting cotton t-shirt should be worn under the brace to
