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ATI Pediatric Nursing Practice Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+ Brand New Version!!
Question 1
A nurse is caring for a 6-month-old infant with congestive heart failure
who is receiving digoxin elixir. Which of the following observations by
the nurse warrants immediate intervention?
A. Apical heart rate of 60 beats per minute
B. Sweating across the forehead
C. Poor feeding ability
D. Respiratory rate of 30 breaths per minute
Answer: A. Apical heart rate of 60 beats per minute
Explanation: A heart rate of 60 beats per minute in a 6-month-old infant
represents significant bradycardia and warrants immediate
intervention. The normal resting heart rate for a 6-month-old ranges
from 80 to 150 beats per minute when awake, with rates as low as 70
during sleep considered acceptable. Bradycardia in an infant receiving
digoxin may indicate digoxin toxicity, which requires prompt assessment
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and potential withholding of the medication. Sweating, poor feeding,
and tachypnea are expected clinical manifestations of heart failure in
infants and should be monitored but do not constitute the same level of
immediate concern as bradycardia.
Question 2
A nurse is providing developmental guidance to the parents of a 4-year-
old child. Which of the following play activities should the nurse
recommend to promote the child's cognitive development?
A. Playing with a large-piece puzzle
B. Riding a tricycle
C. Playing a board game with simple rules
D. Building a tower with large blocks
Answer: C. Playing a board game with simple rules
Explanation: At 4 years of age, children are in Piaget's preoperational
stage and begin to develop symbolic thinking, understand simple rules,
and engage in interactive play. Board games with simple rules promote
cognitive development by encouraging turn-taking, rule comprehension,
and social interaction. Large-piece puzzles and block towers are more
appropriate for younger toddlers, while tricycle riding primarily
promotes gross motor development rather than cognitive skills.
Question 3
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A nurse is assessing a 2-year-old child who has been diagnosed with
iron deficiency anemia. Which of the following findings should the
nurse expect?
A. Pale conjunctivae and brittle nails
B. Hyperactivity and increased appetite
C. Elevated hemoglobin and hematocrit levels
D. Jaundice and hepatomegaly
Answer: A. Pale conjunctivae and brittle nails
Explanation: Iron deficiency anemia in children typically presents with
pallor, particularly of the conjunctivae and nail beds, along with brittle
or spoon-shaped nails (koilonychia), fatigue, and poor appetite.
Hyperactivity is not characteristic; affected children often appear
lethargic. Hemoglobin and hematocrit are decreased, not elevated, in
anemia. Jaundice and hepatomegaly are more consistent with
hemolytic anemias or hepatic pathology rather than iron deficiency.
Question 4
A nurse is caring for a child with acute glomerulonephritis. Which of the
following assessment findings should the nurse report to the healthcare
provider immediately?
A. Periorbital edema upon awakening
B. Urine output of 15 mL over 4 hours
C. Blood pressure of 118/76 mmHg
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D. Mild headache
Answer: B. Urine output of 15 mL over 4 hours
Explanation: A urine output of 15 mL over 4 hours in a child represents
oliguria and is a significant concern in acute glomerulonephritis, as it
may indicate acute kidney injury or progression to renal failure.
Periorbital edema is an expected finding in glomerulonephritis due to
fluid retention. A blood pressure of 118/76 mmHg, while elevated for a
child, does not require immediate reporting unless significantly
hypertensive. A mild headache should be monitored but is not an
immediate priority.
Question 5
A nurse is preparing to administer immunizations to a 12-month-old
child. Which of the following vaccines should the nurse plan to
administer?
A. Hepatitis B vaccine (HepB), Diphtheria, tetanus, and acellular
pertussis vaccine (DTaP), Haemophilus influenzae type b vaccine (Hib),
Inactivated poliovirus vaccine (IPV), Pneumococcal conjugate vaccine
(PCV)
B. DTaP, IPV, Measles, mumps, and rubella vaccine (MMR), Varicella
vaccine (VAR), Hepatitis A vaccine (HepA)
C. MMR, VAR, HepA, and Influenza vaccine
D. DTaP, Hib, IPV, PCV, and MMR
ATI Pediatric Nursing Practice Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+ Brand New Version!!
Question 1
A nurse is caring for a 6-month-old infant with congestive heart failure
who is receiving digoxin elixir. Which of the following observations by
the nurse warrants immediate intervention?
A. Apical heart rate of 60 beats per minute
B. Sweating across the forehead
C. Poor feeding ability
D. Respiratory rate of 30 breaths per minute
Answer: A. Apical heart rate of 60 beats per minute
Explanation: A heart rate of 60 beats per minute in a 6-month-old infant
represents significant bradycardia and warrants immediate
intervention. The normal resting heart rate for a 6-month-old ranges
from 80 to 150 beats per minute when awake, with rates as low as 70
during sleep considered acceptable. Bradycardia in an infant receiving
digoxin may indicate digoxin toxicity, which requires prompt assessment
,2|Page
and potential withholding of the medication. Sweating, poor feeding,
and tachypnea are expected clinical manifestations of heart failure in
infants and should be monitored but do not constitute the same level of
immediate concern as bradycardia.
Question 2
A nurse is providing developmental guidance to the parents of a 4-year-
old child. Which of the following play activities should the nurse
recommend to promote the child's cognitive development?
A. Playing with a large-piece puzzle
B. Riding a tricycle
C. Playing a board game with simple rules
D. Building a tower with large blocks
Answer: C. Playing a board game with simple rules
Explanation: At 4 years of age, children are in Piaget's preoperational
stage and begin to develop symbolic thinking, understand simple rules,
and engage in interactive play. Board games with simple rules promote
cognitive development by encouraging turn-taking, rule comprehension,
and social interaction. Large-piece puzzles and block towers are more
appropriate for younger toddlers, while tricycle riding primarily
promotes gross motor development rather than cognitive skills.
Question 3
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A nurse is assessing a 2-year-old child who has been diagnosed with
iron deficiency anemia. Which of the following findings should the
nurse expect?
A. Pale conjunctivae and brittle nails
B. Hyperactivity and increased appetite
C. Elevated hemoglobin and hematocrit levels
D. Jaundice and hepatomegaly
Answer: A. Pale conjunctivae and brittle nails
Explanation: Iron deficiency anemia in children typically presents with
pallor, particularly of the conjunctivae and nail beds, along with brittle
or spoon-shaped nails (koilonychia), fatigue, and poor appetite.
Hyperactivity is not characteristic; affected children often appear
lethargic. Hemoglobin and hematocrit are decreased, not elevated, in
anemia. Jaundice and hepatomegaly are more consistent with
hemolytic anemias or hepatic pathology rather than iron deficiency.
Question 4
A nurse is caring for a child with acute glomerulonephritis. Which of the
following assessment findings should the nurse report to the healthcare
provider immediately?
A. Periorbital edema upon awakening
B. Urine output of 15 mL over 4 hours
C. Blood pressure of 118/76 mmHg
, 4|Page
D. Mild headache
Answer: B. Urine output of 15 mL over 4 hours
Explanation: A urine output of 15 mL over 4 hours in a child represents
oliguria and is a significant concern in acute glomerulonephritis, as it
may indicate acute kidney injury or progression to renal failure.
Periorbital edema is an expected finding in glomerulonephritis due to
fluid retention. A blood pressure of 118/76 mmHg, while elevated for a
child, does not require immediate reporting unless significantly
hypertensive. A mild headache should be monitored but is not an
immediate priority.
Question 5
A nurse is preparing to administer immunizations to a 12-month-old
child. Which of the following vaccines should the nurse plan to
administer?
A. Hepatitis B vaccine (HepB), Diphtheria, tetanus, and acellular
pertussis vaccine (DTaP), Haemophilus influenzae type b vaccine (Hib),
Inactivated poliovirus vaccine (IPV), Pneumococcal conjugate vaccine
(PCV)
B. DTaP, IPV, Measles, mumps, and rubella vaccine (MMR), Varicella
vaccine (VAR), Hepatitis A vaccine (HepA)
C. MMR, VAR, HepA, and Influenza vaccine
D. DTaP, Hib, IPV, PCV, and MMR
