ATI CARE OF CHILDREN RN PROCTORED
EXAM
COMPREHENSIVE PRACTICE EXAM & IN-DEPTH RATIONALES
Subject: Pediatric Nursing Care (RN Care of Children)
Exam Series: Level 3 Practice Exam (2026-2027 Update)
Total Questions: 70 High-Yield Exam Items
Grounded Material: Official Course Syllabus, Assessment Blueprints, and RN Proctored Guidelines
<b>ATI RN Pediatric Nursing Care Practice Exam: Care of Children RN Proctored Exam (2026-2027
Update)</b><br/><br/>This study guide and comprehensive practice exam has been systematically compiled
directly from pediatric proctored exam blueprints and official pediatric nursing curricula. Designed to prepare
students for the rigorous RN Proctored Exam, it covers the core domains of nursing care of children. These
domains include:<br/>• <b>Pharmacology & Dosage Calculations:</b> Safe medication administration,
calculation of pediatric dosages based on body weight, and clinical indicators of drug toxicity (e.g., Digoxin,
Furosemide, Amoxicillin).<br/>• <b>Cardiovascular Disorders:</b> Nursing interventions for heart failure, care
following arterial cardiac catheterization, and identification of congenital heart defects like Patent Ductus
Arteriosus.<br/>• <b>Respiratory & Infectious Pathologies:</b> Pathophysiology and management of exocrine
dysfunction (Cystic Fibrosis), viral skin infections (Measles, Varicella), acute epiglottitis as an airway emergency,
and bacterial meningitis precautions.<br/>• <b>Gastrointestinal & Nutrition:</b> Nursing care for fluid imbalance
(severe dehydration, gastroenteritis, rotavirus), failure to thrive (FTT), anatomical anomalies (cleft soft palate
feeding), and metabolic disorders (celiac disease).<br/>• <b>Renal, Musculoskeletal, and Health Promotion:</b>
Nephrotic syndrome monitoring, acute post-streptococcal glomerulonephritis findings, cast care,
Legg-Calve-Perthes disease, and essential patient safety guidelines (bicycle safety, SIDS risk reduction, scabies
control).
,ATI CARE OF CHILDREN RN PROCTORED EXAM 2026-2027 UPDATE
PRACTICE EXAM & IN-DEPTH STUDY STUDY GUIDE
Question 1 of 70
A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of the following
findings should the nurse identify as an indication that the medication is effective?
A. An increase in venous pressure
B. A decrease in peripheral edema
C. A decrease in cardiac output
D. An increase in potassium levels
ANSWER ■: B — A decrease in peripheral edema
Explanation: Furosemide is a potent loop diuretic that inhibits sodium and chloride reabsorption in the ascending
loop of Henle, promoting the excretion of water and electrolytes. In a child with heart failure, the primary goal of
furosemide is to reduce fluid volume overload. A decrease in peripheral edema is a key clinical indicator of its
therapeutic effectiveness. An increase in venous pressure or a decrease in cardiac output would suggest worsening
heart failure. Loop diuretics cause hypokalemia (potassium depletion), not an increase in potassium levels.
Question 2 of 70
A nurse is reviewing the laboratory results of a preschooler who has gastroenteritis and notes the client's
potassium level is 3.2 mEq/L. Which of the following assessment findings should the nurse expect?
A. Hypertension
B. Hyporeflexia
C. Hyperactive bowel sounds
D. Oliguria
ANSWER ■: B — Hyporeflexia
Explanation: A serum potassium level of 3.2 mEq/L indicates hypokalemia (normal pediatric range: 3.5 to 5.0
mEq/L). Potassium is essential for neuromuscular excitability. Low potassium levels cause muscle weakness,
hypotonia, and hyporeflexia (diminished deep tendon reflexes). Hypokalemia causes decreased GI motility, leading to
hypoactive bowel sounds, abdominal distension, or paralytic ileus rather than hyperactive bowel sounds. It does not
typically cause hypertension or oliguria directly, although dehydration from gastroenteritis might.
Question 3 of 70
A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the
following actions should the nurse include in the plan of care?
A. Schedule routine oral care every 8 hours
B. Cleanse the gums with saline-soaked gauze
C. Moisten the mucosa with lemon glycerin swabs
D. Administer oral viscous lidocaine
Fully Grounded Practice Exam & Rationales Page 2 of 29 Pediatric Nursing Care
, ATI CARE OF CHILDREN RN PROCTORED EXAM 2026-2027 UPDATE
ANSWER ■: B — Cleanse the gums with saline-soaked gauze
Explanation: Chemotherapy-induced mucositis leads to painful oral ulcers. Cleansing the gums gently with
saline-soaked gauze is a safe, soft, non-abrasive method of maintaining oral hygiene without causing further tissue
trauma or bleeding in a toddler. Oral care should be scheduled frequently (e.g., every 2 to 4 hours), not just every 8
hours. Lemon glycerin swabs are contraindicated because they cause severe irritation, burning, and further drying of
the oral mucosa. Oral viscous lidocaine is not recommended for toddlers due to the risk of suppressing the gag reflex
(which increases aspiration risk) and potential systemic anesthetic toxicity.
Question 4 of 70
A nurse is providing discharge teaching to the parents of an infant who is at risk for sudden infant death
syndrome (SIDS). Which of the following statements by the parent indicates an understanding of the teaching?
A. "I will have my baby sleep next to me in the bed during the night."
B. "I will move my baby's stuffed animal to the corner of her crib while she sleeps."
C. "I will dress my baby in lightweight clothing to sleep."
D. "I will lay my baby on her side to sleep for her naps."
ANSWER ■: C — "I will dress my baby in lightweight clothing to sleep."
Explanation: Overheating is a well-documented risk factor for SIDS; dressing the infant in lightweight clothing to
sleep represents a safe sleep practice. Bed-sharing or co-sleeping increases the risk of suffocation and SIDS. Stuffed
animals, pillows, quilts, or soft bedding should never be placed in the crib because they pose suffocation risks. Infants
should always be placed in a fully supine position (on their back) for all sleep times, not on their side or stomach.
Question 5 of 70
A nurse is providing teaching for the parent of a child who has measles (rubeola). Which of the following
information should the nurse include?
A. Bathe the child using tepid water
B. Remove loose crusts from the lesions
C. Give the child aspirin for a fever
D. Withhold live vaccines for 3 months
ANSWER ■: A — Bathe the child using tepid water
Explanation: Supportive care for measles includes soothing skin irritation and pruritus by bathing the child in tepid
water. Measles rash consists of macular and papular lesions that do not typically form crusts (unlike varicella or
impetigo). Aspirin is strictly contraindicated in children due to the risk of Reye's syndrome. While live vaccines (like
MMR) are contraindicated during acute immunosuppression, active measles does not warrant withholding routinely
scheduled future vaccines, and vitamin A supplementation is often recommended instead.
Fully Grounded Practice Exam & Rationales Page 3 of 29 Pediatric Nursing Care
EXAM
COMPREHENSIVE PRACTICE EXAM & IN-DEPTH RATIONALES
Subject: Pediatric Nursing Care (RN Care of Children)
Exam Series: Level 3 Practice Exam (2026-2027 Update)
Total Questions: 70 High-Yield Exam Items
Grounded Material: Official Course Syllabus, Assessment Blueprints, and RN Proctored Guidelines
<b>ATI RN Pediatric Nursing Care Practice Exam: Care of Children RN Proctored Exam (2026-2027
Update)</b><br/><br/>This study guide and comprehensive practice exam has been systematically compiled
directly from pediatric proctored exam blueprints and official pediatric nursing curricula. Designed to prepare
students for the rigorous RN Proctored Exam, it covers the core domains of nursing care of children. These
domains include:<br/>• <b>Pharmacology & Dosage Calculations:</b> Safe medication administration,
calculation of pediatric dosages based on body weight, and clinical indicators of drug toxicity (e.g., Digoxin,
Furosemide, Amoxicillin).<br/>• <b>Cardiovascular Disorders:</b> Nursing interventions for heart failure, care
following arterial cardiac catheterization, and identification of congenital heart defects like Patent Ductus
Arteriosus.<br/>• <b>Respiratory & Infectious Pathologies:</b> Pathophysiology and management of exocrine
dysfunction (Cystic Fibrosis), viral skin infections (Measles, Varicella), acute epiglottitis as an airway emergency,
and bacterial meningitis precautions.<br/>• <b>Gastrointestinal & Nutrition:</b> Nursing care for fluid imbalance
(severe dehydration, gastroenteritis, rotavirus), failure to thrive (FTT), anatomical anomalies (cleft soft palate
feeding), and metabolic disorders (celiac disease).<br/>• <b>Renal, Musculoskeletal, and Health Promotion:</b>
Nephrotic syndrome monitoring, acute post-streptococcal glomerulonephritis findings, cast care,
Legg-Calve-Perthes disease, and essential patient safety guidelines (bicycle safety, SIDS risk reduction, scabies
control).
,ATI CARE OF CHILDREN RN PROCTORED EXAM 2026-2027 UPDATE
PRACTICE EXAM & IN-DEPTH STUDY STUDY GUIDE
Question 1 of 70
A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of the following
findings should the nurse identify as an indication that the medication is effective?
A. An increase in venous pressure
B. A decrease in peripheral edema
C. A decrease in cardiac output
D. An increase in potassium levels
ANSWER ■: B — A decrease in peripheral edema
Explanation: Furosemide is a potent loop diuretic that inhibits sodium and chloride reabsorption in the ascending
loop of Henle, promoting the excretion of water and electrolytes. In a child with heart failure, the primary goal of
furosemide is to reduce fluid volume overload. A decrease in peripheral edema is a key clinical indicator of its
therapeutic effectiveness. An increase in venous pressure or a decrease in cardiac output would suggest worsening
heart failure. Loop diuretics cause hypokalemia (potassium depletion), not an increase in potassium levels.
Question 2 of 70
A nurse is reviewing the laboratory results of a preschooler who has gastroenteritis and notes the client's
potassium level is 3.2 mEq/L. Which of the following assessment findings should the nurse expect?
A. Hypertension
B. Hyporeflexia
C. Hyperactive bowel sounds
D. Oliguria
ANSWER ■: B — Hyporeflexia
Explanation: A serum potassium level of 3.2 mEq/L indicates hypokalemia (normal pediatric range: 3.5 to 5.0
mEq/L). Potassium is essential for neuromuscular excitability. Low potassium levels cause muscle weakness,
hypotonia, and hyporeflexia (diminished deep tendon reflexes). Hypokalemia causes decreased GI motility, leading to
hypoactive bowel sounds, abdominal distension, or paralytic ileus rather than hyperactive bowel sounds. It does not
typically cause hypertension or oliguria directly, although dehydration from gastroenteritis might.
Question 3 of 70
A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the
following actions should the nurse include in the plan of care?
A. Schedule routine oral care every 8 hours
B. Cleanse the gums with saline-soaked gauze
C. Moisten the mucosa with lemon glycerin swabs
D. Administer oral viscous lidocaine
Fully Grounded Practice Exam & Rationales Page 2 of 29 Pediatric Nursing Care
, ATI CARE OF CHILDREN RN PROCTORED EXAM 2026-2027 UPDATE
ANSWER ■: B — Cleanse the gums with saline-soaked gauze
Explanation: Chemotherapy-induced mucositis leads to painful oral ulcers. Cleansing the gums gently with
saline-soaked gauze is a safe, soft, non-abrasive method of maintaining oral hygiene without causing further tissue
trauma or bleeding in a toddler. Oral care should be scheduled frequently (e.g., every 2 to 4 hours), not just every 8
hours. Lemon glycerin swabs are contraindicated because they cause severe irritation, burning, and further drying of
the oral mucosa. Oral viscous lidocaine is not recommended for toddlers due to the risk of suppressing the gag reflex
(which increases aspiration risk) and potential systemic anesthetic toxicity.
Question 4 of 70
A nurse is providing discharge teaching to the parents of an infant who is at risk for sudden infant death
syndrome (SIDS). Which of the following statements by the parent indicates an understanding of the teaching?
A. "I will have my baby sleep next to me in the bed during the night."
B. "I will move my baby's stuffed animal to the corner of her crib while she sleeps."
C. "I will dress my baby in lightweight clothing to sleep."
D. "I will lay my baby on her side to sleep for her naps."
ANSWER ■: C — "I will dress my baby in lightweight clothing to sleep."
Explanation: Overheating is a well-documented risk factor for SIDS; dressing the infant in lightweight clothing to
sleep represents a safe sleep practice. Bed-sharing or co-sleeping increases the risk of suffocation and SIDS. Stuffed
animals, pillows, quilts, or soft bedding should never be placed in the crib because they pose suffocation risks. Infants
should always be placed in a fully supine position (on their back) for all sleep times, not on their side or stomach.
Question 5 of 70
A nurse is providing teaching for the parent of a child who has measles (rubeola). Which of the following
information should the nurse include?
A. Bathe the child using tepid water
B. Remove loose crusts from the lesions
C. Give the child aspirin for a fever
D. Withhold live vaccines for 3 months
ANSWER ■: A — Bathe the child using tepid water
Explanation: Supportive care for measles includes soothing skin irritation and pruritus by bathing the child in tepid
water. Measles rash consists of macular and papular lesions that do not typically form crusts (unlike varicella or
impetigo). Aspirin is strictly contraindicated in children due to the risk of Reye's syndrome. While live vaccines (like
MMR) are contraindicated during acute immunosuppression, active measles does not warrant withholding routinely
scheduled future vaccines, and vitamin A supplementation is often recommended instead.
Fully Grounded Practice Exam & Rationales Page 3 of 29 Pediatric Nursing Care
