Questions with Verified Answers & Detailed Rationales |
Forms A–D | ATI RN/PN Care of Children | Graded A+ |
Latest 2026/2027 Update
INTRODUCTION
This comprehensive ATI PEDS Proctored Retake Practice 2026 question
bank NGN-style questions with verified answers and detailed rationales,
covering Forms A, B, C, and D across 600 total questions (150 questions
per form). Designed for RN and PN nursing students preparing for the ATI
Care of Children proctored exam, this resource provides evidence-based
explanations to reinforce clinical reasoning and ensure exam success.
Each question is formatted for easy study, making it the ultimate tool for
mastering pediatric nursing concepts and achieving a Graded A+ on the
latest 2026/2027 ATI update.
QUESTION 1
A 2-year-old toddler is brought to the clinic with a fever of 102.5°F
(39.2°C), irritability, and pulling at the right ear. The mother states the
child has had a cold for the past week. Which assessment finding would
indicate acute otitis media (AOM)?
A. Erythematous and bulging tympanic membrane
B. Pearly gray tympanic membrane with light reflex
C. Cerumen impaction obscuring the tympanic membrane
,D. Retracted tympanic membrane with increased mobility
ANSWER: A. Erythematous and bulging tympanic membrane
EXPLANATION: AOM is characterized by inflammation and fluid in the
middle ear. The hallmark signs on otoscopic exam are a bulging,
erythematous (red), and opaque tympanic membrane with
decreased mobility. A pearly gray membrane with light reflex is
normal. Cerumen impaction does not indicate AOM, and a retracted
membrane suggests eustachian tube dysfunction, not acute
infection.
QUESTION 2
The nurse is assessing a 4-year-old child with suspected dehydration due
to gastroenteritis. Which finding is an early sign of hypovolemic shock?
A. Decreased blood pressure
B. Thready, weak peripheral pulses
C. Tachycardia with delayed capillary refill
D. Oliguria for 8 hours
ANSWER: C. Tachycardia with delayed capillary refill
EXPLANATION: In children, tachycardia with prolonged capillary refill
(>2 seconds) is an early compensatory sign of hypovolemia. Blood
pressure remains normal initially due to compensatory
mechanisms. Thready pulses and oliguria occur later as
decompensation progresses. Early recognition of tachycardia and
delayed capillary refill is critical to prevent shock.
,QUESTION 3
A nurse is teaching a parent about administering oral amoxicillin
suspension to a 6-month-old infant with acute otitis media. Which
instruction is correct?
A. Shake the bottle well before each dose
B. Refrigerate the suspension after reconstitution
C. Mix the medication with a full bottle of formula
D. Discontinue the antibiotic once fever resolves
ANSWER: A. Shake the bottle well before each dose
EXPLANATION: Amoxicillin suspension must be shaken vigorously to
ensure uniform distribution of the drug. Refrigeration is not
required; it can be stored at room temperature. Mixing with a full
bottle of formula may lead to incomplete ingestion; use a small
amount if needed. Antibiotics must be completed for the full course
to prevent resistance.
QUESTION 4
A 7-year-old child with asthma is prescribed an albuterol metered-dose
inhaler (MDI) with a spacer. Which instruction is correct for proper use?
A. Inhale rapidly without holding breath
B. Actuate the inhaler before beginning inhalation
C. Wait 1 minute between puffs if a second puff is ordered
D. Use the spacer only for severe attacks
, ANSWER: C. Wait 1 minute between puffs if a second puff is ordered
EXPLANATION: For MDI with spacer, the patient should wait 1 minute
between puffs to allow for maximal bronchodilation and aerosol
settling. The child should inhale slowly (not rapidly) and hold breath
for 5–10 seconds. The inhaler should be actuated during inhalation,
not before. Spacers are recommended for all uses, not just severe
attacks, especially in children.
QUESTION 5
A 5-month-old infant is diagnosed with bronchiolitis caused by
respiratory syncytial virus (RSV). Which intervention is the priority?
A. Administer ribavirin via nebulizer
B. Suction nasal secretions before feeding
C. Place the infant in a cool-mist tent
D. Initiate droplet precautions
ANSWER: B. Suction nasal secretions before feeding
EXPLANATION: In RSV bronchiolitis, nasal congestion is the primary
cause of respiratory distress and feeding difficulty. Suctioning
before feeds maintains airway patency and prevents aspiration.
Ribavirin is reserved for severe cases. Cool-mist tents are
outdated. Droplet precautions are standard, but airway maintenance
is the priority.