Rationales | Latest Update University of Arizona College of Nursing
This comprehensive ATI PN Pediatric Proctored Exam study guide contains
meticulously crafted multiple-choice questions with verified correct answers in
bold italics and detailed rationales in bold italics for each question, organized
sequentially for optimal learning. Each question is designed to mirror the actual
ATI exam format, covering growth and development, acute/chronic illness
management, medication administration, safety, and family-centered care across
all pediatric age groups from infancy through adolescence. Perfect for nursing
students preparing for the ATI PN Pediatric Proctored Exam, this resource
provides the practice and content mastery needed to pass on the first attempt.
Question 1
A nurse is receiving change-of-shift report for four children. Which of the
following children should the nurse assess first?
A) A toddler who has a concussion and an episode of forceful vomiting
B) An adolescent who has infective endocarditis and reports having a headache
C) An adolescent who was placed into halo traction 1 hour ago and reports pain as
6 on a scale of 0 to 10
D) A school-age child who has acute glomerulonephritis and brown-colored urine
Correct Answer: A) A toddler who has a concussion and an episode of
forceful vomiting
Explanation: When determining priority, the nurse should use the ABCs
(airway, breathing, circulation) or the concept of acute vs. chronic/stable.
,Forceful vomiting in a toddler with a concussion is a classic sign of
increased intracranial pressure (ICP). This is a life-threatening
complication that requires immediate intervention to prevent brain damage.
This is the highest priority. Headache with infective endocarditis could
indicate an embolic event, but it is not as immediately life-threatening as
signs of increased ICP. Pain is important to address, but a pain level of 6 in
a patient in halo traction is expected post-procedure and not the highest
priority. Brown-colored urine is a classic sign of acute glomerulonephritis
but indicates a chronic condition and does not require immediate, life-
saving action over the other patients .
Question 2
A 9-year-old child arrives at the emergency department with severe facial
swelling and respiratory distress after a known peanut exposure. The nurse
notes audible wheezing and sees hives on the chest and arms. Which of the
following is the nurse's priority intervention?
A) Administer an albuterol nebulizer treatment
B) Administer oxygen at 6 L/min via nasal cannula
C) Prepare a corticosteroid dose for IV administration
D) Administer intramuscular epinephrine
Correct Answer: D) Administer intramuscular epinephrine
Explanation: The child is showing signs of anaphylaxis, a life-threatening
allergic reaction that causes airway compromise and cardiovascular
collapse. Epinephrine is the only first-line treatment for anaphylaxis. It
reverses vasodilation, bronchoconstriction, and edema. Delaying
,epinephrine can be fatal. Albuterol can help with bronchospasm but does not
address the cardiovascular collapse or laryngeal edema. Oxygen is a
supportive measure but secondary to epinephrine for reversing the
underlying cause. Corticosteroids work too slowly to reverse the acute,
life-threatening symptoms and are used to prevent biphasic reactions
later .
Question 3
A nurse is providing dietary teaching to the guardian of a school-age child
who has cystic fibrosis. Which of the following statements should the nurse
make?
A) "You should offer your child high-protein meals and snacks throughout the
day."
B) "You should decrease your child's dietary fat intake to less than 10% of their
caloric intake."
C) "You should restrict your child's calorie intake to 1,200 per day."
D) "You should give your child a multivitamin once weekly."
Correct Answer: A) "You should offer your child high-protein meals and
snacks throughout the day."
Explanation: Children with cystic fibrosis (CF) have malabsorption due to a
lack of pancreatic enzymes. They require a high-calorie, high-protein, and
high-fat diet to meet their nutritional needs and promote growth. High-
protein and frequent meals help meet the increased metabolic demands and
compensate for malabsorption. High-fat is necessary for energy; fat
restriction is incorrect and dangerous for a child with CF. Calorie
, restriction is the opposite of the care plan. These children need more
calories, not fewer. Multivitamins are typically given daily, not weekly, due
to poor absorption of fat-soluble vitamins (A, D, E, K) .
Question 4
A nurse is caring for an 18-year-old adolescent who is up-to-date on
immunizations and is planning to attend college. The nurse should inform the
client that he should receive which of the following immunizations prior to
moving into a campus dormitory?
A) Pneumococcal polysaccharide
B) Meningococcal polysaccharide
C) Rotavirus
D) Herpes zoster
Correct Answer: B) Meningococcal polysaccharide
Explanation: College students, particularly those living in dormitories, are at
increased risk for meningococcal disease. The meningococcal vaccine is
recommended for adolescents and young adults before college entry.
Pneumococcal vaccine is typically for older adults or those with specific
risk factors. Rotavirus vaccine is given in infancy. Herpes zoster vaccine is
for older adults .
Question 5