ATI Pediatrics Proctored 2026/2027 | ATI RN Pediatrics
Proctored Assessment Study Guide & Practice Questions | ATI
Pediatrics Nursing Exam Prep, Pediatric Growth &
Development, Newborn & Infant Care, Childhood Health
Promotion, Pediatric Assessment, Respiratory Disorders,
Cardiovascular Disorders, Gastrointestinal Disorders,
Neurological Disorders, Endocrine Disorders, Infectious
Diseases, Hematologic Disorders, Fluid & Electrolytes,
Pediatric Pharmacology, Pain Management, Family-Centered
Care, Safety, Prioritization, Delegation, Clinical Judgment,
NGN-Style Case Studies & Detailed Rationales
Question 1: A nurse is assessing a 2-year-old child who has had a
"barking" cough for the past two days that worsens at night. Which
of the following findings should the nurse identify as an early sign
of respiratory distress in this child?
A. Bradycardia
B. Nasal flaring
C. A decrease in respiratory rate
D. A decrease in blood pressure
CORRECT ANSWER: B. Nasal flaring
Rationale: Nasal flaring is a compensatory mechanism used by infants and
young children to decrease airway resistance and increase the diameter of
the nasal passages, which is an early and significant sign of respiratory
distress. Bradycardia is a late and ominous sign of respiratory failure, as is a
decrease in respiratory rate and hypotension.
Question 2: A nurse is caring for a 6-month-old infant with
bronchiolitis caused by RSV. Which of the following interventions is
the priority for this infant?
A. Administering broad-spectrum antibiotics
B. Suctioning the nares with a bulb syringe
C. Placing the infant in a prone position for sleep
D. Encouraging oral intake of clear fluids
CORRECT ANSWER: B. Suctioning the nares with a bulb syringe
Rationale: Infants are obligate nose breathers; therefore, maintaining a clear
airway is the priority. Suctioning the nares helps to clear secretions and
maintain patency of the airway. Antibiotics are not effective against RSV, a
,virus. Prone positioning increases the risk of SIDS. Oral intake may be
decreased due to respiratory effort, and hydration is often maintained with
IV fluids, not forced oral intake.
Question 3: A nurse is providing discharge teaching to the parents
of a child who had a tonsillectomy. Which of the following
statements by the parents indicates an understanding of the
teaching?
A. "We will give our child red-colored liquids to help hide the taste of
medicine."
B. "We will encourage our child to cough frequently to clear the airway."
C. "We will watch for frequent swallowing, which could indicate bleeding."
D. "We will give our child a straw to make drinking fluids easier."
CORRECT ANSWER: C. "We will watch for frequent swallowing,
which could indicate bleeding."
Rationale: Frequent swallowing is a sign of continuous bleeding in the
throat post-tonsillectomy. Red-colored liquids should be avoided because
they can mask the appearance of blood in emesis. Coughing should be
discouraged as it can irritate the surgical site and cause bleeding. Straws
should be avoided as the sucking motion can also dislodge the clot and
cause bleeding.
Question 4: A nurse is assessing a school-age child who has a
history of seizures and is currently taking valproic acid. Which of
the following laboratory values should the nurse monitor closely
due to the adverse effects of this medication?
A. Serum sodium level
B. Serum potassium level
C. Liver function tests
D. Blood urea nitrogen level
CORRECT ANSWER: C. Liver function tests
Rationale: Valproic acid is hepatotoxic and can cause fatal liver failure,
particularly in children under 2 years of age or those with mitochondrial
disorders. Monitoring liver function tests (AST, ALT) is essential. While
valproic acid can cause hyperammonemia, it is not primarily monitored via
BUN. It does not typically cause significant alterations in sodium or
potassium.
,Question 5: A nurse is performing a developmental screening on a
4-year-old child. Which of the following milestones is appropriate
for the nurse to expect the child to achieve?
A. Ties shoelaces
B. Draws a circle
C. Uses a fork to eat independently
D. Rides a tricycle
CORRECT ANSWER: B. Draws a circle
Rationale: By age 4, a child should be able to copy a circle and draw a
person with 2-4 body parts. Tying shoelaces is a fine motor skill expected
around age 5-6. Using a fork independently is typically seen by age 3-4, but
drawing a circle is the more specific and distinguishing milestone for this
age. Rides a tricycle is typically achieved by age 3.
Question 6: A nurse is collecting data from an adolescent. Which of
the following represents the greatest risk for suicide?
A. Active psychiatric disorder
B. Recent breakup with a romantic partner
C. Poor academic performance
D. Conflict with parents
CORRECT ANSWER: A. Active psychiatric disorder
Rationale: An active psychiatric disorder, particularly depression, is the
greatest risk factor for suicide in adolescents. While recent losses, academic
struggles, and family conflict are stressors, an underlying psychiatric
condition significantly amplifies suicide risk and requires immediate
assessment and intervention.
Question 7: A nurse is collecting data from an infant who has otitis
media. The nurse should expect which of the following findings?
A. Tugging on the affected ear lobe
B. Decreased body temperature
C. Increased appetite
D. Swelling behind the ear
CORRECT ANSWER: A. Tugging on the affected ear lobe
, Rationale: Tugging or rubbing the affected ear is a common sign of otitis
media in infants who cannot verbalize pain. Fever, not decreased
temperature, is typically present. Appetite is often decreased due to pain
with sucking. Swelling behind the ear may indicate mastoiditis, a
complication, not a primary finding of otitis media.
Question 8: A nurse is reinforcing teaching with a parent of a 1-
month-old infant who is to undergo initial surgery to treat
Hirschsprung's disease. Which of the following statements should
indicate to the nurse that the parent understands the goal of
surgery?
A. "I'm glad that the ostomy is only temporary."
B. "I understand my baby will need lifelong antibiotics."
C. "My baby will not need any further surgeries."
D. "This surgery will cure all digestive problems."
CORRECT ANSWER: A. "I'm glad that the ostomy is only
temporary."
Rationale: In Hirschsprung's disease, the initial surgery often involves
creating a temporary colostomy to bypass the aganglionic section of the
colon. A second surgery is typically performed later to reconnect the bowel.
Understanding that the ostomy is temporary indicates correct
understanding of the surgical plan.
Question 9: A nurse is caring for an infant who is 1 day
postoperative following surgical repair of a cleft lip. Which of the
following actions should the nurse take?
A. Apply an antibiotic ointment to the suture site
B. Position the infant in the prone position
C. Clean the suture line with hydrogen peroxide
D. Allow the infant to use a pacifier
CORRECT ANSWER: A. Apply an antibiotic ointment to the suture
site
Rationale: Applying antibiotic ointment to the suture site is appropriate to
prevent infection and keep the suture line moist. Prone positioning should
be avoided to protect the surgical site. Hydrogen peroxide is too harsh for
suture care. Pacifiers should be avoided as sucking can stress the suture
line.
Proctored Assessment Study Guide & Practice Questions | ATI
Pediatrics Nursing Exam Prep, Pediatric Growth &
Development, Newborn & Infant Care, Childhood Health
Promotion, Pediatric Assessment, Respiratory Disorders,
Cardiovascular Disorders, Gastrointestinal Disorders,
Neurological Disorders, Endocrine Disorders, Infectious
Diseases, Hematologic Disorders, Fluid & Electrolytes,
Pediatric Pharmacology, Pain Management, Family-Centered
Care, Safety, Prioritization, Delegation, Clinical Judgment,
NGN-Style Case Studies & Detailed Rationales
Question 1: A nurse is assessing a 2-year-old child who has had a
"barking" cough for the past two days that worsens at night. Which
of the following findings should the nurse identify as an early sign
of respiratory distress in this child?
A. Bradycardia
B. Nasal flaring
C. A decrease in respiratory rate
D. A decrease in blood pressure
CORRECT ANSWER: B. Nasal flaring
Rationale: Nasal flaring is a compensatory mechanism used by infants and
young children to decrease airway resistance and increase the diameter of
the nasal passages, which is an early and significant sign of respiratory
distress. Bradycardia is a late and ominous sign of respiratory failure, as is a
decrease in respiratory rate and hypotension.
Question 2: A nurse is caring for a 6-month-old infant with
bronchiolitis caused by RSV. Which of the following interventions is
the priority for this infant?
A. Administering broad-spectrum antibiotics
B. Suctioning the nares with a bulb syringe
C. Placing the infant in a prone position for sleep
D. Encouraging oral intake of clear fluids
CORRECT ANSWER: B. Suctioning the nares with a bulb syringe
Rationale: Infants are obligate nose breathers; therefore, maintaining a clear
airway is the priority. Suctioning the nares helps to clear secretions and
maintain patency of the airway. Antibiotics are not effective against RSV, a
,virus. Prone positioning increases the risk of SIDS. Oral intake may be
decreased due to respiratory effort, and hydration is often maintained with
IV fluids, not forced oral intake.
Question 3: A nurse is providing discharge teaching to the parents
of a child who had a tonsillectomy. Which of the following
statements by the parents indicates an understanding of the
teaching?
A. "We will give our child red-colored liquids to help hide the taste of
medicine."
B. "We will encourage our child to cough frequently to clear the airway."
C. "We will watch for frequent swallowing, which could indicate bleeding."
D. "We will give our child a straw to make drinking fluids easier."
CORRECT ANSWER: C. "We will watch for frequent swallowing,
which could indicate bleeding."
Rationale: Frequent swallowing is a sign of continuous bleeding in the
throat post-tonsillectomy. Red-colored liquids should be avoided because
they can mask the appearance of blood in emesis. Coughing should be
discouraged as it can irritate the surgical site and cause bleeding. Straws
should be avoided as the sucking motion can also dislodge the clot and
cause bleeding.
Question 4: A nurse is assessing a school-age child who has a
history of seizures and is currently taking valproic acid. Which of
the following laboratory values should the nurse monitor closely
due to the adverse effects of this medication?
A. Serum sodium level
B. Serum potassium level
C. Liver function tests
D. Blood urea nitrogen level
CORRECT ANSWER: C. Liver function tests
Rationale: Valproic acid is hepatotoxic and can cause fatal liver failure,
particularly in children under 2 years of age or those with mitochondrial
disorders. Monitoring liver function tests (AST, ALT) is essential. While
valproic acid can cause hyperammonemia, it is not primarily monitored via
BUN. It does not typically cause significant alterations in sodium or
potassium.
,Question 5: A nurse is performing a developmental screening on a
4-year-old child. Which of the following milestones is appropriate
for the nurse to expect the child to achieve?
A. Ties shoelaces
B. Draws a circle
C. Uses a fork to eat independently
D. Rides a tricycle
CORRECT ANSWER: B. Draws a circle
Rationale: By age 4, a child should be able to copy a circle and draw a
person with 2-4 body parts. Tying shoelaces is a fine motor skill expected
around age 5-6. Using a fork independently is typically seen by age 3-4, but
drawing a circle is the more specific and distinguishing milestone for this
age. Rides a tricycle is typically achieved by age 3.
Question 6: A nurse is collecting data from an adolescent. Which of
the following represents the greatest risk for suicide?
A. Active psychiatric disorder
B. Recent breakup with a romantic partner
C. Poor academic performance
D. Conflict with parents
CORRECT ANSWER: A. Active psychiatric disorder
Rationale: An active psychiatric disorder, particularly depression, is the
greatest risk factor for suicide in adolescents. While recent losses, academic
struggles, and family conflict are stressors, an underlying psychiatric
condition significantly amplifies suicide risk and requires immediate
assessment and intervention.
Question 7: A nurse is collecting data from an infant who has otitis
media. The nurse should expect which of the following findings?
A. Tugging on the affected ear lobe
B. Decreased body temperature
C. Increased appetite
D. Swelling behind the ear
CORRECT ANSWER: A. Tugging on the affected ear lobe
, Rationale: Tugging or rubbing the affected ear is a common sign of otitis
media in infants who cannot verbalize pain. Fever, not decreased
temperature, is typically present. Appetite is often decreased due to pain
with sucking. Swelling behind the ear may indicate mastoiditis, a
complication, not a primary finding of otitis media.
Question 8: A nurse is reinforcing teaching with a parent of a 1-
month-old infant who is to undergo initial surgery to treat
Hirschsprung's disease. Which of the following statements should
indicate to the nurse that the parent understands the goal of
surgery?
A. "I'm glad that the ostomy is only temporary."
B. "I understand my baby will need lifelong antibiotics."
C. "My baby will not need any further surgeries."
D. "This surgery will cure all digestive problems."
CORRECT ANSWER: A. "I'm glad that the ostomy is only
temporary."
Rationale: In Hirschsprung's disease, the initial surgery often involves
creating a temporary colostomy to bypass the aganglionic section of the
colon. A second surgery is typically performed later to reconnect the bowel.
Understanding that the ostomy is temporary indicates correct
understanding of the surgical plan.
Question 9: A nurse is caring for an infant who is 1 day
postoperative following surgical repair of a cleft lip. Which of the
following actions should the nurse take?
A. Apply an antibiotic ointment to the suture site
B. Position the infant in the prone position
C. Clean the suture line with hydrogen peroxide
D. Allow the infant to use a pacifier
CORRECT ANSWER: A. Apply an antibiotic ointment to the suture
site
Rationale: Applying antibiotic ointment to the suture site is appropriate to
prevent infection and keep the suture line moist. Prone positioning should
be avoided to protect the surgical site. Hydrogen peroxide is too harsh for
suture care. Pacifiers should be avoided as sucking can stress the suture
line.
