ATI Pediatrics CMS Test 2026/2027 | ATI Pediatrics Content Mastery Series
Proctored Exam Study Guide, ATI Pediatrics Exam Prep, Pediatric Nursing
Review, Growth & Development, Pediatric Pharmacology, Respiratory &
Infectious Disorders, GI Disorders, Emergencies, Family-Centered Care,
Practice Questions, Answers & Rationales
Question 1: A 2-year-old child presents to the emergency department with
inspiratory stridor, a barking cough, and a low-grade fever. The parent reports
that the symptoms worsened significantly during the night. Which of the
following is the priority nursing action?
A. Administer a nebulized racemic epinephrine treatment.
B. Prepare the child for an emergent tracheotomy.
C. Place the child in a position of comfort and allow them to sit upright.
D. Obtain a throat culture to rule out a bacterial infection.
CORRECT ANSWER: C. Place the child in a position of comfort and allow them to
sit upright.
Rationale: This presentation is classic for croup (laryngotracheobronchitis). While
racemic epinephrine and corticosteroids are medical treatments for moderate to
severe croup, the immediate priority nursing action is to place the child in a
position of comfort, which helps to maximize airway patency and reduce
respiratory distress. Agitation and crying can worsen stridor and airway
obstruction. A throat culture is not a priority and is not typically indicated for viral
croup, and a tracheotomy is reserved for severe, life-threatening airway
obstruction that does not respond to other treatments.
Question 2: A 4-month-old infant is scheduled to receive their first set of
immunizations. Prior to administration, the nurse reviews the parent's signed
consent. Which of the following components is legally required for valid
informed consent?
A. A witness signature from a notary public.
B. An explanation of the risks, benefits, and alternatives to the vaccination.
C. A guarantee of vaccine efficacy from the prescribing healthcare provider.
D. A signed statement from both parents or legal guardians.
CORRECT ANSWER: B. An explanation of the risks, benefits, and alternatives to
the vaccination.
,Rationale: Informed consent requires that the parent or guardian receives
sufficient information to make a voluntary decision. This includes a clear
explanation of the procedure's risks, benefits, and available alternatives. A
guarantee of efficacy is not possible and is not a legal requirement. While some
institutions require a witness, a notary is not mandatory. Consent from one legal
guardian is generally sufficient for routine medical care, provided they have the
legal authority to do so.
Question 3: The nurse is assessing a 10-year-old child with a diagnosis of type 1
diabetes mellitus. The child's parent reports that the child has been
experiencing frequent episodes of hypoglycemia in the late afternoon. Which of
the following interventions should the nurse recommend to address this
pattern?
A. Decrease the child's morning dose of short-acting insulin.
B. Provide a carbohydrate snack before the child's afternoon physical activity.
C. Administer an extra dose of insulin before lunch.
D. Increase the child's morning dose of long-acting insulin.
CORRECT ANSWER: B. Provide a carbohydrate snack before the child's afternoon
physical activity.
Rationale: Hypoglycemia in the late afternoon is frequently associated with
increased physical activity during the school day. Providing a carbohydrate snack
(e.g., 15-30 grams) before or during periods of high activity can help to prevent
this drop in blood glucose. The morning insulin dose should not be altered
without a specific medical plan and a full review of the child's glucose patterns; it
is more likely that an adjustment to the insulin-to-carbohydrate ratio or snack
schedule is needed, not an arbitrary decrease or increase in the morning dose.
Question 4: A 6-year-old child is admitted to the pediatric unit with a diagnosis
of acute glomerulonephritis. The nurse's assessment reveals generalized edema,
hypertension, and tea-colored urine. Which of the following dietary
modifications should the nurse anticipate being prescribed for this child?
A. High-protein, low-potassium diet.
B. Low-sodium, fluid-restricted diet.
,C. High-calcium, low-phosphorus diet.
D. Low-fat, high-carbohydrate diet.
CORRECT ANSWER: B. Low-sodium, fluid-restricted diet.
Rationale: Acute glomerulonephritis is characterized by decreased glomerular
filtration rate, leading to fluid retention, hypertension, and edema. The standard
medical management includes dietary sodium restriction and, depending on the
severity of the fluid overload, fluid restriction. A high-protein diet is not indicated
and can further stress the kidneys, and the other dietary modifications are not
specific to this condition.
Question 5: A nurse is assessing a 3-year-old toddler. Which of the following
pain assessment scales should the nurse use?
A. FACES scale
B. Numeric scale
C. CRIES scale
D. Visual analog scale
CORRECT ANSWER: A. FACES scale
Rationale: The FACES pain rating scale is appropriate for pediatric clients who are
3 years old and older. This scale allows the toddler to point to the face that
depicts their current level of pain. The Numeric scale is appropriate for children 5
years and older; CRIES is used for neonates/infants; Visual analog is used for
children 7 years and older.
Question 6: A nurse is providing teaching to the parents of a 4-year-old child
about fine motor development. Which of the following tasks should the nurse
expect the child to perform?
A. Tying shoelaces
B. Drawing a circle
C. Cutting with scissors
D. Writing their name
CORRECT ANSWER: B. Drawing a circle
, Rationale: At age 4, a child should be able to draw a circle and a square. Tying
shoelaces and cutting with scissors are typically achieved around age 5-6; writing
their name is typically achieved around age 5-6.
Question 7: A nurse is assessing a 6-month-old infant during a well-child visit.
Which of the following developmental milestones should the nurse expect the
infant to demonstrate?
A. Sitting without support
B. Rolling from back to front
C. Walking with assistance
D. Pincer grasp
CORRECT ANSWER: B. Rolling from back to front
Rationale: At 6 months, infants typically can roll from back to front. Sitting
without support is achieved around 8 months; walking with assistance is achieved
around 11-12 months; pincer grasp is achieved around 9-10 months.
Question 8: A nurse is assessing the reflexes of a 6-month-old infant. Which of
the following reflexes should have disappeared by this age?
A. Moro reflex
B. Babinski reflex
C. Rooting reflex
D. Palmar grasp
CORRECT ANSWER: A. Moro reflex
Rationale: The Moro (startle) reflex should disappear by 3-4 months of age. The
Babinski reflex may persist until 12 months; rooting disappears around 3-4
months; palmar grasp disappears around 4-6 months.
Question 9: A nurse is providing teaching to the parents of a 2-year-old toddler
about expected developmental milestones. Which of the following statements
by the parents indicates an understanding of the teaching?
A. "My child should be able to ride a tricycle."
B. "My child should be able to build a tower of 6-7 blocks."
Proctored Exam Study Guide, ATI Pediatrics Exam Prep, Pediatric Nursing
Review, Growth & Development, Pediatric Pharmacology, Respiratory &
Infectious Disorders, GI Disorders, Emergencies, Family-Centered Care,
Practice Questions, Answers & Rationales
Question 1: A 2-year-old child presents to the emergency department with
inspiratory stridor, a barking cough, and a low-grade fever. The parent reports
that the symptoms worsened significantly during the night. Which of the
following is the priority nursing action?
A. Administer a nebulized racemic epinephrine treatment.
B. Prepare the child for an emergent tracheotomy.
C. Place the child in a position of comfort and allow them to sit upright.
D. Obtain a throat culture to rule out a bacterial infection.
CORRECT ANSWER: C. Place the child in a position of comfort and allow them to
sit upright.
Rationale: This presentation is classic for croup (laryngotracheobronchitis). While
racemic epinephrine and corticosteroids are medical treatments for moderate to
severe croup, the immediate priority nursing action is to place the child in a
position of comfort, which helps to maximize airway patency and reduce
respiratory distress. Agitation and crying can worsen stridor and airway
obstruction. A throat culture is not a priority and is not typically indicated for viral
croup, and a tracheotomy is reserved for severe, life-threatening airway
obstruction that does not respond to other treatments.
Question 2: A 4-month-old infant is scheduled to receive their first set of
immunizations. Prior to administration, the nurse reviews the parent's signed
consent. Which of the following components is legally required for valid
informed consent?
A. A witness signature from a notary public.
B. An explanation of the risks, benefits, and alternatives to the vaccination.
C. A guarantee of vaccine efficacy from the prescribing healthcare provider.
D. A signed statement from both parents or legal guardians.
CORRECT ANSWER: B. An explanation of the risks, benefits, and alternatives to
the vaccination.
,Rationale: Informed consent requires that the parent or guardian receives
sufficient information to make a voluntary decision. This includes a clear
explanation of the procedure's risks, benefits, and available alternatives. A
guarantee of efficacy is not possible and is not a legal requirement. While some
institutions require a witness, a notary is not mandatory. Consent from one legal
guardian is generally sufficient for routine medical care, provided they have the
legal authority to do so.
Question 3: The nurse is assessing a 10-year-old child with a diagnosis of type 1
diabetes mellitus. The child's parent reports that the child has been
experiencing frequent episodes of hypoglycemia in the late afternoon. Which of
the following interventions should the nurse recommend to address this
pattern?
A. Decrease the child's morning dose of short-acting insulin.
B. Provide a carbohydrate snack before the child's afternoon physical activity.
C. Administer an extra dose of insulin before lunch.
D. Increase the child's morning dose of long-acting insulin.
CORRECT ANSWER: B. Provide a carbohydrate snack before the child's afternoon
physical activity.
Rationale: Hypoglycemia in the late afternoon is frequently associated with
increased physical activity during the school day. Providing a carbohydrate snack
(e.g., 15-30 grams) before or during periods of high activity can help to prevent
this drop in blood glucose. The morning insulin dose should not be altered
without a specific medical plan and a full review of the child's glucose patterns; it
is more likely that an adjustment to the insulin-to-carbohydrate ratio or snack
schedule is needed, not an arbitrary decrease or increase in the morning dose.
Question 4: A 6-year-old child is admitted to the pediatric unit with a diagnosis
of acute glomerulonephritis. The nurse's assessment reveals generalized edema,
hypertension, and tea-colored urine. Which of the following dietary
modifications should the nurse anticipate being prescribed for this child?
A. High-protein, low-potassium diet.
B. Low-sodium, fluid-restricted diet.
,C. High-calcium, low-phosphorus diet.
D. Low-fat, high-carbohydrate diet.
CORRECT ANSWER: B. Low-sodium, fluid-restricted diet.
Rationale: Acute glomerulonephritis is characterized by decreased glomerular
filtration rate, leading to fluid retention, hypertension, and edema. The standard
medical management includes dietary sodium restriction and, depending on the
severity of the fluid overload, fluid restriction. A high-protein diet is not indicated
and can further stress the kidneys, and the other dietary modifications are not
specific to this condition.
Question 5: A nurse is assessing a 3-year-old toddler. Which of the following
pain assessment scales should the nurse use?
A. FACES scale
B. Numeric scale
C. CRIES scale
D. Visual analog scale
CORRECT ANSWER: A. FACES scale
Rationale: The FACES pain rating scale is appropriate for pediatric clients who are
3 years old and older. This scale allows the toddler to point to the face that
depicts their current level of pain. The Numeric scale is appropriate for children 5
years and older; CRIES is used for neonates/infants; Visual analog is used for
children 7 years and older.
Question 6: A nurse is providing teaching to the parents of a 4-year-old child
about fine motor development. Which of the following tasks should the nurse
expect the child to perform?
A. Tying shoelaces
B. Drawing a circle
C. Cutting with scissors
D. Writing their name
CORRECT ANSWER: B. Drawing a circle
, Rationale: At age 4, a child should be able to draw a circle and a square. Tying
shoelaces and cutting with scissors are typically achieved around age 5-6; writing
their name is typically achieved around age 5-6.
Question 7: A nurse is assessing a 6-month-old infant during a well-child visit.
Which of the following developmental milestones should the nurse expect the
infant to demonstrate?
A. Sitting without support
B. Rolling from back to front
C. Walking with assistance
D. Pincer grasp
CORRECT ANSWER: B. Rolling from back to front
Rationale: At 6 months, infants typically can roll from back to front. Sitting
without support is achieved around 8 months; walking with assistance is achieved
around 11-12 months; pincer grasp is achieved around 9-10 months.
Question 8: A nurse is assessing the reflexes of a 6-month-old infant. Which of
the following reflexes should have disappeared by this age?
A. Moro reflex
B. Babinski reflex
C. Rooting reflex
D. Palmar grasp
CORRECT ANSWER: A. Moro reflex
Rationale: The Moro (startle) reflex should disappear by 3-4 months of age. The
Babinski reflex may persist until 12 months; rooting disappears around 3-4
months; palmar grasp disappears around 4-6 months.
Question 9: A nurse is providing teaching to the parents of a 2-year-old toddler
about expected developmental milestones. Which of the following statements
by the parents indicates an understanding of the teaching?
A. "My child should be able to ride a tricycle."
B. "My child should be able to build a tower of 6-7 blocks."
