ATI Pediatrics 2026/2027 | ATI RN Pediatric Nursing Edition 13.0 Study Guide, ATI
Pediatrics Practice Questions & Answers, ATI Pediatric Nursing Exam Prep, ATI
Content Mastery Series, Pediatric Nursing Comprehensive Review, Pediatric
Growth & Development, Newborn & Infant Care, Toddler & Preschool Nursing,
School-Age & Adolescent Nursing, Pediatric Health Assessment, Communicable
Diseases & Immunizations, Respiratory Disorders, Cardiovascular Disorders,
Neurological Disorders, Gastrointestinal Disorders, Endocrine Disorders,
Genitourinary Disorders, Hematological Disorders, Musculoskeletal Disorders,
Integumentary Disorders, Pediatric Emergencies, Chronic Illness & Disabilities,
Psychosocial Pediatric Care, Pharmacology, Clinical Judgment, Prioritization,
NCLEX-Style Practice & Detailed Rationales
Question 1: A nurse is assessing a 2-year-old child who has a
"barking" cough that worsens at night. Which finding is an early
sign of respiratory distress?
A. Bradycardia
B. Nasal flaring
C. Decreased respiratory rate
D. Hypotension
CORRECT ANSWER: B. Nasal flaring
Rationale: Nasal flaring is an early compensatory mechanism used by
young children to decrease airway resistance. Bradycardia, decreased
respiratory rate, and hypotension are late, ominous signs of respiratory
failure.
Question 2: A nurse is caring for a 6-month-old infant with RSV
bronchiolitis. Which intervention is the priority?
A. Administer broad-spectrum antibiotics
B. Suction the nares with a bulb syringe
C. Place the infant in a prone position for sleep
D. Encourage oral intake of clear fluids
CORRECT ANSWER: B. Suction the nares with a bulb syringe
Rationale: Infants are obligate nose breathers. Maintaining a patent airway
by suctioning secretions is the priority. Antibiotics are ineffective against
RSV, prone positioning increases SIDS risk, and oral intake may be limited
by respiratory effort.
,Question 3: A nurse is providing discharge teaching to parents of a
child who had a tonsillectomy. Which statement indicates
understanding?
A. "We will give red-colored liquids to hide the taste of medicine."
B. "We will encourage our child to cough frequently."
C. "We will watch for frequent swallowing, which could indicate bleeding."
D. "We will give our child a straw to make drinking easier."
CORRECT ANSWER: C. "We will watch for frequent swallowing,
which could indicate bleeding."
Rationale: Frequent swallowing is a sign of continuous bleeding post-
tonsillectomy. Red liquids mask blood, coughing can irritate the surgical
site, and straws create suction that can dislodge clots.
Question 4: A nurse is assessing a school-age child taking valproic
acid for seizures. Which laboratory value requires close
monitoring?
A. Serum sodium
B. Serum potassium
C. Liver function tests
D. Blood urea nitrogen
CORRECT ANSWER: C. Liver function tests
Rationale: Valproic acid is hepatotoxic and can cause fatal liver failure,
particularly in children under 2 years. Monitoring AST and ALT is essential.
Question 5: A nurse is performing a developmental screening on a
4-year-old. Which milestone is expected?
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 expected at 5-6 years.
Question 6: A nurse is caring for a 3-month-old infant with
gastroesophageal reflux. Which action should the nurse take?
,A. Place the infant in a prone position after feedings
B. Feed smaller amounts more frequently
C. Add cereal to the infant's bottle
D. Position the infant supine during feedings
CORRECT ANSWER: B. Feed smaller amounts more frequently
Rationale: Smaller, more frequent feedings reduce gastric volume and reflux
episodes. Prone positioning increases SIDS risk, and cereal is not
recommended before 6 months.
Question 7: A nurse is caring for a school-age child with asthma
experiencing an acute attack. Which finding should the nurse
expect?
A. Bradycardia
B. Wheezing
C. Hypotension
D. Bounding pulses
CORRECT ANSWER: B. Wheezing
Rationale: Wheezing is a common finding during asthma exacerbation due
to narrowed airways. Tachycardia, not bradycardia, is more typical.
Question 8: A nurse is teaching a parent of a toddler about injury
prevention. Which statement indicates understanding?
A. "I will leave small toys on the floor so my child can play."
B. "I will keep cleaning products in a cabinet low to the ground."
C. "I will use a rear-facing car seat until my child is 2 years old."
D. "I will give my child nuts because they are healthy."
CORRECT ANSWER: C. "I will use a rear-facing car seat until my
child is 2 years old."
Rationale: Children should ride rear-facing until at least 2 years or until they
reach the seat's weight/height limit. Small toys, cleaning products, and nuts
pose choking or poisoning hazards.
Question 9: A nurse is caring for an adolescent with type 1
diabetes. Which finding requires immediate follow-up?
A. Blood glucose 150 mg/dL
B. Ketones in the urine
, C. Hemoglobin A1c 7%
D. Weight gain of 1 lb in 1 week
CORRECT ANSWER: B. Ketones in the urine
Rationale: Ketones in urine can indicate diabetic ketoacidosis, a life-
threatening complication requiring immediate intervention.
Question 10: A nurse is assessing a 6-month-old infant. Which
finding should the nurse report to the provider?
A. Pulls self to standing position
B. Moves by creeping on hands and knees
C. Takes intentional steps when standing
D. Sits with support by leaning on hands
CORRECT ANSWER: D. Sits with support by leaning on hands
Rationale: A 6-month-old should sit without support. Requiring hand
support to sit may indicate developmental delay requiring further
evaluation.
Question 11: A nurse is preparing to apply lidocaine/prilocaine
cream before IV catheter insertion. Which action should the nurse
take?
A. Apply the cream 1 hour before the procedure
B. Apply the cream immediately before cleansing the site
C. Apply a thick layer and cover with a gauze pad
D. Rub the cream into the skin until no longer visible
CORRECT ANSWER: A. Apply the cream 1 hour before the
procedure
Rationale: Lidocaine/prilocaine cream requires approximately 1 hour to
achieve effective dermal anesthesia before IV insertion.
Question 12: A nurse is teaching a parent about SIDS prevention.
Which statement indicates understanding?
A. "I will let my baby sleep with me in bed at night."
B. "I will allow my baby to have a pacifier while sleeping."
C. "I will place my baby on a soft mattress to sleep."
D. "I will cover my baby with a quilt while sleeping."
Pediatrics Practice Questions & Answers, ATI Pediatric Nursing Exam Prep, ATI
Content Mastery Series, Pediatric Nursing Comprehensive Review, Pediatric
Growth & Development, Newborn & Infant Care, Toddler & Preschool Nursing,
School-Age & Adolescent Nursing, Pediatric Health Assessment, Communicable
Diseases & Immunizations, Respiratory Disorders, Cardiovascular Disorders,
Neurological Disorders, Gastrointestinal Disorders, Endocrine Disorders,
Genitourinary Disorders, Hematological Disorders, Musculoskeletal Disorders,
Integumentary Disorders, Pediatric Emergencies, Chronic Illness & Disabilities,
Psychosocial Pediatric Care, Pharmacology, Clinical Judgment, Prioritization,
NCLEX-Style Practice & Detailed Rationales
Question 1: A nurse is assessing a 2-year-old child who has a
"barking" cough that worsens at night. Which finding is an early
sign of respiratory distress?
A. Bradycardia
B. Nasal flaring
C. Decreased respiratory rate
D. Hypotension
CORRECT ANSWER: B. Nasal flaring
Rationale: Nasal flaring is an early compensatory mechanism used by
young children to decrease airway resistance. Bradycardia, decreased
respiratory rate, and hypotension are late, ominous signs of respiratory
failure.
Question 2: A nurse is caring for a 6-month-old infant with RSV
bronchiolitis. Which intervention is the priority?
A. Administer broad-spectrum antibiotics
B. Suction the nares with a bulb syringe
C. Place the infant in a prone position for sleep
D. Encourage oral intake of clear fluids
CORRECT ANSWER: B. Suction the nares with a bulb syringe
Rationale: Infants are obligate nose breathers. Maintaining a patent airway
by suctioning secretions is the priority. Antibiotics are ineffective against
RSV, prone positioning increases SIDS risk, and oral intake may be limited
by respiratory effort.
,Question 3: A nurse is providing discharge teaching to parents of a
child who had a tonsillectomy. Which statement indicates
understanding?
A. "We will give red-colored liquids to hide the taste of medicine."
B. "We will encourage our child to cough frequently."
C. "We will watch for frequent swallowing, which could indicate bleeding."
D. "We will give our child a straw to make drinking easier."
CORRECT ANSWER: C. "We will watch for frequent swallowing,
which could indicate bleeding."
Rationale: Frequent swallowing is a sign of continuous bleeding post-
tonsillectomy. Red liquids mask blood, coughing can irritate the surgical
site, and straws create suction that can dislodge clots.
Question 4: A nurse is assessing a school-age child taking valproic
acid for seizures. Which laboratory value requires close
monitoring?
A. Serum sodium
B. Serum potassium
C. Liver function tests
D. Blood urea nitrogen
CORRECT ANSWER: C. Liver function tests
Rationale: Valproic acid is hepatotoxic and can cause fatal liver failure,
particularly in children under 2 years. Monitoring AST and ALT is essential.
Question 5: A nurse is performing a developmental screening on a
4-year-old. Which milestone is expected?
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 expected at 5-6 years.
Question 6: A nurse is caring for a 3-month-old infant with
gastroesophageal reflux. Which action should the nurse take?
,A. Place the infant in a prone position after feedings
B. Feed smaller amounts more frequently
C. Add cereal to the infant's bottle
D. Position the infant supine during feedings
CORRECT ANSWER: B. Feed smaller amounts more frequently
Rationale: Smaller, more frequent feedings reduce gastric volume and reflux
episodes. Prone positioning increases SIDS risk, and cereal is not
recommended before 6 months.
Question 7: A nurse is caring for a school-age child with asthma
experiencing an acute attack. Which finding should the nurse
expect?
A. Bradycardia
B. Wheezing
C. Hypotension
D. Bounding pulses
CORRECT ANSWER: B. Wheezing
Rationale: Wheezing is a common finding during asthma exacerbation due
to narrowed airways. Tachycardia, not bradycardia, is more typical.
Question 8: A nurse is teaching a parent of a toddler about injury
prevention. Which statement indicates understanding?
A. "I will leave small toys on the floor so my child can play."
B. "I will keep cleaning products in a cabinet low to the ground."
C. "I will use a rear-facing car seat until my child is 2 years old."
D. "I will give my child nuts because they are healthy."
CORRECT ANSWER: C. "I will use a rear-facing car seat until my
child is 2 years old."
Rationale: Children should ride rear-facing until at least 2 years or until they
reach the seat's weight/height limit. Small toys, cleaning products, and nuts
pose choking or poisoning hazards.
Question 9: A nurse is caring for an adolescent with type 1
diabetes. Which finding requires immediate follow-up?
A. Blood glucose 150 mg/dL
B. Ketones in the urine
, C. Hemoglobin A1c 7%
D. Weight gain of 1 lb in 1 week
CORRECT ANSWER: B. Ketones in the urine
Rationale: Ketones in urine can indicate diabetic ketoacidosis, a life-
threatening complication requiring immediate intervention.
Question 10: A nurse is assessing a 6-month-old infant. Which
finding should the nurse report to the provider?
A. Pulls self to standing position
B. Moves by creeping on hands and knees
C. Takes intentional steps when standing
D. Sits with support by leaning on hands
CORRECT ANSWER: D. Sits with support by leaning on hands
Rationale: A 6-month-old should sit without support. Requiring hand
support to sit may indicate developmental delay requiring further
evaluation.
Question 11: A nurse is preparing to apply lidocaine/prilocaine
cream before IV catheter insertion. Which action should the nurse
take?
A. Apply the cream 1 hour before the procedure
B. Apply the cream immediately before cleansing the site
C. Apply a thick layer and cover with a gauze pad
D. Rub the cream into the skin until no longer visible
CORRECT ANSWER: A. Apply the cream 1 hour before the
procedure
Rationale: Lidocaine/prilocaine cream requires approximately 1 hour to
achieve effective dermal anesthesia before IV insertion.
Question 12: A nurse is teaching a parent about SIDS prevention.
Which statement indicates understanding?
A. "I will let my baby sleep with me in bed at night."
B. "I will allow my baby to have a pacifier while sleeping."
C. "I will place my baby on a soft mattress to sleep."
D. "I will cover my baby with a quilt while sleeping."
