ATI RN Pediatric Nursing Proctored Exam with NGN
2026-2027 Questions and verified answers
1. A nurse is caring for an infant who has suspected bacterial meningitis. Which
diagnostic finding from the cerebrospinal fluid (CSF) analysis confirms this
diagnosis?
A. Elevated glucose and decreased protein
B. Decreased white blood cells and elevated glucose
C. Decreased glucose and elevated protein
D. Clear appearance and normal cell count
Correct Answer: C
Rationale: Bacteria consume glucose and produce waste, leading to characteristically
low glucose levels and high protein concentrations in the CSF.
2. A nurse is witnessing a school-age child experience a tonic-clonic seizure in
bed. Which action should the nurse take first?
A. Insert a plastic airway into the child's mouth.
B. Restrain the child’s arms and legs to prevent injury.
, C. Turn the child onto a side-lying position.
B. Administer a dose of oral diazepam.
Correct Answer: C
Rationale: Turning the child to the side maintains a clear airway and prevents the
aspiration of oral secretions.
3. A nurse is assessing an infant for developmental dysplasia of the hip (DDH).
Which finding should the nurse expect?
A. Symmetrical gluteal folds
B. Lengthening of the affected limb
C. Limited abduction of the affected hip
D. Inward curvature of the lower spine
Correct Answer: C
Rationale: Restricted abduction of the hip on the affected side along with asymmetrical
thigh/gluteal folds are classic signs of DDH.
🩸 Hematology & Oncology
4. A nurse is admitting a child experiencing a vaso-occlusive sickle cell crisis.
Which intervention is the highest priority?
A. Administering prescribed intravenous fluids.
B. Applying cold compresses to painful joints.
C. Administering intramuscular meperidine.
D. Initiating physical therapy exercises.
Correct Answer: A
Rationale: Aggressive hydration is the priority to decrease blood viscosity, reverse the
sickling process, and restore local tissue perfusion.
5. A nurse is caring for a preschool-age child who has a confirmed Wilms' tumor.
Which action must the nurse include in the plan of care?
A. Palpate the abdomen daily to monitor tumor size.
B. Post a sign above the bed that reads "Do Not Palpate Abdomen".
C. Prepare the child for immediate spinal traction.
D. Maintain the child on strict contact precautions.
Correct Answer: B
Rationale: A Wilms' tumor is highly fragile. Palpating the abdomen can rupture the
capsule, causing the malignancy to metastasize throughout the peritoneal cavity.
6. A school-age child with hemophilia A is brought to the clinic after scraping
their knee. Which medication should the nurse anticipate administering?
, A. Factor IX concentrate
B. Factor VIII concentrate
C. Low-dose oral aspirin
D. Low-molecular-weight heparin
Correct Answer: B
Rationale: Hemophilia A is caused by a congenital deficiency of clotting Factor VIII,
which must be replaced during bleeding episodes.
🩸 Endocrine & Immune Disorders
7. A nurse is providing dietary teaching to the parents of a toddler newly
diagnosed with Celiac disease. Which food selection is safe to include in the
child's diet?
A. Whole wheat crackers
B. White rice cereal
C. Rye bread sandwiches
D. Barley soup mix
Correct Answer: B
Rationale: Celiac disease requires a strict gluten-free diet. Rice, corn, and potatoes are
safe, while wheat, rye, barley, and oats must be avoided.
8. A nurse is reviewing laboratory results for a child suspected of having Type 1
diabetes mellitus. Which finding supports this diagnosis?
A. Fasting blood glucose of 70 mg/dL
B. Glycosylated hemoglobin (HbA1c) of 8.5%
C. Absence of ketones in the urine
D. Serum potassium level of 4.2 mEq/L
Correct Answer: B
Rationale: An HbA1c value greater than 6.5% indicates persistent hyperglycemia and is
diagnostic for diabetes mellitus.
9. A nurse is assessing a 10-month-old infant who has acute gastroenteritis and
is experiencing severe dehydration. Which finding should the nurse expect?
A. Sunken anterior fontanel
B. Capillary refill time of 2 seconds
C. Increased urinary output
D. Moist mucous membranes
Correct Answer: A
, Rationale: Severe dehydration in infants manifests as a sunken anterior fontanel,
delayed capillary refill (over 4 seconds), oliguria/anuria, and dry mucous membranes.
10. A nurse is caring for a school-age child who has acute poststreptococcal
glomerulonephritis (APSGN). Which clinical manifestation should the nurse
anticipate?
A. Hypotension and clear, pale urine
B. Periorbital edema and tea-colored urine
C. Generalized rash and polyuria
D. Increased appetite and weight loss
Correct Answer: B
Rationale: Glomerular damage allows red blood cells to enter the urine, causing a
smoky or tea-colored appearance. Fluid retention typically leads to periorbital edema
and hypertension.
11. A nurse is providing care for a toddler who has nephrotic syndrome. Which
laboratory value should the nurse expect to find?
A. Hyperalbuminemia
B. Severe proteinuria
C. Decreased serum cholesterol
D. Decreased specific gravity
Correct Answer: B
Rationale: Increased glomerular permeability in nephrotic syndrome leads to massive
proteinuria, which consequently causes hypoalbuminemia and hyperlipidemia.
🩸 Safety, Poisoning, & Environmental Hazards
12. A nurse in an emergency department is caring for a toddler who accidentally
ingested an unknown quantity of liquid iron supplements. Which medication
should the nurse anticipate administering if toxicity is confirmed?
A. Deferoxamine
B. Activated charcoal
C. Acetylcysteine
D. Phytomenadione
Correct Answer: A
Rationale: Deferoxamine is a specific chelating agent used to bind systemic iron and
remove it via kidneys. Activated charcoal does not bind effectively to iron.
13. A nurse is providing safety education to the parents of a 9-month-old infant.
Which instruction should the nurse include to prevent accidental injury?
2026-2027 Questions and verified answers
1. A nurse is caring for an infant who has suspected bacterial meningitis. Which
diagnostic finding from the cerebrospinal fluid (CSF) analysis confirms this
diagnosis?
A. Elevated glucose and decreased protein
B. Decreased white blood cells and elevated glucose
C. Decreased glucose and elevated protein
D. Clear appearance and normal cell count
Correct Answer: C
Rationale: Bacteria consume glucose and produce waste, leading to characteristically
low glucose levels and high protein concentrations in the CSF.
2. A nurse is witnessing a school-age child experience a tonic-clonic seizure in
bed. Which action should the nurse take first?
A. Insert a plastic airway into the child's mouth.
B. Restrain the child’s arms and legs to prevent injury.
, C. Turn the child onto a side-lying position.
B. Administer a dose of oral diazepam.
Correct Answer: C
Rationale: Turning the child to the side maintains a clear airway and prevents the
aspiration of oral secretions.
3. A nurse is assessing an infant for developmental dysplasia of the hip (DDH).
Which finding should the nurse expect?
A. Symmetrical gluteal folds
B. Lengthening of the affected limb
C. Limited abduction of the affected hip
D. Inward curvature of the lower spine
Correct Answer: C
Rationale: Restricted abduction of the hip on the affected side along with asymmetrical
thigh/gluteal folds are classic signs of DDH.
🩸 Hematology & Oncology
4. A nurse is admitting a child experiencing a vaso-occlusive sickle cell crisis.
Which intervention is the highest priority?
A. Administering prescribed intravenous fluids.
B. Applying cold compresses to painful joints.
C. Administering intramuscular meperidine.
D. Initiating physical therapy exercises.
Correct Answer: A
Rationale: Aggressive hydration is the priority to decrease blood viscosity, reverse the
sickling process, and restore local tissue perfusion.
5. A nurse is caring for a preschool-age child who has a confirmed Wilms' tumor.
Which action must the nurse include in the plan of care?
A. Palpate the abdomen daily to monitor tumor size.
B. Post a sign above the bed that reads "Do Not Palpate Abdomen".
C. Prepare the child for immediate spinal traction.
D. Maintain the child on strict contact precautions.
Correct Answer: B
Rationale: A Wilms' tumor is highly fragile. Palpating the abdomen can rupture the
capsule, causing the malignancy to metastasize throughout the peritoneal cavity.
6. A school-age child with hemophilia A is brought to the clinic after scraping
their knee. Which medication should the nurse anticipate administering?
, A. Factor IX concentrate
B. Factor VIII concentrate
C. Low-dose oral aspirin
D. Low-molecular-weight heparin
Correct Answer: B
Rationale: Hemophilia A is caused by a congenital deficiency of clotting Factor VIII,
which must be replaced during bleeding episodes.
🩸 Endocrine & Immune Disorders
7. A nurse is providing dietary teaching to the parents of a toddler newly
diagnosed with Celiac disease. Which food selection is safe to include in the
child's diet?
A. Whole wheat crackers
B. White rice cereal
C. Rye bread sandwiches
D. Barley soup mix
Correct Answer: B
Rationale: Celiac disease requires a strict gluten-free diet. Rice, corn, and potatoes are
safe, while wheat, rye, barley, and oats must be avoided.
8. A nurse is reviewing laboratory results for a child suspected of having Type 1
diabetes mellitus. Which finding supports this diagnosis?
A. Fasting blood glucose of 70 mg/dL
B. Glycosylated hemoglobin (HbA1c) of 8.5%
C. Absence of ketones in the urine
D. Serum potassium level of 4.2 mEq/L
Correct Answer: B
Rationale: An HbA1c value greater than 6.5% indicates persistent hyperglycemia and is
diagnostic for diabetes mellitus.
9. A nurse is assessing a 10-month-old infant who has acute gastroenteritis and
is experiencing severe dehydration. Which finding should the nurse expect?
A. Sunken anterior fontanel
B. Capillary refill time of 2 seconds
C. Increased urinary output
D. Moist mucous membranes
Correct Answer: A
, Rationale: Severe dehydration in infants manifests as a sunken anterior fontanel,
delayed capillary refill (over 4 seconds), oliguria/anuria, and dry mucous membranes.
10. A nurse is caring for a school-age child who has acute poststreptococcal
glomerulonephritis (APSGN). Which clinical manifestation should the nurse
anticipate?
A. Hypotension and clear, pale urine
B. Periorbital edema and tea-colored urine
C. Generalized rash and polyuria
D. Increased appetite and weight loss
Correct Answer: B
Rationale: Glomerular damage allows red blood cells to enter the urine, causing a
smoky or tea-colored appearance. Fluid retention typically leads to periorbital edema
and hypertension.
11. A nurse is providing care for a toddler who has nephrotic syndrome. Which
laboratory value should the nurse expect to find?
A. Hyperalbuminemia
B. Severe proteinuria
C. Decreased serum cholesterol
D. Decreased specific gravity
Correct Answer: B
Rationale: Increased glomerular permeability in nephrotic syndrome leads to massive
proteinuria, which consequently causes hypoalbuminemia and hyperlipidemia.
🩸 Safety, Poisoning, & Environmental Hazards
12. A nurse in an emergency department is caring for a toddler who accidentally
ingested an unknown quantity of liquid iron supplements. Which medication
should the nurse anticipate administering if toxicity is confirmed?
A. Deferoxamine
B. Activated charcoal
C. Acetylcysteine
D. Phytomenadione
Correct Answer: A
Rationale: Deferoxamine is a specific chelating agent used to bind systemic iron and
remove it via kidneys. Activated charcoal does not bind effectively to iron.
13. A nurse is providing safety education to the parents of a 9-month-old infant.
Which instruction should the nurse include to prevent accidental injury?
