ATI Pediatrics 2026/2027 Study Guide | ACTUAL-Style
ATI Pediatric Nursing Practice Questions & Answers,
RN Pediatrics Exam Prep, ATI Nursing Care of
Children, Verified Answers, Detailed Rationales,
Growth & Development, Pediatric Health Assessment,
Newborn & Infant Care, Childhood Disorders,
Respiratory, Cardiovascular, Neurologic,
Gastrointestinal, Endocrine, Infectious Diseases,
Medication Safety, Emergency Care & Comprehensive
Pediatric Nursing Review
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, a decrease in respiratory rate, and hypotension are
late and ominous signs of respiratory failure.
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 interpersonal losses,
academic difficulties, and family conflict are significant stressors, the
presence of an underlying psychiatric condition substantially elevates
suicide risk.
Question 7: A 4-year-old child is brought to the clinic with a chief
complaint of a harsh, barking cough that worsens at night. The parent
states the child was playing normally earlier in the day but woke up
with this cough and stridor. Which of the following is the priority
nursing intervention for this child?
A. Administer a nebulized beta-agonist treatment
B. Prepare the child for an emergent tracheostomy
C. Provide cool mist humidification and observe for respiratory distress
D. Administer oral corticosteroids as prescribed
, CORRECT ANSWER: C. Provide cool mist humidification and observe
for respiratory distress
Rationale: The presentation of a harsh, barking cough and stridor in a child
is classic for croup (laryngotracheobronchitis). The priority nursing action is
to provide cool mist (or humidified oxygen) to reduce airway edema and
observe the child for signs of increasing respiratory distress. Nebulized
beta-agonists are used for bronchospasm, not primarily for croup. A
tracheostomy is a last resort for severe airway obstruction. Corticosteroids
are a treatment but not the immediate priority over providing humidification
and assessment.
Question 8: A 10-year-old with type 1 diabetes mellitus is brought to the
emergency department with a blood glucose of 450 mg/dL, deep rapid
respirations, and fruity-smelling breath. Which of the following arterial
blood gas findings would the nurse anticipate?
A. pH 7.30, PaCO2 50 mmHg, HCO3 22 mEq/L
B. pH 7.50, PaCO2 30 mmHg, HCO3 28 mEq/L
C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
D. pH 7.35, PaCO2 45 mmHg, HCO3 24 mEq/L
CORRECT ANSWER: C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
Rationale: This child is presenting with diabetic ketoacidosis (DKA). DKA is
characterized by metabolic acidosis with a compensatory respiratory
alkalosis. The arterial blood gas (ABG) would show a low pH (acidosis), a
low HCO3 (metabolic acidosis), and a low PaCO2 (compensatory
hyperventilation to blow off CO2). The correct choice reflects metabolic
acidosis with respiratory compensation.
Question 9: The nurse is assessing a newborn and notes a single
umbilical artery. This finding is most commonly associated with which
congenital anomaly?
A. Congenital heart defects
B. Renal anomalies
C. Neural tube defects
D. Tracheoesophageal fistula
CORRECT ANSWER: B. Renal anomalies
ATI Pediatric Nursing Practice Questions & Answers,
RN Pediatrics Exam Prep, ATI Nursing Care of
Children, Verified Answers, Detailed Rationales,
Growth & Development, Pediatric Health Assessment,
Newborn & Infant Care, Childhood Disorders,
Respiratory, Cardiovascular, Neurologic,
Gastrointestinal, Endocrine, Infectious Diseases,
Medication Safety, Emergency Care & Comprehensive
Pediatric Nursing Review
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, a decrease in respiratory rate, and hypotension are
late and ominous signs of respiratory failure.
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 interpersonal losses,
academic difficulties, and family conflict are significant stressors, the
presence of an underlying psychiatric condition substantially elevates
suicide risk.
Question 7: A 4-year-old child is brought to the clinic with a chief
complaint of a harsh, barking cough that worsens at night. The parent
states the child was playing normally earlier in the day but woke up
with this cough and stridor. Which of the following is the priority
nursing intervention for this child?
A. Administer a nebulized beta-agonist treatment
B. Prepare the child for an emergent tracheostomy
C. Provide cool mist humidification and observe for respiratory distress
D. Administer oral corticosteroids as prescribed
, CORRECT ANSWER: C. Provide cool mist humidification and observe
for respiratory distress
Rationale: The presentation of a harsh, barking cough and stridor in a child
is classic for croup (laryngotracheobronchitis). The priority nursing action is
to provide cool mist (or humidified oxygen) to reduce airway edema and
observe the child for signs of increasing respiratory distress. Nebulized
beta-agonists are used for bronchospasm, not primarily for croup. A
tracheostomy is a last resort for severe airway obstruction. Corticosteroids
are a treatment but not the immediate priority over providing humidification
and assessment.
Question 8: A 10-year-old with type 1 diabetes mellitus is brought to the
emergency department with a blood glucose of 450 mg/dL, deep rapid
respirations, and fruity-smelling breath. Which of the following arterial
blood gas findings would the nurse anticipate?
A. pH 7.30, PaCO2 50 mmHg, HCO3 22 mEq/L
B. pH 7.50, PaCO2 30 mmHg, HCO3 28 mEq/L
C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
D. pH 7.35, PaCO2 45 mmHg, HCO3 24 mEq/L
CORRECT ANSWER: C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
Rationale: This child is presenting with diabetic ketoacidosis (DKA). DKA is
characterized by metabolic acidosis with a compensatory respiratory
alkalosis. The arterial blood gas (ABG) would show a low pH (acidosis), a
low HCO3 (metabolic acidosis), and a low PaCO2 (compensatory
hyperventilation to blow off CO2). The correct choice reflects metabolic
acidosis with respiratory compensation.
Question 9: The nurse is assessing a newborn and notes a single
umbilical artery. This finding is most commonly associated with which
congenital anomaly?
A. Congenital heart defects
B. Renal anomalies
C. Neural tube defects
D. Tracheoesophageal fistula
CORRECT ANSWER: B. Renal anomalies
