ATI Pediatrics Nursing Exam 2026/2027 |
Exam Questions and Verified Answers
with Detailed Rationales
ATI PEDIATRICS NURSING EXAM 2026/2027
EXAM QUESTIONS AND VERIFIED ANSWERS WITH DETAILED RATIONALES
DOCUMENT OVERVIEW
• This comprehensive exam guide contains 200 verified multiple-choice questions
designed to assess mastery of pediatric nursing concepts across all major clinical
domains, with detailed rationales to reinforce understanding and promote
retention.
• Study this material by working through questions sequentially, using rationales
not just to confirm answers but to build clinical reasoning and recognize patterns in
pediatric assessment, interventions, and nursing care priorities.
QUESTION 1
A 4-year-old child presents with a barking cough, inspiratory stridor, and low-
grade fever. Which nursing action should be prioritized?
A) Administer oxygen immediately at 10 L/min
B) Keep the child calm and in an upright position, prepare for possible emergency
airway management
C) Start an IV line for fluid administration
D) Administer broad-spectrum antibiotics
E) Place the child in a supine position to ease breathing
CORRECT ANSWER: B - Keep the child calm and in an upright position, prepare
for possible emergency airway management
,Rationale: This clinical presentation is consistent with croup (laryngotracheitis). The
upright position promotes optimal airway patency and reduces airway obstruction.
Keeping the child calm prevents agitation that could worsen stridor and
compromise the airway. Emergency airway equipment should be readily available.
Oxygen should be humidified if indicated, and supine positioning would worsen
airway obstruction. Croup is typically viral, not bacterial.
QUESTION 2
Which developmental milestone is most characteristic of a 6-month-old
infant?
A) Walking with assistance
B) Speaking in two-word phrases
C) Sitting with minimal support and beginning to transfer objects from one hand to
another
D) Following objects 180 degrees and reaching for objects
E) Pincer grasp with thumb and index finger
CORRECT ANSWER: D - Following objects 180 degrees and reaching for objects
Rationale: At 6 months, infants should demonstrate visual tracking through 180
degrees (past midline) and begin reaching for objects. While some infants may
show early pincer grasp around 6 months, it typically develops more solidly around
9-10 months. Sitting with support occurs around this age, but transfer of objects
between hands is more characteristic of 7-8 months. Walking with assistance and
two-word phrases are much later milestones.
QUESTION 3
A 2-year-old child with acute lymphoblastic leukemia (ALL) is receiving
chemotherapy. Which nursing assessment finding would most concern you?
A) Platelet count of 100,000/mm³
,B) Platelet count of 15,000/mm³
C) Hemoglobin of 8.5 g/dL
D) White blood cell count of 4,500/mm³
E) Reticulocyte count of 2%
CORRECT ANSWER: B - Platelet count of 15,000/mm³
Rationale: A platelet count below 20,000/mm³ places the child at severe risk for
spontaneous bleeding, including intracranial hemorrhage. This is a critical value
requiring immediate intervention (transfusion, strict bleeding precautions). A
platelet count of 100,000/mm³ is low but not critical. Hemoglobin of 8.5 g/dL is low
but manageable with monitoring. A WBC of 4,500/mm³ is slightly low but
acceptable. The reticulocyte count of 2% is normal.
QUESTION 4
An 8-year-old child is admitted with suspected epiglottitis. Which action
should the nurse avoid?
A) Maintaining the child in a sitting position, leaning forward
B) Preparing emergency airway equipment at bedside
C) Attempting to visualize the epiglottis with a tongue depressor
D) Keeping the child NPO
E) Administering humidified oxygen as ordered
CORRECT ANSWER: C - Attempting to visualize the epiglottis with a tongue
depressor
Rationale: Attempting to examine the throat with a tongue depressor can trigger
complete airway obstruction in epiglottitis. This is contraindicated and potentially
dangerous. Diagnosis should be confirmed by lateral neck X-ray or direct
visualization by an anesthesiologist or otolaryngologist in a controlled setting
(usually the operating room). All other actions are appropriate: the tripod position
(sitting, leaning forward) is optimal, emergency equipment must be available, NPO
, status is necessary due to aspiration risk, and humidified oxygen supports
oxygenation.
QUESTION 5
Which reflex should a nurse expect to be absent in a healthy 6-month-old
infant?
A) Moro reflex
B) Palmer grasp reflex
C) Babinski reflex
D) Parachute reflex
E) Rooting reflex
CORRECT ANSWER: A - Moro reflex
Rationale: The Moro (startle) reflex should disappear by 4-6 months of age. Its
persistence beyond this timeframe may indicate neurological abnormality. The
Palmer grasp reflex typically fades by 5-6 months but may still be present. The
Babinski reflex remains present throughout infancy (becomes absent around 12-24
months). The parachute reflex emerges around 6-8 months. The rooting reflex
typically fades by 3-4 months. By 6 months, the Moro reflex should be clearly
absent.
QUESTION 6
A 3-year-old child with Type 1 diabetes mellitus has a blood glucose reading of
350 mg/dL and is exhibiting signs of diabetic ketoacidosis (DKA). Which lab
value would you expect to find?
A) pH of 7.45 with HCO₃⁻ of 26 mEq/L
B) pH of 7.30 with HCO₃⁻ of 16 mEq/L
C) pH of 7.50 with HCO₃⁻ of 30 mEq/L
Exam Questions and Verified Answers
with Detailed Rationales
ATI PEDIATRICS NURSING EXAM 2026/2027
EXAM QUESTIONS AND VERIFIED ANSWERS WITH DETAILED RATIONALES
DOCUMENT OVERVIEW
• This comprehensive exam guide contains 200 verified multiple-choice questions
designed to assess mastery of pediatric nursing concepts across all major clinical
domains, with detailed rationales to reinforce understanding and promote
retention.
• Study this material by working through questions sequentially, using rationales
not just to confirm answers but to build clinical reasoning and recognize patterns in
pediatric assessment, interventions, and nursing care priorities.
QUESTION 1
A 4-year-old child presents with a barking cough, inspiratory stridor, and low-
grade fever. Which nursing action should be prioritized?
A) Administer oxygen immediately at 10 L/min
B) Keep the child calm and in an upright position, prepare for possible emergency
airway management
C) Start an IV line for fluid administration
D) Administer broad-spectrum antibiotics
E) Place the child in a supine position to ease breathing
CORRECT ANSWER: B - Keep the child calm and in an upright position, prepare
for possible emergency airway management
,Rationale: This clinical presentation is consistent with croup (laryngotracheitis). The
upright position promotes optimal airway patency and reduces airway obstruction.
Keeping the child calm prevents agitation that could worsen stridor and
compromise the airway. Emergency airway equipment should be readily available.
Oxygen should be humidified if indicated, and supine positioning would worsen
airway obstruction. Croup is typically viral, not bacterial.
QUESTION 2
Which developmental milestone is most characteristic of a 6-month-old
infant?
A) Walking with assistance
B) Speaking in two-word phrases
C) Sitting with minimal support and beginning to transfer objects from one hand to
another
D) Following objects 180 degrees and reaching for objects
E) Pincer grasp with thumb and index finger
CORRECT ANSWER: D - Following objects 180 degrees and reaching for objects
Rationale: At 6 months, infants should demonstrate visual tracking through 180
degrees (past midline) and begin reaching for objects. While some infants may
show early pincer grasp around 6 months, it typically develops more solidly around
9-10 months. Sitting with support occurs around this age, but transfer of objects
between hands is more characteristic of 7-8 months. Walking with assistance and
two-word phrases are much later milestones.
QUESTION 3
A 2-year-old child with acute lymphoblastic leukemia (ALL) is receiving
chemotherapy. Which nursing assessment finding would most concern you?
A) Platelet count of 100,000/mm³
,B) Platelet count of 15,000/mm³
C) Hemoglobin of 8.5 g/dL
D) White blood cell count of 4,500/mm³
E) Reticulocyte count of 2%
CORRECT ANSWER: B - Platelet count of 15,000/mm³
Rationale: A platelet count below 20,000/mm³ places the child at severe risk for
spontaneous bleeding, including intracranial hemorrhage. This is a critical value
requiring immediate intervention (transfusion, strict bleeding precautions). A
platelet count of 100,000/mm³ is low but not critical. Hemoglobin of 8.5 g/dL is low
but manageable with monitoring. A WBC of 4,500/mm³ is slightly low but
acceptable. The reticulocyte count of 2% is normal.
QUESTION 4
An 8-year-old child is admitted with suspected epiglottitis. Which action
should the nurse avoid?
A) Maintaining the child in a sitting position, leaning forward
B) Preparing emergency airway equipment at bedside
C) Attempting to visualize the epiglottis with a tongue depressor
D) Keeping the child NPO
E) Administering humidified oxygen as ordered
CORRECT ANSWER: C - Attempting to visualize the epiglottis with a tongue
depressor
Rationale: Attempting to examine the throat with a tongue depressor can trigger
complete airway obstruction in epiglottitis. This is contraindicated and potentially
dangerous. Diagnosis should be confirmed by lateral neck X-ray or direct
visualization by an anesthesiologist or otolaryngologist in a controlled setting
(usually the operating room). All other actions are appropriate: the tripod position
(sitting, leaning forward) is optimal, emergency equipment must be available, NPO
, status is necessary due to aspiration risk, and humidified oxygen supports
oxygenation.
QUESTION 5
Which reflex should a nurse expect to be absent in a healthy 6-month-old
infant?
A) Moro reflex
B) Palmer grasp reflex
C) Babinski reflex
D) Parachute reflex
E) Rooting reflex
CORRECT ANSWER: A - Moro reflex
Rationale: The Moro (startle) reflex should disappear by 4-6 months of age. Its
persistence beyond this timeframe may indicate neurological abnormality. The
Palmer grasp reflex typically fades by 5-6 months but may still be present. The
Babinski reflex remains present throughout infancy (becomes absent around 12-24
months). The parachute reflex emerges around 6-8 months. The rooting reflex
typically fades by 3-4 months. By 6 months, the Moro reflex should be clearly
absent.
QUESTION 6
A 3-year-old child with Type 1 diabetes mellitus has a blood glucose reading of
350 mg/dL and is exhibiting signs of diabetic ketoacidosis (DKA). Which lab
value would you expect to find?
A) pH of 7.45 with HCO₃⁻ of 26 mEq/L
B) pH of 7.30 with HCO₃⁻ of 16 mEq/L
C) pH of 7.50 with HCO₃⁻ of 30 mEq/L
