ATI RN PEDIATRIC PROCTORED
EXAM TEST BANK
(NGN-STYLE QUESTIONS & CASE “SCENARIO”)
500+ Qs & Ans to Pass the Exam
This ATI test contains:
Passing Score Guarantee
500+ pediatric nursing ques ons
mul ple-choice format (A, B, C, D) with correct answers
structured ra onales.
incorporate Next Genera on NCLEX (NGN)-style.
Some ques ons feature brief “scenario” elements and ra onales consistent
with entry-level prac cal nursing standards.
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1. NGN-Style Case Scenario
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A nurse is caring for a preschool-age child who awakens during the night crying and
appearing frightened. The parent reports that the child sometimes returns to sleep
immediately and has no memory of the episode, whereas other nights the child
cries, remembers vivid imagery, and is afraid to go back to sleep.
Which of the following findings would most strongly indicate that the child is
experiencing NIGHTMARES rather than night terrors?
A. The child quickly returns to sleep and shows no recall of the incident in the
morning.
B. The child is agitated and thrashes during the event, with profuse sweating.
C. The child does not respond to the parent's comfort during the event.
D. The child awakens fully and can recall the frightening content of the dream.
Answer: D
Expert Explanation: Children who experience nightmares typically awaken fully,
remember the frightening dream, and can often be comforted by a caregiver. In
contrast, a child who has night terrors is difficult to console, may scream or appear
panicked, quickly returns to sleep afterward, and usually has no memory of the
event.
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2. NGN-Style Case Scenario
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,A nurse is caring for a toddler who has acute otitis media and a fever of 40.0°C
(104.0°F). After administering acetaminophen, the nurse plans interventions to
reduce the toddler’s temperature.
Which of the following is the most appropriate next action?
A. Dress the toddler in minimal clothing.
B. Provide a hyperthermia blanket.
C. Place the toddler in a basin of cold water.
D. Offer a high-protein snack.
Answer: A
Expert Explanation: Dressing the toddler in minimal clothing helps promote heat
loss through evaporation and convection. Hyperthermia blankets, cold-water baths,
or other extreme measures can cause shivering, which increases metabolic output
and can raise body temperature further.
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3. NGN-Style Case Scenario
────────────────────────────────────────────────────
A school-age child with asthma is admitted for increased respiratory distress. The
nurse reviews the child’s data:
• Current O2 therapy: 2 L/min by nasal cannula
• Oxygen saturation: 89%
• Arterial blood gases (ABGs): pH 7.50, PaCO2 28 mm Hg, HCO3– 23 mEq/L
• WBC Count: 18,000/mm³
• Respiratory Assessment: Tachypnea, subcostal retractions, increased wheezing
Which of the following findings is the HIGHEST priority to report to the provider?
,A. Elevated white blood cell count
B. pH of 7.50 indicating possible respiratory alkalosis
C. Oxygen saturation of 89% despite supplemental oxygen
D. Presence of increased wheezing on auscultation
Answer: C
Expert Explanation: An oxygen saturation of 89% despite supplemental oxygen is
a critical finding because it indicates the child is not adequately oxygenating and
might be progressing into more severe respiratory compromise. While the other
findings also warrant reporting, low oxygen saturation takes priority.
────────────────────────────────────────────────────
4. A nurse is caring for a preschooler with congestive heart failure who is displaying
wide QRS complexes and peaked T waves on the cardiac monitor. The provider
prescribes additional medications.
Which of the following prescriptions should the nurse clarify before administering?
A. Furosemide IV bolus
B. Enalapril PO
C. Potassium chloride PO
D. Digoxin PO
Answer: C
Expert Explanation: Wide QRS complexes and peaked T waves can be indicative
of hyperkalemia. Administering additional potassium (such as potassium chloride)
could worsen hyperkalemia and place the child at risk for life-threatening cardiac
arrhythmias.
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5. NGN-Style Case Scenario
────────────────────────────────────────────────────
A nurse is assessing a toddler who has recurrent respiratory infections, poor weight
gain, wheezing, and fatty, foul-smelling stools. The nurse suspects cystic fibrosis.
Which of the following actions should the nurse anticipate including in the plan of
care?
A. Obtain a capillary blood lead level.
B. Prepare the child for a sweat chloride test.
C. Schedule a barium enema.
D. Limit fluid intake to reduce pulmonary congestion.
Answer: B
Expert Explanation: A sweat chloride test is the definitive diagnostic test for
cystic fibrosis. The test measures the amount of chloride in the sweat; levels above a
certain threshold indicate cystic fibrosis. Barium enema and lead levels are not
priority tests for this condition, and fluid restriction is not indicated.
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6. A school nurse is preparing to administer atomoxetine (1.2 mg/kg/day PO) to a
child who weighs 75 lb. The available concentration is 40 mg/capsule. How many
capsules should the nurse administer per day? (Round to the nearest whole
number.)
A. 1 capsule
B. 2 capsules
C. 3 capsules
D. 4 capsules
,Answer: A
Expert Explanation: First convert the child’s weight: 75 lb ÷ 2.2 ≈ 34.1 kg. Then
multiply 1.2 mg/kg/day × 34.1 = approximately 41 mg/day. One 40 mg capsule
provides the dosage needed (≈1 capsule).
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7. A nurse is caring for a toddler who has moderate dehydration due to acute
diarrhea. Which of the following is the MOST appropriate nutritional
recommendation?
A. Clear liquids, such as gelatin, for 24 hours
B. Oral rehydration solution (ORS)
C. High-fiber cereals and vegetables
D. Whole cow’s milk exclusively
Answer: B
Expert Explanation: In the setting of acute diarrhea with moderate dehydration,
an oral rehydration solution that contains both electrolytes and fluids is
recommended to correct fluid and electrolyte imbalances safely.
────────────────────────────────────────────────────
8. NGN-Style Case Scenario
────────────────────────────────────────────────────
A nurse is evaluating a toddler’s bowel habits and abdominal assessment. The
nurse notes lethargy, distended abdomen, hypoactive bowel sounds, a palpable fecal
mass, and foul-smelling ribbon-like stools. The toddler’s blood pressure is 110/70
mm Hg, which is slightly elevated for age.
Which of the following conditions should the nurse suspect?
,A. Diarrhea-related dehydration
B. Pyloric stenosis
C. Hirschsprung’s disease
D. Intussusception
Answer: C
Expert Explanation: Ribbon-like, foul-smelling stools, abdominal distension, and
a palpable fecal mass raise concern for Hirschsprung’s disease (congenital
aganglionic megacolon). Lethargy and elevated blood pressure may also be present
due to discomfort or systemic stress.
────────────────────────────────────────────────────
9. A nurse is teaching the guardian of a preschooler who has atopic dermatitis
(eczema) about skin care and prevention of exacerbations. Which of the following
guardian statements indicates effective understanding of the teaching?
A. “I should use hot water to ensure the skin is cleaned thoroughly.”
B. “I should wash clothing in strong detergents to remove all pathogens.”
C. “I should apply an emollient immediately after bathing.”
D. “I should leave my child’s nails untrimmed, so I can see if scratching occurs.”
Answer: C
Expert Explanation: Applying an emollient (moisturizer) immediately after
bathing prevents transepidermal water loss and helps keep the skin hydrated.
Using mild detergents, lukewarm water, and keeping nails trimmed also helps
prevent flare-ups.
────────────────────────────────────────────────────
, 10. A nurse is preparing to administer ibuprofen 5 mg/kg every 6 hours PRN for
fever above 38.0°C (100.5°F) to an infant who weighs 17.6 lb. The available
concentration is 100 mg/5 mL. How many milliliters should the nurse administer
per dose? (Round to the nearest whole number.)
A. 1 mL
B. 2 mL
C. 3 mL
D. 5 mL
Answer: B
Expert Explanation: Convert 17.6 lb to kg: 17.6 lb ÷ 2.2 ≈ 8 kg. Then 5 mg/kg = 5
× 8 = 40 mg. Next, 40 mg ÷ 100 mg × 5 mL = 2 mL.
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11. A nurse is providing dietary teaching to the parent of a school-age child who has
celiac disease. Which of the following foods should the nurse recommend as part of a
gluten-free diet?
A. Wheat bread
B. Barley broth
C. Rye crackers
D. Plain white rice
Answer: D
Expert Explanation: White rice is acceptable in a gluten-free diet. Children with
celiac disease must avoid foods containing gluten, such as wheat, barley, and rye.
────────────────────────────────────────────────────
12. NGN-Style Case Scenario
EXAM TEST BANK
(NGN-STYLE QUESTIONS & CASE “SCENARIO”)
500+ Qs & Ans to Pass the Exam
This ATI test contains:
Passing Score Guarantee
500+ pediatric nursing ques ons
mul ple-choice format (A, B, C, D) with correct answers
structured ra onales.
incorporate Next Genera on NCLEX (NGN)-style.
Some ques ons feature brief “scenario” elements and ra onales consistent
with entry-level prac cal nursing standards.
,────────────────────────────────────────────────────
1. NGN-Style Case Scenario
────────────────────────────────────────────────────
A nurse is caring for a preschool-age child who awakens during the night crying and
appearing frightened. The parent reports that the child sometimes returns to sleep
immediately and has no memory of the episode, whereas other nights the child
cries, remembers vivid imagery, and is afraid to go back to sleep.
Which of the following findings would most strongly indicate that the child is
experiencing NIGHTMARES rather than night terrors?
A. The child quickly returns to sleep and shows no recall of the incident in the
morning.
B. The child is agitated and thrashes during the event, with profuse sweating.
C. The child does not respond to the parent's comfort during the event.
D. The child awakens fully and can recall the frightening content of the dream.
Answer: D
Expert Explanation: Children who experience nightmares typically awaken fully,
remember the frightening dream, and can often be comforted by a caregiver. In
contrast, a child who has night terrors is difficult to console, may scream or appear
panicked, quickly returns to sleep afterward, and usually has no memory of the
event.
────────────────────────────────────────────────────
2. NGN-Style Case Scenario
────────────────────────────────────────────────────
,A nurse is caring for a toddler who has acute otitis media and a fever of 40.0°C
(104.0°F). After administering acetaminophen, the nurse plans interventions to
reduce the toddler’s temperature.
Which of the following is the most appropriate next action?
A. Dress the toddler in minimal clothing.
B. Provide a hyperthermia blanket.
C. Place the toddler in a basin of cold water.
D. Offer a high-protein snack.
Answer: A
Expert Explanation: Dressing the toddler in minimal clothing helps promote heat
loss through evaporation and convection. Hyperthermia blankets, cold-water baths,
or other extreme measures can cause shivering, which increases metabolic output
and can raise body temperature further.
────────────────────────────────────────────────────
3. NGN-Style Case Scenario
────────────────────────────────────────────────────
A school-age child with asthma is admitted for increased respiratory distress. The
nurse reviews the child’s data:
• Current O2 therapy: 2 L/min by nasal cannula
• Oxygen saturation: 89%
• Arterial blood gases (ABGs): pH 7.50, PaCO2 28 mm Hg, HCO3– 23 mEq/L
• WBC Count: 18,000/mm³
• Respiratory Assessment: Tachypnea, subcostal retractions, increased wheezing
Which of the following findings is the HIGHEST priority to report to the provider?
,A. Elevated white blood cell count
B. pH of 7.50 indicating possible respiratory alkalosis
C. Oxygen saturation of 89% despite supplemental oxygen
D. Presence of increased wheezing on auscultation
Answer: C
Expert Explanation: An oxygen saturation of 89% despite supplemental oxygen is
a critical finding because it indicates the child is not adequately oxygenating and
might be progressing into more severe respiratory compromise. While the other
findings also warrant reporting, low oxygen saturation takes priority.
────────────────────────────────────────────────────
4. A nurse is caring for a preschooler with congestive heart failure who is displaying
wide QRS complexes and peaked T waves on the cardiac monitor. The provider
prescribes additional medications.
Which of the following prescriptions should the nurse clarify before administering?
A. Furosemide IV bolus
B. Enalapril PO
C. Potassium chloride PO
D. Digoxin PO
Answer: C
Expert Explanation: Wide QRS complexes and peaked T waves can be indicative
of hyperkalemia. Administering additional potassium (such as potassium chloride)
could worsen hyperkalemia and place the child at risk for life-threatening cardiac
arrhythmias.
,────────────────────────────────────────────────────
5. NGN-Style Case Scenario
────────────────────────────────────────────────────
A nurse is assessing a toddler who has recurrent respiratory infections, poor weight
gain, wheezing, and fatty, foul-smelling stools. The nurse suspects cystic fibrosis.
Which of the following actions should the nurse anticipate including in the plan of
care?
A. Obtain a capillary blood lead level.
B. Prepare the child for a sweat chloride test.
C. Schedule a barium enema.
D. Limit fluid intake to reduce pulmonary congestion.
Answer: B
Expert Explanation: A sweat chloride test is the definitive diagnostic test for
cystic fibrosis. The test measures the amount of chloride in the sweat; levels above a
certain threshold indicate cystic fibrosis. Barium enema and lead levels are not
priority tests for this condition, and fluid restriction is not indicated.
────────────────────────────────────────────────────
6. A school nurse is preparing to administer atomoxetine (1.2 mg/kg/day PO) to a
child who weighs 75 lb. The available concentration is 40 mg/capsule. How many
capsules should the nurse administer per day? (Round to the nearest whole
number.)
A. 1 capsule
B. 2 capsules
C. 3 capsules
D. 4 capsules
,Answer: A
Expert Explanation: First convert the child’s weight: 75 lb ÷ 2.2 ≈ 34.1 kg. Then
multiply 1.2 mg/kg/day × 34.1 = approximately 41 mg/day. One 40 mg capsule
provides the dosage needed (≈1 capsule).
────────────────────────────────────────────────────
7. A nurse is caring for a toddler who has moderate dehydration due to acute
diarrhea. Which of the following is the MOST appropriate nutritional
recommendation?
A. Clear liquids, such as gelatin, for 24 hours
B. Oral rehydration solution (ORS)
C. High-fiber cereals and vegetables
D. Whole cow’s milk exclusively
Answer: B
Expert Explanation: In the setting of acute diarrhea with moderate dehydration,
an oral rehydration solution that contains both electrolytes and fluids is
recommended to correct fluid and electrolyte imbalances safely.
────────────────────────────────────────────────────
8. NGN-Style Case Scenario
────────────────────────────────────────────────────
A nurse is evaluating a toddler’s bowel habits and abdominal assessment. The
nurse notes lethargy, distended abdomen, hypoactive bowel sounds, a palpable fecal
mass, and foul-smelling ribbon-like stools. The toddler’s blood pressure is 110/70
mm Hg, which is slightly elevated for age.
Which of the following conditions should the nurse suspect?
,A. Diarrhea-related dehydration
B. Pyloric stenosis
C. Hirschsprung’s disease
D. Intussusception
Answer: C
Expert Explanation: Ribbon-like, foul-smelling stools, abdominal distension, and
a palpable fecal mass raise concern for Hirschsprung’s disease (congenital
aganglionic megacolon). Lethargy and elevated blood pressure may also be present
due to discomfort or systemic stress.
────────────────────────────────────────────────────
9. A nurse is teaching the guardian of a preschooler who has atopic dermatitis
(eczema) about skin care and prevention of exacerbations. Which of the following
guardian statements indicates effective understanding of the teaching?
A. “I should use hot water to ensure the skin is cleaned thoroughly.”
B. “I should wash clothing in strong detergents to remove all pathogens.”
C. “I should apply an emollient immediately after bathing.”
D. “I should leave my child’s nails untrimmed, so I can see if scratching occurs.”
Answer: C
Expert Explanation: Applying an emollient (moisturizer) immediately after
bathing prevents transepidermal water loss and helps keep the skin hydrated.
Using mild detergents, lukewarm water, and keeping nails trimmed also helps
prevent flare-ups.
────────────────────────────────────────────────────
, 10. A nurse is preparing to administer ibuprofen 5 mg/kg every 6 hours PRN for
fever above 38.0°C (100.5°F) to an infant who weighs 17.6 lb. The available
concentration is 100 mg/5 mL. How many milliliters should the nurse administer
per dose? (Round to the nearest whole number.)
A. 1 mL
B. 2 mL
C. 3 mL
D. 5 mL
Answer: B
Expert Explanation: Convert 17.6 lb to kg: 17.6 lb ÷ 2.2 ≈ 8 kg. Then 5 mg/kg = 5
× 8 = 40 mg. Next, 40 mg ÷ 100 mg × 5 mL = 2 mL.
────────────────────────────────────────────────────
11. A nurse is providing dietary teaching to the parent of a school-age child who has
celiac disease. Which of the following foods should the nurse recommend as part of a
gluten-free diet?
A. Wheat bread
B. Barley broth
C. Rye crackers
D. Plain white rice
Answer: D
Expert Explanation: White rice is acceptable in a gluten-free diet. Children with
celiac disease must avoid foods containing gluten, such as wheat, barley, and rye.
────────────────────────────────────────────────────
12. NGN-Style Case Scenario
