RN ATI PEDIATRIC PROCTORED EXAM 2025 WITH ANSWERS AND
RATIONALE (70 QUESTIONS)
Question 1
A nurse is assessing a child diagnosed with bacterial pneumonia. Which clinical
manifestation should the nurse expect?
A. Drooling
B. Malaise
C. Tinnitus
D. Rhinorrhea
Answer: B. Malaise
Rationale: Bacterial pneumonia in children typically presents with symptoms such as fever,
cough, tachypnea, and malaise (generalized fatigue or discomfort). Drooling is more
associated with conditions like epiglottitis, tinnitus is related to ear or neurological issues,
and rhinorrhea is more common in viral infections like the common cold.
Question 2
A nurse is caring for a newborn with a respiratory rate increasing from 68/min to 76/min,
with moderate grunting and mild intercostal retractions. The nurse should identify the
newborn is at risk for developing:
A. Respiratory distress
,B. Sepsis
C. Hypoglycemia
D. Jaundice
Answer: A. Respiratory distress
Rationale: The increasing respiratory rate, grunting, and intercostal retractions are
hallmark signs of respiratory distress in a newborn. These symptoms indicate the infant is
working harder to breathe, likely due to impaired gas exchange. Sepsis, hypoglycemia, and
jaundice may present with other specific symptoms, such as fever, lethargy, or yellowing of
the skin, respectively.
Question 3
A nurse is recommending food choices for a 2-year-old to promote independence in eating.
Which food should the nurse suggest?
A. Banana slices
B. Grapes
C. Hot dog
D. Popcorn
,Answer: A. Banana slices
Rationale: Banana slices are soft, easy to chew, and appropriately sized for a toddler to
handle, promoting independence in eating. Grapes, hot dogs, and popcorn pose choking
hazards due to their size, shape, or texture, making them unsafe for a 2-year-old.
Question 4
A home health nurse is caring for a child with Lyme disease. Which action is most
appropriate?
A. Ensure the state health department has been notified.
B. Administer antitoxin.
C. Educate the family to avoid sharing personal belongings.
D. Assess for skin necrosis.
Answer: A. Ensure the state health department has been notified.
Rationale: Lyme disease is a reportable condition in many regions due to its public health
implications. Notifying the state health department is a critical nursing action. Antitoxins
are not used for Lyme disease (a bacterial infection treated with antibiotics), sharing
personal belongings is not a primary transmission concern, and skin necrosis is not a
typical complication.
Question 5
, A nurse is caring for a newborn whose mother used methadone during pregnancy. Which
finding indicates the newborn is experiencing withdrawal?
A. Bulging fontanels
B. Acrocyanosis
C. Bradycardia
D. Hypertonicity
Answer: D. Hypertonicity
Rationale: Neonatal abstinence syndrome (NAS) due to methadone exposure often
presents with hypertonicity (increased muscle tone), irritability, and tremors. Bulging
fontanels suggest increased intracranial pressure, acrocyanosis is a normal finding in
newborns, and bradycardia is not typical of NAS (tachycardia is more common).
Question 6
A nurse is teaching a school-age child with asthma about using a peak expiratory flow
meter. Which instruction should the nurse include?
A. Place tongue on the mouthpiece of the meter.
B. Maintain a semi-Fowler’s position during testing.
C. Record the average of the readings.
RATIONALE (70 QUESTIONS)
Question 1
A nurse is assessing a child diagnosed with bacterial pneumonia. Which clinical
manifestation should the nurse expect?
A. Drooling
B. Malaise
C. Tinnitus
D. Rhinorrhea
Answer: B. Malaise
Rationale: Bacterial pneumonia in children typically presents with symptoms such as fever,
cough, tachypnea, and malaise (generalized fatigue or discomfort). Drooling is more
associated with conditions like epiglottitis, tinnitus is related to ear or neurological issues,
and rhinorrhea is more common in viral infections like the common cold.
Question 2
A nurse is caring for a newborn with a respiratory rate increasing from 68/min to 76/min,
with moderate grunting and mild intercostal retractions. The nurse should identify the
newborn is at risk for developing:
A. Respiratory distress
,B. Sepsis
C. Hypoglycemia
D. Jaundice
Answer: A. Respiratory distress
Rationale: The increasing respiratory rate, grunting, and intercostal retractions are
hallmark signs of respiratory distress in a newborn. These symptoms indicate the infant is
working harder to breathe, likely due to impaired gas exchange. Sepsis, hypoglycemia, and
jaundice may present with other specific symptoms, such as fever, lethargy, or yellowing of
the skin, respectively.
Question 3
A nurse is recommending food choices for a 2-year-old to promote independence in eating.
Which food should the nurse suggest?
A. Banana slices
B. Grapes
C. Hot dog
D. Popcorn
,Answer: A. Banana slices
Rationale: Banana slices are soft, easy to chew, and appropriately sized for a toddler to
handle, promoting independence in eating. Grapes, hot dogs, and popcorn pose choking
hazards due to their size, shape, or texture, making them unsafe for a 2-year-old.
Question 4
A home health nurse is caring for a child with Lyme disease. Which action is most
appropriate?
A. Ensure the state health department has been notified.
B. Administer antitoxin.
C. Educate the family to avoid sharing personal belongings.
D. Assess for skin necrosis.
Answer: A. Ensure the state health department has been notified.
Rationale: Lyme disease is a reportable condition in many regions due to its public health
implications. Notifying the state health department is a critical nursing action. Antitoxins
are not used for Lyme disease (a bacterial infection treated with antibiotics), sharing
personal belongings is not a primary transmission concern, and skin necrosis is not a
typical complication.
Question 5
, A nurse is caring for a newborn whose mother used methadone during pregnancy. Which
finding indicates the newborn is experiencing withdrawal?
A. Bulging fontanels
B. Acrocyanosis
C. Bradycardia
D. Hypertonicity
Answer: D. Hypertonicity
Rationale: Neonatal abstinence syndrome (NAS) due to methadone exposure often
presents with hypertonicity (increased muscle tone), irritability, and tremors. Bulging
fontanels suggest increased intracranial pressure, acrocyanosis is a normal finding in
newborns, and bradycardia is not typical of NAS (tachycardia is more common).
Question 6
A nurse is teaching a school-age child with asthma about using a peak expiratory flow
meter. Which instruction should the nurse include?
A. Place tongue on the mouthpiece of the meter.
B. Maintain a semi-Fowler’s position during testing.
C. Record the average of the readings.
