NGN ATI PEDS Actual Proctored Exam 2024/2025 – Verified
Correct Answers and Rationales | Graded A+
Question 1: NGN Case Study: Recognizing Cues A nurse is assessing a 4-month-old infant
during a well-child visit. The nurse notes the infant does not follow objects with
eyes, has poor head control, and does not smile. Which action should the nurse
take first?
A. Document the findings as normal
B. Refer the infant for developmental evaluation
C. Teach the parents about feeding techniques
D. Schedule a follow-up in 2 months
Correct Answer: B. Refer the infant for developmental evaluation
Rationale: The absence of visual tracking, poor head control, and lack of smiling
at 4 months are concerning for developmental delay, requiring referral for further
evaluation (Recognizing Cues). These milestones are expected by this age per ATI
pediatric guidelines. Documentation as normal is incorrect, feeding techniques are
unrelated, and delaying follow-up may miss early intervention opportunities.
Question 2: NGN Case Study: Analyzing Cues A 6-year-old child with asthma presents with
wheezing, respiratory rate of 28 breaths/min, and oxygen saturation of 92
A. Wheezing
B. Respiratory rate of 28 breaths/min
C. Oxygen saturation of 92
D. Use of accessory muscles
Correct Answer: C. Oxygen saturation of 92%
Rationale: An oxygen saturation of 92
Question 3: NGN Case Study: Prioritizing Hypotheses A nurse is caring for a 2-year-old with
suspected dehydration. Findings include dry mucous membranes, heart rate of 140
bpm, and sunken fontanel. Which condition should the nurse prioritize as the most
likely cause?
A. Gastroenteritis
B. Urinary tract infection
C. Pneumonia
D. Meningitis
Correct Answer: A. Gastroenteritis
Rationale: Dry mucous membranes, tachycardia, and sunken fontanel are classic
signs of dehydration, most commonly caused by gastroenteritis in toddlers due to
fluid loss from vomiting or diarrhea (Prioritizing Hypotheses). UTI, pneumonia,
and meningitis may cause fever or other symptoms but are less likely to present
with these specific dehydration cues.
1
,Question 4: NGN Case Study: Generating Solutions A nurse is planning care for a 3-year-old
with type 1 diabetes mellitus. Which intervention should the nurse include to
promote glycemic control?
A. Allow unlimited sugary snacks
B. Monitor blood glucose before meals
C. Administer insulin only when symptomatic
D. Restrict all carbohydrate intake
Correct Answer: B. Monitor blood glucose before meals
Rationale: Monitoring blood glucose before meals allows for insulin adjustments
to maintain glycemic control, a key intervention for type 1 diabetes (Generating
Solutions). Unlimited sugary snacks, symptom-based insulin, or carbohydrate re-
striction are inappropriate and can lead to hypo- or hyperglycemia.
Question 5: NGN Case Study: Taking Action A nurse is caring for a 5-year-old with a new
tracheostomy. The child develops respiratory distress with stridor. Which action
should the nurse take first?
A. Change the tracheostomy tube
B. Suction the tracheostomy
C. Administer oxygen
D. Notify the provider
Correct Answer: B. Suction the tracheostomy
Rationale: Stridor and respiratory distress suggest tracheostomy obstruction, often
due to mucus. Suctioning is the first action to restore airway patency (Taking
Action). Changing the tube is premature, oxygen may be needed but is secondary,
and notifying the provider delays immediate intervention.
Question 6: NGN Case Study: Evaluating Outcomes A nurse administers albuterol via nebulizer
to a 7-year-old with asthma. Which finding indicates the treatment was effective?
A. Persistent wheezing
B. Oxygen saturation of 98
C. Heart rate of 140 bpm
D. Continued use of accessory muscles
Correct Answer: B. Oxygen saturation of 98%
Rationale: An oxygen saturation of 98
Question 7: NGN Case Study: Recognizing Cues A nurse is assessing a 9-month-old infant.
The mother reports the infant does not sit independently or babble. Which action
should the nurse take?
A. Reassure the mother these are normal
B. Refer for developmental screening
2
, C. Teach the mother stimulation techniques
D. Schedule a follow-up in 3 months
Correct Answer: B. Refer for developmental screening
Rationale: Lack of sitting independently and babbling at 9 months are red flags for
developmental delay, warranting referral for screening (Recognizing Cues). These
are not normal, stimulation teaching is secondary, and delaying follow-up risks
missing early intervention.
Question 8: NGN Case Study: Analyzing Cues A 4-year-old child presents with fever, rash,
and conjunctivitis. The nurse suspects Kawasaki disease. Which additional finding
supports this diagnosis?
A. Productive cough
B. Strawberry tongue
C. Hypoglycemia
D. Bradycardia
Correct Answer: B. Strawberry tongue
Rationale: Strawberry tongue is a hallmark sign of Kawasaki disease, along with
fever, rash, and conjunctivitis (Analyzing Cues). Productive cough, hypoglycemia,
and bradycardia are not associated with this condition.
Question 9: NGN Case Study: Prioritizing Hypotheses A nurse is caring for a 3-month-old with
poor weight gain, tachypnea, and diaphoresis during feeding. Which condition
should the nurse suspect as most likely?
A. Gastroesophageal reflux
B. Congenital heart defect
C. Cystic fibrosis
D. Pyloric stenosis
Correct Answer: B. Congenital heart defect
Rationale: Poor weight gain, tachypnea, and diaphoresis during feeding suggest
a congenital heart defect, as increased cardiac workload impairs feeding efficiency
(Prioritizing Hypotheses). Reflux, cystic fibrosis, and pyloric stenosis are less likely
to present with these combined symptoms.
Question 10: NGN Case Study: Generating Solutions A nurse is planning care for a child with
sickle cell disease to prevent vaso-occlusive crises. Which intervention should the
nurse prioritize?
A. Restrict fluid intake
B. Encourage adequate hydration
C. Promote high-impact sports
D. Administer daily aspirin
3
Correct Answers and Rationales | Graded A+
Question 1: NGN Case Study: Recognizing Cues A nurse is assessing a 4-month-old infant
during a well-child visit. The nurse notes the infant does not follow objects with
eyes, has poor head control, and does not smile. Which action should the nurse
take first?
A. Document the findings as normal
B. Refer the infant for developmental evaluation
C. Teach the parents about feeding techniques
D. Schedule a follow-up in 2 months
Correct Answer: B. Refer the infant for developmental evaluation
Rationale: The absence of visual tracking, poor head control, and lack of smiling
at 4 months are concerning for developmental delay, requiring referral for further
evaluation (Recognizing Cues). These milestones are expected by this age per ATI
pediatric guidelines. Documentation as normal is incorrect, feeding techniques are
unrelated, and delaying follow-up may miss early intervention opportunities.
Question 2: NGN Case Study: Analyzing Cues A 6-year-old child with asthma presents with
wheezing, respiratory rate of 28 breaths/min, and oxygen saturation of 92
A. Wheezing
B. Respiratory rate of 28 breaths/min
C. Oxygen saturation of 92
D. Use of accessory muscles
Correct Answer: C. Oxygen saturation of 92%
Rationale: An oxygen saturation of 92
Question 3: NGN Case Study: Prioritizing Hypotheses A nurse is caring for a 2-year-old with
suspected dehydration. Findings include dry mucous membranes, heart rate of 140
bpm, and sunken fontanel. Which condition should the nurse prioritize as the most
likely cause?
A. Gastroenteritis
B. Urinary tract infection
C. Pneumonia
D. Meningitis
Correct Answer: A. Gastroenteritis
Rationale: Dry mucous membranes, tachycardia, and sunken fontanel are classic
signs of dehydration, most commonly caused by gastroenteritis in toddlers due to
fluid loss from vomiting or diarrhea (Prioritizing Hypotheses). UTI, pneumonia,
and meningitis may cause fever or other symptoms but are less likely to present
with these specific dehydration cues.
1
,Question 4: NGN Case Study: Generating Solutions A nurse is planning care for a 3-year-old
with type 1 diabetes mellitus. Which intervention should the nurse include to
promote glycemic control?
A. Allow unlimited sugary snacks
B. Monitor blood glucose before meals
C. Administer insulin only when symptomatic
D. Restrict all carbohydrate intake
Correct Answer: B. Monitor blood glucose before meals
Rationale: Monitoring blood glucose before meals allows for insulin adjustments
to maintain glycemic control, a key intervention for type 1 diabetes (Generating
Solutions). Unlimited sugary snacks, symptom-based insulin, or carbohydrate re-
striction are inappropriate and can lead to hypo- or hyperglycemia.
Question 5: NGN Case Study: Taking Action A nurse is caring for a 5-year-old with a new
tracheostomy. The child develops respiratory distress with stridor. Which action
should the nurse take first?
A. Change the tracheostomy tube
B. Suction the tracheostomy
C. Administer oxygen
D. Notify the provider
Correct Answer: B. Suction the tracheostomy
Rationale: Stridor and respiratory distress suggest tracheostomy obstruction, often
due to mucus. Suctioning is the first action to restore airway patency (Taking
Action). Changing the tube is premature, oxygen may be needed but is secondary,
and notifying the provider delays immediate intervention.
Question 6: NGN Case Study: Evaluating Outcomes A nurse administers albuterol via nebulizer
to a 7-year-old with asthma. Which finding indicates the treatment was effective?
A. Persistent wheezing
B. Oxygen saturation of 98
C. Heart rate of 140 bpm
D. Continued use of accessory muscles
Correct Answer: B. Oxygen saturation of 98%
Rationale: An oxygen saturation of 98
Question 7: NGN Case Study: Recognizing Cues A nurse is assessing a 9-month-old infant.
The mother reports the infant does not sit independently or babble. Which action
should the nurse take?
A. Reassure the mother these are normal
B. Refer for developmental screening
2
, C. Teach the mother stimulation techniques
D. Schedule a follow-up in 3 months
Correct Answer: B. Refer for developmental screening
Rationale: Lack of sitting independently and babbling at 9 months are red flags for
developmental delay, warranting referral for screening (Recognizing Cues). These
are not normal, stimulation teaching is secondary, and delaying follow-up risks
missing early intervention.
Question 8: NGN Case Study: Analyzing Cues A 4-year-old child presents with fever, rash,
and conjunctivitis. The nurse suspects Kawasaki disease. Which additional finding
supports this diagnosis?
A. Productive cough
B. Strawberry tongue
C. Hypoglycemia
D. Bradycardia
Correct Answer: B. Strawberry tongue
Rationale: Strawberry tongue is a hallmark sign of Kawasaki disease, along with
fever, rash, and conjunctivitis (Analyzing Cues). Productive cough, hypoglycemia,
and bradycardia are not associated with this condition.
Question 9: NGN Case Study: Prioritizing Hypotheses A nurse is caring for a 3-month-old with
poor weight gain, tachypnea, and diaphoresis during feeding. Which condition
should the nurse suspect as most likely?
A. Gastroesophageal reflux
B. Congenital heart defect
C. Cystic fibrosis
D. Pyloric stenosis
Correct Answer: B. Congenital heart defect
Rationale: Poor weight gain, tachypnea, and diaphoresis during feeding suggest
a congenital heart defect, as increased cardiac workload impairs feeding efficiency
(Prioritizing Hypotheses). Reflux, cystic fibrosis, and pyloric stenosis are less likely
to present with these combined symptoms.
Question 10: NGN Case Study: Generating Solutions A nurse is planning care for a child with
sickle cell disease to prevent vaso-occlusive crises. Which intervention should the
nurse prioritize?
A. Restrict fluid intake
B. Encourage adequate hydration
C. Promote high-impact sports
D. Administer daily aspirin
3
