ATI PEDIATRICS PROCTORED EXAM / REAL EXAM QUESTIONS
AND ANSWERS/ FULLY COVERED FOR 2025-2026/ LATEST
VERSION/ 100% VERIFIED/ GRADED A+
1.
A 5-year-old child is brought to the clinic with fever, sore throat, and a sandpaper-like
rash on the trunk. The parent reports that the child had a mild sore throat 4 days ago. On
assessment, the nurse notes a strawberry tongue and tender anterior cervical lymph nodes.
Which condition is most likely?
Answer: Scarlet fever (group A streptococcal infection)
Rationale: Fever, sore throat, sandpaper rash, and strawberry tongue are classic findings
of scarlet fever. Early recognition and treatment with antibiotics prevent complications.
2.
A neonate born at 36 weeks gestation is experiencing feeding difficulties, lethargy, and
episodes of apnea. The nurse notes hypotonia and a weak cry. The mother mentions that
she did not receive prenatal care and has a history of drug use.
Which condition should the nurse suspect?
Answer: Neonatal abstinence syndrome (NAS)
Rationale: Infants exposed to opioids in utero often present with irritability, hypotonia,
poor feeding, and respiratory instability.
3.
A 10-year-old child with type 1 diabetes presents to the clinic with fruity-smelling breath,
nausea, vomiting, and abdominal pain. Vital signs reveal tachycardia and tachypnea.
What is the most important immediate action?
Answer: Assess blood glucose and ketones; prepare for treatment of diabetic
ketoacidosis (DKA).
Rationale: Classic DKA signs require urgent monitoring and IV fluid and insulin therapy
to prevent complications.
,4.
A 3-year-old with a history of frequent ear infections presents with fever and tugging at
the right ear. The nurse notes bulging, erythematous tympanic membranes on otoscopic
exam.
Which nursing action is appropriate?
Answer: Administer prescribed antibiotics and provide analgesics.
Rationale: Acute otitis media with fever and tympanic membrane changes requires
antibiotic therapy; pain management is essential.
5.
An infant with suspected pyloric stenosis presents with projectile vomiting after each
feeding and is visibly hungry afterward. The mother reports decreased wet diapers. The
nurse notes a palpable olive-shaped mass in the right upper quadrant.
What is the nurse’s priority action?
Answer: Prepare the infant for surgical correction after correcting dehydration and
electrolyte imbalance.
Rationale: Pyloric stenosis is a surgical emergency. Stabilization with IV fluids and
electrolyte replacement is essential before surgery.
6.
A school-age child with asthma is brought to the ED with wheezing, chest tightness, and
oxygen saturation of 88% on room air. The child has used a rescue inhaler multiple times
without relief.
Which is the priority intervention?
Answer: Administer nebulized short-acting bronchodilator and provide
supplemental oxygen.
Rationale: Hypoxia and persistent wheezing indicate a severe exacerbation; rapid
intervention is required to improve oxygenation.
7.
,A 7-year-old with sickle cell disease is admitted with severe leg pain, swelling, and low-
grade fever. The parent reports the child has not been drinking enough fluids due to pain.
Which interventions are priority?
Answer: Hydration with IV fluids and pain management with opioids.
Rationale: Adequate hydration reduces sickling and vaso-occlusive events; pain relief
improves comfort and mobility.
8.
A 12-year-old is brought to the clinic after fainting during soccer practice. The child
reports chest pain with exertion and a family history of sudden cardiac death.
What is the most appropriate next step?
Answer: Refer for urgent cardiac evaluation, including ECG and echocardiogram.
Rationale: Syncope with exertion and family history suggests hypertrophic
cardiomyopathy, which can be life-threatening.
9.
A toddler with a history of frequent choking episodes presents with coughing, gagging,
and wheezing after meals. The parent reports the child tires easily during feeding.
Which intervention is most appropriate?
Answer: Refer for a swallow evaluation and modify feeding techniques.
Rationale: Dysphagia increases aspiration risk; assessment ensures safe nutrition.
10.
A 4-year-old presents with a purplish rash on the lower extremities, joint swelling, and
abdominal pain. The parent reports a recent upper respiratory infection.
Which complication should the nurse monitor for?
Answer: Renal involvement, including hematuria and proteinuria (Henoch–
Schönlein purpura).
Rationale: HSP can cause kidney damage; monitoring urine and renal function is
essential.
, 11.
An infant with bronchiolitis due to RSV is admitted with nasal flaring, retractions, and
oxygen saturation of 87%. The nurse is preparing care.
Which intervention should be implemented first?
Answer: Provide supplemental oxygen and suction nasal secretions as needed.
Rationale: Infants are obligate nose breathers; airway support is priority.
12.
A 6-year-old with acute lymphoblastic leukemia reports pain while swallowing and
refuses to eat. Oral mucositis is present.
Which nursing action is appropriate?
Answer: Offer soft, bland foods and administer prescribed topical anesthetics
before meals.
Rationale: Pain management improves oral intake and prevents nutritional deficits.
13.
A toddler presents with sudden, severe abdominal pain and “currant jelly” stools. The
parent reports intermittent crying and pulling knees to chest.
Which action is most important?
Answer: Notify the provider immediately for possible intussusception.
Rationale: Intussusception is a medical emergency; early intervention prevents bowel
necrosis.
14.
An infant born at 28 weeks is in the NICU receiving phototherapy for
hyperbilirubinemia. The parent asks why the eyes are covered.
What should the nurse explain?
AND ANSWERS/ FULLY COVERED FOR 2025-2026/ LATEST
VERSION/ 100% VERIFIED/ GRADED A+
1.
A 5-year-old child is brought to the clinic with fever, sore throat, and a sandpaper-like
rash on the trunk. The parent reports that the child had a mild sore throat 4 days ago. On
assessment, the nurse notes a strawberry tongue and tender anterior cervical lymph nodes.
Which condition is most likely?
Answer: Scarlet fever (group A streptococcal infection)
Rationale: Fever, sore throat, sandpaper rash, and strawberry tongue are classic findings
of scarlet fever. Early recognition and treatment with antibiotics prevent complications.
2.
A neonate born at 36 weeks gestation is experiencing feeding difficulties, lethargy, and
episodes of apnea. The nurse notes hypotonia and a weak cry. The mother mentions that
she did not receive prenatal care and has a history of drug use.
Which condition should the nurse suspect?
Answer: Neonatal abstinence syndrome (NAS)
Rationale: Infants exposed to opioids in utero often present with irritability, hypotonia,
poor feeding, and respiratory instability.
3.
A 10-year-old child with type 1 diabetes presents to the clinic with fruity-smelling breath,
nausea, vomiting, and abdominal pain. Vital signs reveal tachycardia and tachypnea.
What is the most important immediate action?
Answer: Assess blood glucose and ketones; prepare for treatment of diabetic
ketoacidosis (DKA).
Rationale: Classic DKA signs require urgent monitoring and IV fluid and insulin therapy
to prevent complications.
,4.
A 3-year-old with a history of frequent ear infections presents with fever and tugging at
the right ear. The nurse notes bulging, erythematous tympanic membranes on otoscopic
exam.
Which nursing action is appropriate?
Answer: Administer prescribed antibiotics and provide analgesics.
Rationale: Acute otitis media with fever and tympanic membrane changes requires
antibiotic therapy; pain management is essential.
5.
An infant with suspected pyloric stenosis presents with projectile vomiting after each
feeding and is visibly hungry afterward. The mother reports decreased wet diapers. The
nurse notes a palpable olive-shaped mass in the right upper quadrant.
What is the nurse’s priority action?
Answer: Prepare the infant for surgical correction after correcting dehydration and
electrolyte imbalance.
Rationale: Pyloric stenosis is a surgical emergency. Stabilization with IV fluids and
electrolyte replacement is essential before surgery.
6.
A school-age child with asthma is brought to the ED with wheezing, chest tightness, and
oxygen saturation of 88% on room air. The child has used a rescue inhaler multiple times
without relief.
Which is the priority intervention?
Answer: Administer nebulized short-acting bronchodilator and provide
supplemental oxygen.
Rationale: Hypoxia and persistent wheezing indicate a severe exacerbation; rapid
intervention is required to improve oxygenation.
7.
,A 7-year-old with sickle cell disease is admitted with severe leg pain, swelling, and low-
grade fever. The parent reports the child has not been drinking enough fluids due to pain.
Which interventions are priority?
Answer: Hydration with IV fluids and pain management with opioids.
Rationale: Adequate hydration reduces sickling and vaso-occlusive events; pain relief
improves comfort and mobility.
8.
A 12-year-old is brought to the clinic after fainting during soccer practice. The child
reports chest pain with exertion and a family history of sudden cardiac death.
What is the most appropriate next step?
Answer: Refer for urgent cardiac evaluation, including ECG and echocardiogram.
Rationale: Syncope with exertion and family history suggests hypertrophic
cardiomyopathy, which can be life-threatening.
9.
A toddler with a history of frequent choking episodes presents with coughing, gagging,
and wheezing after meals. The parent reports the child tires easily during feeding.
Which intervention is most appropriate?
Answer: Refer for a swallow evaluation and modify feeding techniques.
Rationale: Dysphagia increases aspiration risk; assessment ensures safe nutrition.
10.
A 4-year-old presents with a purplish rash on the lower extremities, joint swelling, and
abdominal pain. The parent reports a recent upper respiratory infection.
Which complication should the nurse monitor for?
Answer: Renal involvement, including hematuria and proteinuria (Henoch–
Schönlein purpura).
Rationale: HSP can cause kidney damage; monitoring urine and renal function is
essential.
, 11.
An infant with bronchiolitis due to RSV is admitted with nasal flaring, retractions, and
oxygen saturation of 87%. The nurse is preparing care.
Which intervention should be implemented first?
Answer: Provide supplemental oxygen and suction nasal secretions as needed.
Rationale: Infants are obligate nose breathers; airway support is priority.
12.
A 6-year-old with acute lymphoblastic leukemia reports pain while swallowing and
refuses to eat. Oral mucositis is present.
Which nursing action is appropriate?
Answer: Offer soft, bland foods and administer prescribed topical anesthetics
before meals.
Rationale: Pain management improves oral intake and prevents nutritional deficits.
13.
A toddler presents with sudden, severe abdominal pain and “currant jelly” stools. The
parent reports intermittent crying and pulling knees to chest.
Which action is most important?
Answer: Notify the provider immediately for possible intussusception.
Rationale: Intussusception is a medical emergency; early intervention prevents bowel
necrosis.
14.
An infant born at 28 weeks is in the NICU receiving phototherapy for
hyperbilirubinemia. The parent asks why the eyes are covered.
What should the nurse explain?
