NEW ATI PEDIATRICS PROCTORED EXAM / REAL EXAM
QUESTIONS AND ANSWERS/ ALL COVERED FOR 2025-2026/
LATEST VERSION/ 100% VERIFIED/ GRADED A+
1. A nurse is caring for a 6-month-old infant admitted with bronchiolitis caused by
RSV. Which of the following findings requires immediate intervention?
A. Oxygen saturation of 91% while asleep
B. Nasal flaring and intercostal retractions
C. Moderate nasal congestion and productive cough
D. RR of 42/min with clear lung sounds after suctioning
Correct Answer: B — Nasal flaring and intercostal retractions
Rationale:
Nasal flaring and intercostal retractions indicate increased work of breathing and
potential respiratory decompensation. Infants with RSV can deteriorate quickly, and signs
of respiratory distress require immediate intervention such as suctioning, humidified O₂,
or potential escalation of care.
An O₂ saturation of 91% (A) is borderline but not emergent during sleep. Moderate
congestion and cough (C) are expected findings. RR of 42/min (D) is within normal
limits for infants (30–60/min).
2. A school-age child with type 1 diabetes presents with fatigue, excessive thirst, and
deep, rapid respirations. Which laboratory result should the nurse expect?
A. Blood glucose of 60 mg/dL
B. Urine specific gravity of 1.010
C. Serum bicarbonate of 14 mEq/L
D. Potassium of 3.0 mEq/L
Correct Answer: C — Serum bicarbonate of 14 mEq/L
Rationale:
These symptoms indicate diabetic ketoacidosis (DKA). A hallmark lab finding is low
serum bicarbonate due to metabolic acidosis.
Glucose would be elevated—not low—so A is incorrect. Urine specific gravity in DKA is
typically elevated (not normal as in B) due to dehydration. Potassium may be high or
normal initially (not necessarily low), making D an unreliable expected finding.
,3. A nurse is teaching the parents of a toddler with newly diagnosed iron-deficiency
anemia. Which parental statement indicates a need for further teaching?
A. “We will give the iron supplement on an empty stomach.”
B. “We will avoid giving milk with the iron drops.”
C. “We know stools might become dark in color.”
D. “We will mix the iron drops with a full bottle of milk.”
Correct Answer: D — “We will mix the iron drops with a full bottle of milk.”
Rationale:
Milk inhibits iron absorption, so iron supplements should never be mixed with milk.
Iron absorbs best on an empty stomach (A), stools may darken (C), and milk should be
avoided around dosing (B), so these statements are correct.
4. A nurse is assessing a 3-year-old child who is hospitalized for dehydration due to
gastroenteritis. Which finding indicates severe dehydration?
A. Capillary refill of 2 seconds
B. Mild tachycardia with normal blood pressure
C. Sunken fontanel and oliguria
D. Cold, mottled extremities and rapid, thready pulse
Correct Answer: D — Cold, mottled extremities and rapid, thready pulse
Rationale:
Severe dehydration in toddlers presents as perfusion failure, including poor skin
perfusion, weak pulses, tachycardia, and possible hypotension.
Cap refill of 2 seconds (A) and mild tachycardia (B) suggest mild dehydration. Sunken
fontanel and oliguria (C) indicate moderate dehydration.
5. A nurse provides discharge teaching to the parents of a child with sickle cell
disease. Which instruction has the HIGHEST priority in preventing a vaso-occlusive
crisis?
,A. Ensure the child avoids strenuous exercise
B. Maintain hydration with increased fluid intake
C. Keep vaccinations up to date
D. Administer ibuprofen at the first sign of pain
Correct Answer: B — Maintain hydration with increased fluid intake
Rationale:
Dehydration is the MOST common trigger for vaso-occlusive crises. Adequate hydration
keeps blood less viscous and prevents sickling episodes. Exercise limits are important
(A), vaccinations help prevent infection (C), and pain control matters (D), but none are as
critical as hydration.
6. A preschool child is scheduled for a tonsillectomy. Which finding should lead the
nurse to postpone surgery and notify the provider?
A. The child reports a sore throat when swallowing
B. Platelet count of 75,000/mm³
C. Temperature of 37.8°C (100°F)
D. Mild congestion from seasonal allergies
Correct Answer: B — Platelet count of 75,000/mm³
Rationale:
A platelet count of 75,000/mm³ indicates thrombocytopenia, which presents significant
bleeding risk during and after surgery.
A sore throat (A) is expected. A low-grade fever (C) or mild allergies (D) generally do
not preclude elective tonsillectomy unless symptoms worsen.
7. A nurse is preparing a dose of digoxin for an infant with heart failure. Before
administering, which finding requires the nurse to hold the dose?
A. Apical pulse of 98/min
B. Vomiting after the previous dose
, C. Serum potassium of 4.0 mEq/L
D. Mild periorbital edema
Correct Answer: B — Vomiting after the previous dose
Rationale:
Vomiting can indicate digoxin toxicity, especially in infants. The nurse should hold the
medication and notify the provider.
Apical pulse of 98/min (A) is acceptable (hold if <90/min). Potassium of 4.0 (C) is
normal. Mild edema (D) is related to heart failure, not digoxin toxicity.
8. A teenager with cystic fibrosis is admitted with a pulmonary exacerbation. Which
intervention is most important PRIOR to chest physiotherapy?
A. Administering a bronchodilator
B. Giving high-calorie nutritional supplements
C. Monitoring oxygen saturation trends
D. Encouraging fluid intake
Correct Answer: A — Administering a bronchodilator
Rationale:
Bronchodilators open the airways and improve the effectiveness of chest physiotherapy
by promoting mucus clearance.
Nutrition (B), oxygen monitoring (C), and hydration (D) are important but not the
priority for this step of care.
9. A 4-year-old child has a fever of 102°F. Which nursing intervention is most
appropriate?
A) Encourage fluid intake
B) Give a cold bath
C) Restrict fluids
D) Administer aspirin
Answer: A) Encourage fluid intake
QUESTIONS AND ANSWERS/ ALL COVERED FOR 2025-2026/
LATEST VERSION/ 100% VERIFIED/ GRADED A+
1. A nurse is caring for a 6-month-old infant admitted with bronchiolitis caused by
RSV. Which of the following findings requires immediate intervention?
A. Oxygen saturation of 91% while asleep
B. Nasal flaring and intercostal retractions
C. Moderate nasal congestion and productive cough
D. RR of 42/min with clear lung sounds after suctioning
Correct Answer: B — Nasal flaring and intercostal retractions
Rationale:
Nasal flaring and intercostal retractions indicate increased work of breathing and
potential respiratory decompensation. Infants with RSV can deteriorate quickly, and signs
of respiratory distress require immediate intervention such as suctioning, humidified O₂,
or potential escalation of care.
An O₂ saturation of 91% (A) is borderline but not emergent during sleep. Moderate
congestion and cough (C) are expected findings. RR of 42/min (D) is within normal
limits for infants (30–60/min).
2. A school-age child with type 1 diabetes presents with fatigue, excessive thirst, and
deep, rapid respirations. Which laboratory result should the nurse expect?
A. Blood glucose of 60 mg/dL
B. Urine specific gravity of 1.010
C. Serum bicarbonate of 14 mEq/L
D. Potassium of 3.0 mEq/L
Correct Answer: C — Serum bicarbonate of 14 mEq/L
Rationale:
These symptoms indicate diabetic ketoacidosis (DKA). A hallmark lab finding is low
serum bicarbonate due to metabolic acidosis.
Glucose would be elevated—not low—so A is incorrect. Urine specific gravity in DKA is
typically elevated (not normal as in B) due to dehydration. Potassium may be high or
normal initially (not necessarily low), making D an unreliable expected finding.
,3. A nurse is teaching the parents of a toddler with newly diagnosed iron-deficiency
anemia. Which parental statement indicates a need for further teaching?
A. “We will give the iron supplement on an empty stomach.”
B. “We will avoid giving milk with the iron drops.”
C. “We know stools might become dark in color.”
D. “We will mix the iron drops with a full bottle of milk.”
Correct Answer: D — “We will mix the iron drops with a full bottle of milk.”
Rationale:
Milk inhibits iron absorption, so iron supplements should never be mixed with milk.
Iron absorbs best on an empty stomach (A), stools may darken (C), and milk should be
avoided around dosing (B), so these statements are correct.
4. A nurse is assessing a 3-year-old child who is hospitalized for dehydration due to
gastroenteritis. Which finding indicates severe dehydration?
A. Capillary refill of 2 seconds
B. Mild tachycardia with normal blood pressure
C. Sunken fontanel and oliguria
D. Cold, mottled extremities and rapid, thready pulse
Correct Answer: D — Cold, mottled extremities and rapid, thready pulse
Rationale:
Severe dehydration in toddlers presents as perfusion failure, including poor skin
perfusion, weak pulses, tachycardia, and possible hypotension.
Cap refill of 2 seconds (A) and mild tachycardia (B) suggest mild dehydration. Sunken
fontanel and oliguria (C) indicate moderate dehydration.
5. A nurse provides discharge teaching to the parents of a child with sickle cell
disease. Which instruction has the HIGHEST priority in preventing a vaso-occlusive
crisis?
,A. Ensure the child avoids strenuous exercise
B. Maintain hydration with increased fluid intake
C. Keep vaccinations up to date
D. Administer ibuprofen at the first sign of pain
Correct Answer: B — Maintain hydration with increased fluid intake
Rationale:
Dehydration is the MOST common trigger for vaso-occlusive crises. Adequate hydration
keeps blood less viscous and prevents sickling episodes. Exercise limits are important
(A), vaccinations help prevent infection (C), and pain control matters (D), but none are as
critical as hydration.
6. A preschool child is scheduled for a tonsillectomy. Which finding should lead the
nurse to postpone surgery and notify the provider?
A. The child reports a sore throat when swallowing
B. Platelet count of 75,000/mm³
C. Temperature of 37.8°C (100°F)
D. Mild congestion from seasonal allergies
Correct Answer: B — Platelet count of 75,000/mm³
Rationale:
A platelet count of 75,000/mm³ indicates thrombocytopenia, which presents significant
bleeding risk during and after surgery.
A sore throat (A) is expected. A low-grade fever (C) or mild allergies (D) generally do
not preclude elective tonsillectomy unless symptoms worsen.
7. A nurse is preparing a dose of digoxin for an infant with heart failure. Before
administering, which finding requires the nurse to hold the dose?
A. Apical pulse of 98/min
B. Vomiting after the previous dose
, C. Serum potassium of 4.0 mEq/L
D. Mild periorbital edema
Correct Answer: B — Vomiting after the previous dose
Rationale:
Vomiting can indicate digoxin toxicity, especially in infants. The nurse should hold the
medication and notify the provider.
Apical pulse of 98/min (A) is acceptable (hold if <90/min). Potassium of 4.0 (C) is
normal. Mild edema (D) is related to heart failure, not digoxin toxicity.
8. A teenager with cystic fibrosis is admitted with a pulmonary exacerbation. Which
intervention is most important PRIOR to chest physiotherapy?
A. Administering a bronchodilator
B. Giving high-calorie nutritional supplements
C. Monitoring oxygen saturation trends
D. Encouraging fluid intake
Correct Answer: A — Administering a bronchodilator
Rationale:
Bronchodilators open the airways and improve the effectiveness of chest physiotherapy
by promoting mucus clearance.
Nutrition (B), oxygen monitoring (C), and hydration (D) are important but not the
priority for this step of care.
9. A 4-year-old child has a fever of 102°F. Which nursing intervention is most
appropriate?
A) Encourage fluid intake
B) Give a cold bath
C) Restrict fluids
D) Administer aspirin
Answer: A) Encourage fluid intake
