RN ATI Pediatric Proctored Exam 2023 – 200
Practice Questions (with NGN & Verified Answers)
1. A nurse is assessing a 2-year-old child. Which finding requires immediate further evaluation?
A) Height at the 10th percentile
B) Blood pressure 90/50 mm Hg
C) Head circumference that has increased 3 cm in 2 months
D) Heart rate 110/min while sleeping
Answer: C – Rapid increase in head circumference in a toddler may indicate hydrocephalus or increased
intracranial pressure, requiring urgent evaluation.
2. A nurse is providing education to parents of a child with cystic fibrosis. Which statement indicates
understanding?
A) “We will limit our child’s salt intake.”
B) “We will perform chest physiotherapy after meals.”
C) “We will give pancreatic enzymes with snacks and meals.”
D) “We will avoid high-calorie foods.”
Answer: C – Pancreatic enzymes must be given with all meals and snacks to aid fat absorption. Chest
physiotherapy is done before meals to prevent vomiting.
3. A 6-month-old infant is brought to the ED with lethargy, poor feeding, and a bulging fontanel. Which
action should the nurse take first?
,A) Administer acetaminophen
B) Obtain blood culture
C) Prepare for lumbar puncture
D) Start IV antibiotics
Answer: D – These symptoms suggest bacterial meningitis. IV antibiotics should be started immediately
after blood cultures, but before lumbar puncture if unstable.
4. A nurse is caring for a child with acute lymphoblastic leukemia (ALL) who has a fever. Which
intervention is priority?
A) Administer antipyretic
B) Obtain blood cultures
C) Start broad-spectrum antibiotics
D) Check absolute neutrophil count
Answer: C – In neutropenic fever, antibiotics are the priority to prevent sepsis. Blood cultures are
obtained, but antibiotics should not be delayed.
5. A nurse is teaching a parent of a child with newly diagnosed type 1 diabetes. Which statement
indicates need for further teaching?
A) “I will rotate insulin injection sites.”
B) “I will give insulin even if my child is sick.”
C) “I will check urine ketones when blood glucose is high.”
D) “I will give extra insulin if my child eats a large meal.”
,Answer: D – Parents should not give extra insulin without a prescribed sliding scale; instead, they should
follow the child’s insulin-to-carb ratio.
6. A 4-year-old child is hospitalized for asthma exacerbation. Which assessment finding indicates
worsening respiratory status?
A) Oxygen saturation 95% on room air
B) Increased wheezing in all lung fields
C) Silent chest on auscultation
D) Respiratory rate 24/min
Answer: C – Silent chest indicates severe airway obstruction and impending respiratory failure.
7. A nurse is assessing a newborn with suspected esophageal atresia and tracheoesophageal fistula.
Which finding is most consistent?
A) Bilious vomiting
B) Excessive oral secretions with choking
C) Absent bowel sounds
D) Abdominal distention at birth
Answer: B – Excessive, frothy oral secretions and choking with feeding are classic for esophageal atresia.
8. A nurse is preparing to administer vaccines to a 2-month-old infant. Which vaccines should be given?
A) DTaP, IPV, HepB, Hib, PCV13, Rotavirus
B) DTaP, MMR, Varicella
, C) Tdap, HPV, MenACWY
D) HepA, Hib, Rotavirus
Answer: A – At 2 months: DTaP, IPV, Hib, PCV13, Rotavirus, and HepB if not given at birth.
9. A 10-year-old child with sickle cell disease reports severe chest pain and difficulty breathing. What is
the nurse’s priority?
A) Administer pain medication
B) Apply oxygen
C) Notify respiratory therapy
D) Position child upright
Answer: B – These symptoms suggest acute chest syndrome; oxygen is priority to prevent hypoxia.
10. A nurse is calculating the maintenance fluid requirement for a child weighing 18 kg. What is the 24-
hour amount?
A) 1000 mL
B) 1300 mL
C) 1500 mL
D) 1700 mL
Answer: B – Using 4-2-1 rule: 4 mL/kg for first 10 kg = 40 mL/hr; 2 mL/kg for next 10 kg = 16 mL/hr; total
56 mL/hr × 24 = 1344 mL → ~1300 mL.
Practice Questions (with NGN & Verified Answers)
1. A nurse is assessing a 2-year-old child. Which finding requires immediate further evaluation?
A) Height at the 10th percentile
B) Blood pressure 90/50 mm Hg
C) Head circumference that has increased 3 cm in 2 months
D) Heart rate 110/min while sleeping
Answer: C – Rapid increase in head circumference in a toddler may indicate hydrocephalus or increased
intracranial pressure, requiring urgent evaluation.
2. A nurse is providing education to parents of a child with cystic fibrosis. Which statement indicates
understanding?
A) “We will limit our child’s salt intake.”
B) “We will perform chest physiotherapy after meals.”
C) “We will give pancreatic enzymes with snacks and meals.”
D) “We will avoid high-calorie foods.”
Answer: C – Pancreatic enzymes must be given with all meals and snacks to aid fat absorption. Chest
physiotherapy is done before meals to prevent vomiting.
3. A 6-month-old infant is brought to the ED with lethargy, poor feeding, and a bulging fontanel. Which
action should the nurse take first?
,A) Administer acetaminophen
B) Obtain blood culture
C) Prepare for lumbar puncture
D) Start IV antibiotics
Answer: D – These symptoms suggest bacterial meningitis. IV antibiotics should be started immediately
after blood cultures, but before lumbar puncture if unstable.
4. A nurse is caring for a child with acute lymphoblastic leukemia (ALL) who has a fever. Which
intervention is priority?
A) Administer antipyretic
B) Obtain blood cultures
C) Start broad-spectrum antibiotics
D) Check absolute neutrophil count
Answer: C – In neutropenic fever, antibiotics are the priority to prevent sepsis. Blood cultures are
obtained, but antibiotics should not be delayed.
5. A nurse is teaching a parent of a child with newly diagnosed type 1 diabetes. Which statement
indicates need for further teaching?
A) “I will rotate insulin injection sites.”
B) “I will give insulin even if my child is sick.”
C) “I will check urine ketones when blood glucose is high.”
D) “I will give extra insulin if my child eats a large meal.”
,Answer: D – Parents should not give extra insulin without a prescribed sliding scale; instead, they should
follow the child’s insulin-to-carb ratio.
6. A 4-year-old child is hospitalized for asthma exacerbation. Which assessment finding indicates
worsening respiratory status?
A) Oxygen saturation 95% on room air
B) Increased wheezing in all lung fields
C) Silent chest on auscultation
D) Respiratory rate 24/min
Answer: C – Silent chest indicates severe airway obstruction and impending respiratory failure.
7. A nurse is assessing a newborn with suspected esophageal atresia and tracheoesophageal fistula.
Which finding is most consistent?
A) Bilious vomiting
B) Excessive oral secretions with choking
C) Absent bowel sounds
D) Abdominal distention at birth
Answer: B – Excessive, frothy oral secretions and choking with feeding are classic for esophageal atresia.
8. A nurse is preparing to administer vaccines to a 2-month-old infant. Which vaccines should be given?
A) DTaP, IPV, HepB, Hib, PCV13, Rotavirus
B) DTaP, MMR, Varicella
, C) Tdap, HPV, MenACWY
D) HepA, Hib, Rotavirus
Answer: A – At 2 months: DTaP, IPV, Hib, PCV13, Rotavirus, and HepB if not given at birth.
9. A 10-year-old child with sickle cell disease reports severe chest pain and difficulty breathing. What is
the nurse’s priority?
A) Administer pain medication
B) Apply oxygen
C) Notify respiratory therapy
D) Position child upright
Answer: B – These symptoms suggest acute chest syndrome; oxygen is priority to prevent hypoxia.
10. A nurse is calculating the maintenance fluid requirement for a child weighing 18 kg. What is the 24-
hour amount?
A) 1000 mL
B) 1300 mL
C) 1500 mL
D) 1700 mL
Answer: B – Using 4-2-1 rule: 4 mL/kg for first 10 kg = 40 mL/hr; 2 mL/kg for next 10 kg = 16 mL/hr; total
56 mL/hr × 24 = 1344 mL → ~1300 mL.
