ATI RN PEDIATRICS PROCTOR FINAL
EXAM COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS
1. A nurse is caring for a 3-year-old child who has epiglottitis. Which of the following actions
should the nurse take first?
A. Obtain a throat culture to identify the causative agent.
B. Initiate IV access for antibiotic administration.
C. Examine the throat using a tongue blade to assess for edema.
D. Place the child in a tripod position and provide humidified oxygen.
Answer: D
Conceptual Explanation: Airway management is the priority. The tripod position helps
open the airway. Examining the throat with a tongue blade is strictly contraindicated as it
can trigger laryngospasm and complete airway obstruction.
2. A nurse is teaching the parents of a school-age child with cystic fibrosis about dietary
requirements. Which instruction is most appropriate?
A. Provide a high-calorie, high-protein diet with supplemental pancreatic enzymes.
,B. Restrict sodium intake to prevent fluid retention.
C. Limit fat intake to 20% of total daily calories.
D. Administer fat-soluble vitamins once a week.
Answer: A
Conceptual Explanation: Children with CF require a high-calorie, high-protein diet to
support growth due to malabsorption. Pancreatic enzymes must be taken with all meals
and snacks to assist digestion.
3. A nurse is assessing an infant with Tetralogy of Fallot who begins to have a hypercyanotic
(‘tet’) spell. Which action should the nurse take first?
A. Administer 100% oxygen via face mask.
B. Administer morphine sulfate intravenously.
C. Place the infant in a knee-chest position.
D. Prepare for immediate endotracheal intubation.
Answer: C
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which decreases the right-to-left shunt and improves oxygenation during a tet spell.
4. A 4-year-old child is admitted with suspected Wilms tumor. Which of the following is a
critical nursing intervention?
A. Place a ‘Do Not Palpate Abdomen’ sign over the child’s bed.
, B. Palpate the abdomen every 4 hours to monitor for tumor growth.
C. Prepare the child for a bone marrow aspiration.
D. Maintain the child on a strictly low-protein diet.
Answer: A
Conceptual Explanation: Wilms tumor (nephroblastoma) is encapsulated. Palpation can
cause the tumor to rupture and spread cancerous cells into the peritoneal cavity.
5. A nurse is assessing a 10-month-old infant. Which of the following findings should be
reported to the provider as a potential developmental delay?
A. The infant is unable to sit steadily without support.
B. The infant cannot stand alone.
C. The infant lacks a pincer grasp.
D. The infant does not have any erupted teeth.
Answer: A
Conceptual Explanation: Infants should be able to sit steadily without support by age 8
months. Standing alone usually occurs around 10-12 months, and pincer grasp develops
around 9 months.
6. A child is diagnosed with Acute Poststreptococcal Glomerulonephritis (APSGN). Which
clinical manifestation should the nurse expect?
A. Hypotension and polyuria.
EXAM COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS
1. A nurse is caring for a 3-year-old child who has epiglottitis. Which of the following actions
should the nurse take first?
A. Obtain a throat culture to identify the causative agent.
B. Initiate IV access for antibiotic administration.
C. Examine the throat using a tongue blade to assess for edema.
D. Place the child in a tripod position and provide humidified oxygen.
Answer: D
Conceptual Explanation: Airway management is the priority. The tripod position helps
open the airway. Examining the throat with a tongue blade is strictly contraindicated as it
can trigger laryngospasm and complete airway obstruction.
2. A nurse is teaching the parents of a school-age child with cystic fibrosis about dietary
requirements. Which instruction is most appropriate?
A. Provide a high-calorie, high-protein diet with supplemental pancreatic enzymes.
,B. Restrict sodium intake to prevent fluid retention.
C. Limit fat intake to 20% of total daily calories.
D. Administer fat-soluble vitamins once a week.
Answer: A
Conceptual Explanation: Children with CF require a high-calorie, high-protein diet to
support growth due to malabsorption. Pancreatic enzymes must be taken with all meals
and snacks to assist digestion.
3. A nurse is assessing an infant with Tetralogy of Fallot who begins to have a hypercyanotic
(‘tet’) spell. Which action should the nurse take first?
A. Administer 100% oxygen via face mask.
B. Administer morphine sulfate intravenously.
C. Place the infant in a knee-chest position.
D. Prepare for immediate endotracheal intubation.
Answer: C
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which decreases the right-to-left shunt and improves oxygenation during a tet spell.
4. A 4-year-old child is admitted with suspected Wilms tumor. Which of the following is a
critical nursing intervention?
A. Place a ‘Do Not Palpate Abdomen’ sign over the child’s bed.
, B. Palpate the abdomen every 4 hours to monitor for tumor growth.
C. Prepare the child for a bone marrow aspiration.
D. Maintain the child on a strictly low-protein diet.
Answer: A
Conceptual Explanation: Wilms tumor (nephroblastoma) is encapsulated. Palpation can
cause the tumor to rupture and spread cancerous cells into the peritoneal cavity.
5. A nurse is assessing a 10-month-old infant. Which of the following findings should be
reported to the provider as a potential developmental delay?
A. The infant is unable to sit steadily without support.
B. The infant cannot stand alone.
C. The infant lacks a pincer grasp.
D. The infant does not have any erupted teeth.
Answer: A
Conceptual Explanation: Infants should be able to sit steadily without support by age 8
months. Standing alone usually occurs around 10-12 months, and pincer grasp develops
around 9 months.
6. A child is diagnosed with Acute Poststreptococcal Glomerulonephritis (APSGN). Which
clinical manifestation should the nurse expect?
A. Hypotension and polyuria.
