Comprehensive ATI Pediatrics Exam
Prep: High-Yield Questions with
Detailed Rationales for Nursing
Students and NCLEX Review
QUESTION 1
A nurse is caring for a 4-year-old child who is prescribed an oral liquid medication. The
child refuses to take the medication. Which of the following actions should the nurse
take?
A) Mix the medication with a large volume of the child's favorite juice.
B) Tell the child that the medication tastes like candy.
C) Offer the child a choice between two acceptable cups to drink the medication from.
D) Restrain the child to administer the medication safely.
Answer: C
Rationale: Offering a choice (e.g., "Do you want the red cup or the blue cup?") gives the
preschooler a sense of control, which is developmentally appropriate and promotes
cooperation. Mixing with a large volume of juice is contraindicated because the child
might not drink it all, resulting in an inaccurate dose. Telling the child it tastes like candy
is a lie and breaks trust. Restraint is a last resort and should not be the first action.
QUESTION 2
A nurse is assessing a 6-month-old infant during a well-child visit. Which of the
following findings should the nurse report to the provider?
A) Presence of a positive Moro reflex.
B) Inability to sit without support.
,C) Weight that has tripled since birth.
D) Presence of a closed posterior fontanel.
Answer: A
Rationale: The Moro (startle) reflex should disappear by 3 to 4 months of age. Its
presence at 6 months is a neurological abnormality and should be reported. A 6-month-
old can usually sit with support but not independently. A tripled birth weight is a
milestone for 12 months; at 6 months, it should have doubled. The posterior fontanel
closes by 2 months of age.
QUESTION 3
A nurse is providing education to a parent of a child with a new diagnosis of type 1
diabetes mellitus. Which of the following statements by the parent indicates a need for
further teaching?
A) "I will give my child insulin subcutaneously according to the prescribed sliding scale."
B) "I will test my child's blood glucose levels before meals and at bedtime."
C) "I will give my child an extra snack before soccer practice."
D) "I will draw up the cloudy insulin first, then the clear insulin."
Answer: D
Rationale: The mnemonic "Clear to Cloudy" is used for mixing insulins (e.g., Regular
[clear] then NPH [cloudy]). Drawing up the cloudy insulin first would contaminate the
clear vial. The other options are correct for managing diabetes and hypoglycemia during
exercise.
QUESTION 4
A nurse is caring for a 2-year-old child who is having a tonic-clonic seizure. Which of the
following actions is the nurse's priority?
A) Insert a padded tongue blade into the child's mouth.
B) Restrain the child's limbs to prevent injury.
C) Place the child in a side-lying position.
D) Administer a dose of rectal diazepam.
,Answer: C
Rationale: The priority during a seizure is to maintain a patent airway and prevent
aspiration. Placing the child in a side-lying (recovery) position allows secretions to drain
from the mouth. Do not insert anything into the mouth as it can cause injury or
obstruction. Do not restrain limbs as it can cause fractures.
QUESTION 5
A nurse is assessing a school-aged child who has acute post-streptococcal
glomerulonephritis (APSGN). Which of the following findings should the nurse expect?
A) Hypotension.
B) Periorbital edema.
C) Polyuria.
D) Increased serum complement C3 levels.
Answer: B
Rationale: APSGN is characterized by periorbital edema (especially in the morning),
hypertension (not hypotension), and hematuria. Oliguria (decreased urine output) is
common. Serum complement C3 levels are temporarily decreased, not increased.
QUESTION 6
A nurse is teaching a parent about the introduction of solid foods to a 5-month-old
infant. Which of the following statements is appropriate for the nurse to include?
A) "Begin with iron-fortified rice cereal mixed with formula or breast milk."
B) "Introduce a new single-ingredient food every day."
C) "Start with pureed meats to provide adequate protein."
D) "Add honey to the cereal to make it taste sweeter."
Answer: A
Rationale: Iron-fortified rice cereal is the recommended first solid food because it's
easily digestible and has a low allergenic potential. It should be mixed with formula or
breast milk to a thin consistency. New foods should be introduced one at a time over 4-
, 7 days to watch for allergies. Honey should be avoided in the first year due to botulism
spores.
QUESTION 7
A nurse is performing an assessment on a 3-year-old child. Which of the following
developmental milestones should the nurse expect the child to be able to perform?
A) Tie their shoelaces.
B) Ride a tricycle.
C) Draw a person with six body parts.
D) Skip on alternate feet.
Answer: B
Rationale: Riding a tricycle is a gross motor skill expected for a 3-year-old. Tying
shoelaces is a 5- to 6-year-old skill. Drawing a person with six body parts is a 5-year-old
skill. Skipping is a 5-year-old gross motor skill.
QUESTION 8
A nurse is caring for a child with a diagnosis of Kawasaki disease. Which of the following
assessment findings is the priority to report to the provider?
A) Erythema and cracking of the lips.
B) Bilateral conjunctival injection.
C) Changes in the child's peripheral pulses.
D) Peeling of the skin on the hands and feet.
Answer: C
Rationale: Kawasaki disease causes vasculitis that can lead to coronary artery
aneurysms. Changes in peripheral pulses (e.g., diminished or absent) indicate
compromised cardiac output or thrombosis and is a priority finding. The other findings
(strawberry tongue/conjunctivitis, peeling skin) are clinical manifestations of the disease
but are not as immediately life-threatening.
QUESTION 9
A nurse is assessing a newborn. Which of the following findings should the nurse report
Prep: High-Yield Questions with
Detailed Rationales for Nursing
Students and NCLEX Review
QUESTION 1
A nurse is caring for a 4-year-old child who is prescribed an oral liquid medication. The
child refuses to take the medication. Which of the following actions should the nurse
take?
A) Mix the medication with a large volume of the child's favorite juice.
B) Tell the child that the medication tastes like candy.
C) Offer the child a choice between two acceptable cups to drink the medication from.
D) Restrain the child to administer the medication safely.
Answer: C
Rationale: Offering a choice (e.g., "Do you want the red cup or the blue cup?") gives the
preschooler a sense of control, which is developmentally appropriate and promotes
cooperation. Mixing with a large volume of juice is contraindicated because the child
might not drink it all, resulting in an inaccurate dose. Telling the child it tastes like candy
is a lie and breaks trust. Restraint is a last resort and should not be the first action.
QUESTION 2
A nurse is assessing a 6-month-old infant during a well-child visit. Which of the
following findings should the nurse report to the provider?
A) Presence of a positive Moro reflex.
B) Inability to sit without support.
,C) Weight that has tripled since birth.
D) Presence of a closed posterior fontanel.
Answer: A
Rationale: The Moro (startle) reflex should disappear by 3 to 4 months of age. Its
presence at 6 months is a neurological abnormality and should be reported. A 6-month-
old can usually sit with support but not independently. A tripled birth weight is a
milestone for 12 months; at 6 months, it should have doubled. The posterior fontanel
closes by 2 months of age.
QUESTION 3
A nurse is providing education to a parent of a child with a new diagnosis of type 1
diabetes mellitus. Which of the following statements by the parent indicates a need for
further teaching?
A) "I will give my child insulin subcutaneously according to the prescribed sliding scale."
B) "I will test my child's blood glucose levels before meals and at bedtime."
C) "I will give my child an extra snack before soccer practice."
D) "I will draw up the cloudy insulin first, then the clear insulin."
Answer: D
Rationale: The mnemonic "Clear to Cloudy" is used for mixing insulins (e.g., Regular
[clear] then NPH [cloudy]). Drawing up the cloudy insulin first would contaminate the
clear vial. The other options are correct for managing diabetes and hypoglycemia during
exercise.
QUESTION 4
A nurse is caring for a 2-year-old child who is having a tonic-clonic seizure. Which of the
following actions is the nurse's priority?
A) Insert a padded tongue blade into the child's mouth.
B) Restrain the child's limbs to prevent injury.
C) Place the child in a side-lying position.
D) Administer a dose of rectal diazepam.
,Answer: C
Rationale: The priority during a seizure is to maintain a patent airway and prevent
aspiration. Placing the child in a side-lying (recovery) position allows secretions to drain
from the mouth. Do not insert anything into the mouth as it can cause injury or
obstruction. Do not restrain limbs as it can cause fractures.
QUESTION 5
A nurse is assessing a school-aged child who has acute post-streptococcal
glomerulonephritis (APSGN). Which of the following findings should the nurse expect?
A) Hypotension.
B) Periorbital edema.
C) Polyuria.
D) Increased serum complement C3 levels.
Answer: B
Rationale: APSGN is characterized by periorbital edema (especially in the morning),
hypertension (not hypotension), and hematuria. Oliguria (decreased urine output) is
common. Serum complement C3 levels are temporarily decreased, not increased.
QUESTION 6
A nurse is teaching a parent about the introduction of solid foods to a 5-month-old
infant. Which of the following statements is appropriate for the nurse to include?
A) "Begin with iron-fortified rice cereal mixed with formula or breast milk."
B) "Introduce a new single-ingredient food every day."
C) "Start with pureed meats to provide adequate protein."
D) "Add honey to the cereal to make it taste sweeter."
Answer: A
Rationale: Iron-fortified rice cereal is the recommended first solid food because it's
easily digestible and has a low allergenic potential. It should be mixed with formula or
breast milk to a thin consistency. New foods should be introduced one at a time over 4-
, 7 days to watch for allergies. Honey should be avoided in the first year due to botulism
spores.
QUESTION 7
A nurse is performing an assessment on a 3-year-old child. Which of the following
developmental milestones should the nurse expect the child to be able to perform?
A) Tie their shoelaces.
B) Ride a tricycle.
C) Draw a person with six body parts.
D) Skip on alternate feet.
Answer: B
Rationale: Riding a tricycle is a gross motor skill expected for a 3-year-old. Tying
shoelaces is a 5- to 6-year-old skill. Drawing a person with six body parts is a 5-year-old
skill. Skipping is a 5-year-old gross motor skill.
QUESTION 8
A nurse is caring for a child with a diagnosis of Kawasaki disease. Which of the following
assessment findings is the priority to report to the provider?
A) Erythema and cracking of the lips.
B) Bilateral conjunctival injection.
C) Changes in the child's peripheral pulses.
D) Peeling of the skin on the hands and feet.
Answer: C
Rationale: Kawasaki disease causes vasculitis that can lead to coronary artery
aneurysms. Changes in peripheral pulses (e.g., diminished or absent) indicate
compromised cardiac output or thrombosis and is a priority finding. The other findings
(strawberry tongue/conjunctivitis, peeling skin) are clinical manifestations of the disease
but are not as immediately life-threatening.
QUESTION 9
A nurse is assessing a newborn. Which of the following findings should the nurse report
