ATI RN Pediatric Nursing Proctored Exam 2026 (NGN) - Simulated Practice
NGN Question Formats Included:
Multiple Choice (MC)
Select All That Apply (SATA)
Matrix/Grid (MR)
Bowtie (BT)
QUESTION 1 (Multiple Choice)
A nurse is assessing a child who has bacterial pneumonia. Which of the following manifestations should
the nurse expect?
A. Drooling
B. Malaise
C. Tinnitus
D. Rhinorrhea
Correct Answer: B. Malaise
Rationale: Bacterial pneumonia typically presents with fever, chills, productive cough, tachypnea, and
malaise. Drooling (A) is a classic sign of epiglottitis. Tinnitus (C) is associated with ototoxic medications
(e.g., aminoglycosides) or salicylate toxicity. Rhinorrhea (D) is more commonly associated with viral
upper respiratory infections.
QUESTION 2 (Select All That Apply)
A nurse is caring for a 4-month-old infant with a suspected diagnosis of cystic fibrosis (CF). Which of
the following findings should the nurse expect? (Select all that apply.)
,A. Meconium ileus
B. Salty skin
C. Steatorrhea
D. Bradycardia
E. Hyperglycemia
Correct Answer: A, B, C
Rationale: Cystic fibrosis affects the exocrine glands and mucus-producing cells. Manifestations include
meconium ileus in newborns (A), excessively salty sweat (B), and steatorrhea (fatty, foul-smelling
stools) due to pancreatic insufficiency (C). Bradycardia (D) and hyperglycemia (E) are not typical initial
presentations (though CF-related diabetes can occur later).
QUESTION 3 (Matrix/Grid)
A nurse is assessing a 2-year-old child. The nurse should identify which of the following findings as an
expected developmental milestone or a sign of delay. Drag and drop the findings into the correct
category.
| Finding | Expected Milestone | Sign of Delay |
| : | :: | :: |
| Kicks a ball | X | |
| Uses 2-word phrases | X | |
| Cannot walk independently | | X |
| Stacks 6 blocks | X | |
| Cannot point to named body parts | | X |
Rationale: By 2 years, a child should kick a ball, use 2-word phrases, stack 6 blocks, and point to
named body parts. Inability to walk independently or point to body parts by 2 years indicates a
developmental delay.
, QUESTION 4 (Multiple Choice)
A nurse is providing teaching to the parents of a child who has asthma. Which of the following
instructions should the nurse include in the teaching?
A. "Use the peak flow meter immediately after using the rescue inhaler."
B. "Administer the corticosteroid inhaler before the bronchodilator."
C. "Limit fluid intake during an acute asthma attack."
D. "Expect the child to have a chronic, productive cough."
Correct Answer: B. Administer the corticosteroid inhaler before the bronchodilator.
Rationale: If a client uses both a bronchodilator and a corticosteroid inhaler, the bronchodilator should
be used first to open the airways, followed by the corticosteroid. Peak flow meters (A) should be used
before the inhaler to get a baseline. Fluid intake (C) should be encouraged to thin secretions. Asthma
(D) typically presents with a dry, hacking cough or wheezing, not a chronic productive cough.
QUESTION 5 (Bowtie)
A nurse is caring for a child who is experiencing an acute asthma exacerbation. Complete the following
sentence by choosing from the lists of options.
The nurse should first identify 1. [Condition] and then initiate 2. [Action] while monitoring for 3.
[Parameter].
1. Condition:
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
2. Action:
Administer albuterol via nebulizer
NGN Question Formats Included:
Multiple Choice (MC)
Select All That Apply (SATA)
Matrix/Grid (MR)
Bowtie (BT)
QUESTION 1 (Multiple Choice)
A nurse is assessing a child who has bacterial pneumonia. Which of the following manifestations should
the nurse expect?
A. Drooling
B. Malaise
C. Tinnitus
D. Rhinorrhea
Correct Answer: B. Malaise
Rationale: Bacterial pneumonia typically presents with fever, chills, productive cough, tachypnea, and
malaise. Drooling (A) is a classic sign of epiglottitis. Tinnitus (C) is associated with ototoxic medications
(e.g., aminoglycosides) or salicylate toxicity. Rhinorrhea (D) is more commonly associated with viral
upper respiratory infections.
QUESTION 2 (Select All That Apply)
A nurse is caring for a 4-month-old infant with a suspected diagnosis of cystic fibrosis (CF). Which of
the following findings should the nurse expect? (Select all that apply.)
,A. Meconium ileus
B. Salty skin
C. Steatorrhea
D. Bradycardia
E. Hyperglycemia
Correct Answer: A, B, C
Rationale: Cystic fibrosis affects the exocrine glands and mucus-producing cells. Manifestations include
meconium ileus in newborns (A), excessively salty sweat (B), and steatorrhea (fatty, foul-smelling
stools) due to pancreatic insufficiency (C). Bradycardia (D) and hyperglycemia (E) are not typical initial
presentations (though CF-related diabetes can occur later).
QUESTION 3 (Matrix/Grid)
A nurse is assessing a 2-year-old child. The nurse should identify which of the following findings as an
expected developmental milestone or a sign of delay. Drag and drop the findings into the correct
category.
| Finding | Expected Milestone | Sign of Delay |
| : | :: | :: |
| Kicks a ball | X | |
| Uses 2-word phrases | X | |
| Cannot walk independently | | X |
| Stacks 6 blocks | X | |
| Cannot point to named body parts | | X |
Rationale: By 2 years, a child should kick a ball, use 2-word phrases, stack 6 blocks, and point to
named body parts. Inability to walk independently or point to body parts by 2 years indicates a
developmental delay.
, QUESTION 4 (Multiple Choice)
A nurse is providing teaching to the parents of a child who has asthma. Which of the following
instructions should the nurse include in the teaching?
A. "Use the peak flow meter immediately after using the rescue inhaler."
B. "Administer the corticosteroid inhaler before the bronchodilator."
C. "Limit fluid intake during an acute asthma attack."
D. "Expect the child to have a chronic, productive cough."
Correct Answer: B. Administer the corticosteroid inhaler before the bronchodilator.
Rationale: If a client uses both a bronchodilator and a corticosteroid inhaler, the bronchodilator should
be used first to open the airways, followed by the corticosteroid. Peak flow meters (A) should be used
before the inhaler to get a baseline. Fluid intake (C) should be encouraged to thin secretions. Asthma
(D) typically presents with a dry, hacking cough or wheezing, not a chronic productive cough.
QUESTION 5 (Bowtie)
A nurse is caring for a child who is experiencing an acute asthma exacerbation. Complete the following
sentence by choosing from the lists of options.
The nurse should first identify 1. [Condition] and then initiate 2. [Action] while monitoring for 3.
[Parameter].
1. Condition:
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
2. Action:
Administer albuterol via nebulizer
