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ATI Pediatrics Proctored Exam 2025 –
170 Rationalized Questions with
Verified Answers | NGN-Style Review |
100% Pass Rate
Question 1
A nurse is assessing a 6-month-old infant during a well-child visit. Which finding requires
further evaluation?
A. Head circumference increased by 0.5 cm since last visit
B. Posterior fontanel is closed
C. Able to roll from back to front
D. Presence of two lower central incisors
Rationale: The posterior fontanel typically closes by 2–3 months of age. A closed posterior
fontanel at 6 months is expected and does not require further evaluation, but the question tests
the nurse’s knowledge of developmental milestones. Options A, C, and D are normal for a 6-
month-old infant. Per ATI Pediatrics guidelines, any deviation from expected fontanel closure
would warrant further assessment, but this finding is normal.
Question 2
NGN Case Study: A 4-year-old child is admitted with suspected bacterial meningitis. The child
is irritable, has a fever of 39.5°C (103.1°F), and exhibits nuchal rigidity. Lumbar puncture results
are pending.
Question: Which intervention should the nurse prioritize?
A. Administer oral acetaminophen
B. Initiate IV antibiotics
C. Encourage oral fluid intake
D. Apply a warm compress to the neck
Rationale: Bacterial meningitis is a medical emergency requiring prompt administration of
IV antibiotics to prevent complications like seizures or brain damage, per ATI Pediatrics.
Acetaminophen may reduce fever but does not address the infection. Oral fluids are
contraindicated due to risk of aspiration in an irritable child, and warm compresses are
inappropriate for nuchal rigidity.
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Question 3
A nurse is teaching parents about safety for their 2-year-old child. Which statement indicates a
need for further teaching?
A. “We keep all medications in a locked cabinet.”
B. “We use a rear-facing car seat in the back seat.”
C. “We let our child play with small toys when supervised.”
D. “We installed safety gates at the top and bottom of stairs.”
Rationale: Small toys pose a choking hazard for a 2-year-old, even with supervision, per ATI
Pediatrics. All other options reflect appropriate safety measures for this age group.
Question 4
NGN Select All That Apply: A nurse is caring for a 10-year-old with type 1 diabetes mellitus.
Which findings indicate possible diabetic ketoacidosis (DKA)? Select all that apply.
A. Blood glucose 450 mg/dL
B. Fruity breath odor
C. Bradycardia
D. Kussmaul respirations
E. Increased urine output
Correct Answers: A, B, D
Rationale: DKA is characterized by hyperglycemia (blood glucose >250 mg/dL), fruity
breath odor due to ketone production, and Kussmaul respirations as the body compensates for
metabolic acidosis, per ATI Pediatrics. Bradycardia is not typical (tachycardia is more common),
and increased urine output occurs early but decreases as dehydration worsens.
Question 5
A nurse is assessing a newborn with suspected respiratory distress syndrome (RDS). Which
finding is expected?
A. Bradypnea
B. Nasal flaring
C. Clear lung sounds
D. Hypercapnia
, 3
Rationale: Nasal flaring is a sign of respiratory distress in newborns with RDS due to increased
work of breathing, per ATI Pediatrics. Bradypnea and clear lung sounds are not typical, and
hypercapnia is a laboratory finding, not a clinical observation.
Question 6
NGN Bowtie: A 3-month-old infant presents with poor feeding, lethargy, and a heart rate of 180
bpm. The nurse suspects congestive heart failure (CHF). Drag and drop the interventions and
monitoring actions into the appropriate categories.
Interventions:
1. Administer digoxin
2. Provide supplemental oxygen
3. Restrict fluids
Monitoring:
4. Monitor daily weights
5. Assess respiratory rate
Correct Answer:
Interventions: 1, 2
Monitoring: 4, 5
Rationale: In CHF, digoxin improves cardiac output, and supplemental oxygen addresses
hypoxia. Fluid restriction is not always indicated in infants unless severe edema is present.
Daily weights monitor fluid status, and respiratory rate assesses breathing effort, per ATI
Pediatrics.
Question 7
A nurse is preparing to administer an IM injection to a 15-month-old child. Which site is most
appropriate?
A. Deltoid
B. Vastus lateralis
C. Gluteus maximus
D. Ventrogluteal
Rationale: The vastus lateralis is the preferred IM injection site for infants and toddlers due to
adequate muscle mass and safety, per ATI Pediatrics. The deltoid and gluteus maximus are not
recommended for this age group.
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Question 8
A 7-year-old child with asthma is prescribed albuterol via nebulizer. Which statement by the
parent indicates understanding of the medication?
A. “This will prevent asthma attacks.”
B. “This will relieve acute symptoms.”
C. “This is a daily maintenance medication.”
D. “This will reduce lung inflammation.”
Rationale: Albuterol, a short-acting beta-agonist, relieves acute asthma symptoms by causing
bronchodilation, per ATI Pediatrics. It does not prevent attacks or reduce inflammation.
Question 9
NGN Case Study: A 5-year-old child is admitted with dehydration due to gastroenteritis. The
child has dry mucous membranes, sunken eyes, and a heart rate of 140 bpm. IV fluids are
ordered.
Question: What is the priority nursing action?
A. Encourage oral rehydration
B. Administer IV bolus of 0.9% sodium chloride
C. Obtain a stool culture
D. Apply a cool compress
Rationale: IV bolus of 0.9% sodium chloride is the priority to correct dehydration in a child
with severe symptoms, per ATI Pediatrics. Oral rehydration is inappropriate for severe
dehydration, and other actions are secondary.
Question 10
A nurse is caring for a child with sickle cell anemia in vaso-occlusive crisis. Which intervention
is most appropriate?
A. Apply cold compresses to joints
B. Administer IV fluids and pain medication
C. Encourage high-intensity exercise
D. Restrict fluid intake
Rationale: IV fluids promote hydration to reduce blood viscosity, and pain medication
manages severe pain in a vaso-occlusive crisis, per ATI Pediatrics. Cold compresses may worsen
vasoconstriction, and exercise is contraindicated.
ATI Pediatrics Proctored Exam 2025 –
170 Rationalized Questions with
Verified Answers | NGN-Style Review |
100% Pass Rate
Question 1
A nurse is assessing a 6-month-old infant during a well-child visit. Which finding requires
further evaluation?
A. Head circumference increased by 0.5 cm since last visit
B. Posterior fontanel is closed
C. Able to roll from back to front
D. Presence of two lower central incisors
Rationale: The posterior fontanel typically closes by 2–3 months of age. A closed posterior
fontanel at 6 months is expected and does not require further evaluation, but the question tests
the nurse’s knowledge of developmental milestones. Options A, C, and D are normal for a 6-
month-old infant. Per ATI Pediatrics guidelines, any deviation from expected fontanel closure
would warrant further assessment, but this finding is normal.
Question 2
NGN Case Study: A 4-year-old child is admitted with suspected bacterial meningitis. The child
is irritable, has a fever of 39.5°C (103.1°F), and exhibits nuchal rigidity. Lumbar puncture results
are pending.
Question: Which intervention should the nurse prioritize?
A. Administer oral acetaminophen
B. Initiate IV antibiotics
C. Encourage oral fluid intake
D. Apply a warm compress to the neck
Rationale: Bacterial meningitis is a medical emergency requiring prompt administration of
IV antibiotics to prevent complications like seizures or brain damage, per ATI Pediatrics.
Acetaminophen may reduce fever but does not address the infection. Oral fluids are
contraindicated due to risk of aspiration in an irritable child, and warm compresses are
inappropriate for nuchal rigidity.
, 2
Question 3
A nurse is teaching parents about safety for their 2-year-old child. Which statement indicates a
need for further teaching?
A. “We keep all medications in a locked cabinet.”
B. “We use a rear-facing car seat in the back seat.”
C. “We let our child play with small toys when supervised.”
D. “We installed safety gates at the top and bottom of stairs.”
Rationale: Small toys pose a choking hazard for a 2-year-old, even with supervision, per ATI
Pediatrics. All other options reflect appropriate safety measures for this age group.
Question 4
NGN Select All That Apply: A nurse is caring for a 10-year-old with type 1 diabetes mellitus.
Which findings indicate possible diabetic ketoacidosis (DKA)? Select all that apply.
A. Blood glucose 450 mg/dL
B. Fruity breath odor
C. Bradycardia
D. Kussmaul respirations
E. Increased urine output
Correct Answers: A, B, D
Rationale: DKA is characterized by hyperglycemia (blood glucose >250 mg/dL), fruity
breath odor due to ketone production, and Kussmaul respirations as the body compensates for
metabolic acidosis, per ATI Pediatrics. Bradycardia is not typical (tachycardia is more common),
and increased urine output occurs early but decreases as dehydration worsens.
Question 5
A nurse is assessing a newborn with suspected respiratory distress syndrome (RDS). Which
finding is expected?
A. Bradypnea
B. Nasal flaring
C. Clear lung sounds
D. Hypercapnia
, 3
Rationale: Nasal flaring is a sign of respiratory distress in newborns with RDS due to increased
work of breathing, per ATI Pediatrics. Bradypnea and clear lung sounds are not typical, and
hypercapnia is a laboratory finding, not a clinical observation.
Question 6
NGN Bowtie: A 3-month-old infant presents with poor feeding, lethargy, and a heart rate of 180
bpm. The nurse suspects congestive heart failure (CHF). Drag and drop the interventions and
monitoring actions into the appropriate categories.
Interventions:
1. Administer digoxin
2. Provide supplemental oxygen
3. Restrict fluids
Monitoring:
4. Monitor daily weights
5. Assess respiratory rate
Correct Answer:
Interventions: 1, 2
Monitoring: 4, 5
Rationale: In CHF, digoxin improves cardiac output, and supplemental oxygen addresses
hypoxia. Fluid restriction is not always indicated in infants unless severe edema is present.
Daily weights monitor fluid status, and respiratory rate assesses breathing effort, per ATI
Pediatrics.
Question 7
A nurse is preparing to administer an IM injection to a 15-month-old child. Which site is most
appropriate?
A. Deltoid
B. Vastus lateralis
C. Gluteus maximus
D. Ventrogluteal
Rationale: The vastus lateralis is the preferred IM injection site for infants and toddlers due to
adequate muscle mass and safety, per ATI Pediatrics. The deltoid and gluteus maximus are not
recommended for this age group.
, 4
Question 8
A 7-year-old child with asthma is prescribed albuterol via nebulizer. Which statement by the
parent indicates understanding of the medication?
A. “This will prevent asthma attacks.”
B. “This will relieve acute symptoms.”
C. “This is a daily maintenance medication.”
D. “This will reduce lung inflammation.”
Rationale: Albuterol, a short-acting beta-agonist, relieves acute asthma symptoms by causing
bronchodilation, per ATI Pediatrics. It does not prevent attacks or reduce inflammation.
Question 9
NGN Case Study: A 5-year-old child is admitted with dehydration due to gastroenteritis. The
child has dry mucous membranes, sunken eyes, and a heart rate of 140 bpm. IV fluids are
ordered.
Question: What is the priority nursing action?
A. Encourage oral rehydration
B. Administer IV bolus of 0.9% sodium chloride
C. Obtain a stool culture
D. Apply a cool compress
Rationale: IV bolus of 0.9% sodium chloride is the priority to correct dehydration in a child
with severe symptoms, per ATI Pediatrics. Oral rehydration is inappropriate for severe
dehydration, and other actions are secondary.
Question 10
A nurse is caring for a child with sickle cell anemia in vaso-occlusive crisis. Which intervention
is most appropriate?
A. Apply cold compresses to joints
B. Administer IV fluids and pain medication
C. Encourage high-intensity exercise
D. Restrict fluid intake
Rationale: IV fluids promote hydration to reduce blood viscosity, and pain medication
manages severe pain in a vaso-occlusive crisis, per ATI Pediatrics. Cold compresses may worsen
vasoconstriction, and exercise is contraindicated.
