ATI PN PEDIATRICS PROCTORED EXAM/
ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES GRADED A+
LATEST
1. A nurse is caring for a toddler who is postoperative following a
tonsillectomy. Which of the following findings requires immediate
intervention?
A. The child is swallowing frequently
B. The child is drowsy
C. The child refuses oral fluids
D. The child is requesting an ice collar
Correct Answer: A. The child is swallowing frequently
Rationale: Frequent swallowing is a classic sign of post-tonsillectomy bleeding,
even if there is no visible bleeding. This requires immediate evaluation.
Drowsiness and poor oral intake are expected after anesthesia. Ice collars help
reduce pain and swelling.
2. A school-age child with sickle cell anemia presents with severe pain in the
legs and abdomen. Which nursing action is the priority?
A. Apply warm compresses
B. Administer prescribed opioid analgesic
C. Encourage oral fluid intake
D. Provide passive range of motion exercises
Correct Answer: B. Administer prescribed opioid analgesic
Rationale: Pain crisis is severe and requires immediate opioid administration.
Hydration is also important but is not the first priority once the child is in acute
distress. Cold compresses are contraindicated; warmth may help but is secondary.
,3. A toddler with Kawasaki disease is being discharged. Which instruction
should the nurse include?
A. Avoid vaccinations for 12 months
B. Offer high-protein diet
C. Expect peeling of the hands and feet
D. Restrict all physical activity for 6 months
Correct Answer: C. Expect peeling of the hands and feet
Rationale: Peeling is normal in the subacute phase. Vaccinations are only delayed
if the child receives IVIG, not always for 12 months. Diet and activity are
individualized.
4. A nurse assesses a 4-month-old infant during a well-child visit. Which
finding should the nurse report to the provider?
A. Has not yet rolled from front to back
B. Exhibits persistent head lag
C. Smiles spontaneously
D. Grasps an object placed in hand
Correct Answer: B. Exhibits persistent head lag
Rationale: Persistent head lag beyond 3 months suggests neuromuscular delay
and must be reported. Rolling may not occur until around 5 months.
5. A school-age child with asthma is experiencing wheezing and retractions.
Which medication should the nurse anticipate administering first?
A. Montelukast
B. Inhaled fluticasone
C. Albuterol
D. Prednisone PO
Correct Answer: C. Albuterol
Rationale: Albuterol is a short-acting beta agonist used for acute bronchospasm.
The others are maintenance medications.
,6. A nurse is preparing to administer amoxicillin to a child with otitis media.
Which finding requires clarification before administration?
A. The child had hives after a dose of penicillin
B. The child has a mild fever
C. The child refuses oral medications
D. The child reports ear pain
Correct Answer: A. The child had hives after penicillin
Rationale: Hives indicate an IgE-mediated allergy; penicillin-based antibiotics
should not be given.
7. A newborn is diagnosed with hypoglycemia. Which manifestation supports
this diagnosis?
A. Jitteriness
B. Lethargy
C. Poor feeding
D. All of the above
Correct Answer: D. All of the above
Rationale: Common signs of neonatal hypoglycemia include jitteriness,
weak/high-pitched cry, apnea, poor feeding, and lethargy.
8. A nurse caring for a child receiving chemotherapy notes oral mucositis.
Which intervention is appropriate?
A. Brush teeth with a firm-bristled brush
B. Offer lemon swabs
C. Provide soft, non-acidic foods
D. Use alcohol-based mouthwash
Correct Answer: C. Provide soft, non-acidic foods
Rationale: Soft, bland foods decrease irritation. Avoid lemon, alcohol, and firm
bristles.
, 9. A nurse is caring for a toddler with acute gastroenteritis and dehydration.
Which lab value indicates severe dehydration?
A. Sodium 134
B. Urine specific gravity 1.010
C. Capillary refill 5 seconds
D. Hematocrit 35%
Correct Answer: C. Capillary refill 5 seconds
Rationale: Delayed cap refill >4 sec indicates severe dehydration; urine SG and
Na may be normal.
10. A child with type 1 diabetes is pale, shaky, and sweating. Which snack is
most appropriate?
A. Cheese stick
B. Peanut butter crackers
C. 4 oz orange juice
D. Half a sandwich
Correct Answer: C. 4 oz orange juice
Rationale: Hypoglycemia is treated with fast-acting carbohydrates.
11. A 3-year-old child's parent reports the child uses magical thinking. This is
characteristic of which developmental stage?
A. Trust vs mistrust
B. Autonomy vs shame
C. Initiative vs guilt
D. Industry vs inferiority
Correct Answer: C. Initiative vs guilt
Rationale: Preschoolers engage in magical thinking and imaginative play.
ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES GRADED A+
LATEST
1. A nurse is caring for a toddler who is postoperative following a
tonsillectomy. Which of the following findings requires immediate
intervention?
A. The child is swallowing frequently
B. The child is drowsy
C. The child refuses oral fluids
D. The child is requesting an ice collar
Correct Answer: A. The child is swallowing frequently
Rationale: Frequent swallowing is a classic sign of post-tonsillectomy bleeding,
even if there is no visible bleeding. This requires immediate evaluation.
Drowsiness and poor oral intake are expected after anesthesia. Ice collars help
reduce pain and swelling.
2. A school-age child with sickle cell anemia presents with severe pain in the
legs and abdomen. Which nursing action is the priority?
A. Apply warm compresses
B. Administer prescribed opioid analgesic
C. Encourage oral fluid intake
D. Provide passive range of motion exercises
Correct Answer: B. Administer prescribed opioid analgesic
Rationale: Pain crisis is severe and requires immediate opioid administration.
Hydration is also important but is not the first priority once the child is in acute
distress. Cold compresses are contraindicated; warmth may help but is secondary.
,3. A toddler with Kawasaki disease is being discharged. Which instruction
should the nurse include?
A. Avoid vaccinations for 12 months
B. Offer high-protein diet
C. Expect peeling of the hands and feet
D. Restrict all physical activity for 6 months
Correct Answer: C. Expect peeling of the hands and feet
Rationale: Peeling is normal in the subacute phase. Vaccinations are only delayed
if the child receives IVIG, not always for 12 months. Diet and activity are
individualized.
4. A nurse assesses a 4-month-old infant during a well-child visit. Which
finding should the nurse report to the provider?
A. Has not yet rolled from front to back
B. Exhibits persistent head lag
C. Smiles spontaneously
D. Grasps an object placed in hand
Correct Answer: B. Exhibits persistent head lag
Rationale: Persistent head lag beyond 3 months suggests neuromuscular delay
and must be reported. Rolling may not occur until around 5 months.
5. A school-age child with asthma is experiencing wheezing and retractions.
Which medication should the nurse anticipate administering first?
A. Montelukast
B. Inhaled fluticasone
C. Albuterol
D. Prednisone PO
Correct Answer: C. Albuterol
Rationale: Albuterol is a short-acting beta agonist used for acute bronchospasm.
The others are maintenance medications.
,6. A nurse is preparing to administer amoxicillin to a child with otitis media.
Which finding requires clarification before administration?
A. The child had hives after a dose of penicillin
B. The child has a mild fever
C. The child refuses oral medications
D. The child reports ear pain
Correct Answer: A. The child had hives after penicillin
Rationale: Hives indicate an IgE-mediated allergy; penicillin-based antibiotics
should not be given.
7. A newborn is diagnosed with hypoglycemia. Which manifestation supports
this diagnosis?
A. Jitteriness
B. Lethargy
C. Poor feeding
D. All of the above
Correct Answer: D. All of the above
Rationale: Common signs of neonatal hypoglycemia include jitteriness,
weak/high-pitched cry, apnea, poor feeding, and lethargy.
8. A nurse caring for a child receiving chemotherapy notes oral mucositis.
Which intervention is appropriate?
A. Brush teeth with a firm-bristled brush
B. Offer lemon swabs
C. Provide soft, non-acidic foods
D. Use alcohol-based mouthwash
Correct Answer: C. Provide soft, non-acidic foods
Rationale: Soft, bland foods decrease irritation. Avoid lemon, alcohol, and firm
bristles.
, 9. A nurse is caring for a toddler with acute gastroenteritis and dehydration.
Which lab value indicates severe dehydration?
A. Sodium 134
B. Urine specific gravity 1.010
C. Capillary refill 5 seconds
D. Hematocrit 35%
Correct Answer: C. Capillary refill 5 seconds
Rationale: Delayed cap refill >4 sec indicates severe dehydration; urine SG and
Na may be normal.
10. A child with type 1 diabetes is pale, shaky, and sweating. Which snack is
most appropriate?
A. Cheese stick
B. Peanut butter crackers
C. 4 oz orange juice
D. Half a sandwich
Correct Answer: C. 4 oz orange juice
Rationale: Hypoglycemia is treated with fast-acting carbohydrates.
11. A 3-year-old child's parent reports the child uses magical thinking. This is
characteristic of which developmental stage?
A. Trust vs mistrust
B. Autonomy vs shame
C. Initiative vs guilt
D. Industry vs inferiority
Correct Answer: C. Initiative vs guilt
Rationale: Preschoolers engage in magical thinking and imaginative play.
