ATI Pediatric Nursing (PEDS ATI) Exam Study Guide,
Comprehensive ATI Proctored Exam Prep Notes, Practice
Questions, Child Health Nursing Review, and NCLEX-Style
Pediatric Nursing Concepts for Nursing Students
Question 1: 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. The infant rolls from back to
abdomen. B. The infant sits with minimal support. C. The infant has no tooth eruption. D. The
infant exhibits head lag when pulled to sit. CORRECT ANSWER: D. The infant exhibits head lag
when pulled to sit. Rationale: Head lag should resolve by 4 months. Persistence at 6 months
indicates potential neurological impairment and requires further evaluation. Rolling over and
sitting with support are expected milestones. Tooth eruption varies and absence at 6 months is
normal.
Question 2: A nurse is preparing to administer an immunization to a toddler. Which of the
following actions should the nurse take to minimize pain?
A. Apply a topical anesthetic cream 1 hour before the injection.
B. Administer the injection into the deltoid muscle.
C. Have the parent hold the toddler securely during the procedure.
D. Rub the injection site vigorously after administration.
CORRECT ANSWER: A. Apply a topical anesthetic cream 1 hour before the injection.
Rationale: Topical anesthetics like EMLA cream require time to take effect and significantly
reduce pain perception in children. The vastus lateralis is preferred for toddlers, not the
deltoid. While holding is necessary for safety, it does not minimize pain physiologically. Rubbing
the site can increase irritation.
Question 3: A nurse is caring for a child with acute epiglottitis. Which of the following
interventions is the priority?
A. Obtain a throat culture.
B. Maintain the child in an upright position.
C. Administer a sedative to reduce anxiety.
D. Encourage the child to drink fluids.
CORRECT ANSWER: B. Maintain the child in an upright position.
Rationale: Maintaining an upright position helps keep the airway open in epiglottitis. Throat
cultures or tongue depressors can cause laryngospasm and airway obstruction. Sedatives can
depress respiratory drive. Oral intake is restricted until the airway is secured.
Question 4: A nurse is teaching a parent about safety measures for a 2-year-old child. Which
of the following statements by the parent indicates an understanding of the teaching?
A. "I will keep the car seat facing backward until my child is 3 years old."
B. "I will place my child in the front seat with an airbag."
C. "I will use a booster seat immediately."
D. "I will allow my child to stand on the car seat."
CORRECT ANSWER: A. "I will keep the car seat facing backward until my child is 3 years old."
Rationale: Rear-facing car seats are recommended until at least age 2, preferably longer (up to
3 or 4 depending on height/weight limits). Children should never be in the front seat with an
,active airbag. Booster seats are for older children who have outgrown harness seats. Standing
on a car seat is unsafe.
Question 5: A nurse is assessing a school-age child with suspected appendicitis. Which of the
following findings should the nurse expect?
A. Pain in the left lower quadrant.
B. Rebound tenderness in the right lower quadrant.
C. Diarrhea as the primary symptom.
D. High-grade fever preceding pain.
CORRECT ANSWER: B. Rebound tenderness in the right lower quadrant.
Rationale: Appendicitis typically presents with pain migrating to the right lower quadrant
(McBurney's point) and rebound tenderness. Left lower quadrant pain suggests other issues.
Constipation is more common than diarrhea. Fever usually follows the onset of pain, not
precedes it.
Question 6: A nurse is caring for an infant with heart failure. Which of the following findings
indicates effective treatment?
A. Increased respiratory rate.
B. Decreased urine output.
C. Weight gain of 1 kg in 2 days.
D. Improved feeding tolerance.
CORRECT ANSWER: D. Improved feeding tolerance.
Rationale: Infants with heart failure fatigue easily during feeding. Improved tolerance indicates
better cardiac output. Increased respiratory rate and decreased urine output indicate
worsening failure. Rapid weight gain suggests fluid retention.
Question 7: A nurse is preparing to administer digoxin to a toddler. The apical pulse is
90/min. Which of the following actions should the nurse take?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Administer half the dose.
D. Recheck the pulse in 1 hour.
CORRECT ANSWER: B. Withhold the medication and notify the provider.
Rationale: The lower limit for apical pulse before administering digoxin in a toddler is typically
100/min (infants) or 90/min (older children), but for toddlers, 90 is often the cutoff. However,
standard ATI guidance often suggests withholding if below 90-110 depending on age. For a
toddler, 90 is borderline/low. Withholding and notifying is the safest action to prevent toxicity.
Correction: For toddlers, the cutoff is often 90. If it is exactly 90, some protocols say administer.
However, to ensure safety in exam context, if it is at the lower limit, notifying is prudent. Let's
make the pulse 80/min for clarity in future questions. For this question, 90/min is often the
cutoff. Let's assume the protocol is <90 withhold. If it is 90, it is acceptable. Let me adjust the
question value to 80/min for clear correctness. Revised Question 7: A nurse is preparing to
administer digoxin to a toddler. The apical pulse is 80/min. Which of the following actions
should the nurse take? CORRECT ANSWER: B. Withhold the medication and notify the
, provider. Rationale: Digoxin should be withheld if the apical pulse is below 90/min in a toddler
to prevent bradycardia and toxicity. The provider must be notified for further instructions.
Question 8: A nurse is teaching a parent about managing a child with cystic fibrosis. Which of
the following instructions should the nurse include?
A. Restrict fluid intake to prevent congestion.
B. Administer pancreatic enzymes with meals.
C. Limit high-calorie snacks.
D. Avoid chest physiotherapy during infections.
CORRECT ANSWER: B. Administer pancreatic enzymes with meals.
Rationale: Pancreatic enzymes are essential for digestion and must be taken with every meal
and snack. Fluids should be increased to thin secretions. High-calorie, high-protein diets are
recommended. Chest physiotherapy is crucial, especially during infections.
Question 9: A nurse is caring for a child with a sickle cell crisis. Which of the following
interventions is the priority?
A. Administer meperidine for pain.
B. Apply cold compresses to joints.
C. Ensure adequate hydration.
D. Restrict movement of affected limbs.
CORRECT ANSWER: C. Ensure adequate hydration.
Rationale: Hydration reduces blood viscosity and prevents further sickling. Meperidine is
avoided due to seizure risk. Cold compresses cause vasoconstriction and worsen sickling.
Movement should be encouraged as tolerated to prevent stasis.
Question 10: A nurse is assessing a newborn for signs of hypoglycemia. Which of the
following findings should the nurse expect?
A. Hyperthermia.
B. Jitteriness.
C. High-pitched cry.
D. Bulging fontanels.
CORRECT ANSWER: B. Jitteriness.
Rationale: Jitteriness, tremors, and irritability are common signs of neonatal hypoglycemia.
Hypothermia is more common than hyperthermia. A high-pitched cry and bulging fontanels
suggest increased intracranial pressure.
Question 11: A nurse is caring for a child with a cast on the left arm. Which of the following
findings indicates neurovascular compromise?
A. Warm skin around the cast.
B. Capillary refill of 2 seconds.
C. Inability to move fingers.
D. Mild swelling at the edge of the cast.
CORRECT ANSWER: C. Inability to move fingers.
Rationale: Inability to move digits indicates nerve impairment or compartment syndrome.
Warm skin and 2-second refill are normal. Mild swelling can be normal initially, but paralysis is
critical.
Comprehensive ATI Proctored Exam Prep Notes, Practice
Questions, Child Health Nursing Review, and NCLEX-Style
Pediatric Nursing Concepts for Nursing Students
Question 1: 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. The infant rolls from back to
abdomen. B. The infant sits with minimal support. C. The infant has no tooth eruption. D. The
infant exhibits head lag when pulled to sit. CORRECT ANSWER: D. The infant exhibits head lag
when pulled to sit. Rationale: Head lag should resolve by 4 months. Persistence at 6 months
indicates potential neurological impairment and requires further evaluation. Rolling over and
sitting with support are expected milestones. Tooth eruption varies and absence at 6 months is
normal.
Question 2: A nurse is preparing to administer an immunization to a toddler. Which of the
following actions should the nurse take to minimize pain?
A. Apply a topical anesthetic cream 1 hour before the injection.
B. Administer the injection into the deltoid muscle.
C. Have the parent hold the toddler securely during the procedure.
D. Rub the injection site vigorously after administration.
CORRECT ANSWER: A. Apply a topical anesthetic cream 1 hour before the injection.
Rationale: Topical anesthetics like EMLA cream require time to take effect and significantly
reduce pain perception in children. The vastus lateralis is preferred for toddlers, not the
deltoid. While holding is necessary for safety, it does not minimize pain physiologically. Rubbing
the site can increase irritation.
Question 3: A nurse is caring for a child with acute epiglottitis. Which of the following
interventions is the priority?
A. Obtain a throat culture.
B. Maintain the child in an upright position.
C. Administer a sedative to reduce anxiety.
D. Encourage the child to drink fluids.
CORRECT ANSWER: B. Maintain the child in an upright position.
Rationale: Maintaining an upright position helps keep the airway open in epiglottitis. Throat
cultures or tongue depressors can cause laryngospasm and airway obstruction. Sedatives can
depress respiratory drive. Oral intake is restricted until the airway is secured.
Question 4: A nurse is teaching a parent about safety measures for a 2-year-old child. Which
of the following statements by the parent indicates an understanding of the teaching?
A. "I will keep the car seat facing backward until my child is 3 years old."
B. "I will place my child in the front seat with an airbag."
C. "I will use a booster seat immediately."
D. "I will allow my child to stand on the car seat."
CORRECT ANSWER: A. "I will keep the car seat facing backward until my child is 3 years old."
Rationale: Rear-facing car seats are recommended until at least age 2, preferably longer (up to
3 or 4 depending on height/weight limits). Children should never be in the front seat with an
,active airbag. Booster seats are for older children who have outgrown harness seats. Standing
on a car seat is unsafe.
Question 5: A nurse is assessing a school-age child with suspected appendicitis. Which of the
following findings should the nurse expect?
A. Pain in the left lower quadrant.
B. Rebound tenderness in the right lower quadrant.
C. Diarrhea as the primary symptom.
D. High-grade fever preceding pain.
CORRECT ANSWER: B. Rebound tenderness in the right lower quadrant.
Rationale: Appendicitis typically presents with pain migrating to the right lower quadrant
(McBurney's point) and rebound tenderness. Left lower quadrant pain suggests other issues.
Constipation is more common than diarrhea. Fever usually follows the onset of pain, not
precedes it.
Question 6: A nurse is caring for an infant with heart failure. Which of the following findings
indicates effective treatment?
A. Increased respiratory rate.
B. Decreased urine output.
C. Weight gain of 1 kg in 2 days.
D. Improved feeding tolerance.
CORRECT ANSWER: D. Improved feeding tolerance.
Rationale: Infants with heart failure fatigue easily during feeding. Improved tolerance indicates
better cardiac output. Increased respiratory rate and decreased urine output indicate
worsening failure. Rapid weight gain suggests fluid retention.
Question 7: A nurse is preparing to administer digoxin to a toddler. The apical pulse is
90/min. Which of the following actions should the nurse take?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Administer half the dose.
D. Recheck the pulse in 1 hour.
CORRECT ANSWER: B. Withhold the medication and notify the provider.
Rationale: The lower limit for apical pulse before administering digoxin in a toddler is typically
100/min (infants) or 90/min (older children), but for toddlers, 90 is often the cutoff. However,
standard ATI guidance often suggests withholding if below 90-110 depending on age. For a
toddler, 90 is borderline/low. Withholding and notifying is the safest action to prevent toxicity.
Correction: For toddlers, the cutoff is often 90. If it is exactly 90, some protocols say administer.
However, to ensure safety in exam context, if it is at the lower limit, notifying is prudent. Let's
make the pulse 80/min for clarity in future questions. For this question, 90/min is often the
cutoff. Let's assume the protocol is <90 withhold. If it is 90, it is acceptable. Let me adjust the
question value to 80/min for clear correctness. Revised Question 7: A nurse is preparing to
administer digoxin to a toddler. The apical pulse is 80/min. Which of the following actions
should the nurse take? CORRECT ANSWER: B. Withhold the medication and notify the
, provider. Rationale: Digoxin should be withheld if the apical pulse is below 90/min in a toddler
to prevent bradycardia and toxicity. The provider must be notified for further instructions.
Question 8: A nurse is teaching a parent about managing a child with cystic fibrosis. Which of
the following instructions should the nurse include?
A. Restrict fluid intake to prevent congestion.
B. Administer pancreatic enzymes with meals.
C. Limit high-calorie snacks.
D. Avoid chest physiotherapy during infections.
CORRECT ANSWER: B. Administer pancreatic enzymes with meals.
Rationale: Pancreatic enzymes are essential for digestion and must be taken with every meal
and snack. Fluids should be increased to thin secretions. High-calorie, high-protein diets are
recommended. Chest physiotherapy is crucial, especially during infections.
Question 9: A nurse is caring for a child with a sickle cell crisis. Which of the following
interventions is the priority?
A. Administer meperidine for pain.
B. Apply cold compresses to joints.
C. Ensure adequate hydration.
D. Restrict movement of affected limbs.
CORRECT ANSWER: C. Ensure adequate hydration.
Rationale: Hydration reduces blood viscosity and prevents further sickling. Meperidine is
avoided due to seizure risk. Cold compresses cause vasoconstriction and worsen sickling.
Movement should be encouraged as tolerated to prevent stasis.
Question 10: A nurse is assessing a newborn for signs of hypoglycemia. Which of the
following findings should the nurse expect?
A. Hyperthermia.
B. Jitteriness.
C. High-pitched cry.
D. Bulging fontanels.
CORRECT ANSWER: B. Jitteriness.
Rationale: Jitteriness, tremors, and irritability are common signs of neonatal hypoglycemia.
Hypothermia is more common than hyperthermia. A high-pitched cry and bulging fontanels
suggest increased intracranial pressure.
Question 11: A nurse is caring for a child with a cast on the left arm. Which of the following
findings indicates neurovascular compromise?
A. Warm skin around the cast.
B. Capillary refill of 2 seconds.
C. Inability to move fingers.
D. Mild swelling at the edge of the cast.
CORRECT ANSWER: C. Inability to move fingers.
Rationale: Inability to move digits indicates nerve impairment or compartment syndrome.
Warm skin and 2-second refill are normal. Mild swelling can be normal initially, but paralysis is
critical.
