ATI PEDIATRICS PROCTORED EXAM 2026 RETAKE EXAM WITH COMPLETE 100 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED A+
Question 1
Which condition in a child should alert a nurse to the need for increased fluid requirements?
A) Increased intracranial pressure (ICP)
B) Congestive heart failure
C) Fever
D) Mechanical ventilation
E) Renal failure
Correct Answer: C) Fever
Rationale: Fever leads to great insensible fluid loss in young children because of an
increased body surface area relative to fluid volume and an increased metabolic rate.
Congestive heart failure and increased ICP usually require fluid restriction to prevent
overload or cerebral edema. Mechanical ventilation typically provides humidified air,
which can actually decrease insensible loss.
Question 2
Which type of dehydration is defined as "dehydration that occurs in conditions in which
electrolyte and water deficits are present in approximately balanced proportion"?
A) Hypotonic dehydration
B) Hypertonic dehydration
C) Isotonic dehydration
D) Isosmotic dehydration
E) Accumulative dehydration
Correct Answer: C) Isotonic dehydration
Rationale: Isotonic dehydration is the most frequent form of dehydration in children.
Electrolytes and water are lost in balanced proportions, and the serum sodium remains
within normal limits. Hypotonic occurs when electrolyte loss exceeds water loss, and
hypertonic occurs when water loss exceeds electrolyte loss.
Question 3
A nurse is admitting an infant with dehydration caused by water loss in excess of electrolyte loss.
Which type of dehydration is this infant experiencing?
A) Isotonic
B) Isosmotic
C) Hypotonic
D) Hypertonic
E) Hypovolemic
Correct Answer: D) Hypertonic
Rationale: Hypertonic dehydration results from water loss in excess of electrolyte loss and is
the most dangerous type. It is often caused by high-solute tube feedings or poorly mixed
, 2
formula. It leads to cellular shrinkage, particularly in the brain, which can cause
permanent neurological damage.
Question 4
An infant is brought to the emergency department with suspected dehydration. Which physical
assessment finding should the nurse expect?
A) Brisk capillary refill
B) Weight gain
C) Bradycardia
D) Poor skin turgor
E) Bulging fontanels
Correct Answer: D) Poor skin turgor
Rationale: Clinical manifestations of dehydration include poor skin turgor (tenting), weight
loss, lethargy, and tachycardia. The infant would have a prolonged capillary refill (not
brisk) and sunken fontanels (not bulging). Bradycardia is a late sign of cardiovascular
collapse, whereas tachycardia is the expected initial compensatory mechanism.
Question 5
A parent reports that their toddler has had acute diarrhea for 24 hours. Which associated factor
should the nurse ask about that is a common cause of acute diarrhea?
A) Celiac disease
B) Antibiotic therapy
C) Immunodeficiency
D) Protein malnutrition
E) Hirschsprung disease
Correct Answer: B) Antibiotic therapy
Rationale: Acute diarrhea is a sudden increase in frequency and change in consistency of
stools, often caused by infectious agents or antibiotic therapy, which alters the normal
intestinal flora. Celiac disease, immunodeficiency, and protein malnutrition are typically
associated with chronic diarrhea.
Question 6
Which therapeutic management should the nurse prepare to initiate first for a child with acute
diarrhea and moderate dehydration?
A) Clear liquids (apple juice, soda)
B) Adsorbents like kaolin and pectin
C) Oral rehydration solution (ORS)
D) Antidiarrheal medications such as loperamide
E) IV bolus of 5% Dextrose
Correct Answer: C) Oral rehydration solution (ORS)
Rationale: ORS (e.g., Pedialyte) is the first-line treatment for mild to moderate dehydration.
, 3
Clear liquids like juice or soda are high in sugar and low in electrolytes, which can worsen
diarrhea through osmotic effects. Antidiarrheals are generally avoided in children because
they mask symptoms and can slow the clearance of pathogens.
Question 7
A school-age child with diarrhea has been rehydrated. The nurse is discussing the child's diet
with the family. Which statement by the parent indicates a correct understanding?
A) "I will keep my child on a clear liquid diet for the next 24 hours."
B) "I should encourage my child to drink carbonated drinks but avoid food."
C) "I will offer my child the BRAT diet (bananas, rice, applesauce, toast)."
D) "I should have my child eat a normal diet with easily digested foods."
E) "I will restrict all solid foods until the diarrhea has completely stopped."
Correct Answer: D) "I should have my child eat a normal diet with easily digested foods."
Rationale: Early reintroduction of a normal diet is desirable and actually lessens the
severity and duration of the illness. The BRAT diet is no longer recommended because it is
low in energy, protein, and fat. Clear liquids and carbonated drinks are too high in
carbohydrates and low in electrolytes.
Question 8
A young child is brought to the emergency department with severe dehydration secondary to
acute diarrhea and vomiting. Therapeutic management of this child should begin with:
A) Oral rehydration solution (ORS)
B) Clear liquids, 1 to 2 ounces at a time
C) Intravenous (IV) fluids
D) Administration of antidiarrheal medication
E) Small, frequent feedings of full-strength formula
Correct Answer: C) Intravenous (IV) fluids
Rationale: In children with severe dehydration or those in shock, IV fluids (usually isotonic
saline or Ringer's Lactate) are initiated immediately. ORS is only used for mild to
moderate dehydration. Clear liquids and antidiarrheals are contraindicated for acute
infectious diarrhea.
Question 9
A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She wants to
give him loperamide (Imodium). The nurse's response should be:
A) It is not indicated for acute infectious diarrhea.
B) It is indicated because it slows intestinal motility.
C) It is indicated because it decreases the number of stools.
D) It is indicated if given with a dose of antibiotics.
E) It is indicated only if the child has no fever.
Correct Answer: A) It is not indicated for acute infectious diarrhea.
CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED A+
Question 1
Which condition in a child should alert a nurse to the need for increased fluid requirements?
A) Increased intracranial pressure (ICP)
B) Congestive heart failure
C) Fever
D) Mechanical ventilation
E) Renal failure
Correct Answer: C) Fever
Rationale: Fever leads to great insensible fluid loss in young children because of an
increased body surface area relative to fluid volume and an increased metabolic rate.
Congestive heart failure and increased ICP usually require fluid restriction to prevent
overload or cerebral edema. Mechanical ventilation typically provides humidified air,
which can actually decrease insensible loss.
Question 2
Which type of dehydration is defined as "dehydration that occurs in conditions in which
electrolyte and water deficits are present in approximately balanced proportion"?
A) Hypotonic dehydration
B) Hypertonic dehydration
C) Isotonic dehydration
D) Isosmotic dehydration
E) Accumulative dehydration
Correct Answer: C) Isotonic dehydration
Rationale: Isotonic dehydration is the most frequent form of dehydration in children.
Electrolytes and water are lost in balanced proportions, and the serum sodium remains
within normal limits. Hypotonic occurs when electrolyte loss exceeds water loss, and
hypertonic occurs when water loss exceeds electrolyte loss.
Question 3
A nurse is admitting an infant with dehydration caused by water loss in excess of electrolyte loss.
Which type of dehydration is this infant experiencing?
A) Isotonic
B) Isosmotic
C) Hypotonic
D) Hypertonic
E) Hypovolemic
Correct Answer: D) Hypertonic
Rationale: Hypertonic dehydration results from water loss in excess of electrolyte loss and is
the most dangerous type. It is often caused by high-solute tube feedings or poorly mixed
, 2
formula. It leads to cellular shrinkage, particularly in the brain, which can cause
permanent neurological damage.
Question 4
An infant is brought to the emergency department with suspected dehydration. Which physical
assessment finding should the nurse expect?
A) Brisk capillary refill
B) Weight gain
C) Bradycardia
D) Poor skin turgor
E) Bulging fontanels
Correct Answer: D) Poor skin turgor
Rationale: Clinical manifestations of dehydration include poor skin turgor (tenting), weight
loss, lethargy, and tachycardia. The infant would have a prolonged capillary refill (not
brisk) and sunken fontanels (not bulging). Bradycardia is a late sign of cardiovascular
collapse, whereas tachycardia is the expected initial compensatory mechanism.
Question 5
A parent reports that their toddler has had acute diarrhea for 24 hours. Which associated factor
should the nurse ask about that is a common cause of acute diarrhea?
A) Celiac disease
B) Antibiotic therapy
C) Immunodeficiency
D) Protein malnutrition
E) Hirschsprung disease
Correct Answer: B) Antibiotic therapy
Rationale: Acute diarrhea is a sudden increase in frequency and change in consistency of
stools, often caused by infectious agents or antibiotic therapy, which alters the normal
intestinal flora. Celiac disease, immunodeficiency, and protein malnutrition are typically
associated with chronic diarrhea.
Question 6
Which therapeutic management should the nurse prepare to initiate first for a child with acute
diarrhea and moderate dehydration?
A) Clear liquids (apple juice, soda)
B) Adsorbents like kaolin and pectin
C) Oral rehydration solution (ORS)
D) Antidiarrheal medications such as loperamide
E) IV bolus of 5% Dextrose
Correct Answer: C) Oral rehydration solution (ORS)
Rationale: ORS (e.g., Pedialyte) is the first-line treatment for mild to moderate dehydration.
, 3
Clear liquids like juice or soda are high in sugar and low in electrolytes, which can worsen
diarrhea through osmotic effects. Antidiarrheals are generally avoided in children because
they mask symptoms and can slow the clearance of pathogens.
Question 7
A school-age child with diarrhea has been rehydrated. The nurse is discussing the child's diet
with the family. Which statement by the parent indicates a correct understanding?
A) "I will keep my child on a clear liquid diet for the next 24 hours."
B) "I should encourage my child to drink carbonated drinks but avoid food."
C) "I will offer my child the BRAT diet (bananas, rice, applesauce, toast)."
D) "I should have my child eat a normal diet with easily digested foods."
E) "I will restrict all solid foods until the diarrhea has completely stopped."
Correct Answer: D) "I should have my child eat a normal diet with easily digested foods."
Rationale: Early reintroduction of a normal diet is desirable and actually lessens the
severity and duration of the illness. The BRAT diet is no longer recommended because it is
low in energy, protein, and fat. Clear liquids and carbonated drinks are too high in
carbohydrates and low in electrolytes.
Question 8
A young child is brought to the emergency department with severe dehydration secondary to
acute diarrhea and vomiting. Therapeutic management of this child should begin with:
A) Oral rehydration solution (ORS)
B) Clear liquids, 1 to 2 ounces at a time
C) Intravenous (IV) fluids
D) Administration of antidiarrheal medication
E) Small, frequent feedings of full-strength formula
Correct Answer: C) Intravenous (IV) fluids
Rationale: In children with severe dehydration or those in shock, IV fluids (usually isotonic
saline or Ringer's Lactate) are initiated immediately. ORS is only used for mild to
moderate dehydration. Clear liquids and antidiarrheals are contraindicated for acute
infectious diarrhea.
Question 9
A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She wants to
give him loperamide (Imodium). The nurse's response should be:
A) It is not indicated for acute infectious diarrhea.
B) It is indicated because it slows intestinal motility.
C) It is indicated because it decreases the number of stools.
D) It is indicated if given with a dose of antibiotics.
E) It is indicated only if the child has no fever.
Correct Answer: A) It is not indicated for acute infectious diarrhea.
