ATI PEDIATRICS NGN EXAM NEWEST WITH COMPLETE ALL 100 QUESTIONS AND CORRECT
DETAILED ANSWERS| BRAND NEW VERSION!!!
Question 1
A nurse reports an incident of suspected child abuse. One of the parents of the child becomes
upset and demands to know the reason for the nurse's action. Which of the following responses
by the nurse is appropriate?
A) "I reported the incident to my supervisor who decided to contact the authorities."
B) "The provider will be coming to explain the situation to you shortly."
C) "I am unable to discuss this, but I can contact my supervisor to speak with you."
D) "As a nurse, I am required by law to report suspected child abuse."
E) "The bruises on your child do not match the story you provided to the triage nurse."
Correct Answer: D) "As a nurse, I am required by law to report suspected child abuse."
Rationale: Nurses are mandated reporters under the law in all 50 states. When a nurse has a
reasonable suspicion of child abuse or neglect, they are legally and ethically obligated to
report it to the appropriate authorities. Stating this fact directly to the parent is a
professional and factual way to handle the confrontation without being accusatory or
shifting blame to others, such as a supervisor or provider.
Question 2
A nurse is preparing to administer vaccines to a 12-month-old (1-year-old) child. Which of the
following vaccines are typically indicated at this age? (Select all that apply/Identify the correct
combination)
A) Measles, mumps, rubella (MMR)
B) Diphtheria, tetanus, and acellular pertussis (DTaP)
C) Varicella (VAR)
D) Human papillomavirus (HPV4)
E) Rotavirus (RV)
Correct Answer: A, B, and C) Measles, mumps rubella (MMR); Diphtheria, tetanus and
acellular pertussis (DTaP); Varicella (VAR)
Rationale: According to the CDC immunization schedule, the 12-to-15-month window is the
recommended time for the first doses of MMR and Varicella. The 4th dose of DTaP is also
recommended between 15-18 months, but can be administered as early as 12 months
provided 6 months have passed since the 3rd dose. Rotavirus is typically completed by 8
months of age, and HPV is not started until at least age 9.
Question 3
A nurse is speaking with the mother of a 6-year-old child during a well-child visit. Which of the
following statements by the mother should the nurse identify as a potential concern requiring
further assessment?
A) "My child often tries to cheat when we play board games together."
B) "My child has recently lost both of his front top teeth."
, 2
C) "Sometimes my child acts a bit bossy when playing with his friends."
D) "The teacher says my child has to squint to see the board in class."
E) "My child enjoys collecting small rocks and sorting them by color."
Correct Answer: D) "The teacher says my child has to squint to see the board."
Rationale: Squinting to see the board is a classic sign of myopia (nearsightedness) or other
visual impairments. In school-age children, vision problems can lead to learning difficulties
and headaches if not corrected with lenses. Losing primary teeth, sorting objects (concrete
operations), being "bossy," and testing rules in games are all developmentally appropriate
behaviors for a 6-year-old.
Question 4
A nurse is performing a physical assessment on a 2-year-old toddler. At what point in the
physical examination should the nurse examine the child's tympanic membrane?
A) At the beginning of the exam while the child is still calm.
B) Before auscultating the chest and abdomen.
C) Immediately after taking the child's height and weight.
D) At the very end of the examination.
E) Only if the parent reports the child has had a fever.
Correct Answer: D) At the end
Rationale: For toddlers and preschoolers, the sequence of a physical exam should be "least
invasive to most invasive." Examining the ears (tympanic membrane) and the throat are
often distressing and intrusive to a child. By leaving these procedures for the end, the nurse
avoids making the child cry or become uncooperative early in the exam, which would
interfere with auscultating the heart and lungs.
Question 5
A school nurse identifies that a child has pediculosis capitis (head lice) and provides education to
the child's parents. Which of the following statements by the parents indicates an understanding
of the teaching?
A) "I will treat all of the family members with the medicated shampoo tonight just to be on the
safe side."
B) "Any toys or items that cannot be dry cleaned or washed must be thrown away immediately."
C) "All recently used clothing, bedding, and towels must be washed in hot water."
D) "My child must be completely free of nits before they are allowed to return to school."
E) "I should apply mayonnaise to the child's hair and leave it overnight to suffocate the lice."
Correct Answer: C) "All recently used clothing, bedding, and towels must be washed in hot
water."
Rationale: Pediculosis capitis is managed by killing the active lice and removing nits. To
prevent re-infestation, environmental measures include washing bedding, towels, and
clothes in hot water (at least 130°F) and drying them on a high-heat cycle. Medicated
, 3
shampoo should only be used on members with active infestation. Non-washable items
should be sealed in plastic bags for 14 days, not thrown out. The "No-Nit" policy is no
longer recommended by the AAP/CDC as it keeps children out of school unnecessarily.
Question 6
A 3-year-old child is admitted to the pediatric unit with a suspected diagnosis of Wilms' tumor
(nephroblastoma). Which of the following is the priority nursing intervention?
A) Placing a sign over the child's bed that says "Do not palpate abdomen."
B) Obtaining a 24-hour urine collection for catecholamines.
C) Monitoring the child for signs of increased intracranial pressure.
D) Restricting the child's total fluid intake to 50% of maintenance.
E) Preparing the child for a bone marrow aspiration.
Correct Answer: A) Do not palpate abdomen.
Rationale: Wilms' tumor is a common intra-abdominal kidney tumor in children. It is
encapsulated. Firm palpation of the abdomen could cause the tumor capsule to rupture,
potentially resulting in the seeding/dissemination of cancer cells throughout the abdomen.
A sign must be placed to alert all staff and students to avoid abdominal palpation.
Question 7
A nurse is caring for a 2-month-old infant who is postoperative following a surgical repair of a
cleft lip. Which of the following actions should the nurse take?
A) Position the infant on their abdomen to facilitate drainage.
B) Offer the infant a pacifier to help soothe them.
C) Administer ibuprofen as needed for mild-to-moderate pain.
D) Encourage the parents to rock the infant to keep them calm.
E) Use a standard firm nipple for the first feeding post-op.
Correct Answer: D) Encourage the parents to rock the infant.
Rationale: Keeping the infant calm and preventing crying is essential to minimize tension on
the new suture line. Rocking and holding provide comfort. The infant should be positioned
on their back or side, never the abdomen, to prevent the suture line from rubbing against
the sheets. Pacifiers are contraindicated as sucking can damage the repair. Special feeding
devices (like a syringe or Logan bow) are used rather than standard nipples.
Question 8
A nurse is assessing a 15-month-old child who has a suspected case of otitis media. Which of the
following assessment findings should the nurse expect?
A) Pain when manipulating the external ear lobe (pinna).
B) Visible clear drainage leaking from the affected ear canal.
C) The child is frequently tugging or pulling on the affected ear lobe.
D) Severe erythema and edema of the skin behind the ear.
E) A sudden improvement in hearing in the affected ear.
, 4
Correct Answer: C) Tugging on the affected ear lobe
Rationale: Otitis media is an infection of the middle ear. In infants and toddlers who cannot
verbalize pain, tugging or pulling at the ear, irritability, and waking up at night are
common signs. Pain when manipulating the pinna is more characteristic of Otitis Externa
(Swimmer's ear). Drainage would only occur if the tympanic membrane has ruptured.
Question 9
A nurse is providing discharge teaching to the parents of a child who just received a cast for a
fractured tibia. Which of the following instructions is the priority?
A) "Keep the casted leg elevated above the level of the heart for the first 24-48 hours."
B) "Use a hair dryer on a cool setting if the child complains of itching under the cast."
C) "Apply a small amount of lotion to the skin at the edges of the cast to prevent dryness."
D) "Allow the child to walk on the cast as soon as they get home to keep the muscle strong."
E) "Cover the cast with a plastic bag only when the child is going outside in the rain."
Correct Answer: A) "Keep the casted leg elevated above the level of the heart for the first 24-
48 hours."
Rationale: Elevation is the priority to reduce swelling and prevent Compartment Syndrome,
which is a neurovascular emergency. While cool air for itching is helpful, it is not as critical
as edema management. Patients should not walk on a new cast until cleared by a provider,
and lotion should be avoided as it can trap moisture and cause skin maceration.
Question 10
A nurse is assessing a child with suspected epiglottitis. Which of the following actions should the
nurse take first?
A) Obtain a throat culture to identify the causative organism.
B) Inspect the child's throat using a sterile tongue blade.
C) Place the child in a side-lying position to prevent aspiration.
D) Ensure that emergency airway equipment is available at the bedside.
E) Encourage the child to lie flat to help with the physical exam.
Correct Answer: D) Ensure that emergency airway equipment is available at the bedside.
Rationale: Epiglottitis is a life-threatening emergency caused by swelling that can
completely block the airway. The nurse must never use a tongue blade or obtain a throat
culture unless a provider who can perform an emergency intubation or tracheostomy is
present, as these actions can trigger a laryngospasm and total airway occlusion. The child
should be allowed to sit in a position of comfort (tripod position).
Question 11
A nurse is caring for an infant who has Hirschsprung disease. Which of the following findings
should the nurse expect?
A) Passage of bright red, jelly-like stools.
B) Projectile vomiting after every feeding.
DETAILED ANSWERS| BRAND NEW VERSION!!!
Question 1
A nurse reports an incident of suspected child abuse. One of the parents of the child becomes
upset and demands to know the reason for the nurse's action. Which of the following responses
by the nurse is appropriate?
A) "I reported the incident to my supervisor who decided to contact the authorities."
B) "The provider will be coming to explain the situation to you shortly."
C) "I am unable to discuss this, but I can contact my supervisor to speak with you."
D) "As a nurse, I am required by law to report suspected child abuse."
E) "The bruises on your child do not match the story you provided to the triage nurse."
Correct Answer: D) "As a nurse, I am required by law to report suspected child abuse."
Rationale: Nurses are mandated reporters under the law in all 50 states. When a nurse has a
reasonable suspicion of child abuse or neglect, they are legally and ethically obligated to
report it to the appropriate authorities. Stating this fact directly to the parent is a
professional and factual way to handle the confrontation without being accusatory or
shifting blame to others, such as a supervisor or provider.
Question 2
A nurse is preparing to administer vaccines to a 12-month-old (1-year-old) child. Which of the
following vaccines are typically indicated at this age? (Select all that apply/Identify the correct
combination)
A) Measles, mumps, rubella (MMR)
B) Diphtheria, tetanus, and acellular pertussis (DTaP)
C) Varicella (VAR)
D) Human papillomavirus (HPV4)
E) Rotavirus (RV)
Correct Answer: A, B, and C) Measles, mumps rubella (MMR); Diphtheria, tetanus and
acellular pertussis (DTaP); Varicella (VAR)
Rationale: According to the CDC immunization schedule, the 12-to-15-month window is the
recommended time for the first doses of MMR and Varicella. The 4th dose of DTaP is also
recommended between 15-18 months, but can be administered as early as 12 months
provided 6 months have passed since the 3rd dose. Rotavirus is typically completed by 8
months of age, and HPV is not started until at least age 9.
Question 3
A nurse is speaking with the mother of a 6-year-old child during a well-child visit. Which of the
following statements by the mother should the nurse identify as a potential concern requiring
further assessment?
A) "My child often tries to cheat when we play board games together."
B) "My child has recently lost both of his front top teeth."
, 2
C) "Sometimes my child acts a bit bossy when playing with his friends."
D) "The teacher says my child has to squint to see the board in class."
E) "My child enjoys collecting small rocks and sorting them by color."
Correct Answer: D) "The teacher says my child has to squint to see the board."
Rationale: Squinting to see the board is a classic sign of myopia (nearsightedness) or other
visual impairments. In school-age children, vision problems can lead to learning difficulties
and headaches if not corrected with lenses. Losing primary teeth, sorting objects (concrete
operations), being "bossy," and testing rules in games are all developmentally appropriate
behaviors for a 6-year-old.
Question 4
A nurse is performing a physical assessment on a 2-year-old toddler. At what point in the
physical examination should the nurse examine the child's tympanic membrane?
A) At the beginning of the exam while the child is still calm.
B) Before auscultating the chest and abdomen.
C) Immediately after taking the child's height and weight.
D) At the very end of the examination.
E) Only if the parent reports the child has had a fever.
Correct Answer: D) At the end
Rationale: For toddlers and preschoolers, the sequence of a physical exam should be "least
invasive to most invasive." Examining the ears (tympanic membrane) and the throat are
often distressing and intrusive to a child. By leaving these procedures for the end, the nurse
avoids making the child cry or become uncooperative early in the exam, which would
interfere with auscultating the heart and lungs.
Question 5
A school nurse identifies that a child has pediculosis capitis (head lice) and provides education to
the child's parents. Which of the following statements by the parents indicates an understanding
of the teaching?
A) "I will treat all of the family members with the medicated shampoo tonight just to be on the
safe side."
B) "Any toys or items that cannot be dry cleaned or washed must be thrown away immediately."
C) "All recently used clothing, bedding, and towels must be washed in hot water."
D) "My child must be completely free of nits before they are allowed to return to school."
E) "I should apply mayonnaise to the child's hair and leave it overnight to suffocate the lice."
Correct Answer: C) "All recently used clothing, bedding, and towels must be washed in hot
water."
Rationale: Pediculosis capitis is managed by killing the active lice and removing nits. To
prevent re-infestation, environmental measures include washing bedding, towels, and
clothes in hot water (at least 130°F) and drying them on a high-heat cycle. Medicated
, 3
shampoo should only be used on members with active infestation. Non-washable items
should be sealed in plastic bags for 14 days, not thrown out. The "No-Nit" policy is no
longer recommended by the AAP/CDC as it keeps children out of school unnecessarily.
Question 6
A 3-year-old child is admitted to the pediatric unit with a suspected diagnosis of Wilms' tumor
(nephroblastoma). Which of the following is the priority nursing intervention?
A) Placing a sign over the child's bed that says "Do not palpate abdomen."
B) Obtaining a 24-hour urine collection for catecholamines.
C) Monitoring the child for signs of increased intracranial pressure.
D) Restricting the child's total fluid intake to 50% of maintenance.
E) Preparing the child for a bone marrow aspiration.
Correct Answer: A) Do not palpate abdomen.
Rationale: Wilms' tumor is a common intra-abdominal kidney tumor in children. It is
encapsulated. Firm palpation of the abdomen could cause the tumor capsule to rupture,
potentially resulting in the seeding/dissemination of cancer cells throughout the abdomen.
A sign must be placed to alert all staff and students to avoid abdominal palpation.
Question 7
A nurse is caring for a 2-month-old infant who is postoperative following a surgical repair of a
cleft lip. Which of the following actions should the nurse take?
A) Position the infant on their abdomen to facilitate drainage.
B) Offer the infant a pacifier to help soothe them.
C) Administer ibuprofen as needed for mild-to-moderate pain.
D) Encourage the parents to rock the infant to keep them calm.
E) Use a standard firm nipple for the first feeding post-op.
Correct Answer: D) Encourage the parents to rock the infant.
Rationale: Keeping the infant calm and preventing crying is essential to minimize tension on
the new suture line. Rocking and holding provide comfort. The infant should be positioned
on their back or side, never the abdomen, to prevent the suture line from rubbing against
the sheets. Pacifiers are contraindicated as sucking can damage the repair. Special feeding
devices (like a syringe or Logan bow) are used rather than standard nipples.
Question 8
A nurse is assessing a 15-month-old child who has a suspected case of otitis media. Which of the
following assessment findings should the nurse expect?
A) Pain when manipulating the external ear lobe (pinna).
B) Visible clear drainage leaking from the affected ear canal.
C) The child is frequently tugging or pulling on the affected ear lobe.
D) Severe erythema and edema of the skin behind the ear.
E) A sudden improvement in hearing in the affected ear.
, 4
Correct Answer: C) Tugging on the affected ear lobe
Rationale: Otitis media is an infection of the middle ear. In infants and toddlers who cannot
verbalize pain, tugging or pulling at the ear, irritability, and waking up at night are
common signs. Pain when manipulating the pinna is more characteristic of Otitis Externa
(Swimmer's ear). Drainage would only occur if the tympanic membrane has ruptured.
Question 9
A nurse is providing discharge teaching to the parents of a child who just received a cast for a
fractured tibia. Which of the following instructions is the priority?
A) "Keep the casted leg elevated above the level of the heart for the first 24-48 hours."
B) "Use a hair dryer on a cool setting if the child complains of itching under the cast."
C) "Apply a small amount of lotion to the skin at the edges of the cast to prevent dryness."
D) "Allow the child to walk on the cast as soon as they get home to keep the muscle strong."
E) "Cover the cast with a plastic bag only when the child is going outside in the rain."
Correct Answer: A) "Keep the casted leg elevated above the level of the heart for the first 24-
48 hours."
Rationale: Elevation is the priority to reduce swelling and prevent Compartment Syndrome,
which is a neurovascular emergency. While cool air for itching is helpful, it is not as critical
as edema management. Patients should not walk on a new cast until cleared by a provider,
and lotion should be avoided as it can trap moisture and cause skin maceration.
Question 10
A nurse is assessing a child with suspected epiglottitis. Which of the following actions should the
nurse take first?
A) Obtain a throat culture to identify the causative organism.
B) Inspect the child's throat using a sterile tongue blade.
C) Place the child in a side-lying position to prevent aspiration.
D) Ensure that emergency airway equipment is available at the bedside.
E) Encourage the child to lie flat to help with the physical exam.
Correct Answer: D) Ensure that emergency airway equipment is available at the bedside.
Rationale: Epiglottitis is a life-threatening emergency caused by swelling that can
completely block the airway. The nurse must never use a tongue blade or obtain a throat
culture unless a provider who can perform an emergency intubation or tracheostomy is
present, as these actions can trigger a laryngospasm and total airway occlusion. The child
should be allowed to sit in a position of comfort (tripod position).
Question 11
A nurse is caring for an infant who has Hirschsprung disease. Which of the following findings
should the nurse expect?
A) Passage of bright red, jelly-like stools.
B) Projectile vomiting after every feeding.
