ATI Nursing Care of Children Proctored Exam 2026 | 100 Detailed Pediatric
Nursing MCQs with Rationales, Study Guide, and Exam Prep Tips
1. Assessing a Child with Asthma
Question 1:
A 7-year-old child with a history of asthma is brought to the clinic with
wheezing, coughing, and difficulty breathing. The nurse notes the child
is using accessory muscles and has a respiratory rate of 36 breaths per
minute. Which of the following interventions should the nurse
implement first?
A. Administer a short-acting bronchodilator via nebulizer
B. Obtain a complete health history from the parents
C. Teach the child how to use a peak flow meter
D. Administer a corticosteroid orally
Correct Answer: A
Explanation:
The child is exhibiting signs of an acute asthma exacerbation:
wheezing, tachypnea, and accessory muscle use. According to the ATI
Nursing guidelines, the priority is to ensure airway patency and
improve oxygenation. Administering a short-acting bronchodilator
(e.g., albuterol) via nebulizer provides rapid relief of bronchospasm.
• B (history) and C (peak flow teaching) are important but not
immediate priorities in acute distress.
• D (oral corticosteroid) helps inflammation but acts slower than a
bronchodilator.
2. Monitoring for Cystic Fibrosis Complications
,Question 2:
A 5-year-old child with cystic fibrosis (CF) presents for routine follow-
up. Which assessment finding requires the highest priority
intervention?
A. Foul-smelling, bulky stools
B. Persistent cough with crackles in the lungs
C. Weight at the 25th percentile for age
D. Pancreatic enzyme dose missed with a meal
Correct Answer: B
Explanation:
In CF, respiratory complications are the leading cause of morbidity
and mortality. Crackles and persistent cough indicate possible
infection or worsening pulmonary status, which requires prompt
intervention.
• A (stools) and D (enzyme missed) are important but do not pose
immediate respiratory risk.
• C (weight) indicates nutritional concern but is not an acute
priority.
3. Medication Administration for ADHD
Question 3:
A 9-year-old child diagnosed with ADHD is prescribed
methylphenidate. The nurse should include which instruction when
teaching the parents?
A. Administer the medication at bedtime to promote concentration
B. Monitor for appetite suppression and weight loss
C. Avoid physical activity due to risk of cardiovascular collapse
D. Expect the medication to cure ADHD over time
,Correct Answer: B
Explanation:
Stimulant medications like methylphenidate can suppress appetite
and affect growth, so monitoring weight and nutrition is important.
• A is incorrect: stimulants are given in the morning to avoid
insomnia.
• C is incorrect: normal physical activity is encouraged.
• D is incorrect: stimulants manage symptoms, not cure ADHD.
4. Vaccination Safety
Question 4:
The nurse is preparing to administer the MMR vaccine to a 15-month-
old child. Which finding indicates a contraindication?
A. Mild nasal congestion
B. Current low-grade fever of 100.2°F
C. History of anaphylaxis to neomycin
D. Receiving antibiotics for an ear infection
Correct Answer: C
Explanation:
A history of anaphylaxis to neomycin is a contraindication for MMR,
as it can cause a severe allergic reaction.
• A and B are mild illnesses, which are not contraindications.
• D (antibiotics) does not affect vaccine administration.
5. Caring for a Child with Acute Diarrhea
, Question 5:
A 2-year-old is admitted with acute diarrhea and signs of mild
dehydration. Which intervention should the nurse prioritize?
A. Begin oral rehydration therapy (ORT) immediately
B. Encourage the child to eat regular solid foods
C. Administer an antidiarrheal medication
D. Assess for recent travel history
Correct Answer: A
Explanation:
Fluid replacement is the highest priority in dehydration to prevent
hypovolemic shock. ORT is preferred in mild dehydration.
• B is secondary: feeding is important but rehydration comes first.
• C is incorrect: antidiarrheals are not recommended for young
children.
• D is important for history but not urgent.
6. Signs of Increased Intracranial Pressure in Children
Question 6:
A 6-year-old child is admitted after a head injury. The nurse observes
vomiting, irritability, and a blood pressure of 110/70 mmHg with a heart
rate of 50 bpm. Which action should the nurse take first?
A. Assess the child’s level of consciousness
B. Administer antiemetic medication
C. Elevate the child’s legs
D. Prepare the child for MRI
Correct Answer: A
Explanation:
The child shows signs of increased intracranial pressure (ICP):
Nursing MCQs with Rationales, Study Guide, and Exam Prep Tips
1. Assessing a Child with Asthma
Question 1:
A 7-year-old child with a history of asthma is brought to the clinic with
wheezing, coughing, and difficulty breathing. The nurse notes the child
is using accessory muscles and has a respiratory rate of 36 breaths per
minute. Which of the following interventions should the nurse
implement first?
A. Administer a short-acting bronchodilator via nebulizer
B. Obtain a complete health history from the parents
C. Teach the child how to use a peak flow meter
D. Administer a corticosteroid orally
Correct Answer: A
Explanation:
The child is exhibiting signs of an acute asthma exacerbation:
wheezing, tachypnea, and accessory muscle use. According to the ATI
Nursing guidelines, the priority is to ensure airway patency and
improve oxygenation. Administering a short-acting bronchodilator
(e.g., albuterol) via nebulizer provides rapid relief of bronchospasm.
• B (history) and C (peak flow teaching) are important but not
immediate priorities in acute distress.
• D (oral corticosteroid) helps inflammation but acts slower than a
bronchodilator.
2. Monitoring for Cystic Fibrosis Complications
,Question 2:
A 5-year-old child with cystic fibrosis (CF) presents for routine follow-
up. Which assessment finding requires the highest priority
intervention?
A. Foul-smelling, bulky stools
B. Persistent cough with crackles in the lungs
C. Weight at the 25th percentile for age
D. Pancreatic enzyme dose missed with a meal
Correct Answer: B
Explanation:
In CF, respiratory complications are the leading cause of morbidity
and mortality. Crackles and persistent cough indicate possible
infection or worsening pulmonary status, which requires prompt
intervention.
• A (stools) and D (enzyme missed) are important but do not pose
immediate respiratory risk.
• C (weight) indicates nutritional concern but is not an acute
priority.
3. Medication Administration for ADHD
Question 3:
A 9-year-old child diagnosed with ADHD is prescribed
methylphenidate. The nurse should include which instruction when
teaching the parents?
A. Administer the medication at bedtime to promote concentration
B. Monitor for appetite suppression and weight loss
C. Avoid physical activity due to risk of cardiovascular collapse
D. Expect the medication to cure ADHD over time
,Correct Answer: B
Explanation:
Stimulant medications like methylphenidate can suppress appetite
and affect growth, so monitoring weight and nutrition is important.
• A is incorrect: stimulants are given in the morning to avoid
insomnia.
• C is incorrect: normal physical activity is encouraged.
• D is incorrect: stimulants manage symptoms, not cure ADHD.
4. Vaccination Safety
Question 4:
The nurse is preparing to administer the MMR vaccine to a 15-month-
old child. Which finding indicates a contraindication?
A. Mild nasal congestion
B. Current low-grade fever of 100.2°F
C. History of anaphylaxis to neomycin
D. Receiving antibiotics for an ear infection
Correct Answer: C
Explanation:
A history of anaphylaxis to neomycin is a contraindication for MMR,
as it can cause a severe allergic reaction.
• A and B are mild illnesses, which are not contraindications.
• D (antibiotics) does not affect vaccine administration.
5. Caring for a Child with Acute Diarrhea
, Question 5:
A 2-year-old is admitted with acute diarrhea and signs of mild
dehydration. Which intervention should the nurse prioritize?
A. Begin oral rehydration therapy (ORT) immediately
B. Encourage the child to eat regular solid foods
C. Administer an antidiarrheal medication
D. Assess for recent travel history
Correct Answer: A
Explanation:
Fluid replacement is the highest priority in dehydration to prevent
hypovolemic shock. ORT is preferred in mild dehydration.
• B is secondary: feeding is important but rehydration comes first.
• C is incorrect: antidiarrheals are not recommended for young
children.
• D is important for history but not urgent.
6. Signs of Increased Intracranial Pressure in Children
Question 6:
A 6-year-old child is admitted after a head injury. The nurse observes
vomiting, irritability, and a blood pressure of 110/70 mmHg with a heart
rate of 50 bpm. Which action should the nurse take first?
A. Assess the child’s level of consciousness
B. Administer antiemetic medication
C. Elevate the child’s legs
D. Prepare the child for MRI
Correct Answer: A
Explanation:
The child shows signs of increased intracranial pressure (ICP):
