ATI PN Pediatric Proctored Exam 2023/2024: NGN 60 Questions and Answers | Actual PN Pediatric

ATI PN Pediatric Proctored Exam 2023/2024:
NGN 60 Questions and Answers | Actual PN
Pediatric


Question 1
A nurse is planning care for a child with severe diarrhea. What is the priority action?
 A. Introduce a regular diet
 B. Rehydrate the child
 C. Maintain fluid therapy
 D. Assess fluid balance

Correct Answer: D. Assess fluid balance

Rationale: According to the nursing process, assessment is the first step. Before
implementing interventions like rehydration, the nurse must assess the degree of
dehydration (e.g., lab results, skin turgor, weight) to determine the correct fluid
replacement.

Question 2
A nurse is caring for a toddler whose parent reports a mass in the abdomen and pink-colored
urine. What is the nurse's priority intervention?
 A. Schedule an abdominal ultrasound
 B. Instruct the parent to avoid pressing on the area
 C. Determine if the child is in pain
 D. Obtain a urine specimen

Correct Answer: B. Instruct the parent to avoid pressing on the area

Rationale: These symptoms suggest Wilms' tumor (nephroblastoma). Palpating the
abdomen can cause tumor seeding or rupture. The priority is to avoid manipulation of the
mass.

Question 3
A nurse is assessing a 3-year-old at a well-child visit. Which finding requires immediate
reporting to the provider?
 A. Blood pressure 90/50 mm Hg
 B. Respiratory rate 45/min
 C. Weight 14.5 kg (32 lb)
 D. Heart rate 110/min

Correct Answer: B. Respiratory rate 45/min

,Rationale: The expected respiratory rate for a 3-year-old is 20-30 breaths/min. A rate of
45/min is tachypneic and indicates respiratory distress.

Question 4
A nurse is preparing to administer an immunization to a 4-year-old child. Which action
should the nurse take?
 A. Place the child in a prone position
 B. Ask the caregiver to leave the room
 C. Use a 24-gauge needle
 D. Aspirate for 3 seconds before injecting

Correct Answer: C. Use a 24-gauge needle

Rationale: A 24-gauge needle is smaller in diameter, minimizing tissue trauma and pain for
the child. The child should be upright (sitting) to reduce fear, and caregivers should stay to
provide security. Aspiration is no longer recommended for routine immunizations.

Question 5
A nurse is reviewing lab results for an infant receiving treatment for severe dehydration.
Which value indicates treatment is effective?
 A. Potassium 2.9 mEq/L
 B. Sodium 140 mEq/L
 C. Urine specific gravity 1.035
 D. BUN 25 mg/dL

Correct Answer: B. Sodium 140 mEq/L

Rationale: Normal serum sodium is 135-145 mEq/L. A level of 140 is within normal range.
High specific gravity (>1.030) and high BUN indicate dehydration; low potassium indicates
continued loss.

Question 6
A nurse is providing teaching about social development to parents of a preschooler. Which
play activity is most appropriate?
 A. Play pat-a-cake
 B. Use a push-pull toy
 C. Create a scrapbook
 D. Play dress-up

Correct Answer: D. Play dress-up

Rationale: Preschoolers (3-6 years) engage in imaginative play. Dress-up allows them to
imitate adult roles, which helps develop social skills and understanding of the world.

Question 7
The parent of a 2-month-old reports projectile vomiting followed by hunger. What is the
appropriate response?

,  A. "Bring your infant into the clinic today."
 B. "Burp your child more frequently."
 C. "Give an oral rehydration solution."
 D. "Try switching to a different formula."

Correct Answer: A. "Bring your infant into the clinic today."

Rationale: Projectile vomiting in an infant 2-8 weeks old is characteristic of hypertrophic
pyloric stenosis. This requires immediate evaluation to prevent dehydration and electrolyte
imbalances.

Question 8
A nurse is caring for a child with acute glomerulonephritis. What is the first action?
 A. Place on a no-salt-added diet
 B. Check the child's daily weight
 C. Educate parents on complications
 D. Maintain a saline lock

Correct Answer: B. Check the child's daily weight

Rationale: Daily weight is the most sensitive indicator of fluid balance. Since
glomerulonephritis causes fluid retention leading to hypertension and edema, the nurse
must establish a baseline weight first to monitor treatment effectiveness.

Question 9
A nurse is caring for a child with bacterial meningitis. What is the priority intervention?
 A. Administer antibiotics when available
 B. Reduce environmental stimuli
 C. Document intake and output
 D. Maintain seizure precautions

Correct Answer: A. Administer antibiotics when available

Rationale: Bacterial meningitis is a medical emergency. While reducing stimuli and seizure
precautions manage symptoms, the priority is administering antibiotics promptly to
eradicate the infection and reduce intracranial pressure.

Question 10
A school nurse is screening for scoliosis in an 11-year-old. What instruction should be given?
 A. "Lie prone on the examination table."
 B. "Touch your chin to your chest."
 C. "Turn to the side and relax."
 D. "Bend forward with arms dangling."

Correct Answer: D. "Bend forward with arms dangling."

, Rationale: The Adams forward bend test is the standard screening test for scoliosis. This
position makes asymmetry of the ribs or flanks (rib hump) most visible.

Question 11
A nurse is assessing an infant for hypertrophic pyloric stenosis. What finding is expected?
 A. Projectile vomiting
 B. Bile-colored vomit
 C. Absent bowel sounds
 D. Fever

Correct Answer: A. Projectile vomiting

Rationale: Projectile vomiting typically occurs 30-60 minutes after feeding. The vomitus is
non-bilious (no bile) because the obstruction is above the ampulla of Vater.

Question 12
A nurse is providing discharge teaching for a child with cystic fibrosis. Which statement
indicates understanding?
 A. "I will make sure my child washes hands before eating."
 B. "I will restrict the amount of salt in my child's meals."
 C. "I will put my child in daycare to socialize."
 D. "I will provide low-fat meals for my child."

Correct Answer: A. "I will make sure my child washes hands before eating."

Rationale: CF patients have thick mucus that traps bacteria, making them prone to
respiratory infections. Hand hygiene is crucial. CF patients need high-calorie, high-protein,
high-fat diets and often need salt supplements because they lose salt through sweat.

Question 13
A nurse is caring for a 4-year-old post-ventriculoperitoneal (VP) shunt insertion. Which
finding is the priority?
 A. Lethargy
 B. Lying flat on the unaffected side
 C. Refusal to eat breakfast
 D. Crying when parents leave

Correct Answer: A. Lethargy

Rationale: Lethargy is a sign of increased intracranial pressure (ICP) or shunt malfunction.
This is a priority finding over behavioral issues or positional preferences.

Question 14
A preschooler has croup. Which finding should be reported to the provider immediately?
 A. Barky cough
 B. Paroxysmal laryngeal spasms at night
 C. Hoarseness