2023 ATI RN
PEDIATRIC
EXAM QUESTIONS
(NGN-STYLE QUESTIONS & CASE SCENARIOS)
GET A LEVEL 2 OR HIGHER
What You’ll Get:
• 300 PEDIATRIC nursing questions
• Detailed answer rationales for each question
• Exam-focused, high-yield content
Perfect For:
• RN nursing students
• ATI PEDIATRIC Exam prep
• NCLEX-RN preparation
,Not affiliated with ATI, VATI or NCLEX. For study purposes only.
QUESTION 1: SEVERE DIARRHEA PRIORITY
A nurse is planning care for a child who has severe diarrhea. Which of the
following actions is the nurse's priority?
A. Administer antidiarrheal medication
B. Assess fluid balance
C. Obtain stool culture
D. Place the child on NPO status
CORRECT ANSWER: B
RATIONALE: Assessing fluid balance is the priority for a child with severe diarrhea
because dehydration and electrolyte imbalances are the most life-threatening
complications.
Fluid balance assessment includes:
• Intake and output: Urine output, stool frequency/volume, emesis
• Physical signs: Skin turgor, mucous membranes, capillary refill, fontanels
(infants)
• Vital signs: Tachycardia, hypotension, fever
• Weight changes: Rapid weight loss indicates fluid loss
• Laboratory values: Electrolytes (especially potassium), BUN, creatinine
Why other options are incorrect:
• A: Antidiarrheals are contraindicated in infectious diarrhea (prolongs pathogen
exposure)
• C: Stool culture important for diagnosis but not priority over stabilization
• D: NPO status unnecessary; oral rehydration preferred if tolerated
,QUESTION 2: WILMS' TUMOR PRIORITY
A nurse is caring for a toddler whose parent states that the child has a mass in his
abdominal area and his urine is a pink color. Which of the following actions is the
nurse's priority?
A. Instruct the parent to avoid pressing on the abdominal area
B. Prepare the child for immediate surgery
C. Obtain a urine sample for urinalysis
D. Administer pain medication
CORRECT ANSWER: A
RATIONALE: Avoiding abdominal palpation is the priority because the description
suggests Wilms' tumor (nephroblastoma), and tumor rupture can cause seeding of
cancer cells into the peritoneum.
Wilms' tumor characteristics:
• Painless abdominal mass (most common presenting sign)
• Hematuria (pink/red urine) in 15-25% of cases
• "Handle with care" - no abdominal palpation or compression
Nursing priorities:
1. Protect tumor from trauma (no palpation, handle gently)
2. Preoperative imaging (CT/MRI to assess extent and contralateral kidney)
3. Surgical resection (nephrectomy) once staged
Why other options are incorrect:
• B: Surgery requires preoperative staging first; not immediate
• C: Urinalysis helpful but not priority over protecting tumor
• D: Wilms' tumor is typically painless; pain medication not priority
QUESTION 3: ACUTE GLOMERULONEPHRITIS PRIORITY
, A nurse is caring for a child who has acute glomerulonephritis. Which of the
following actions is the nurse's priority?
A. Check the child's weight daily
B. Monitor blood pressure every 4 hours
C. Restrict protein intake
D. Administer diuretics
CORRECT ANSWER: A
RATIONALE: Daily weight monitoring is the priority for acute glomerulonephritis
because it is the most sensitive indicator of fluid retention and edema progression.
Acute glomerulonephritis pathophysiology:
• Immune-mediated glomerular inflammation (often post-streptococcal)
• Decreased GFR → sodium and water retention
• Edema (periorbital, peripheral, ascites)
• Hypertension (from fluid overload)
• Hematuria (tea-colored urine)
Why daily weight is priority:
• Early indicator of fluid retention before overt edema
• Guides therapy: Diuretics, fluid restriction, sodium restriction
• 1 kg weight gain = 1 liter fluid retention
Why other options are important but not priority:
• B: BP monitoring important but follows weight assessment
• C: Protein restriction rarely needed in AGN (unlike nephrotic syndrome)
• D: Diuretics ordered based on weight and edema assessment
QUESTION 4: BACTERIAL MENINGITIS PRIORITY
PEDIATRIC
EXAM QUESTIONS
(NGN-STYLE QUESTIONS & CASE SCENARIOS)
GET A LEVEL 2 OR HIGHER
What You’ll Get:
• 300 PEDIATRIC nursing questions
• Detailed answer rationales for each question
• Exam-focused, high-yield content
Perfect For:
• RN nursing students
• ATI PEDIATRIC Exam prep
• NCLEX-RN preparation
,Not affiliated with ATI, VATI or NCLEX. For study purposes only.
QUESTION 1: SEVERE DIARRHEA PRIORITY
A nurse is planning care for a child who has severe diarrhea. Which of the
following actions is the nurse's priority?
A. Administer antidiarrheal medication
B. Assess fluid balance
C. Obtain stool culture
D. Place the child on NPO status
CORRECT ANSWER: B
RATIONALE: Assessing fluid balance is the priority for a child with severe diarrhea
because dehydration and electrolyte imbalances are the most life-threatening
complications.
Fluid balance assessment includes:
• Intake and output: Urine output, stool frequency/volume, emesis
• Physical signs: Skin turgor, mucous membranes, capillary refill, fontanels
(infants)
• Vital signs: Tachycardia, hypotension, fever
• Weight changes: Rapid weight loss indicates fluid loss
• Laboratory values: Electrolytes (especially potassium), BUN, creatinine
Why other options are incorrect:
• A: Antidiarrheals are contraindicated in infectious diarrhea (prolongs pathogen
exposure)
• C: Stool culture important for diagnosis but not priority over stabilization
• D: NPO status unnecessary; oral rehydration preferred if tolerated
,QUESTION 2: WILMS' TUMOR PRIORITY
A nurse is caring for a toddler whose parent states that the child has a mass in his
abdominal area and his urine is a pink color. Which of the following actions is the
nurse's priority?
A. Instruct the parent to avoid pressing on the abdominal area
B. Prepare the child for immediate surgery
C. Obtain a urine sample for urinalysis
D. Administer pain medication
CORRECT ANSWER: A
RATIONALE: Avoiding abdominal palpation is the priority because the description
suggests Wilms' tumor (nephroblastoma), and tumor rupture can cause seeding of
cancer cells into the peritoneum.
Wilms' tumor characteristics:
• Painless abdominal mass (most common presenting sign)
• Hematuria (pink/red urine) in 15-25% of cases
• "Handle with care" - no abdominal palpation or compression
Nursing priorities:
1. Protect tumor from trauma (no palpation, handle gently)
2. Preoperative imaging (CT/MRI to assess extent and contralateral kidney)
3. Surgical resection (nephrectomy) once staged
Why other options are incorrect:
• B: Surgery requires preoperative staging first; not immediate
• C: Urinalysis helpful but not priority over protecting tumor
• D: Wilms' tumor is typically painless; pain medication not priority
QUESTION 3: ACUTE GLOMERULONEPHRITIS PRIORITY
, A nurse is caring for a child who has acute glomerulonephritis. Which of the
following actions is the nurse's priority?
A. Check the child's weight daily
B. Monitor blood pressure every 4 hours
C. Restrict protein intake
D. Administer diuretics
CORRECT ANSWER: A
RATIONALE: Daily weight monitoring is the priority for acute glomerulonephritis
because it is the most sensitive indicator of fluid retention and edema progression.
Acute glomerulonephritis pathophysiology:
• Immune-mediated glomerular inflammation (often post-streptococcal)
• Decreased GFR → sodium and water retention
• Edema (periorbital, peripheral, ascites)
• Hypertension (from fluid overload)
• Hematuria (tea-colored urine)
Why daily weight is priority:
• Early indicator of fluid retention before overt edema
• Guides therapy: Diuretics, fluid restriction, sodium restriction
• 1 kg weight gain = 1 liter fluid retention
Why other options are important but not priority:
• B: BP monitoring important but follows weight assessment
• C: Protein restriction rarely needed in AGN (unlike nephrotic syndrome)
• D: Diuretics ordered based on weight and edema assessment
QUESTION 4: BACTERIAL MENINGITIS PRIORITY
