ATI RN Pediatric Nursing Proctored Exam with NGN
Questions with Answers and Rationale 2024/2025
1. Question:
A nurse is caring for a 6-month-old infant who is experiencing a fever. The nurse
should prioritize which of the following actions?
A) Administer acetaminophen as ordered.
B) Ensure the infant is bundled in warm clothing.
C) Perform a lumbar puncture to assess for meningitis.
D) Encourage the infant's mother to offer fluids to the infant.
Answer: A) Administer acetaminophen as ordered.
Rationale: Fever is common in infants and can be caused by various conditions.
Administering an antipyretic such as acetaminophen is a priority to help reduce
fever and provide comfort. Ensuring the infant is not overdressed and keeping the
infant hydrated with fluids are also important but secondary interventions. A
lumbar puncture is not routinely performed unless there are specific indications of
meningitis, such as a high fever, a stiff neck, and irritability.
2. Question:
A nurse is assessing a 4-year-old child with asthma who is experiencing shortness
of breath and wheezing. The nurse notes that the child has a prolonged expiratory
phase. Which of the following is the most appropriate nursing action?
A) Administer a nebulized bronchodilator as ordered.
B) Place the child in a supine position to help with airflow.
C) Encourage the child to take slow, deep breaths.
D) Offer the child a high-calorie snack to boost energy.
Answer: A) Administer a nebulized bronchodilator as ordered.
Rationale: A prolonged expiratory phase, along with wheezing and shortness of
breath, indicates bronchoconstriction typical of an asthma exacerbation. The most
appropriate intervention is administering a bronchodilator to help relieve the
,bronchospasm and improve airflow. Placing the child in a supine position or
offering a high-calorie snack would not address the immediate respiratory needs.
Encouraging slow, deep breaths is helpful for relaxation but is not a primary
intervention for an asthma attack.
3. Question:
A nurse is educating the parents of a 2-year-old child about the proper use of car
seats. Which of the following is the most important guideline for ensuring the
child’s safety in the car seat?
A) The car seat should be placed in the front passenger seat.
B) The harness straps should be positioned over the child's shoulders.
C) The car seat should be used rear-facing until the child reaches 40 pounds.
D) The car seat should be used in forward-facing mode at 18 months.
Answer: B) The harness straps should be positioned over the child's shoulders.
Rationale: The most important guideline for car seat safety is ensuring that the
harness straps are positioned at or just above the child's shoulders to provide
optimal protection. Children should remain rear-facing as long as possible, ideally
until the age of 2 or until they reach the height and weight limits specified by the
car seat manufacturer. The car seat should always be in the back seat, as the front
seat is considered unsafe for children due to airbag deployment risks.
4. Question:
A nurse is caring for a 3-year-old child with a diagnosis of acute otitis media
(AOM). Which of the following statements made by the parent indicates the need
for further teaching?
A) “I will give my child the full course of antibiotics as prescribed.”
B) “I will avoid giving my child a bottle while lying down.”
C) “I will reduce my child’s fluid intake if they have a fever.”
D) “I will use acetaminophen to help with my child’s pain and fever.”
Answer: C) “I will reduce my child’s fluid intake if they have a fever.”
,Rationale: Children with otitis media should be encouraged to drink fluids to
prevent dehydration, especially if they have a fever. Reducing fluid intake can
worsen dehydration. Giving the full course of antibiotics, avoiding lying down
with a bottle (to reduce the risk of further ear infections), and using acetaminophen
to manage pain and fever are appropriate interventions for treating AOM.
5. Question:
A 10-year-old child with cystic fibrosis is hospitalized due to a respiratory
infection. The nurse should prioritize which of the following interventions?
A) Administer pancreatic enzymes with meals.
B) Monitor oxygen saturation levels closely.
C) Encourage the child to eat high-fat, high-protein foods.
D) Restrict physical activity to prevent fatigue.
Answer: B) Monitor oxygen saturation levels closely.
Rationale: Cystic fibrosis (CF) affects the respiratory system, and respiratory
infections are common in these patients. Monitoring oxygen saturation levels is
critical to ensure adequate oxygenation. Administering pancreatic enzymes is
important for digestion but not the priority in the acute setting. Encouraging high-
fat, high-protein foods is important for overall nutrition, but managing respiratory
status takes precedence. Physical activity is encouraged in CF patients to improve
lung function, but activity should be adjusted based on the child’s current
condition.
6. Question:
A nurse is caring for an infant diagnosed with pyloric stenosis. The nurse should
expect which of the following findings?
A) Jaundice and hepatomegaly.
B) Projectile vomiting after feeding.
C) Decreased bowel sounds and abdominal distension.
D) Loose, watery stools with mucus.
, Answer: B) Projectile vomiting after feeding.
Rationale: Pyloric stenosis is a condition in which the pyloric sphincter becomes
thickened, causing an obstruction between the stomach and small intestine.
Projectile vomiting after feeding is a hallmark sign of this condition. Jaundice and
hepatomegaly are not typically associated with pyloric stenosis, and decreased
bowel sounds or loose stools are more indicative of other gastrointestinal issues,
not pyloric stenosis.
7. Question:
A 14-year-old adolescent with diabetes is admitted with diabetic ketoacidosis
(DKA). The nurse should monitor for which of the following complications during
treatment?
A) Hypokalemia.
B) Respiratory acidosis.
C) Cerebral edema.
D) Hypertension.
Answer: C) Cerebral edema.
Rationale: Cerebral edema is a serious complication that can occur during the
treatment of DKA, especially when fluids and electrolytes are corrected too
quickly. The nurse should monitor for signs of neurological deterioration, such as
changes in consciousness or abnormal behavior. Hypokalemia can occur as
potassium is re-distributed into cells during treatment, but cerebral edema is the
most critical complication to watch for. Respiratory acidosis and hypertension are
not common complications of DKA treatment.
8. Question:
A nurse is caring for a 5-year-old child who is recovering from a tonsillectomy.
The nurse should instruct the child’s parents to monitor for which of the following
potential complications post-surgery?
A) Increased appetite and weight gain.
Questions with Answers and Rationale 2024/2025
1. Question:
A nurse is caring for a 6-month-old infant who is experiencing a fever. The nurse
should prioritize which of the following actions?
A) Administer acetaminophen as ordered.
B) Ensure the infant is bundled in warm clothing.
C) Perform a lumbar puncture to assess for meningitis.
D) Encourage the infant's mother to offer fluids to the infant.
Answer: A) Administer acetaminophen as ordered.
Rationale: Fever is common in infants and can be caused by various conditions.
Administering an antipyretic such as acetaminophen is a priority to help reduce
fever and provide comfort. Ensuring the infant is not overdressed and keeping the
infant hydrated with fluids are also important but secondary interventions. A
lumbar puncture is not routinely performed unless there are specific indications of
meningitis, such as a high fever, a stiff neck, and irritability.
2. Question:
A nurse is assessing a 4-year-old child with asthma who is experiencing shortness
of breath and wheezing. The nurse notes that the child has a prolonged expiratory
phase. Which of the following is the most appropriate nursing action?
A) Administer a nebulized bronchodilator as ordered.
B) Place the child in a supine position to help with airflow.
C) Encourage the child to take slow, deep breaths.
D) Offer the child a high-calorie snack to boost energy.
Answer: A) Administer a nebulized bronchodilator as ordered.
Rationale: A prolonged expiratory phase, along with wheezing and shortness of
breath, indicates bronchoconstriction typical of an asthma exacerbation. The most
appropriate intervention is administering a bronchodilator to help relieve the
,bronchospasm and improve airflow. Placing the child in a supine position or
offering a high-calorie snack would not address the immediate respiratory needs.
Encouraging slow, deep breaths is helpful for relaxation but is not a primary
intervention for an asthma attack.
3. Question:
A nurse is educating the parents of a 2-year-old child about the proper use of car
seats. Which of the following is the most important guideline for ensuring the
child’s safety in the car seat?
A) The car seat should be placed in the front passenger seat.
B) The harness straps should be positioned over the child's shoulders.
C) The car seat should be used rear-facing until the child reaches 40 pounds.
D) The car seat should be used in forward-facing mode at 18 months.
Answer: B) The harness straps should be positioned over the child's shoulders.
Rationale: The most important guideline for car seat safety is ensuring that the
harness straps are positioned at or just above the child's shoulders to provide
optimal protection. Children should remain rear-facing as long as possible, ideally
until the age of 2 or until they reach the height and weight limits specified by the
car seat manufacturer. The car seat should always be in the back seat, as the front
seat is considered unsafe for children due to airbag deployment risks.
4. Question:
A nurse is caring for a 3-year-old child with a diagnosis of acute otitis media
(AOM). Which of the following statements made by the parent indicates the need
for further teaching?
A) “I will give my child the full course of antibiotics as prescribed.”
B) “I will avoid giving my child a bottle while lying down.”
C) “I will reduce my child’s fluid intake if they have a fever.”
D) “I will use acetaminophen to help with my child’s pain and fever.”
Answer: C) “I will reduce my child’s fluid intake if they have a fever.”
,Rationale: Children with otitis media should be encouraged to drink fluids to
prevent dehydration, especially if they have a fever. Reducing fluid intake can
worsen dehydration. Giving the full course of antibiotics, avoiding lying down
with a bottle (to reduce the risk of further ear infections), and using acetaminophen
to manage pain and fever are appropriate interventions for treating AOM.
5. Question:
A 10-year-old child with cystic fibrosis is hospitalized due to a respiratory
infection. The nurse should prioritize which of the following interventions?
A) Administer pancreatic enzymes with meals.
B) Monitor oxygen saturation levels closely.
C) Encourage the child to eat high-fat, high-protein foods.
D) Restrict physical activity to prevent fatigue.
Answer: B) Monitor oxygen saturation levels closely.
Rationale: Cystic fibrosis (CF) affects the respiratory system, and respiratory
infections are common in these patients. Monitoring oxygen saturation levels is
critical to ensure adequate oxygenation. Administering pancreatic enzymes is
important for digestion but not the priority in the acute setting. Encouraging high-
fat, high-protein foods is important for overall nutrition, but managing respiratory
status takes precedence. Physical activity is encouraged in CF patients to improve
lung function, but activity should be adjusted based on the child’s current
condition.
6. Question:
A nurse is caring for an infant diagnosed with pyloric stenosis. The nurse should
expect which of the following findings?
A) Jaundice and hepatomegaly.
B) Projectile vomiting after feeding.
C) Decreased bowel sounds and abdominal distension.
D) Loose, watery stools with mucus.
, Answer: B) Projectile vomiting after feeding.
Rationale: Pyloric stenosis is a condition in which the pyloric sphincter becomes
thickened, causing an obstruction between the stomach and small intestine.
Projectile vomiting after feeding is a hallmark sign of this condition. Jaundice and
hepatomegaly are not typically associated with pyloric stenosis, and decreased
bowel sounds or loose stools are more indicative of other gastrointestinal issues,
not pyloric stenosis.
7. Question:
A 14-year-old adolescent with diabetes is admitted with diabetic ketoacidosis
(DKA). The nurse should monitor for which of the following complications during
treatment?
A) Hypokalemia.
B) Respiratory acidosis.
C) Cerebral edema.
D) Hypertension.
Answer: C) Cerebral edema.
Rationale: Cerebral edema is a serious complication that can occur during the
treatment of DKA, especially when fluids and electrolytes are corrected too
quickly. The nurse should monitor for signs of neurological deterioration, such as
changes in consciousness or abnormal behavior. Hypokalemia can occur as
potassium is re-distributed into cells during treatment, but cerebral edema is the
most critical complication to watch for. Respiratory acidosis and hypertension are
not common complications of DKA treatment.
8. Question:
A nurse is caring for a 5-year-old child who is recovering from a tonsillectomy.
The nurse should instruct the child’s parents to monitor for which of the following
potential complications post-surgery?
A) Increased appetite and weight gain.
