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This pediatric ATI RN exam is more than memorizing facts—it’s about applying knowledge in clinical scenarios. Our study material emphasizes critical thinking, interpretation of data, and prioritization skills. Through scenario-based questions and case studies, students learn to assess symptoms, apply nursing interventions, anticipate complications, and effectively communicate with children and their families. This practical focus ensures that you are not just passing the exam but are also confident in providing high-quality patient care. 2023 Peds ATI RN Proctored Exam, ATI RN pediatric exam 2023, pediatric nursing ATI RN study guide, ATI RN pediatrics practice questions 2023, ATI RN pediatric nursing test prep, ATI RN pediatric proctored exam review, pediatric nursing ATI practice test, ATI RN pediatric nursing questions and answers, 2023 ATI RN pediatrics exam review, ATI RN pediatric test bank 2023, pediatric ATI RN exam study materials, ATI RN pediatric clinical scenarios
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QUESTION 1 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A nurse is teaching the parent of a preschooler who has a history of acute asthma attacks. The child has mild intermittent asthma symptoms, and today’s vital signs are within normal limits for age.
A. “I will use a humidifier in my child’s room at night.” B. “I will give my child a cough suppressant every 6 hours if he has a cough.” C. “I should avoid using a wet mop on my floors when I am cleaning.” D. “I should keep my child indoors when I mow the yard.”
ANSWER: D
EXPERT EXPLANATION: Yard work such as mowing often stirs up grass, weed, and other environmental allergens that can trigger an acute asthma attack. Keeping the child indoors during lawn maintenance or high pollen counts can significantly reduce exposure to triggers. The other options do not accurately reflect recommended preventative measures for asthma.
──────────────────────────────────────────────────────── QUESTION 2 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A nurse is assessing a 6-year-old child immediately following surgery for a perforated appendix. The child’s current vital signs are: Temp 99.3°F (37.4°C), HR 110/min, RR 24/min, BP 105/68 mm Hg, O2 sat 98% on room air.
EXPERT EXPLANATION: The nurse elicits the biceps reflex by placing a thumb on the biceps tendon in the antecubital fossa area (labeled as “A” in the diagram) and tapping the thumb with the reflex hammer. The triceps and brachioradialis reflexes are tested at locations B and C, respectively.
──────────────────────────────────────────────────────── QUESTION 4 (NGN-Style: Drag-and-Drop / Anticipated vs. Contraindicated) ──────────────────────────────────────────────────────── CASE SCENARIO: A nurse is caring for a toddler who has hemophilia. The provider is considering several new prescriptions after the toddler’s recent fall indicated possible joint involvement (hemarthrosis).
ANSWERS:
EXPERT EXPLANATION:
──────────────────────────────────────────────────────── QUESTION 5 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A nurse is providing discharge teaching to the parent of an 18-month-old toddler who is being discharged for dehydration secondary to acute diarrhea. The toddler’s weight is 12 kg (26.5 lb), and current vitals are stable.
A. “I will offer my child small amounts of fruit juice frequently.” B. “I will avoid giving my child solid foods until the diarrhea has stopped.” C. “I will monitor my child’s number of wet diapers.” D. “I will give my child polyethylene glycol daily for 7 days.”
ANSWER: C
EXPERT EXPLANATION: Monitoring the child’s urine output (e.g., counting wet diapers) is crucial to ensure adequate hydration status and to detect any recurrence or worsening of dehydration.
──────────────────────────────────────────────────────── QUESTION 6 (NGN-Style: Prioritization - Matrix) ──────────────────────────────────────────────────────── CASE SCENARIO:
A nurse is caring for a school-age child 1 day following an appendectomy for a ruptured appendix. The nurse reviews the child’s latest labs and performs a focused physical assessment.
A. WBC count 24,000/mm³ (elevated from 10,000/mm³ preop) B. Oxygen saturation 98% on room air C. Platelet count 210,000/mm³ D. Rigid, distended abdomen with sharp pain E. Temperature 101.5°F (38.6°C) F. Scant serous drainage on abdominal dressing
CORRECT ANSWERS: A, D, E
EXPERT EXPLANATION:
──────────────────────────────────────────────────────── QUESTION 8 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A school-age child is 2 days postoperative following an open reduction and casting of a fracture in the right arm. The nurse is reviewing the child’s most recent lab results and notes the following vital signs: Temp 99.9°F (37.7°C), HR 108/min, RR 22/min, BP 104/64 mm Hg.
A. Increased erythrocyte sedimentation rate (ESR) B. Apical pulse 92/min C. Respiratory rate 24/min D. Taking an oral analgesic twice daily
ANSWER: A
EXPERT EXPLANATION: An increased ESR reveals active inflammation and might suggest osteomyelitis or another infection. The other findings are either within expected limits or do not necessarily indicate a complication related to the fracture repair.
──────────────────────────────────────────────────────── QUESTION 9 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A 15-year-old adolescent was admitted following a head injury sustained during sports. The adolescent has had mild confusion over the last 48 hours. Recent labs reveal serum sodium 128 mEq/L and decreased urine output.
A. Elevated serum sodium level B. Decreased urine specific gravity C. Mental confusion D. Weak peripheral pulses
QUESTION 11 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A preschooler is scheduled for hydrotherapy to debride severe burns on the torso. The nurse assesses the child and prepares pre-procedure interventions.
A. Apply topical antimicrobial ointment to the child’s wound. B. Place a mesh gauze dressing over the child’s wound. C. Initiate prophylactic antibiotic therapy for the child. D. Administer an analgesic to the child.
ANSWER: D
EXPERT EXPLANATION: Hydrotherapy for wound debridement is painful. Administering an appropriate analgesic (and/or sedation) before the procedure is essential for pain control, reduces physiologic stress, and improves cooperation.
──────────────────────────────────────────────────────── QUESTION 12 (NGN-Style: Single Best Answer - Priority Setting) ──────────────────────────────────────────────────────── CASE SCENARIO: An 8-year-old child is brought to the ED with early signs of shock. Current vitals: HR 135/min, RR 32/min, BP 84/54 mm Hg, O2 sat 90% on room air. The nurse establishes the airway and stabilizes respirations.
A. Insert an indwelling urinary catheter. B. Measure the child’s weight and height.
C. Initiate IV access. D. Maintain continuous ECG monitoring.
ANSWER: C
EXPERT EXPLANATION: After ensuring the child’s airway and breathing are stabilized, the priority is to secure vascular access for fluid resuscitation and medication administration. This intervention addresses circulation and is critical in treating shock.
──────────────────────────────────────────────────────── QUESTION 13 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A preschool-age child is hospitalized for minor surgery. The child’s guardian must leave the hospital for a few hours, and another family member will stay with the child.
A. “Your guardian will be back at 7 p.m.” B. “Your guardian will be back after taking care of your sibling.” C. “Your guardian will be back in the morning.” D. “Your guardian will be back after you eat.”
ANSWER: D
EXPERT EXPLANATION: Preschoolers best understand time when explained relative to familiar activities (e.g., mealtimes, bedtime). Stating “after you eat” helps the child relate the guardian’s return to a recognizable daily routine.
A. Area in the right lower quadrant, two-thirds the distance from the umbilicus to the anterior superior iliac spine B. The left lower quadrant near the sigmoid region C. The right upper quadrant near the liver
ANSWER: A
EXPERT EXPLANATION: McBurney’s point is classically described as located roughly one-third to two-thirds of the distance between the umbilicus and the anterior superior iliac spine (ASIS) in the right lower quadrant. This is the most common site of localized tenderness in appendicitis.
──────────────────────────────────────────────────────── QUESTION 16 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A nurse is providing teaching to the guardians of a preschooler about age- appropriate play that promotes social development.
A. Playing pat-a-cake B. Using a push-pull toy C. Creating a scrapbook D. Playing dress-up
ANSWER: D
EXPERT EXPLANATION: Preschoolers often engage in imaginative and cooperative play. Dress-up encourages social interaction, creativity, and role-playing skills, thereby promoting social and cognitive development.
QUESTION 17 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: An adolescent who is experiencing fatigue and was recently diagnosed with iron deficiency anemia is reviewing dietary choices with the nurse.
A. ½ cup whole milk B. 1 cup orange juice C. ½ cup raisins D. 1 cup raw carrots
ANSWER: C
EXPERT EXPLANATION: Raisins contain a relatively high amount of nonheme iron compared to the other listed items. Nonheme iron is found in plant-based sources and certain fortified foods.
──────────────────────────────────────────────────────── QUESTION 18 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A school-age child presents to the clinic complaining of feeling tired and dizzy. The nurse reviews the child’s lab results.
A. A low hematocrit level
QUESTION 20 (NGN-Style: Single Best Answer - Priority Setting) ──────────────────────────────────────────────────────── CASE SCENARIO: A nurse is receiving a change-of-shift report for four pediatric patients. One of them is a school-age child with sickle cell disease who now complains of decreased vision in the left eye.
A. A school-age child who has sickle cell anemia and reports decreased vision in the left eye B. A school-age child who has cystic fibrosis and a frequent nonproductive cough C. A preschooler who has asthma with a peak flow meter reading in the green zone D. An adolescent who has meningitis and reports sensitivity to light and noise
ANSWER: A
EXPERT EXPLANATION: In a child with sickle cell disease, a sudden decrease in vision can signal an acute vaso-occlusive crisis affecting retinal vessels, which can be vision-threatening. This is the most urgent finding. The other conditions, while important, are less emergent based on the data provided.
QUESTION 21 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A nurse is providing anticipatory guidance to the guardian of a 2-year-old toddler. The guardian reports that the toddler “suddenly has strong opinions on everything” and does not like to share toys. The toddler’s vital signs are within normal limits for age.
A. Demonstrates consistent impulse control B. Understands right from wrong clearly C. Separates easily from the guardian for extended periods D. Expresses likes and dislikes
ANSWER: D
EXPERT EXPLANATION: It is normal for toddlers to assert autonomy by expressing preferences and dislikes, often refusing to comply with requests. They are refining their sense of self and beginning to test boundaries. The other answer choices describe behaviors more typical of older children (e.g., consistent impulse control, clear separation for long periods, established moral understanding).
──────────────────────────────────────────────────────── QUESTION 22 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A preschooler with a recent diagnosis of neutropenia is brought to the pediatric clinic for follow-up. The child’s absolute neutrophil count (ANC) is significantly low. The guardian reports wanting to keep the child active and socially engaged.
A. “Take your child’s temperature just once each week.” B. “Taking your child to a busy movie theater is a good way to lift their mood.” C. “Avoid using your toddler’s daycare center for now.” D. “Schedule your child’s varicella immunization as soon as possible.”
QUESTION 24 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: An emergency department charge nurse is teaching a group of newly licensed nurses about recognizing signs of child maltreatment. The nurse presents a hypothetical case of a 4-year-old child.
A. Recurrent urinary tract infections B. Symmetric burns of the lower extremities C. Failure to thrive D. Lack of subcutaneous fat
ANSWER: B
EXPERT EXPLANATION: Symmetric, uniform burns on the lower extremities (often demarcated in specific shapes or patterns) are a classic potential sign of inflicted injury or physical abuse. Recurrent UTIs could suggest sexual abuse or poor hygiene rather than physical abuse. Failure to thrive and lack of subcutaneous fat may more commonly indicate neglect or malnutrition.
──────────────────────────────────────────────────────── QUESTION 25 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A 10-year-old child is admitted to the pediatric unit following a head injury sustained during sports practice. The child’s vital signs are: Temp 98.7°F (37.1°C),
HR 86/min, RR 18/min, BP 100/60 mm Hg. Recent labs show Na+ of 150 mEq/L, and the child reports thirst and frequent urination.
A. Increased urine specific gravity B. Elevated serum sodium level C. Decreased oral fluid intake D. Decreased urine output
ANSWER: B
EXPERT EXPLANATION: Diabetes insipidus (DI) often presents with water loss leading to hypernatremia (high serum sodium), accompanied by polyuria and polydipsia. The decreased production or action of antidiuretic hormone (ADH) causes large volumes of dilute urine (low urine specific gravity) and can elevate sodium levels due to free water loss.
──────────────────────────────────────────────────────── QUESTION 26 (NGN-Style: Single Best Answer) ──────────────────────────────────────────────────────── CASE SCENARIO: A mother brings her 8-month-old infant to the clinic, reporting that the infant’s skin in the diaper area is red, inflamed, and beginning to peel. The nurse suspects diaper dermatitis.
A. Antibiotic ointment B. Zinc oxide
