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ATI Paediatric Proctored Exam
(CHECK THE LAST PAGE FOR MULTIPLE VERSIONS OF THE EXAM AND
OTHER ATI EXAMS)
1) A nurse is providing discharge teaching to the parents of a 6-month-old infant who is
postoperative following hypospadias repair with a stent placement. Which of the following
instructions should the nurse include in the teaching?
a) "You may bathe your infant in an infant bathtub when you go home."
b) "Apply hydrocortisone cream to your infant's penis daily."
c) "You should clamp your infant's stent twice daily."
d) "Allow the stent to drain directly into your infant's diaper."
Answer: c) "You should clamp your infant's stent twice daily."
Rationale:
Clamping the stent prevents urine leakage and maintains stent patency, aiding in the healing
process after hypospadias repair.
2) A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The
nurse should secure the sensor to which of the following areas on the infant?
a) Wrist
b) Great toe
c) Index finger
d) Heel
Answer: b) Great toe
Rationale:
Securing the sensor to the infant's great toe provides an accurate reading of oxygen saturation
levels.
3) A nurse is caring for a school-age child who has primary nephrotic syndrome and is taking
prednisone. Following 1 week of treatment, which of the following manifestations indicates to
the nurse that the medication is effective?
a) Decreased edema
b) Increased abdominal girth

c) Decreased appetite
d) Increased protein in the urine
Answer: a) Decreased edema
Rationale:
Prednisone helps reduce inflammation and fluid retention, leading to decreased edema, which is
a positive sign of medication effectiveness in nephrotic syndrome.
4) A nurse is planning care for a newly admitted school-age child who has generalized seizure
disorder. Which of the following interventions should the nurse plan to include?
a) Ensure that a padded tongue blade is at the child's bedside.
b) Allow the child to play video games on a tablet computer.
c) Allow the child to take a tub bath independently.
d) Ensure the oxygen source is functioning in the child's room.
Answer: d) Ensure the oxygen source is functioning in the child's room.
Rationale:
Ensuring the availability of oxygen is important in the management of seizures, as some
seizures can lead to respiratory compromise.
5) A nurse is receiving change-of-shift report for four children. Which of the following children
should the nurse assess first?
a) A toddler who has a concussion and an episode of forceful vomiting
b) An adolescent who has infective endocarditis and reports having a headache
c) An adolescent who was placed into halo traction 1 hr ago and reports pain as 6 on a scale of 0
to 10
d) A school-age child who has acute glomerulonephritis and brown-colored urine
Answer: a) A toddler who has a concussion and an episode of forceful vomiting
Rationale:
Forceful vomiting following a concussion raises concern for increased intracranial pressure,
requiring immediate assessment and intervention to prevent further complications.
6) A nurse is providing dietary teaching to the guardian of a school-age child who has cystic
fibrosis. Which of the following statements should the nurse make?

a) "You should offer your child high-protein meals and snacks throughout the day."
b) "You should decrease your child's dietary fat intake to less than 10% of their caloric intake."
c) "You should restrict your child's calorie intake to 1,200 per day."
d) "You should give your child a multivitamin once weekly."
Answer: a) "You should offer your child high-protein meals and snacks throughout the day."
Rationale:
Children with cystic fibrosis often have increased energy needs due to malabsorption, so
providing high-protein meals and snacks throughout the day can help meet these needs and
support growth and development.
7) A nurse assessing a school-age child who has an infratentorial brain tumor. Which of the
following findings should the nurse identify as a manifestation of increased intracranial
pressure?
a) Hypotension
b) Reports insomnia
c) Difficulty concentrating
d) Tachycardia
Answer: d) Tachycardia
Rationale:
Tachycardia can be a compensatory mechanism in response to increased intracranial pressure,
reflecting the body's attempt to maintain cerebral perfusion.
8) A nurse is providing teaching to an adolescent about how to manage tinea pedis. Which of
the following statements by the adolescent indicates an understanding of the teaching?
a) "I should buy plastic shoes to wear at the swimming pool."
b) "I should wear sandals as much as possible."
c) "I should place the permethrin cream between my toes twice daily."
d) "I should seal my nonwashable shoes in plastic bags for a couple of weeks."
Answer: b) "I should wear sandals as much as possible."
Rationale:

Wearing sandals allows for better air circulation, which helps prevent the warm, moist
environment that encourages fungal growth associated with tinea pedis.
9) A nurse is caring for a school-age child who has diabetes mellitus and was admitted with a
diagnosis of diabetic ketoacidosis. When performing the respiratory assessment, which of the
following findings should the nurse expect?
a) Deep respirations of 32/min
b) Shallow respirations of 10/min
c) Paradoxic respirations of 26/min
d) Periods of apnea lasting for 20 seconds
Answer: a) Deep respirations of 32/min
Rationale:
Deep, rapid respirations (Kussmaul respirations) are a compensatory response to metabolic
acidosis, which is characteristic of diabetic ketoacidosis.
10) A nurse is planning an educational program to teach parents about protecting their children
from sunburns. Which of the following instructions should the nurse plan to include?
a) "Allow your child to play outside during the hours between 10:00 a.m. and 2:00 p.m."
b) "Choose a waterproof sunscreen with a minimum SPF of 15."
c) "Dress your child in loose weave polyester fabric prior to sun exposure."
d) "Reapply sunscreen every 4 hours."
Answer: d) "Reapply sunscreen every 4 hours."
Rationale:
Sunscreen should be reapplied every 2 hours or more frequently if swimming or sweating
heavily to maintain its effectiveness in protecting the skin from sunburn.
11) A nurse is providing teaching to the parents of a preschooler who has heart failure and a
new prescription for digoxin twice daily. Which of the following instructions should the nurse
include in the teaching?
a) "Use a kitchen teaspoon to measure the medication."
b) "Brush the child's teeth after giving the medication."

c) "Double the next dose if the child misses a dose."
d) "Repeat the dose if the child vomits."
Answer: b) "Brush the child's teeth after giving the medication."
Rationale:
Digoxin can cause tooth discoloration, so brushing the child's teeth after administration helps
prevent this adverse effect.
12) A nurse is providing teaching to the family of a school-age child who has juvenile
idiopathic arthritis. Which if the following instructions should the nurse include in the teaching?
a) "Limit movement of the child's large joints."
b) "Encourage the child to perform independent selfcare."
c) "Provide the child with a soft mattress for sleeping."
d) "Schedule a 2-hour daily nap for the child in the afternoon."
Answer: b) "Encourage the child to perform independent self-care."
Rationale:
Encouraging independence in self-care activities fosters the child's autonomy and promotes
self-esteem, despite the challenges posed by juvenile idiopathic arthritis.
13) A nurse is creating a plan of care for a child who has varicella. Which of the following
interventions should the nurse include?
a) Maintain the child's room temperature at 80° F.
b) Prepare the child for a lumbar puncture.
c) Administer aspirin to the child for a temperature greater than 38.3° C (101° F).
d) Initiate airborne precautions for the child.
Answer: d) Initiate airborne precautions for the child.
Rationale:

Varicella (chickenpox) is transmitted through airborne droplets, so initiating airborne
precautions helps prevent the spread of the virus to others.
Additional Options:
a) Maintaining the child's room temperature at 80° F is not necessary for the management of
varicella.
b) Preparing the child for a lumbar puncture is not indicated for the management of varicella.
c) Administering aspirin to the child for a temperature greater than 38.3° C (101° F) is
contraindicated due to the risk of Reye's syndrome.
14) A nurse is assessing a school-age child who has an acute spinal cord injury following a
sports injury 1 week ago. Identify the area the nurse should tap to elicit the bicep reflex.
i) Option A: Bicep tendon, located in the antecubital fossa of the elbow.
Answer: i) Correct answer is A
Rationale:
The bicep reflex, also known as the bicep jerk or biceps reflex, is elicited by tapping the bicep
tendon, which is situated in the antecubital fossa of the elbow. This reflex tests the integrity of
the C5-C6 spinal nerve roots and the musculocutaneous nerve. In cases of acute spinal cord
injury, testing reflexes like the bicep reflex can provide valuable information about the level
and severity of the injury.
15) A school nurse is providing an in-service for faculty about improving education for students
who have ADHD. Which of the following statements by a faculty member indicates an
understanding of the teaching?
a) "I will plan to increase the amount of homework I assign to students who have ADHD."
b) "I will give students who have ADHD the same amount of time as other students to complete
tests."
c) "I will allow students who have ADHD one rest break throughout the day."
d) "I will teach challenging academic subjects to students who have ADHD in the morning."
Answer: c) "I will allow students who have ADHD one rest break throughout the day."
Rationale:

Allowing students with ADHD periodic breaks throughout the day can help them manage their
attention and energy levels, improving their overall focus and academic performance.
Additional Options:
a) Increasing the amount of homework for students with ADHD may overwhelm them and
exacerbate their difficulties with attention and time management.
b) Giving students with ADHD the same amount of time as other students to complete tests
may not accommodate their potential need for additional time due to attention deficits.
d) Teaching challenging academic subjects to students with ADHD in the morning may not be
effective, as they may experience peak symptoms of inattention and hyperactivity during this
time.
1. A nurse is assisting with the care of a child who is postoperative and received a transfusion
during a surgical procedure. Which of the following findings indicates the child is having a
hemolytic reaction?
a) Chills and flank pain
b) Pruritus and flushing
c) Rales and cyanosis
d) Bradycardia and diarrhea
Answer: a) Chills and flank pain
Rationale:
Chills and flank pain are findings that indicate an incompatibility of the transfused blood
product with the client's blood. The nurse should identify this finding as an indication that the
child is having a hemolytic reaction.
Additional Options:
b) Pruritus and flushing may indicate an allergic reaction to the transfused blood product.
c) Rales and cyanosis may indicate a transfusion-related acute lung injury (TRALI).
d) Bradycardia and diarrhea are not typically associated with a hemolytic reaction.
2. A nurse is collecting data from a child during a well-child visit. The nurse should recognize
that which of the following findings places the child at a higher risk for abuse?
a) The child is 6 years old.
b) The child is male.
c) The child was born at 30 weeks of gestation.

d) The child was born via cesarean birth.
Answer: c) The child was born at 30 weeks of gestation.
Rationale:
The nurse should identify that children who are born prematurely are at greater risk for abuse
because of the potential for impaired bonding during early infancy.
Additional Options:
a) Age alone does not necessarily place a child at higher risk for abuse.
b) Gender is not a sole determinant for the risk of abuse.
d) Mode of birth does not directly correlate with the risk of abuse.
3. A nurse is reinforcing teaching with the guardian of a child who has a new diagnosis of
rheumatic fever. Which of the following statements by the guardian indicates an understanding
of the teaching?
a) “I should not give my child aspirin for pain or fever.”
b) “My child will take antibiotic for 6 months.”
c) “My child might have a period of irregular movement of the extremities.”
d) “I should expect there to be blood in my child’s urine.”
Answer: c) “My child might have a period of irregular movement of the extremities.”
Rationale:
The nurse should instruct the guardian that the child might experience chorea weeks or months
after the initial diagnosis. Chorea is a temporary lack of coordination and the presence of
sudden, irregular movements or periods of clumsiness.
Additional Options:
a) Aspirin is actually indicated for rheumatic fever to reduce inflammation and prevent blood
clotting complications.
b) Antibiotics are typically prescribed for a shorter duration (usually 10 days to a few weeks) to
eradicate the streptococcal infection that triggers rheumatic fever.
d) Blood in the urine is not a typical manifestation of rheumatic fever.
4. A nurse is collecting data from an infant during a well-child visit. Which of the following
sites should the nurse use when obtaining the infant’s heart rate?
a) Apical
b) Radial

c) Carotid
d) Femoral
Answer: a) Apical
Rationale:
The nurse should use the apical pulse to obtain the infant's heart rate and count it for a full
minute because it gives a reliable rate and rhythm and provides accurate baseline assessment
data. In an infant, the apical heart rate is auscultated at the fourth intercostal space lateral to the
midclavicular line.
Additional Options:
b) Radial pulse assessment is more appropriate for older children and adults.
c) Carotid and d) femoral pulses are typically assessed in emergency situations or when
assessing for specific conditions.
5. A nurse is preparing a toddler for suturing of a minor facial laceration. The nurse should
place the toddler in which of the following restraints?
a) Mummy restraint
b) Jacket restraint
c) Elbow restraint
d) Wrist restraint
Answer: a) Mummy restraint
Rationale:
The nurse should use a mummy wrap when a short-term restraint is needed for treatment of the
toddler that involves the head and neck. The nurse should always use the least amount of
restraint necessary.
Additional Options:
b) Jacket, c) elbow, and d) wrist restraints are not appropriate for restraining a toddler during a
procedure involving the head and neck.
6. A nurse is reinforcing dietary teaching with the parent of a 2-year-old toddler. Which of the
following should the nurse include in the teaching?
a) "It is recommended that the toddler consumes no more than 12 ounces of fruit juice each
day."
b) "An appropriate serving size is 1 tablespoon of food per year of age."

c) "Introduce healthy finger foods like carrots and celery sticks."
d) "Encourage 5 cups of low-fat milk each day."
Answer: b) "An appropriate serving size is 1 tablespoon of food per year of age."
Rationale:
The nurse should include that an appropriate serving size for a 2-year-old toddler is 1
tablespoon of food per year of age.
Additional Options:
a) Limiting fruit juice intake is important, but the recommended amount varies depending on
age and dietary needs.
c) Introducing healthy finger foods is a good practice for toddlers to encourage self-feeding and
explore different textures and tastes.
d) Encouraging 5 cups of low-fat milk each day exceeds the recommended intake for toddlers
and may lead to excessive caloric intake and displacement of other nutrient-rich foods.

Document Details

  • Subject: Nursing
  • Exam Authority: ATI
  • Semester/Year: 2022

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