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2024 ATI PEDIATRIC EXAM WITH NGN QUESTIONS
AND CORRECT ANSWERS
- A nurse is collecting data from a 9 - month-old infant. Which of the following findings would require further intervention? A. Positive Babinski reflex
Rationale: The Babinski reflex disappears after 1 year of age. Therefore, a 9-month-old infant
with a positive Babinski reflex is a finding that does not require further intervention. B. Positive Moro reflex
Rationale: The Moro reflex disappears approximately at 3- 4 months of age. Therefore, a
9 - month-old infant with a positive Moro reflex is a finding that requires further intervention C. Negative Doll’s eye reflex
Rationale: A negative Doll’s eye reflex is a normal finding. Therefore, a 9 - month-old infant
with a negative Doll’s eye reflex is a finding that does not require further intervention. D. Negative Crawl reflex
Rationale: A negative Crawl reflex disappears after 6 months of age. Therefore, a 9 - month-
old infant with a negative Crawl reflex is a finding that does not require further intervention.
- A nurse is reinforcing teaching a parent of a child who has a fracture of the epiphyseal plate. Which of the following is an appropriate statement by the nurse?
A. “The blood supply to the bone is disrupted.”
Rationale: Children heal fractures in less time than adults because of the generous blood
supply to the bone and the epiphyseal plate. B. “Normal bone growth can be affected.”
Rationale: A fracture of the epiphyseal plate can affect growth in a child. Therefore, it needs
to be detected and treated rapidly. C. “Bone marrow can be lost though the fracture.”
Rationale: The epiphyseal plate is the cartilage growth plate. Therefore, bone marrow is
not lost through this type of fracture. D. “The healing process will take longer.”
Rationale: Children heal fractures in less time than adults because of the generous blood
supply to the bone and the epiphyseal plate.
- A nurse is planning care for a child who has juvenile rheumatoid arthritis. Which of the following is an appropriate action for the nurse to take? A. Administer opioids on a schedule.
Rationale: NSAIDs are used to control pain. Therefore, administering opioids on a schedule
is not an appropriate action for the nurse to take. B. Schedule prolonged periods of complete joint immobilization daily.
Rationale: Physical mobility will assist in preserving function and maintaining mobility.
Therefore, prolonged periods of complete joint immobilization is not an appropriate action for the nurse to take. C. Apply cool compresses for 20 minutes every hour.
Rationale: Heat is beneficial for relieving pain and stiffness. Therefore, applying cool
compresses for 20 minutes every hour is not an appropriate action for the nurse to take. D. Maintain night splints to the affected joint.
Rationale: Maintaining night splints to the affected joints will assist in range of
motion. Therefore, this is an appropriate action for the nurse to take.
- A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.) A. Symptoms are continuous throughout the day. B. Daytime symptoms occur more than twice a week. C. Nighttime symptoms occur approximately twice a month. D. Minor limitations occur with normal activity. E. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value.
Rationale: Symptoms are continuous throughout the day is incorrect. Continual asthma
symptoms throughout the day are seen with severe persistent asthma. Daytime symptoms occur more than twice a week is correct. A child with mild persistent asthma will typically have daytime symptoms more than twice a week, but not daily. Nighttime symptoms occur approximately twice a month is incorrect. Nighttime symptoms occurring approximately twice a month are seen with intermittent asthma. Minor limitations occur with normal activity is correct. A child with mild persistent asthma will have some minor limitations with normal daily activities. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value is correct. A child with mild persistent asthma will have a PEF greater than or equal to 80% of the predicted value.
- A nurse working in a pediatric clinic is collecting data on a preschool-age child who has a rash on his arm. The mother reports that the child was recently exposed to impetigo contagiosa. Which of the following manifestations should the nurse expect to find with this skin infection? A. Scaling patches that are clear in the center.
Rationale: This finding is associated with tinia corporis (ringworm), not impetigo.
B. Honey-colored crusts caused by dried exudate.
Rationale: This finding is associated with impetigo contagiosa. Honey-colored crusts develop
when vesicles rupture and the exudate dries. C. Firm papules with a roughened, finely papillomatous texture.
Rationale: This finding is associated with verruca (warts), not impetigo.
D. "Sometimes my child acts bossy with his friends."
Rationale: Children of this age are often bossy and are learning how to interact
with peers. This is an expected finding. A. A nurse working at a clinic speaks on the telephone with the parent of a 2-month-old infant. The parent tells the nurse that the infant has projectile vomiting followed by hunger after meals. Which of the following responses by the nurse is appropriate? A. "Bring your infant into the clinic today to be seen."
Rationale: The manifestations of worsening projectile vomiting, which started at about 6
weeks of age, and the child acting hungry afterwards, are indicative of pyloric stenosis. The baby needs to be examined in the clinic as soon as possible by the provider. B. "Burp your child more frequently during feedings."
Rationale: This is not an appropriate response by the nurse.
C. "Give your infant an oral rehydrating solution."
Rationale: This is not an appropriate response by the nurse.
D. "You might want to try switching to different formula."
Rationale: This is not an appropriate response by the nurse.
- A parent expresses concern to the nurse about his 5 - year-old child's stuttering. Which of the following statements is an appropriate nursing response? A. "Look directly at your son when he is speaking."
Rationale: Taking time to listen attentively to a child who stutters is an appropriate
recommendation. B. "Try encouraging your son to begin saying the word again."
Rationale: This response is inappropriate, as it calls attention unnecessarily to the child's
disfluent speech pattern. C. "Many children his age have problems with stuttering."
Rationale: This response is inappropriate, because it dismisses the parent's concern without
offering any recommendations for helping the child. D. "Be sure to correct the child's speech gently and without judgement."
Rationale: This is an inappropriate response, because it calls attention to the child's problem
and might reinforce feelings of inadequacy.
- A nurse is talking to a parent who is concerned about her hospitalized 5 - year-old child's behavior and asks the nurse if it is "normal." The nurse explains that regression is common in hospitalized children and may manifest by which of the following? A. Bedwetting several times a day
Rationale: Bedwetting by a preschooler who does not usually do so is a sign of regression
in preschoolers. B. Crying when the parent leaves
Rationale: This behavior is expected with preschoolers and is not a sign of regression.
C. Eating only food from home
Rationale: Preschoolers are reluctant to make changes in their dietary habits when ill. This
is not a sign of regression. D. Cuddling a threadbare blanket at bedtime
Rationale: Transitional objects are helpful in any situation where a child feels
anxiety or stress. This is not a sign of regression.
- A nurse is planning care for a child with suspected epiglottitis. Which of the following is an appropriate action for the nurse to take? A. Obtain a throat culture
Rationale: Obtaining a throat culture on a child with suspected epiglottitis could precipitate
obstruction of the airway and should be avoided. B. Place client in an upright position
Rationale: Placing the child in an upright position will assist in maintaining a patent airway
and is an appropriate action for the nurse to take. C. Transfer for a throat x-ray
Rationale: The airway of a child with suspected epiglottitis could become obstructed
easily, therefore transferring for a throat x-ray is not an appropriate action for the nurse to take. D. Visualize the epiglottis with a tongue depressor
Rationale: Visualizing the epiglottis with a tongue depressor on a child with suspected
epiglottitis could precipitate obstruction of the airway and should be avoided.
- A school nurse is screening an 11 - year-old client for idiopathic scoliosis. Which of the following instructions should the nurse give the client for this examination? A. “Lie prone on the examination table.”
Rationale: With the client in this position, the nurse might notice some asymmetry due to
scoliosis. However, this position does not exaggerate the manifestations of this disorder and is not part of the standard scoliosis screening procedure. B. “Touch your chin to your chest and then look up at the ceiling.”
Rationale: These movements might help the nurse test flexion and hyperextension of the
neck to evaluate the cervical spine. They are not part of the standard scoliosis screening procedure. C. “Turn to the side and remain in a relaxed position.”
Rationale: Scoliosis is a lateral curvature of the spine that the nurse might not detect from a
side view. This position might help the nurse note kyphosis, a convex thoracic curvature of the thoracic spine, or lordosis, an abnormal lumbar curvature. D. “Bend forward from the waist with your head and arms downward.”
Rationale: Called the Adams position, this posture will make any asymmetry of the ribs and
flanks easier for the nurse to recognize.
- A nurse is talking to the parents of an 8-month-old who will be hospitalized for surgery. Which of the following actions should the nurse explain to the parents will help prepare the infant for the hospital? A. Buy a new toy and give it to the infant at the hospital.
Rationale: This action could be an effective anxiety-reduction strategy with a preschooler
or school-age child, as a new toy could provide the child with distraction. This is not an appropriate action to take for a hospitalized infant. B. Bring the infant’s favorite blanket to the hospital.
Rationale: Infants of this age have separation anxiety and often need a transitional object,
such as a blanket or toy, that brings them comfort. The transitional object is especially important when the child is in unfamiliar surroundings, or the parent is not there to provide comfort. Having the object will help to provide the infant with a sense of security. C. Purchase new loose-fitting, soft pajamas for the child.
Rationale: This action could be an effective anxiety-reduction strategy with an older school-
age child or adolescent, as new clothes could help with the child’s anxiety about body image. This is not an appropriate action to take for a hospitalized infant. D. Read the child a story about hospitalization.
Rationale: This action could be an effective anxiety-reduction strategy with a preschooler
or school-age child because it will help to prepare the child for a new, anxiety- producing experience. This is not an appropriate action to take for a hospitalized infant.
- A nurse is planning care for a hospitalized 4 - year-old child. The nurse should include providing a A. plastic stethoscope.
Rationale: Preschool play centers on imitation of adults. Providing a stethoscope allows the
child to imitate the staff and helps ease the fear of unfamiliar equipment. B. brightly colored mobile.
Rationale: A brightly colored mobile is appropriate for a very young infant. It would not
meet the activity needs of a preschooler. C. jigsaw puzzle.
Rationale: A jigsaw puzzle is too difficult for most preschoolers and will frustrate rather
than entertain the child. D. helium-filled latex balloon.
Rationale: Helium balloons might entertain the child, but the rubber in a deflated latex
balloon presents a choking hazard.
- A nurse is caring for an infant with spinal bifida. Which of the following is an appropriate action for the nurse to take? A. Obtain rectal temperature
Rationale: Rectal temperature could case rectal prolapse and should be avoided.
B. Place in prone position
Rationale: Placing the infant in prone position will assist in preventing trama to the lesion.
C. Cover lesion with a dry cloth
Rationale: The lesion should be covered with a moist cloth to prevent drying.
D. Perform ROM to lower extremities
Rationale: Movement of the lower extremities could cause tension on the lesion and should
be avoided.
- A school-age child is brought to the emergency department with a 2-day history of nausea, vomiting, and report of severe right lower quadrant pain. The child's WBC is 17,000/mm3 so appendicitis is suspected. Which of the following statements made by the child is most concerning to the nurse? A. “I am scared and I want to go home.”
Rationale: Many children are frightened by the health care setting. Since this is not
unexpected, this is not the most concerning statement to the nurse. B. “I am hungry and thirsty.”
Rationale: A client with a 2 - day history of nausea and vomiting might be dehydrated and feel
both hungry and thirsty. Children may report feeling hungry right after vomiting. Since this is not unexpected, this is not the most concerning statement to the nurse.
- An assistive personnel (AP) on a pediatric unit brings to the attention of the nurse several client measurements obtained with the morning vital signs. Which of the following clients should the nurse plan to visit first? A. 7 - year-old client with diabetes insipidus and a urine specific gravity of 1.
Rationale: A specific gravity of 1.002 is much lower than the expected reference range (1.
to 1.030) and indicates urine output that is extremely dilute. The client is losing excessive water and is in danger of hypovolemia. Therefore, the nurse should plan to visit this client first. B. 1 - year-old client with roseola and a temperature of 39°C (102.2°F)
Rationale: A fever of 39°C (102.2°F) is an expected finding in a child with roseola; therefore,
this is not the client that the nurse should plan to visit first. C. 4 - year-old client with status asthmaticus and a pulse oximetry of 95%
Rationale: This value, 95%, is considered within the expected range; therefore, this is not the
client that the nurse should plan to visit first. D. 10 - year-old client with sickle cell anemia and a pain rating of 6 out of 10
Rationale: A pain level of 6 is not unexpected or life threatening. Therefore, this is not
the client that the nurse should plan to visit first.
- A nurse is collecting data from an infant. Which of the following is clinical manifestation of a large patent ductus arteriosus? A. Cyanosis with crying
Rationale: A patent ductus arteriosus is failure of the artery connecting the aorta and
pulmonary artery to close after birth causing a left-to-right shunt. Therefore, cyanosis is not a clinical manifestation of a large patent ductus arteriosus. B. Machinery-like murmur
Rationale: A patent ductus arteriosus is failure of the artery connecting the aorta and
pulmonary artery to close after birth causing a left-to-right shunt. A machinery- like murmur is a clinical manifestation found in infants with a large patent ductus arteriosus. C. Weak pulses
Rationale: A patent ductus arteriosus is failure of the artery connecting the aorta and
pulmonary artery to close after birth causing a left-to-right shunt. Therefore,
bounding pulses are a clinical manifestation of a large patent ductus arteriosus. D. Chronic hypoxemia
Rationale: A patent ductus arteriosus is failure of the artery connecting the aorta and
pulmonary artery to close after birth causing a left-to-right shunt. Therefore, chronic hypoxemia is not a clinical manifestation of a large patent ductus arteriosus.
End of Test *items are not administered in this order. CAA_DetailedAnswerKey created 10/05/2012 page 18 of 18
- A nurse is caring for a pre-school age child who has a epiglottitis with a barking cough. Which of the following is an appropriate nursing action? A. Encourage coughing.
Rationale: Encouraging the client to cough is not an appropriate nursing and precipitates a
complete obstruction. B. Attempt to obtain a throat culture.
Rationale: Attempting to obtain a throat culture is not an appropriate nursing action and
may precipitate a complete obstruction. C. Visualize the back of the throat.
Rationale: Trying to visualize the back of the throat is not an appropriate nursing action
and may precipitate a complete obstruction. D. Apply oxygen.
Rationale: Applying high-flow oxygen on the client and keeping the client calm is an
appropriate action by the nurse to improve oxygenation.
- A nurse is reinforcing teaching to the parents of a child who has cystic fibrosis and has a prescription for pancrelipase (Pancrease) capsules. Which of the following should the nurse include in the teaching? A. Administer the medication with meals and snacks.
Rationale: Pancrelipase is a digestive enzyme that must be administered with all snacks or
meals in order for the food to be properly digested. B. Capsules must be taken whole.
Rationale: The medication maybe taken whole or the capsules may be opened up and the
contents sprinkled on soft food.
C. This medication may be discontinued when symptoms diminish.
Rationale: Pancreatic enzymes will be needed throughout the child's life.
D. This medication may cause a diarrhea.
Rationale: With sufficient replacement of the pancreatic enzyme, the client should experience a
decrease in the number of stools.
- A nurse is collecting data from an 11-month-old infant. Which of the following clinical manifestations is suggestive of a central nervous system infection? A. Oliguria
Rationale: Oliguria is a clinical manifestation of shock or kidney disease. However, it is not a
clinical manifestation of a central nervous system infection. B. Bulging fontanel
Rationale: A central nervous system infection causes increased intracranial pressure.
Therefore, bulging fontanels are a clinical manifestation of a central nervous system infection. C. Negative Brudzinski sign
Rationale: A positive Brudzinski sign is a clinical manifestation of a central nervous system
infection. D. Jaundice
Rationale: Jaundice is a clinical manifestation liver disease. However, not a clinical
manifestation of a central nervous system infection.
- A nurse is caring for a child diagnosed with tinea pedis. The nurse should respond with which of the following when asked by the parent what the common name for this disorder is? A. Shingles
Rationale: Shingles is the common name for varicella zoster.
B. Athlete’s foot
Rationale: Athlete’s foot is the common name for tinea pedis.
C. Fever blister
Rationale: Fever blister is the common name for herpes simplex virus type I.
