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ATI Pediatrics Proctored Exam EXAM
QUESTIONS ACCURATE AND VERIFIED
ACTUAL EXAM QUESTIONS WITH DETAILED
ANSWERS FOR GUARANTEED PASS |
ALREADY GRADED A
1. What is an expected finding in a school-age child with glomerulonephritis? A. Clear urine B. Frothy urine C. Brown-colored urine ✅ D. Cloudy urine Rationale: Brown-colored (tea-colored) urine is a hallmark sign due to hematuria from glomerular inflammation. 2. McBurney’s point is associated with: A. Gastric ulcer B. Appendicitis ✅ C. Pancreatitis D. Cholecystitis Rationale: Pain at McBurney’s point (right lower abdomen) is a classic sign of appendicitis. 3. Which of the following are expected findings in a child with celiac disease? A. Constipation and weight gain B. Bloody stool and fever C. Steatorrhea, distended abdomen, weight loss ✅ D. Jaundice and itching Rationale: Gluten intolerance leads to fat malabsorption (steatorrhea), abdominal bloating, and weight loss.
4. What type of vomiting is associated with pyloric stenosis? A. Coffee ground B. Projectile ✅ C. Bilious D. Regurgitation Rationale: Projectile vomiting is characteristic due to hypertrophy of the pyloric muscle. 5. What is used to treat scabies lesions? A. Hydrocortisone B. Benzoyl peroxide C. Permethrin 5% cream ✅ D. Calamine lotion Rationale: Permethrin 5% is the first-line treatment for scabies infestations. 6. Which symptom is a classic manifestation of pertussis? A. Productive cough B. Dry hacking cough ✅ C. Sore throat D. Nasal congestion Rationale: The paroxysmal dry, hacking cough is a hallmark of whooping cough (pertussis). 7. Which of the following is a manifestation of acute streptococcal pharyngitis? A. White patches on the tongue B. Inflamed throat with exudate ✅ C. Pale oral mucosa D. Nasal discharge Rationale: Exudative pharyngitis with inflammation is characteristic of streptococcal infection.
A. Every 6 months B. Only during flare-ups C. Every 12–24 months ✅ D. Once a year Rationale: Pulmonary function testing is recommended every 1–2 years to monitor airway status.
13. What is appropriate nursing care during a lumbar puncture? A. Keep child upright for 24 hours post-procedure B. No fluids for 12 hours C. Apply topical analgesic 60 min before and keep child flat after ✅ D. Elevate the head of bed Rationale: Lying flat prevents spinal headache; analgesics reduce procedural pain. 14. What diet is appropriate for a child with cystic fibrosis? A. Low fat, low protein B. High fiber C. High protein, high calorie, unrestricted fat ✅ D. Bland diet Rationale: CF patients need high-calorie, high-protein diets with fat to compensate for malabsorption. 15. Can a child with celiac disease consume malt? A. Yes, in small amounts B. Only if it's gluten-free C. No, it contains gluten ✅ D. Yes, if symptoms are absent Rationale: Malt is derived from barley and contains gluten—contraindicated in celiac disease. 16. What should be done after giving oral digoxin suspension to a child?
A. Provide food immediately B. Give water only C. Brush the child’s teeth ✅ D. Administer a second dose Rationale: Brushing prevents tooth decay and staining from the sugary medication.
17. A sign of digoxin toxicity in children includes: A. Diarrhea B. Decreased appetite and vomiting ✅ C. Flushed skin D. Increased urination Rationale: Early signs of toxicity include GI upset and poor feeding. 18. What are signs of brainstem herniation? A. Hyperthermia and hypertension B. Seizures and vomiting C. Cushing’s triad: HTN, bradycardia, decreased respirations ✅ D. Headache and stiff neck Rationale: Cushing’s triad is a classic sign of increased ICP leading to herniation. 19. What is a key intervention for lead toxicity? A. High iron diet only B. Vitamin D supplementation C. Chelation therapy and iron-rich diet ✅ D. Avoid sugar Rationale: Chelation is needed for levels ≥45 mcg/dL; iron and calcium reduce absorption. 20. What is an expected finding after an appendectomy? A. Return of bowel sounds immediately B. Peristalsis present
Rationale: MMR contains trace elements of these allergens—contraindicated in hypersensitive individuals.
25. Wheezing is described as: A. Gurgling noise in throat B. High-pitched musical sound on expiration ✅ C. Continuous rattling sound D. Clicking sound during breathing Rationale: Wheezes are musical and expiratory—caused by narrowed airways. 26. What are crackles best described as? A. Continuous high-pitched whistling sounds B. Low rumbling sounds during expiration C. High-pitched, short, non-continuous sounds at the end of inspiration ✅ D. Loud wheezing sounds heard on both inspiration and expiration Rationale: Crackles are short, popping sounds heard at the end of inspiration due to fluid or collapsed alveoli opening. 27. Post-op care after a cardiac catheterization includes: A. Full bed rest for 1 week B. Take tub baths after 24 hours C. Avoid strenuous activity for 3 days, keep site dry ✅ D. Only clear liquids for 24 hours Rationale: Strenuous activity should be avoided; site must stay dry; pressure dressing is removed the day after. 28. Mononucleosis is caused by: A. Herpes simplex virus B. Epstein-Barr virus ✅ C. Cytomegalovirus D. Hepatitis A
Rationale: The Epstein-Barr virus is the primary cause of infectious mononucleosis.
29. Which stool description is typical of intussusception? A. Black tarry stools B. Bright red blood only C. Currant jelly-like stools D. Hard, pellet-like stool Rationale: Intussusception causes blood and mucus in stool, resembling red currant jelly. 30. A child with a ventricular septal defect (VSD) will most likely present with: A. Cyanosis B. Silent murmur C. Loud, harsh murmur D. Bounding pulses Rationale: VSD causes turbulent flow, leading to a loud and harsh systolic murmur. 31. What is a sign of coarctation of the aorta? A. Bounding femoral pulses B. Weak femoral pulses and high BP C. Cyanosis of the feet only D. Split S2 heart sound Rationale: Narrowing causes high BP and diminished pulses in the lower extremities. 32. What should you do first for an infant experiencing a hypercyanotic spell (Tet spell)? A. Administer antibiotics B. Place in prone position C. Place infant in knee-to-chest position D. Give nebulizer treatment Rationale: Knee-to-chest position improves venous return and reduces right-to-left shunting.
37. Desmopressin is used to treat: A. SIADH B. Hypersecretion of ADH C. Hyposecretion of ADH D. Cushing’s syndrome Rationale: Desmopressin mimics ADH and is used to treat diabetes insipidus (low ADH). 38. CF diet management includes: A. Avoiding fats B. Enzymes only at bedtime C. Pancreatic enzymes with meals/snacks D. No fluids with meals Rationale: Enzymes help with digestion of nutrients, especially fats, and must be taken with food. 39. What is the priority intervention for a toddler with suspected epiglottitis? A. Obtain throat culture B. Administer nebulizer treatment C. Prepare for nasotracheal intubation D. Start IV antibiotics immediately Rationale: Airway protection is the priority—intubation or tracheostomy may be necessary. 40. Which vaccine helps prevent epiglottitis? A. DTaP B. Hib C. MMR D. Polio Rationale: Haemophilus influenzae type B (Hib) vaccine prevents the bacterial cause of epiglottitis.
41. What is a hallmark sign of Kawasaki disease? A. Periorbital swelling B. Cough with rash C. Strawberry tongue and cracked lips D. Green nasal discharge Rationale: Kawasaki disease causes inflammation of blood vessels with mucosal involvement. 42. Major complication of Kawasaki disease includes: A. Pulmonary embolism B. Coronary artery aneurysm C. GI bleed D. Renal failure Rationale: The most serious risk is coronary artery involvement, leading to aneurysms or MI. 43. Phenytoin therapy may cause which side effect? A. Alopecia B. Gingival hyperplasia C. Rash D. Night sweats Rationale: Gum overgrowth is a common side effect of long-term phenytoin use. 44. A hoarse voice in a child may indicate: A. Diphtheria B. Measles C. Scarlet fever D. Mumps Rationale: Diphtheria causes inflammation of the upper airway and can lead to hoarseness. 45. A facial rash in a child lasting 1–4 days likely indicates:
A. Encourage high activity levels B. Administer antivirals C. Administer salicylates and ensure bed rest D. Use cool compresses only Rationale: Bed rest and anti-inflammatory medications are crucial in managing rheumatic fever.
50. Heart failure management in children includes: A. Encourage regular sports B. Give large meals C. Small, frequent meals and restrict activity D. Use high-fiber diet Rationale: HF increases metabolic demands; small frequent meals and activity restrictions preserve energy. 51. Which is a sign of a hemolytic transfusion reaction? A. Hypertension B. Flank pain C. Bradycardia D. Rash and itching only Rationale: Hemolytic reactions cause RBC destruction, leading to flank/back pain due to kidney involvement. 52. The pneumococcal polysaccharide vaccine is recommended for: A. All children at age 2 B. Children with high-risk conditions aged 2– 18 C. Every infant under 12 months D. All school-aged children Rationale: It protects high-risk children (e.g., with chronic illness) from Streptococcus pneumoniae. 53. The meningococcal polysaccharide vaccine is recommended for:
A. All toddlers B. All incoming college students C. Children under 1 year D. Only healthcare workers Rationale: Close living conditions (like dormitories) increase meningitis risk, so it’s recommended for new college students.
54. When should the final dose of rotavirus vaccine be given? A. After 12 months B. Before 8 months C. Any time in the first year D. Before 2 years Rationale: To reduce risk of intussusception, final dose must be administered before 8 months of age. 55. A child with asthma should not: A. Use a dehumidifier B. Play outside when mowing is happening C. Use an air purifier D. Wet mop the floors Rationale: Grass and pollen can trigger asthma—mowing should be avoided. 56. Nursing interventions for a child with heart failure include: A. Restrict fluids aggressively B. Weigh weekly C. Weigh daily and restrict play D. Increase salt intake Rationale: Daily weights assess fluid status; play is restricted to conserve energy. 57. Which of the following helps decrease risk of asthma exacerbation?
C. Scarlet fever D. Varicella Rationale: These small bluish-white spots appear on the buccal mucosa before the measles rash.
62. Which organism causes mononucleosis? A. Hepatitis A B. Varicella zoster C. Epstein-Barr virus D. Adenovirus Rationale: EBV is the causative agent of infectious mononucleosis. 63. A child with cystic fibrosis should have pancreatic enzymes: A. 2 hours after eating B. At bedtime only C. With meals and snacks D. Before bed Rationale: Enzymes aid digestion and must be taken with every meal/snack. 64. Which is NOT part of a cystic fibrosis diet? A. High calorie B. Low fat C. High protein D. Adequate hydration Rationale: CF diets are high fat to meet energy demands—not restricted. 65. A child with SIADH will likely show: A. Increased sodium and dehydration B. Low sodium and decreased urine output
C. High urine output D. Dry mucous membranes Rationale: SIADH causes water retention → dilutional hyponatremia and low output.
66. Expected finding after an appendectomy: A. Return of bowel sounds within 1 hour B. Peristalsis C. Absent bowel sounds and elevated WBC D. Soft abdomen Rationale: Post-op ileus and inflammation are common findings. 67. Which child should not receive the MMR vaccine? A. Allergy to latex B. Allergy to neomycin or gelatin C. History of asthma D. Egg sensitivity only Rationale: MMR contains traces of neomycin and gelatin—contraindicated in severe allergies to these. 68. Which describes wheezing? A. Popping noises at inspiration B. Low grunting C. High-pitched musical sound, especially on expiration D. Crackling sounds with coughing Rationale: Wheezing indicates narrowed airways, common in asthma or bronchiolitis. 69. What is the best description of crackles? A. Musical sound on expiration B. Fine, non-continuous popping at end of inspiration
- flexed sitting position What position is used for a femoral venipuncture? - answwersupine with legs in a frog position How is Hirshprung's disease diagnosed? - answwerbiopsy on a small amount of tissue from the colon How is pyloric stenosis diagnosed? - answweran upper GI series nursing interventions post op following a surgical repair of cleft lip and palate - answwer-avoid placing objects in the infant's mouth
- gently suction the mouth with a bulb syringe PRN to maintain a patent airway
- position the infant upright
- clean the incision with sterile saline or sterile water after each feeding and as needed manifestation sof tracheomalacia - answwer-barking cough
- stridor
- wheezing
- cyanosis
- apnea What does an ASO titer check for? - answwera recent strep infection What should alert the nurse that a toddler in acute respiratory distress may have epiglottitis? - answwerdrooling
How should an infant be fed following a cleft palate repair? Why? - answwerclear liquids in a cup for 7-10 days to prevent trauma/injury to the suture line What are children with hemophilia at risk for? - answwerbleeding What kind of murmur is expected with VSD? - answwermurmur at the left sternal border? What kind of murmur is expected with ASD? - answwerdiastolic murmur What is an expected finding in a child who has an atrioventricular canal defect? - answwercyanosis that increases with crying interventions for an infant with GERD - answwer-give lansoprazole 30 min before feeding
- place infant in a seat or at a 30 degree angle for 1 hr after feedings
- avoid feedings just before bedtime
- at rice cereal to the milk/formula to thicken the feedings and decrease the episodes of vomiting phenytoin - answwerseizure medication lab findings in a child with acute lymphocytic leukemia - answwer-low platelet count
- low RBC count
- very high WBC count
- low Hct level
