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Pediatric Nursing Exam: NGN-Style Questions and Answers, Exams of Pediatrics

Miami Dade College (MDC)Pediatrics

A series of next generation nclex (ngn)-style questions and answers focused on pediatric nursing. It covers various scenarios and conditions, such as acute glomerulonephritis, seizure disorders, type 1 diabetes mellitus, and respiratory syncytial virus (rsv). Each question is accompanied by a detailed rationale, making it a valuable resource for nursing students preparing for exams or entry-level practical nursing. The content emphasizes critical thinking and application of nursing principles in pediatric care, offering insights into appropriate interventions and assessments. It also includes topics like lactose intolerance, postoperative care after open-heart surgery, and phenylketonuria (pku).

Typology: Exams

2024/2025

Available from 05/16/2025

Lectjohn
Lectjohn 🇺🇸

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ATI PEDIATRIC
PROCTORED EXAM
(NGN-STYLE QUESTIONS & CASE “SCENARIO”)
Actual Qs & Ans to Pass the Exam
This ATI test contains:
Passing Score Guarantee
70 pediatric nursing questions
multiple-choice format (A, B, C, D) with correct answers
structured rationales.
incorporate Next Generation NCLEX (NGN)-style.
Some questions feature brief “scenario” elements and
rationales consistent with entry-level practical nursing
standards.
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Partial preview of the text

Download Pediatric Nursing Exam: NGN-Style Questions and Answers and more Exams Pediatrics in PDF only on Docsity!

ATI PEDIATRIC

PROCTORED EXAM

(NGN-STYLE QUESTIONS & CASE “SCENARIO”)

Actual Qs & Ans to Pass the Exam

This ATI test contains:

 Passing Score Guarantee

 70 pediatric nursing questions

 multiple-choice format (A, B, C, D) with correct answers

 structured rationales.

 incorporate Next Generation NCLEX (NGN)-style.

 Some questions feature brief “scenario” elements and

rationales consistent with entry-level practical nursing

standards.

  1. NGN Scenario: A nurse is educating the parent of a school-age child diagnosed with acute glomerulonephritis about recommended dietary modifications. The child’s most recent labs show mild fluid retention, and the provider has recommended dietary changes to manage symptoms.

Question: Which of the following dietary instructions should the nurse include in the teaching?

A. Increase the child’s calcium intake. B. Decrease the child’s sodium intake. C. Increase the child’s intake of carbohydrates. D. Decrease the child’s fat intake.

Answer: B. Decrease the child’s sodium intake

Explanation:

  • Children with glomerulonephritis often exhibit fluid retention and edema; limiting sodium intake helps reduce fluid retention.
  • Increasing carbs or calcium is not specifically indicated for glomerulonephritis, and fat restriction is not the primary intervention.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is providing discharge teaching to parents of a school-age child newly diagnosed with a seizure disorder. The child’s typical seizure pattern includes occasional generalized tonic-clonic activity. Parents are unsure about what to do during a seizure if it occurs at home.

D. Glycosuria

Answer: A. HbA1c of 11.5%

Explanation:

  • An HbA1c of 11.5% is significantly above target (generally <7.5% for many pediatric patients), indicating poor long-term glycemic control and an increased risk of complications.
  • While glycosuria and cholesterol levels warrant attention, the critical finding requiring immediate intervention is the very high HbA1c.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: The nurse is providing anticipatory guidance to the parent of a 1-month-old infant regarding routine immunizations. The provider has asked the nurse to discuss the recommended immunization schedule.

Question: According to the recommended U.S. childhood immunization schedule, which of the following immunizations is typically started in the first 2 months of life?

A. Varicella (VAR) B. Measles, Mumps, Rubella (MMR) C. Inactivated Poliovirus (IPV) D. Hepatitis A (HepA)

Answer: C. Inactivated Poliovirus (IPV)

Explanation:

  • IPV is one of the primary series vaccinations started at 2 months of age.
  • MMR and Varicella are typically given later (at 12–15 months).
  • Hepatitis A vaccines start around 12 months.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is reviewing laboratory reports for a toddler admitted with suspected hemolytic uremic syndrome (HUS). The provider noted clinical signs of kidney dysfunction and hemolysis.

Question: Which of the following laboratory findings should the nurse expect to see in a toddler with HUS?

A. Creatinine 0.3 mg/dL B. Hemoglobin 18 g/dL C. Absence of urine casts D. BUN 28 mg/dL

Answer: D. BUN 28 mg/dL

Explanation:

  • HUS often leads to acute kidney injury, causing elevated BUN levels.
  • Creatinine is typically elevated; a level of 0.3 mg/dL would be unusually low for someone in renal distress.
  • Hemoglobin often decreases due to hemolysis.
  • Urine casts may be present.
  1. NGN Scenario: A nurse is caring for a 10-year-old child hospitalized with a sickle cell crisis. The child complains of pain in the joints and has swelling in both knees.

Answer: B. Tachypnea

Explanation:

  • A respiratory rate of 65/min is abnormally high for a 6-month-old and can indicate increased work of breathing. Immediate notification is necessary because it can precede further respiratory compromise.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is planning dietary teaching for an adolescent diagnosed with lactose intolerance. The adolescent reports frequent bloating and discomfort after dairy consumption.

Question: Which of the following instructions should the nurse include?

A. “You can drink milk on an empty stomach to reduce symptoms.” B. “Choose flavored yogurt instead of plain yogurt.” C. “You can tolerate plain milk better than chocolate milk.” D. “Replace milk with nondairy sources of calcium.”

Answer: D. “Replace milk with nondairy sources of calcium.”

Explanation:

  • Individuals with lactose intolerance need adequate calcium from nondairy sources (e.g., leafy greens, fortified products, almonds) or lactose-free products.
  • Consuming dairy on an empty stomach often worsens symptoms.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A toddler weighing 12 kg (26.5 lb) is two days postoperative after open-heart surgery and is in the pediatric ICU. Current output via Foley catheter is 15 mL over the last two hours.

Question: Which of the following findings should the nurse report immediately to the provider?

A. Skin temperature of 36°C (96.8°F) B. Pedal and posterior tibial pulses of 2+ C. Urine output of 15 mL in the last 2 hours D. Chest tube drainage of 22 mL in the last hour

Answer: C. Urine output of 15 mL in the last 2 hours

Explanation:

  • For pediatric patients, a minimum of 1 mL/kg/hr of urine output is desired. At 12 kg, the child should produce at least 24 mL in 2 hours.
  • Reduced urine output could indicate renal hypoperfusion or acute kidney injury— must be addressed immediately.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is teaching a parent about appropriate dietary choices for a 10-month-old infant who has phenylketonuria (PKU). The infant is starting to transition to more solid foods.

Question: Which of the following parent statements indicates an understanding of proper dietary management?

  • Celiac disease requires lifelong gluten-free (no wheat, rye, barley) dietary management.
  • Wheat flour must be avoided; gluten-free alternatives include rice or corn flour.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is administering albuterol via a metered-dose inhaler to a preschool-age child hospitalized with an acute asthma exacerbation. Recent peak flow reading is 80% of personal best.

Question: Which of the following findings should the nurse report immediately to the provider?

A. Respiratory rate of 24/min B. Peak flow rate of 80% of personal best C. Intercostal retractions D. Elevated heart rate

Answer: C. Intercostal retractions

Explanation:

  • Intercostal retractions signal increased respiratory effort or distress, indicating the child may be deteriorating or in an escalating asthma attack.
  • Tachycardia can be a side effect of albuterol but is less concerning than signs of respiratory distress.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario:

A nurse is caring for a school-age child (7 years old) who is 1 hour postoperative following a tonsillectomy. The child is drowsy but arousable. The family is at the bedside seeking guidance.

Question: Which of the following actions has the highest priority for this child at this time?

A. Offer cranberry juice frequently. B. Encourage the child to cough effectively. C. Observe for frequent swallowing. D. Position the child supine for comfort.

Answer: C. Observe for frequent swallowing.

Explanation:

  • Frequent swallowing may indicate active bleeding at the surgical site, which is a serious postoperative complication.
  • Acidic juices are often avoided immediately post-tonsillectomy. Coughing or clearing the throat vigorously can disrupt the surgical site.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is assessing a 10-year-old child who has heart failure. The child’s parent reports that the child tires easily during activity, has difficulty breathing, and has noticed weight gain over the last two weeks.

Question: Which of the following clinical findings are most characteristic of childhood heart failure exacerbation?

A. Bradycardia, weight loss, bounding pulses

  • Repeated vomiting can be a significant indicator of increased intracranial pressure or head injury progression.
  • A GCS of 15 is normal, and a negative Babinski reflex is expected for a toddler.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is caring for a toddler with terminal-stage neuroblastoma. The toddler requires frequent analgesia and is restless. The parents ask, “How can we help our child right now?”

Question: Which of the following responses by the nurse is most appropriate?

A. “Talk to your child about the meaning of death.” B. “Encourage your child’s classmates to visit daily.” C. “Stay close to your child for comfort and security.” D. “Change your child’s daily schedule to keep them distracted.”

Answer: C. “Stay close to your child for comfort and security.”

Explanation:

  • Terminally ill children benefit from a calm, comforting presence. Physical closeness reduces anxiety and provides emotional support.
  • Discussion of death depends on the child’s developmental stage.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario (Calculation Question): A nurse is preparing to administer an oral antibiotic (cephalexin) to a child with otitis media. The prescription states: Cephalexin 25 mg/kg PO. The child weighs 22 kg. The concentration of cephalexin solution is 250 mg per 5 mL.

Question: How many milliliters should the nurse administer per dose? (Round to the nearest whole number.)

A. 5 mL B. 9 mL C. 11 mL D. 15 mL

Step-by-Step:

  • Dose needed: 25 mg/kg × 22 kg = 550 mg
  • Available: 250 mg per 5 mL
  • Ratio: 250 mg : 5 mL = 550 mg : X mL
  • Solve: (550 × 5) / 250 = 11 mL

Answer: C. 11 mL

Explanation:

  • Each 5 mL provides 250 mg. To reach 550 mg, you need 11 mL.
  1. NGN Scenario: During a 2-week well-baby visit, the parent reports that the newborn always keeps her head tilted to the right side and is unable to turn easily to the left.

Question: Which of the following anatomical structures should the nurse further assess based on this concern?

A. Posterior fontanel

  1. NGN Scenario: A nurse is admitting an infant with gastroesophageal reflux disease (GERD). During the initial assessment, the infant has frequent cough and wheezing sounds on auscultation.

Question: Which of the following assessment findings should the nurse address as the top priority?

A. Regurgitation B. Wheezing C. Excessive crying D. Weight loss

Answer: B. Wheezing

Explanation:

  • Wheezing may indicate aspiration or airway involvement, which requires prompt evaluation.
  • While regurgitation and weight loss are concerning, potential respiratory compromise is the immediate priority.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A breastfed infant is brought to the clinic with several days of diarrhea and decreased wet diapers. The provider suspects severe dehydration.

Question:

Which of the following clinical manifestations is consistent with severe dehydration in an infant?

A. Capillary refill of 3 seconds B. Rapid respirations C. Bradycardia D. Warm extremities

Answer: B. Rapid respirations

Explanation:

  • As dehydration worsens, compensatory tachypnea often occurs.
  • Warm extremities and capillary refill of 3 seconds are less indicative of severe dehydration. Tachycardia is also expected rather than bradycardia.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A nurse is teaching a group of female adolescents about healthy dietary habits, especially considering increased nutritional demands during adolescence.

Question: Which nutritional recommendation should the nurse stress?

A. Consume 1,500 to 1,700 calories per day. B. Decrease vitamin D intake once menstruation begins. C. Increase daily dietary iron intake. D. Limit sodium intake to 3,000 grams per day.

Answer: C. Increase daily dietary iron intake.

Explanation:

Which of the following actions should the nurse take first?

A. Report the disease to the state health department. B. Initiate contact isolation precautions. C. Administer IV amphotericin B. D. Apply topical lidocaine ointment.

Answer: B. Initiate contact isolation precautions.

Explanation:

  • Impetigo (bacterial skin infection) is highly contagious; contact precautions are required.
  • Amphotericin B is for fungal infections, not impetigo. Reporting varies by jurisdiction; immediate isolation is key.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A school-age child with cystic fibrosis (CF) is being discharged. The parents want detailed instructions on how to optimize the child’s nutritional status, knowing the child’s pancreatic function is limited.

Question: Which of the following parent statements indicates proper understanding of discharge teaching?

A. “I should limit my child’s fluid intake.” B. “We need to reduce salt in our child’s diet.” C. “We will give our child pancreatic enzymes with snacks and meals.” D. “I will prepare low-fat meals with limited protein for my child.”

Answer: C. “We will give our child pancreatic enzymes with snacks and meals.”

Explanation:

  • Pancreatic enzyme replacement is essential for CF patients to aid digestion and improve nutrient absorption.
  • Increased fluid intake and a healthy amount of dietary salt are often recommended due to excessive losses in sweat.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: A 4-year-old child with meningitis is prescribed gentamicin. After 3 days of antibiotic therapy, the nurse reviews the child’s lab results.

Question: Which laboratory value would be most concerning and require immediate provider notification?

A. Serum creatinine 1.4 mg/dL B. Serum creatinine 0.3 mg/dL C. BUN 6 mg/dL D. BUN 12 mg/dL

Answer: A. Serum creatinine 1.4 mg/dL

Explanation:

  • Gentamicin can be nephrotoxic, and an elevated creatinine (1.4 mg/dL is high for a 4-year-old) can indicate renal impairment.
  • Normal creatinine in a young child is typically <1.0 mg/dL.

──────────────────────────────────────────────────────────── ────────────

  1. NGN Scenario: