Pediatrics HESI PN Exam Review 2026:
Comprehensive Questions, Answers &
Detailed Rationales
1. The practical nurse (PN) is monitoring a child who is
manifesting signs of shock after a motor vehicle collision.
Which finding is most important for the PN to report to the
charge nurse?
a) narrowing pulse pressure
b) apprehension
c) irritability
d) thirst - answer-Answer: A
2. Rationale:
3. As shock progresses, perfusion in the microcirculation
becomes marginal despite compensatory adjustments, and
the signs of decompensated shock become pronounced,
such as tachycardia and narrowing pulse pressure (A). (The
difference between systolic and diastolic blood pressure),
which should be reported immediately. (B,C, and D) are not
as significant as (A).
4. The mother of a 9 month old male infant is concerned
because he cries whenever she leaves him with a sitter.
What is the best response for the practical nurse (PN) to
provide?
a) "Have you noticed whether your baby is teething?"
b) "Crying when you leave him in a healthy sign of
attachment."
, c) "Consider taking the baby to the doctor because he
may be ill."
d) "You could consider leaving the infant more often so he
can adjust." - answer-Answer: B
5. Rationale:
6. Healthy attachment is manifested by stranger anxiety in late
infancy (B). Pain from teething expressed by the infant's
cries does not occur only when the mother leaves the infant
with another person (A). The PN should evaluate the infant's
developmental needs (C) before suggesting the infant may
be ill. An infant who manifests stranger anxiety is best
supported by the mother if the infant is left for shorter
periods of time, not (D).
7. Which preoperative action is most important for the practical
nurse (PN) to implement for a newborn with
meningomyelocele?
a) document vital signs
b) prevent skin breakdown
c) minimize the risk for infection
d) monitor neurologic functioning - answer-Answer: C
8. Rationale:
9. A meningomyelocele provides a direct entry for bacteria into
the central nervous system, leading to meningitis. Measures
that protect the integrity of the meningomyelocele sac and
infection control measures should be implemented to
minimize the risk of infection (C). (A,B, and D) should be
implemented but do not have the priority of (C).
10. The practical nurse is caring for a 6 year old girl who
had surgery 12 hours ago. The child tells the PN that she
does not have pain but a few minutes later, tells her parents
, that she does. What child development concept is relevant to
this situation?
a) inconsistency in pain reporting suggests that pain not
present
b) a child may have pain yet deny its presence to the
nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their
parents - answer-Answer: B
11. Rationale:
12. A child may fear receiving an injection for pain or may
believe that pain is a deserved punishment for some
misdeed, so the pain is denied (D) when the nurse asks the
child, who then readily admits having pain to a parent. This
behavior should not be interpreted as (C) but as a valid
indication of pain. (A and C) are incorrect interpretations of
this behavior.
13. A 6 year old who had a tonsillectomy 12 hours ago is
complaining of thirst. What should the practical nurse (PN)
offer?
a) popsicle
b) lemonade
c) orange juice
d) chocolate milk - answer-Answer: A
14. Rationale:
15. Small amounts of clear liquids without red dyes should
be offered to the child. Popsicles (A) are cold and help
soothe a dry throat. Citrus drinks (B and C) are acidic and
irritate the operative site in the posterior oropharynx. Milk (D)
Comprehensive Questions, Answers &
Detailed Rationales
1. The practical nurse (PN) is monitoring a child who is
manifesting signs of shock after a motor vehicle collision.
Which finding is most important for the PN to report to the
charge nurse?
a) narrowing pulse pressure
b) apprehension
c) irritability
d) thirst - answer-Answer: A
2. Rationale:
3. As shock progresses, perfusion in the microcirculation
becomes marginal despite compensatory adjustments, and
the signs of decompensated shock become pronounced,
such as tachycardia and narrowing pulse pressure (A). (The
difference between systolic and diastolic blood pressure),
which should be reported immediately. (B,C, and D) are not
as significant as (A).
4. The mother of a 9 month old male infant is concerned
because he cries whenever she leaves him with a sitter.
What is the best response for the practical nurse (PN) to
provide?
a) "Have you noticed whether your baby is teething?"
b) "Crying when you leave him in a healthy sign of
attachment."
, c) "Consider taking the baby to the doctor because he
may be ill."
d) "You could consider leaving the infant more often so he
can adjust." - answer-Answer: B
5. Rationale:
6. Healthy attachment is manifested by stranger anxiety in late
infancy (B). Pain from teething expressed by the infant's
cries does not occur only when the mother leaves the infant
with another person (A). The PN should evaluate the infant's
developmental needs (C) before suggesting the infant may
be ill. An infant who manifests stranger anxiety is best
supported by the mother if the infant is left for shorter
periods of time, not (D).
7. Which preoperative action is most important for the practical
nurse (PN) to implement for a newborn with
meningomyelocele?
a) document vital signs
b) prevent skin breakdown
c) minimize the risk for infection
d) monitor neurologic functioning - answer-Answer: C
8. Rationale:
9. A meningomyelocele provides a direct entry for bacteria into
the central nervous system, leading to meningitis. Measures
that protect the integrity of the meningomyelocele sac and
infection control measures should be implemented to
minimize the risk of infection (C). (A,B, and D) should be
implemented but do not have the priority of (C).
10. The practical nurse is caring for a 6 year old girl who
had surgery 12 hours ago. The child tells the PN that she
does not have pain but a few minutes later, tells her parents
, that she does. What child development concept is relevant to
this situation?
a) inconsistency in pain reporting suggests that pain not
present
b) a child may have pain yet deny its presence to the
nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their
parents - answer-Answer: B
11. Rationale:
12. A child may fear receiving an injection for pain or may
believe that pain is a deserved punishment for some
misdeed, so the pain is denied (D) when the nurse asks the
child, who then readily admits having pain to a parent. This
behavior should not be interpreted as (C) but as a valid
indication of pain. (A and C) are incorrect interpretations of
this behavior.
13. A 6 year old who had a tonsillectomy 12 hours ago is
complaining of thirst. What should the practical nurse (PN)
offer?
a) popsicle
b) lemonade
c) orange juice
d) chocolate milk - answer-Answer: A
14. Rationale:
15. Small amounts of clear liquids without red dyes should
be offered to the child. Popsicles (A) are cold and help
soothe a dry throat. Citrus drinks (B and C) are acidic and
irritate the operative site in the posterior oropharynx. Milk (D)
