HESI PEDIATRIC EXIT EXAM 2026!!! ACTUAL EXAM COMPLETE 250 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
Question 1
A newborn has just been delivered via C-section with a myelomeningocele that was detected
prenatally. The child is scheduled for surgery within the first 48 hours. Which of the following
nursing actions is appropriate?
A) Place the child in a semi-Fowler's position to decrease pressure on the spinal cord
B) Apply a heat lamp to facilitate drying and toughening of the sac
C) Apply soft restraints to prevent disruption of the sac
D) Assess head circumference and fontanels for signs of increased intracranial pressure (ICP)
E) Place the infant in a supine position to protect the airway
Correct Answer: D) Assess head circumference and fontanels for signs of ICP.
Rationale: Hydrocephalus is a very common complication associated with
myelomeningocele (spina bifida cystica). Because the flow of cerebrospinal fluid is often
obstructed, the nurse must monitor for signs of developing hydrocephalus by measuring
head circumference and checking for bulging fontanels. The child should be placed in a
prone position (not semi-Fowler's or supine) to prevent pressure on the sac, and heat lamps
are avoided as they can dry out the sac and cause it to rupture.
Question 2
A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The
nurse should plan which priority intervention when caring for this child?
A) Maintain a structured routine and keep stimulation to a minimum
B) Communicate at the child’s level and maintain constant eye contact
C) Use therapeutic touch to calm the child during all procedures
D) Switch from one assessment activity to another quickly to maintain interest
E) Place the child in a room near the nurse's station for frequent monitoring
Correct Answer: A) Maintain a structured routine and keep stimulation to a minimum
Rationale: Children with ASD often experience sensory overload and have a significant need
for predictability and routine. A quiet, low-stimulation environment helps prevent
behavioral outbursts and decreases anxiety. Constant eye contact and therapeutic touch
may be perceived as threatening or overwhelming to a child with ASD, and assessments
should be performed slowly and one at a time.
Question 3
A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis (UA)
during this acute phase to show which of the following?
A) Bacteriuria and gross hematuria
B) Hematuria and proteinuria
C) Bacteriuria and increased specific gravity
D) Proteinuria and decreased specific gravity
E) Glucosuria and ketonuria
Correct Answer: B) Hematuria and proteinuria
, 2
Rationale: Acute glomerulonephritis is characterized by inflammation of the glomeruli,
which allows red blood cells and protein to leak into the urine. Hematuria (often appearing
as smoky or "tea-colored" urine) and mild-to-moderate proteinuria are the classic findings.
Bacteriuria is not expected because this is an inflammatory/immune response, usually
following a streptococcal infection, not a direct bacterial infection of the urinary tract.
Question 4
A child has been admitted to the pediatric unit with suspected meningitis. The CSF analysis
reveals the following: Appearance: Clear, WBC: within normal limits, Protein: within normal
limits, Glucose: within normal limits, Culture: negative. Based on these results, the nurse
suspects that the child has:
A) Bacterial meningitis
B) Meningococcal meningitis
C) Viral meningitis
D) Hydrocephalus
E) Encephalitis
Correct Answer: C) Viral meningitis
Rationale: In bacterial meningitis, the CSF is typically cloudy with high WBCs, elevated
protein, and decreased glucose (as bacteria consume the sugar). Viral (aseptic) meningitis
typically presents with clear CSF, normal or slightly elevated protein, and normal glucose
levels. Since all findings are within normal limits and the culture is negative, viral
meningitis is the most likely suspect among the options.
Question 5
A two-year-old has had one bout of nephrosis (nephrotic syndrome). His mother suspects a
recurrence when she observes swelling around his eyes. The nurse helps to confirm the condition
by recognizing what additional symptom?
A) Blood pressure 140/90
B) Marked proteinuria
C) Tea-colored urine
D) A history of positive strep infections
E) High fever and chills
Correct Answer: B) Marked proteinuria
Rationale: The hallmark of nephrotic syndrome is "massive" or marked proteinuria caused
by increased glomerular permeability. This loss of protein leads to hypoalbuminemia,
which causes fluid to shift into the tissues (edema), starting with periorbital swelling.
Hypertension and tea-colored urine (hematuria) are more characteristic of
glomerulonephritis, not nephrotic syndrome.
Question 6
The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis
, 3
like her oldest son did when he was an infant. The nurse should base her response on which
statement?
A) Meningitis rarely occurs during infancy; after the first year of life, it is more common.
B) Often a genetic predisposition to meningitis is found and family members are more likely to
get it.
C) Vaccination to prevent all types of meningitis is now available and should be administered at
6 months.
D) Vaccination to prevent Haemophilus influenzae type B (Hib) meningitis has decreased the
frequency of this disease.
E) Prophylactic antibiotics are given to all infants whose siblings had meningitis.
Correct Answer: D) Vaccination to prevent Haemophilus influenzae type B (Hib) meningitis
has decreased the frequency of this disease.
Rationale: The Hib vaccine is a standard part of the pediatric immunization schedule. Since
its introduction, the incidence of bacterial meningitis in infants and young children has
dropped significantly. While it does not prevent all types of meningitis (e.g., viral or other
bacterial strains), it targets one of the most historically common and dangerous causes.
Question 7
A six-week-old infant is brought to the pediatrician's office for a well-baby visit. During the
examination, the physician displaces the femoral head and reduces it back into place by
manipulation of the thighs and hips. The nurse recognizes that the physician is performing:
A) Barlow and Ortolani tests
B) Gowers' test
C) Pavlik test
D) Trendelenburg test
E) Phalen's maneuver
Correct Answer: A) Barlow and ortalani tests for developmental dysplasia of the hip
Rationale: The Barlow test involves adducting the hip while applying pressure to see if the
femoral head can be displaced. The Ortolani test involves abducting the hip to see if a
displaced femoral head "clicks" back into the acetabulum. These are the standard
maneuvers used to screen for developmental dysplasia of the hip (DDH) in infants.
Question 8
A 10-year-old is admitted with possible appendicitis. The lab results indicate a WBC count of
17,000, increased segmented neutrophils, decreased lymphocytes, and 6% bands. The patient
complains of abdominal pain localized at McBurney's point. Which statement most accurately
describes the data?
A) Lab work reveals a left shift and pain localized in the right lower quadrant
B) Lab work reveals a right shift and pain localized in the left upper quadrant
C) Lab work reveals normal findings with pain localized in the epigastric area
, 4
D) Lab work reveals a possible viral infection with pain localized in the left upper quadrant
E) Lab work reveals chronic inflammation with pain in the right upper quadrant
Correct Answer: A) Lab work revels a left shift and pain localized in the right lower
quadrant
Rationale: An increase in WBCs with an increase in immature neutrophils (bands) is known
as a "left shift," which indicates a significant bacterial infection. McBurney's point is
located in the right lower quadrant (RLQ) and is the classic site for localized pain in
appendicitis.
Question 9
A nurse is caring for a boy with probable intussusception. He had diarrhea before admission, but
while waiting for an air enema to reduce the intussusception, he produced a normal brown stool.
Which nursing action is the most appropriate?
A) Notify the practitioner
B) Measure abdominal girth
C) Auscultate for bowel sounds
D) Take vital signs, including blood pressure
E) Prepare the patient for immediate surgery
Correct Answer: A) Notify practitioner
Rationale: In intussusception, the passage of a normal brown stool indicates that the
"telescoped" portion of the bowel has spontaneously reduced itself. This means the
scheduled procedure (air or barium enema) or surgery may no longer be necessary. The
nurse must notify the physician immediately so the treatment plan can be re-evaluated.
Question 10
The nurse is evaluating a child who is being treated for nephrotic syndrome. Which observation
indicates successful treatment of the condition?
A) Diuresis and weight loss
B) Improved appetite and weight gain
C) Increase in urine specific gravity
D) Return of temperature and pulse to normal
E) Increase in blood pressure
Correct Answer: A) Diuresis and weight loss
Rationale: Success in treating nephrotic syndrome is marked by the reduction of edema. As
the kidneys stop leaking protein and the protein levels in the blood stabilize, fluid is pulled
from the tissues back into the vascular space and excreted, resulting in increased urine
output (diuresis) and a corresponding drop in weight.
Question 11
A young child is brought to the emergency room with suspected meningitis. Blood work, urine
cultures, and a spinal tap have been completed. He is being admitted to the pediatric unit. Which
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
Question 1
A newborn has just been delivered via C-section with a myelomeningocele that was detected
prenatally. The child is scheduled for surgery within the first 48 hours. Which of the following
nursing actions is appropriate?
A) Place the child in a semi-Fowler's position to decrease pressure on the spinal cord
B) Apply a heat lamp to facilitate drying and toughening of the sac
C) Apply soft restraints to prevent disruption of the sac
D) Assess head circumference and fontanels for signs of increased intracranial pressure (ICP)
E) Place the infant in a supine position to protect the airway
Correct Answer: D) Assess head circumference and fontanels for signs of ICP.
Rationale: Hydrocephalus is a very common complication associated with
myelomeningocele (spina bifida cystica). Because the flow of cerebrospinal fluid is often
obstructed, the nurse must monitor for signs of developing hydrocephalus by measuring
head circumference and checking for bulging fontanels. The child should be placed in a
prone position (not semi-Fowler's or supine) to prevent pressure on the sac, and heat lamps
are avoided as they can dry out the sac and cause it to rupture.
Question 2
A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The
nurse should plan which priority intervention when caring for this child?
A) Maintain a structured routine and keep stimulation to a minimum
B) Communicate at the child’s level and maintain constant eye contact
C) Use therapeutic touch to calm the child during all procedures
D) Switch from one assessment activity to another quickly to maintain interest
E) Place the child in a room near the nurse's station for frequent monitoring
Correct Answer: A) Maintain a structured routine and keep stimulation to a minimum
Rationale: Children with ASD often experience sensory overload and have a significant need
for predictability and routine. A quiet, low-stimulation environment helps prevent
behavioral outbursts and decreases anxiety. Constant eye contact and therapeutic touch
may be perceived as threatening or overwhelming to a child with ASD, and assessments
should be performed slowly and one at a time.
Question 3
A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis (UA)
during this acute phase to show which of the following?
A) Bacteriuria and gross hematuria
B) Hematuria and proteinuria
C) Bacteriuria and increased specific gravity
D) Proteinuria and decreased specific gravity
E) Glucosuria and ketonuria
Correct Answer: B) Hematuria and proteinuria
, 2
Rationale: Acute glomerulonephritis is characterized by inflammation of the glomeruli,
which allows red blood cells and protein to leak into the urine. Hematuria (often appearing
as smoky or "tea-colored" urine) and mild-to-moderate proteinuria are the classic findings.
Bacteriuria is not expected because this is an inflammatory/immune response, usually
following a streptococcal infection, not a direct bacterial infection of the urinary tract.
Question 4
A child has been admitted to the pediatric unit with suspected meningitis. The CSF analysis
reveals the following: Appearance: Clear, WBC: within normal limits, Protein: within normal
limits, Glucose: within normal limits, Culture: negative. Based on these results, the nurse
suspects that the child has:
A) Bacterial meningitis
B) Meningococcal meningitis
C) Viral meningitis
D) Hydrocephalus
E) Encephalitis
Correct Answer: C) Viral meningitis
Rationale: In bacterial meningitis, the CSF is typically cloudy with high WBCs, elevated
protein, and decreased glucose (as bacteria consume the sugar). Viral (aseptic) meningitis
typically presents with clear CSF, normal or slightly elevated protein, and normal glucose
levels. Since all findings are within normal limits and the culture is negative, viral
meningitis is the most likely suspect among the options.
Question 5
A two-year-old has had one bout of nephrosis (nephrotic syndrome). His mother suspects a
recurrence when she observes swelling around his eyes. The nurse helps to confirm the condition
by recognizing what additional symptom?
A) Blood pressure 140/90
B) Marked proteinuria
C) Tea-colored urine
D) A history of positive strep infections
E) High fever and chills
Correct Answer: B) Marked proteinuria
Rationale: The hallmark of nephrotic syndrome is "massive" or marked proteinuria caused
by increased glomerular permeability. This loss of protein leads to hypoalbuminemia,
which causes fluid to shift into the tissues (edema), starting with periorbital swelling.
Hypertension and tea-colored urine (hematuria) are more characteristic of
glomerulonephritis, not nephrotic syndrome.
Question 6
The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis
, 3
like her oldest son did when he was an infant. The nurse should base her response on which
statement?
A) Meningitis rarely occurs during infancy; after the first year of life, it is more common.
B) Often a genetic predisposition to meningitis is found and family members are more likely to
get it.
C) Vaccination to prevent all types of meningitis is now available and should be administered at
6 months.
D) Vaccination to prevent Haemophilus influenzae type B (Hib) meningitis has decreased the
frequency of this disease.
E) Prophylactic antibiotics are given to all infants whose siblings had meningitis.
Correct Answer: D) Vaccination to prevent Haemophilus influenzae type B (Hib) meningitis
has decreased the frequency of this disease.
Rationale: The Hib vaccine is a standard part of the pediatric immunization schedule. Since
its introduction, the incidence of bacterial meningitis in infants and young children has
dropped significantly. While it does not prevent all types of meningitis (e.g., viral or other
bacterial strains), it targets one of the most historically common and dangerous causes.
Question 7
A six-week-old infant is brought to the pediatrician's office for a well-baby visit. During the
examination, the physician displaces the femoral head and reduces it back into place by
manipulation of the thighs and hips. The nurse recognizes that the physician is performing:
A) Barlow and Ortolani tests
B) Gowers' test
C) Pavlik test
D) Trendelenburg test
E) Phalen's maneuver
Correct Answer: A) Barlow and ortalani tests for developmental dysplasia of the hip
Rationale: The Barlow test involves adducting the hip while applying pressure to see if the
femoral head can be displaced. The Ortolani test involves abducting the hip to see if a
displaced femoral head "clicks" back into the acetabulum. These are the standard
maneuvers used to screen for developmental dysplasia of the hip (DDH) in infants.
Question 8
A 10-year-old is admitted with possible appendicitis. The lab results indicate a WBC count of
17,000, increased segmented neutrophils, decreased lymphocytes, and 6% bands. The patient
complains of abdominal pain localized at McBurney's point. Which statement most accurately
describes the data?
A) Lab work reveals a left shift and pain localized in the right lower quadrant
B) Lab work reveals a right shift and pain localized in the left upper quadrant
C) Lab work reveals normal findings with pain localized in the epigastric area
, 4
D) Lab work reveals a possible viral infection with pain localized in the left upper quadrant
E) Lab work reveals chronic inflammation with pain in the right upper quadrant
Correct Answer: A) Lab work revels a left shift and pain localized in the right lower
quadrant
Rationale: An increase in WBCs with an increase in immature neutrophils (bands) is known
as a "left shift," which indicates a significant bacterial infection. McBurney's point is
located in the right lower quadrant (RLQ) and is the classic site for localized pain in
appendicitis.
Question 9
A nurse is caring for a boy with probable intussusception. He had diarrhea before admission, but
while waiting for an air enema to reduce the intussusception, he produced a normal brown stool.
Which nursing action is the most appropriate?
A) Notify the practitioner
B) Measure abdominal girth
C) Auscultate for bowel sounds
D) Take vital signs, including blood pressure
E) Prepare the patient for immediate surgery
Correct Answer: A) Notify practitioner
Rationale: In intussusception, the passage of a normal brown stool indicates that the
"telescoped" portion of the bowel has spontaneously reduced itself. This means the
scheduled procedure (air or barium enema) or surgery may no longer be necessary. The
nurse must notify the physician immediately so the treatment plan can be re-evaluated.
Question 10
The nurse is evaluating a child who is being treated for nephrotic syndrome. Which observation
indicates successful treatment of the condition?
A) Diuresis and weight loss
B) Improved appetite and weight gain
C) Increase in urine specific gravity
D) Return of temperature and pulse to normal
E) Increase in blood pressure
Correct Answer: A) Diuresis and weight loss
Rationale: Success in treating nephrotic syndrome is marked by the reduction of edema. As
the kidneys stop leaking protein and the protein levels in the blood stabilize, fluid is pulled
from the tissues back into the vascular space and excreted, resulting in increased urine
output (diuresis) and a corresponding drop in weight.
Question 11
A young child is brought to the emergency room with suspected meningitis. Blood work, urine
cultures, and a spinal tap have been completed. He is being admitted to the pediatric unit. Which
