NURS 320 HESI PEDIATRICS PEDIATRIC NURSING QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027
Section One: Questions 1–100
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute epiglottitis. Which
nursing intervention is the absolute priority upon admission?
A. Assess the child's arterial blood gas values.
B. Obtain a clean-catch urine specimen for urinalysis.
C. Ensure emergency airway equipment is available at the bedside.
D. Visualize the throat with a tongue depressor to confirm inflammation.
🟢 Correct answer: C
🔴 RATIONALE: Acute epiglottitis is a medical emergency that can progress rapidly to total airway
occlusion. Emergency tracheostomy or endotracheal intubation equipment must be kept at the
bedside. Visualizing the throat with a tongue depressor is strictly contraindicated because it can
trigger a fatal laryngospasm.
A nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which
muscle site should the nurse select as the safest location?
A. Dorsogluteal muscle
B. Ventrogluteal muscle
C. Deltoid muscle
D. Vastus lateralis muscle
🟢 Correct answer: D
🔴 RATIONALE: The vastus lateralis muscle is the largest muscle mass in infants and contains no
major nerves or blood vessels, making it the safest and preferred site for intramuscular injections in
,children under 12 months of age. The dorsogluteal site should be avoided until the child has been
walking for at least a year due to the risk of sciatic nerve injury.
The parents of a 2-year-old toddler tell the clinic nurse that their child frequently throws violent
temper tantrums. What guidance should the nurse offer?
A. Punish the child immediately by placing them in a time-out for 10 minutes.
B. Ensure the child is safe and ignore the tantrum behavior completely.
C. Offer the child a favorite toy or treat to calm them down.
D. Argue with the child calmly until they listen to reason.
🟢 Correct answer: B
🔴 RATIONALE: Temper tantrums are a normal aspect of a toddler's development as they assert
independence. The most effective approach is to ignore the behavior while ensuring the child is
safe from injury. Giving rewards or attention during a tantrum reinforces the negative behavior, and
long time-outs (greater than 1 minute per year of age) are ineffective.
A 6-year-old child is recovering from a tonsillectomy. Which assessment finding should alert the
nurse to a potential postoperative hemorrhage?
A. Infrequent coughing up of dark brown secretions
B. Reports of a mild sore throat radiating to the ears
C. Frequent, continuous swallowing actions by the child
D. A transient low-grade temperature of 99.4 degrees Fahrenheit
🟢 Correct answer: C
🔴 RATIONALE: Frequent or continuous swallowing is a classic, early sign of postoperative
bleeding in a child following a tonsillectomy, as blood trickles down the back of the pharynx. Dark
brown secretions indicate old blood and are expected, whereas frequent swallowing indicates
active, fresh bleeding that requires immediate intervention.
,A 3-month-old infant is brought to the emergency department with suspected Shaken Baby
Syndrome. Which classic assessment triad is most indicative of this condition?
A. Retinal hemorrhages, subdural hematoma, and encephalopathy
B. Fractured clavicle, scalp hematoma, and abdominal bruising
C. Microcephaly, cataracts, and congenital heart defects
D. Hyperactivity, jaundice, and persistent projectile vomiting
🟢 Correct answer: A
🔴 RATIONALE: Shaken Baby Syndrome (abusive head trauma) is characterized by a classic
clinical triad of retinal hemorrhages, subdural or subarachnoid hematomas, and severe
neurological changes or encephalopathy. This occurs due to the violent acceleration-deceleration
forces exerted on the infant's fragile brain tissue and cranial vessels.
A nurse is reviewing the laboratory results of an infant with a suspected diagnosis of pyloric
stenosis. Which metabolic imbalance should the nurse expect to find?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
🟢 Correct answer: C
🔴 RATIONALE: Hypertrophic pyloric stenosis causes persistent, projectile vomiting, which leads
to a massive loss of hydrochloric acid and potassium from the stomach. This depletion results in
hypokalemic, hypochloremic metabolic alkalosis.
While assessing a 10-month-old infant, the nurse notes that the anterior fontanel is flat and slightly
soft. What is the correct interpretation of this finding?
A. The infant is experiencing severe cranial dehydration.
B. This is a normal anatomical finding for an infant of this age.
, C. The fontanel has closed prematurely, indicating craniosynostosis.
D. The infant has increased intracranial pressure requiring surgery.
🟢 Correct answer: B
🔴 RATIONALE: The anterior fontanel normally closes between 12 and 18 months of age. A flat,
soft fontanel in a 10-month-old infant is a perfectly normal finding. Sunken fontanels indicate
dehydration, while bulging fontanels indicate elevated intracranial pressure.
A child with tetralogy of Fallot becomes suddenly distressed, cyanotic, and dyspneic during a blood
draw. Which immediate action should the nurse take first?
A. Administer a high-dose intravenous fluid bolus.
B. Place the child in a knee-chest position.
C. Prepare for emergency endotracheal intubation.
D. Administer a standard dose of intramuscular epinephrine.
🟢 Correct answer: B
🔴 RATIONALE: The child is experiencing a hypercyanotic spell, often referred to as a "tet spell."
Placing the child in a knee-chest position increases systemic vascular resistance, which decreases
the right-to-left shunting of unoxygenated blood across the ventricular septal defect, thereby
improving pulmonary blood flow and oxygenation.
A school-age child is admitted to the hospital with acute post-streptococcal glomerulonephritis
(APSGN). Which clinical manifestation should the nurse anticipate during the assessment?
A. Profuse watery diarrhea and high fever
B. Hypotension and generalized polyuria
C. Periorbital edema and smoky, tea-colored urine
D. Severe generalized pruritus and clay-colored stools
🟢 Correct answer: C
🔴 RATIONALE: APSGN is an immune-complex disease that occurs following a streptococcal
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027
Section One: Questions 1–100
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute epiglottitis. Which
nursing intervention is the absolute priority upon admission?
A. Assess the child's arterial blood gas values.
B. Obtain a clean-catch urine specimen for urinalysis.
C. Ensure emergency airway equipment is available at the bedside.
D. Visualize the throat with a tongue depressor to confirm inflammation.
🟢 Correct answer: C
🔴 RATIONALE: Acute epiglottitis is a medical emergency that can progress rapidly to total airway
occlusion. Emergency tracheostomy or endotracheal intubation equipment must be kept at the
bedside. Visualizing the throat with a tongue depressor is strictly contraindicated because it can
trigger a fatal laryngospasm.
A nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which
muscle site should the nurse select as the safest location?
A. Dorsogluteal muscle
B. Ventrogluteal muscle
C. Deltoid muscle
D. Vastus lateralis muscle
🟢 Correct answer: D
🔴 RATIONALE: The vastus lateralis muscle is the largest muscle mass in infants and contains no
major nerves or blood vessels, making it the safest and preferred site for intramuscular injections in
,children under 12 months of age. The dorsogluteal site should be avoided until the child has been
walking for at least a year due to the risk of sciatic nerve injury.
The parents of a 2-year-old toddler tell the clinic nurse that their child frequently throws violent
temper tantrums. What guidance should the nurse offer?
A. Punish the child immediately by placing them in a time-out for 10 minutes.
B. Ensure the child is safe and ignore the tantrum behavior completely.
C. Offer the child a favorite toy or treat to calm them down.
D. Argue with the child calmly until they listen to reason.
🟢 Correct answer: B
🔴 RATIONALE: Temper tantrums are a normal aspect of a toddler's development as they assert
independence. The most effective approach is to ignore the behavior while ensuring the child is
safe from injury. Giving rewards or attention during a tantrum reinforces the negative behavior, and
long time-outs (greater than 1 minute per year of age) are ineffective.
A 6-year-old child is recovering from a tonsillectomy. Which assessment finding should alert the
nurse to a potential postoperative hemorrhage?
A. Infrequent coughing up of dark brown secretions
B. Reports of a mild sore throat radiating to the ears
C. Frequent, continuous swallowing actions by the child
D. A transient low-grade temperature of 99.4 degrees Fahrenheit
🟢 Correct answer: C
🔴 RATIONALE: Frequent or continuous swallowing is a classic, early sign of postoperative
bleeding in a child following a tonsillectomy, as blood trickles down the back of the pharynx. Dark
brown secretions indicate old blood and are expected, whereas frequent swallowing indicates
active, fresh bleeding that requires immediate intervention.
,A 3-month-old infant is brought to the emergency department with suspected Shaken Baby
Syndrome. Which classic assessment triad is most indicative of this condition?
A. Retinal hemorrhages, subdural hematoma, and encephalopathy
B. Fractured clavicle, scalp hematoma, and abdominal bruising
C. Microcephaly, cataracts, and congenital heart defects
D. Hyperactivity, jaundice, and persistent projectile vomiting
🟢 Correct answer: A
🔴 RATIONALE: Shaken Baby Syndrome (abusive head trauma) is characterized by a classic
clinical triad of retinal hemorrhages, subdural or subarachnoid hematomas, and severe
neurological changes or encephalopathy. This occurs due to the violent acceleration-deceleration
forces exerted on the infant's fragile brain tissue and cranial vessels.
A nurse is reviewing the laboratory results of an infant with a suspected diagnosis of pyloric
stenosis. Which metabolic imbalance should the nurse expect to find?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
🟢 Correct answer: C
🔴 RATIONALE: Hypertrophic pyloric stenosis causes persistent, projectile vomiting, which leads
to a massive loss of hydrochloric acid and potassium from the stomach. This depletion results in
hypokalemic, hypochloremic metabolic alkalosis.
While assessing a 10-month-old infant, the nurse notes that the anterior fontanel is flat and slightly
soft. What is the correct interpretation of this finding?
A. The infant is experiencing severe cranial dehydration.
B. This is a normal anatomical finding for an infant of this age.
, C. The fontanel has closed prematurely, indicating craniosynostosis.
D. The infant has increased intracranial pressure requiring surgery.
🟢 Correct answer: B
🔴 RATIONALE: The anterior fontanel normally closes between 12 and 18 months of age. A flat,
soft fontanel in a 10-month-old infant is a perfectly normal finding. Sunken fontanels indicate
dehydration, while bulging fontanels indicate elevated intracranial pressure.
A child with tetralogy of Fallot becomes suddenly distressed, cyanotic, and dyspneic during a blood
draw. Which immediate action should the nurse take first?
A. Administer a high-dose intravenous fluid bolus.
B. Place the child in a knee-chest position.
C. Prepare for emergency endotracheal intubation.
D. Administer a standard dose of intramuscular epinephrine.
🟢 Correct answer: B
🔴 RATIONALE: The child is experiencing a hypercyanotic spell, often referred to as a "tet spell."
Placing the child in a knee-chest position increases systemic vascular resistance, which decreases
the right-to-left shunting of unoxygenated blood across the ventricular septal defect, thereby
improving pulmonary blood flow and oxygenation.
A school-age child is admitted to the hospital with acute post-streptococcal glomerulonephritis
(APSGN). Which clinical manifestation should the nurse anticipate during the assessment?
A. Profuse watery diarrhea and high fever
B. Hypotension and generalized polyuria
C. Periorbital edema and smoky, tea-colored urine
D. Severe generalized pruritus and clay-colored stools
🟢 Correct answer: C
🔴 RATIONALE: APSGN is an immune-complex disease that occurs following a streptococcal
