HSEI PEDIATRICS EXAM 2026 WITH
QUESTION AND ANSWERS 100% VERIFIED
ANSWERS
A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine
evaluation. Which assessment finding suggests the presence of a common complication
often experienced by those with Down syndrome?
A. Presence of a systolic murmur
B. New onset of patchy alopecia
C. Complaints of long bone pain
D. Recent projectile vomiting - CORRECT ANSWER - A. Presence of a systolic murmur
Rationale:
Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down
syndrome). Defects of the atrial or ventricular septum that create systolic murmurs are the
most common heart defects associated with this congenital anomaly.
A 3-month-old infant returns from surgery with elbow restraints and a Logan bow over a
cleft lip suture line. Which intervention should the nurse implement to maintain suture line
integrity during the initial postoperative period?
A. Place the infant upright in an infant seat position.
,B. Provide mittens with the use of elbow restraints.
C. Use soft rubber catheters for nasal suctioning. - CORRECT ANSWER - A. Place the
infant upright in an infant seat position.
Rationale:
The use of an infant seat simulates a supine position with the head elevated and also
prevents aspiration. Prone positioning should be avoided to prevent disruption of the
protective Logan bow and prevent the infant from rubbing the face on the bed surface.
Mittens are not necessary and decrease the ability to provide sensory comfort, such as
hand holding. Nasal suctioning should be avoided to prevent trauma or dislodging clots at
the surgical site. Water-soluble lubricant will dry the suture line and cause crusting, which
predisposes the suture line to poor healing and scarring.
A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F. What
caloric amount does this child need?
a 400 calories/day b 500 calories/day c 600 calories/day
d 700 calories/day - CORRECT ANSWER - c 600
calories/day
A 3-week-old infant is referred to an orthopedic clinic because the pediatrician heard a click
when flexing the child's right hip during a routine physical examination. The orthopedic
physician suspects that the child might have developmental dysplasia of the hip (DDH). The
parents ask the nurse to identify risk factors commonly associated with DDH. Which
response is accurate?
,A. Vertex delivery
B. Male gender
C. Breech presentation
D. Second-born child - CORRECT ANSWER - C. Breech presentation
Rationale:
Developmental dysplasia of the hip (DDH) occurs more often in infants who present in the
breech position, not the vertex (head-first) position. Twice as many females as males
present in the breech position; thus, 80% of children with DDH are females, not males. Of
breech presentations, 60% occur with first-born children, not subsequent siblings, possibly
because of the unstretched uterus and compaction of the surrounding abdominal contents,
which tend to increase compression on the uterus in the nulliparous woman.
A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of psychosocial
development is the nurse addressing when teaching inhalation therapy?
A. Autonomy
B. Industry
C. Trust
D. Initiative - CORRECT ANSWER - D. Initiative
Rationale:
, Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson theory of
psychosocial development. They enjoy being active and participating in role playing.
"Autonomy vs. Shame and Doubt" occurs at 1 to 3 years of age. "Industry vs. Inferiority"
occurs at 6 to 11 years; "Trust vs. Mistrust" occurs from birth to 1 year of age.
A 6-month-old male infant is admitted to the postanesthesia care unit with elbow restraints
in place. He has an endotracheal tube and is ventilator-dependent but will be extubated
soon following recovery from anesthesia. Which nursing intervention should be included in
this child's plan of care?
A. Keep restraints on at all times to prevent unplanned extubation.
B. Remove restraints one at a time and provide range-of-motion exercises. C. Remove all
restraints simultaneously and provide play activities.
D. Document the reason for application of the restraints every 72 hours. - CORRECT
ANSWER - B.
Remove restraints one at a time and provide range-of-motion
Rationale:
Removing restraints one at a time is safer than option C. The infant should have the
restrained extremities assessed frequently for signs of neurologic or vascular impairment,
and range-ofmotion exercises should be performed with these assessments. Under no
circumstances should restraints be applied to the client continuously. Documentation of
assessment findings regarding the restrained extremities must occur much more frequently
than every 72 hours; however, the reason for using restraints must be justified and should
be stated in the medical record
QUESTION AND ANSWERS 100% VERIFIED
ANSWERS
A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine
evaluation. Which assessment finding suggests the presence of a common complication
often experienced by those with Down syndrome?
A. Presence of a systolic murmur
B. New onset of patchy alopecia
C. Complaints of long bone pain
D. Recent projectile vomiting - CORRECT ANSWER - A. Presence of a systolic murmur
Rationale:
Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down
syndrome). Defects of the atrial or ventricular septum that create systolic murmurs are the
most common heart defects associated with this congenital anomaly.
A 3-month-old infant returns from surgery with elbow restraints and a Logan bow over a
cleft lip suture line. Which intervention should the nurse implement to maintain suture line
integrity during the initial postoperative period?
A. Place the infant upright in an infant seat position.
,B. Provide mittens with the use of elbow restraints.
C. Use soft rubber catheters for nasal suctioning. - CORRECT ANSWER - A. Place the
infant upright in an infant seat position.
Rationale:
The use of an infant seat simulates a supine position with the head elevated and also
prevents aspiration. Prone positioning should be avoided to prevent disruption of the
protective Logan bow and prevent the infant from rubbing the face on the bed surface.
Mittens are not necessary and decrease the ability to provide sensory comfort, such as
hand holding. Nasal suctioning should be avoided to prevent trauma or dislodging clots at
the surgical site. Water-soluble lubricant will dry the suture line and cause crusting, which
predisposes the suture line to poor healing and scarring.
A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F. What
caloric amount does this child need?
a 400 calories/day b 500 calories/day c 600 calories/day
d 700 calories/day - CORRECT ANSWER - c 600
calories/day
A 3-week-old infant is referred to an orthopedic clinic because the pediatrician heard a click
when flexing the child's right hip during a routine physical examination. The orthopedic
physician suspects that the child might have developmental dysplasia of the hip (DDH). The
parents ask the nurse to identify risk factors commonly associated with DDH. Which
response is accurate?
,A. Vertex delivery
B. Male gender
C. Breech presentation
D. Second-born child - CORRECT ANSWER - C. Breech presentation
Rationale:
Developmental dysplasia of the hip (DDH) occurs more often in infants who present in the
breech position, not the vertex (head-first) position. Twice as many females as males
present in the breech position; thus, 80% of children with DDH are females, not males. Of
breech presentations, 60% occur with first-born children, not subsequent siblings, possibly
because of the unstretched uterus and compaction of the surrounding abdominal contents,
which tend to increase compression on the uterus in the nulliparous woman.
A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of psychosocial
development is the nurse addressing when teaching inhalation therapy?
A. Autonomy
B. Industry
C. Trust
D. Initiative - CORRECT ANSWER - D. Initiative
Rationale:
, Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson theory of
psychosocial development. They enjoy being active and participating in role playing.
"Autonomy vs. Shame and Doubt" occurs at 1 to 3 years of age. "Industry vs. Inferiority"
occurs at 6 to 11 years; "Trust vs. Mistrust" occurs from birth to 1 year of age.
A 6-month-old male infant is admitted to the postanesthesia care unit with elbow restraints
in place. He has an endotracheal tube and is ventilator-dependent but will be extubated
soon following recovery from anesthesia. Which nursing intervention should be included in
this child's plan of care?
A. Keep restraints on at all times to prevent unplanned extubation.
B. Remove restraints one at a time and provide range-of-motion exercises. C. Remove all
restraints simultaneously and provide play activities.
D. Document the reason for application of the restraints every 72 hours. - CORRECT
ANSWER - B.
Remove restraints one at a time and provide range-of-motion
Rationale:
Removing restraints one at a time is safer than option C. The infant should have the
restrained extremities assessed frequently for signs of neurologic or vascular impairment,
and range-ofmotion exercises should be performed with these assessments. Under no
circumstances should restraints be applied to the client continuously. Documentation of
assessment findings regarding the restrained extremities must occur much more frequently
than every 72 hours; however, the reason for using restraints must be justified and should
be stated in the medical record
