Pediatrics HESI Practice Exam Questions
with Answers | Complete Study Guide with
Practice Questions, Verified Correct Answers
& Detailed Rationales | Updated 2026/2027
Question 1
The nurse is preparing a child with an intussusception for a prescribed barium enema.
What is the main purpose of conducting this procedure prior to surgical intervention?
A. Evacuate the bowel of impacted feces.
B. Reduce the invaginated bowel segment.
C. Locate the presence of diverticula.
D. Identify the area of esophageal atresia.
Answer: B
Rationale: Intussusception is an invagination or telescoping of one portion of the
intestine into another. Hydrostatic pressure from barium instillation often reduces the
area of bowel intussusception, negating the need for surgical intervention.
Question 2
The nurse is teaching an adolescent girl with scoliosis about a Milwaukee brace that her
health care provider has prescribed. Which instruction should the nurse provide to this
client?
A. Remove the brace 1 hour each day for bathing only.
B. Remove the brace only for back range-of-motion exercises.
C. Wear the brace against the bare skin to ensure a good fit.
D. Wearing the brace will cure the spinal curvature.
Answer: A
Rationale: The Milwaukee brace should be worn 23 hours a day and removed a total of
1 hour a day for hygiene. A T-shirt should be worn under the brace to protect the skin.
The brace will not cure the curvature.
Question 3
The nurse should teach the parents of a child with a cyanotic heart defect to perform
pg. 1
,which action when a hypercyanotic spell occurs?
A. Place the child's head flat, with the knees on pillows above the level of the heart.
B. Have the child lie on the right side, with the head elevated on one pillow.
C. Allow the child to assume a knee-chest position, with the head and chest slightly
elevated.
D. Encourage the child to sit up at a 45-degree angle, drink cold water, and take deep
breaths.
Answer: C
Rationale: Assuming a knee-chest position with the head and chest slightly elevated
helps restore hemodynamic equilibrium by increasing systemic vascular resistance.
Question 4
During routine screening at a school clinic, an otoscope examination of a child's ear
reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable.
Based on these findings, what action should the nurse take?
A. No action is required, because this is an expected finding for a school-aged child.
B. Ask if the child has had a cold, runny nose, or any ear pain lately.
C. Send a note home advising parents to have the child evaluated by a health care
provider.
D. Call the parents and have them take the child home from school for the rest of the
day.
Answer: B
Rationale: The tympanic membrane is normally pearly gray, not bulging, and
movable. Because these findings are not completely normal, further assessment of
history and related signs and symptoms are needed.
Question 5
A newborn female whose mother is HIV-positive is scheduled for the first follow-up
assessment with the nurse. If the child is HIV-positive, which initial symptom is she
most likely to exhibit?
A. Shortness of breath
B. Joint pain
C. Persistent cold
D. Organomegaly
Answer: C
pg. 2
, Rationale: The most typical presenting symptom of a child who contracted AIDS
through vertical transmission is a persistent cold or respiratory infection due to
decreased ability to defend against common infections.
Question 6
A child breaks out with varicella infection (chickenpox) while hospitalized for a minor
surgical procedure. Which intervention should the nurse implement first?
A. Place a mask on the child before transporting the child outside the room.
B. Immunize exposed family members with the varicella vaccine.
C. Place the child in strict isolation to prevent an outbreak on the unit.
D. Determine which staff have had varicella before making assignments.
Answer: C
Rationale: Varicella is spread by direct or indirect contact. Strict isolation is indicated
to prevent further exposure. Staff who have had varicella should be assigned to care for
this client.
Question 7
When inserting a nasogastric tube into the stomach of a 3-month-old infant, which
nursing intervention is most important to implement?
A. Use a blanket as a mummy restraint.
B. Monitor the infant's heart rate.
C. Lubricate the catheter with saline.
D. Explain the procedure to the parents.
Answer: B
Rationale: The most important nursing action is to monitor the infant's heart rate,
which may decrease because of vagal nerve stimulation when the tube is inserted.
Question 8
A burned child is brought to the emergency department, and the nurse uses a modified
rule of nines to estimate the percentage of the body burned. When calculating the
percentage of burn, which parts of the child's body is proportionally larger than an
adult's?
A. Head and neck
B. Arms and chest
C. Legs and abdomen
D. Back and abdomen
pg. 3
with Answers | Complete Study Guide with
Practice Questions, Verified Correct Answers
& Detailed Rationales | Updated 2026/2027
Question 1
The nurse is preparing a child with an intussusception for a prescribed barium enema.
What is the main purpose of conducting this procedure prior to surgical intervention?
A. Evacuate the bowel of impacted feces.
B. Reduce the invaginated bowel segment.
C. Locate the presence of diverticula.
D. Identify the area of esophageal atresia.
Answer: B
Rationale: Intussusception is an invagination or telescoping of one portion of the
intestine into another. Hydrostatic pressure from barium instillation often reduces the
area of bowel intussusception, negating the need for surgical intervention.
Question 2
The nurse is teaching an adolescent girl with scoliosis about a Milwaukee brace that her
health care provider has prescribed. Which instruction should the nurse provide to this
client?
A. Remove the brace 1 hour each day for bathing only.
B. Remove the brace only for back range-of-motion exercises.
C. Wear the brace against the bare skin to ensure a good fit.
D. Wearing the brace will cure the spinal curvature.
Answer: A
Rationale: The Milwaukee brace should be worn 23 hours a day and removed a total of
1 hour a day for hygiene. A T-shirt should be worn under the brace to protect the skin.
The brace will not cure the curvature.
Question 3
The nurse should teach the parents of a child with a cyanotic heart defect to perform
pg. 1
,which action when a hypercyanotic spell occurs?
A. Place the child's head flat, with the knees on pillows above the level of the heart.
B. Have the child lie on the right side, with the head elevated on one pillow.
C. Allow the child to assume a knee-chest position, with the head and chest slightly
elevated.
D. Encourage the child to sit up at a 45-degree angle, drink cold water, and take deep
breaths.
Answer: C
Rationale: Assuming a knee-chest position with the head and chest slightly elevated
helps restore hemodynamic equilibrium by increasing systemic vascular resistance.
Question 4
During routine screening at a school clinic, an otoscope examination of a child's ear
reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable.
Based on these findings, what action should the nurse take?
A. No action is required, because this is an expected finding for a school-aged child.
B. Ask if the child has had a cold, runny nose, or any ear pain lately.
C. Send a note home advising parents to have the child evaluated by a health care
provider.
D. Call the parents and have them take the child home from school for the rest of the
day.
Answer: B
Rationale: The tympanic membrane is normally pearly gray, not bulging, and
movable. Because these findings are not completely normal, further assessment of
history and related signs and symptoms are needed.
Question 5
A newborn female whose mother is HIV-positive is scheduled for the first follow-up
assessment with the nurse. If the child is HIV-positive, which initial symptom is she
most likely to exhibit?
A. Shortness of breath
B. Joint pain
C. Persistent cold
D. Organomegaly
Answer: C
pg. 2
, Rationale: The most typical presenting symptom of a child who contracted AIDS
through vertical transmission is a persistent cold or respiratory infection due to
decreased ability to defend against common infections.
Question 6
A child breaks out with varicella infection (chickenpox) while hospitalized for a minor
surgical procedure. Which intervention should the nurse implement first?
A. Place a mask on the child before transporting the child outside the room.
B. Immunize exposed family members with the varicella vaccine.
C. Place the child in strict isolation to prevent an outbreak on the unit.
D. Determine which staff have had varicella before making assignments.
Answer: C
Rationale: Varicella is spread by direct or indirect contact. Strict isolation is indicated
to prevent further exposure. Staff who have had varicella should be assigned to care for
this client.
Question 7
When inserting a nasogastric tube into the stomach of a 3-month-old infant, which
nursing intervention is most important to implement?
A. Use a blanket as a mummy restraint.
B. Monitor the infant's heart rate.
C. Lubricate the catheter with saline.
D. Explain the procedure to the parents.
Answer: B
Rationale: The most important nursing action is to monitor the infant's heart rate,
which may decrease because of vagal nerve stimulation when the tube is inserted.
Question 8
A burned child is brought to the emergency department, and the nurse uses a modified
rule of nines to estimate the percentage of the body burned. When calculating the
percentage of burn, which parts of the child's body is proportionally larger than an
adult's?
A. Head and neck
B. Arms and chest
C. Legs and abdomen
D. Back and abdomen
pg. 3
