Peds HESI Version 2
"A mother tells the nurse that her child does not want anything to do with toilet training and yells
"NO!" consistently when she tries to toilet train. The child is 2 years old. According to Erikson,
the nurse interprets that the child is experiencing which psychosocial crisis?"
a. autonomy vs shame and doubt
b. initiative vs guilt
c. industry vs inferiority
d. trust vs mistrust - ANSAutonomy vs shame and doubt
A 2-year-old child is admitted to the hospital with juvenile rheumatoid arthritis (JRA). During the
focused assessment, the nurse makes it a priority to note the presence of which of the
following?"
a. increased irritability and the child's insistence to be carried out
b. complaints of joint stiffness
c. history of daily temperature elevations
d. description of how difficult it is to move around after periods of inactivity - ANSincreased
irritability and the child's insistence to be carried out
A mother of a toddler who is hospitalized with mild dehydration must leave her child to go to
work. Which behavior would the nurse expect to observe in the toddler immediately after the
mother's departure?
a. silently curled in bed with a blanket
b. loudly crying and kicking both legs
c. playing quietly with a favorite toy
d. sucking thumb and rocking back and forth - ANSloudly crying and kicking both legs
"A newborn infant is diagnosed with hypospadias, and the mother asks the nurse about the
disorder. The nurse bases the response on which of the following?"
a. it is a congenital anomaly in which the actual opening of the urethra meatus is below the
normal placement on the glans penis
b. it occurs when one or both testes fail to descend through the inguinal canal into the scrotal
sac
c. it is a congenital anomaly in which the actual opening of the urethral meatus is dorsal to the
urethral opening
d. it is a congential anomaly characterized by the extrusion of the urinary bladder to the outside
of the body - ANSit is a congenital anomaly in which the actual opening of the urethra meatus is
below the normal placement on the glans penis
,A home care nurse is providing instructions to a child with cystic fibrosis about how to perform
the "huff" maneuver; the child asks the nurse about the purpose of this type of breathing. The
nurse makes which response to the child?
a. "this type of breathing is used to mobilize secretions so that they can be easily coughed out"
b. "this type of breathing prolongs inspiration time"
c. "this type of breathing moves air out of the lower lungs"
d. "this type of breathing moves air through the lungs" - ANS"this type of breathing is used to
mobilize secretions so that they can be easily coughed out"
A home care nurse is instructing the mother of a child with cystic fibrosis (CF) about the
appropriate dietary measures. The nurse tells the mother that the child needs to consume a:
a. low calorie, low fat diet
b. high calorie, high protein diet
c. low calorie, low protein diet
d. high calorie, restricted fat - ANShigh calorie, high protein diet
Breathing exercises and postural drainage is prescribed for a child with cystic fibrosis. A nurse
implements these procedures by telling the child to:
a. perform the postural drainage, then the breathing exercises
b. perform the breathing exercises, then the postural drainage
c. schedule the procedures so they are 4 hours apart
d. perform postural drainage in the morning and breathing exercises in the evening -
ANSperform the postural drainage, then the breathing exercises
A nurse is reviewing the results of a sweat test performed on a child with cystic fibrosis (CF).
The nurse would expect to note which finding?
a. a sweat sodium concentration less than 40 mEq/L
b. a sweat potassium concentration less than 40 mEq/L
c. a sweat potassium concentration greater than 40 mEq/L
d. a sweat sodium concentration greater than 60 mEq/L - ANSa sweat sodium concentration
greater than 60 mEq/L
Methylphenidate (Ritalin) is prescribed for a child with a diagnosis of attention deficit
hyperactivity disorder (ADHD). The nurse provides instructions to the mother regarding the
administration of the medication and tells the mother to administer the medication:
a. before dinner and at bedtime
b. before breakfast and before the noontime meal
c. in the morning after breakfast and at bedtime
d. at the noontime and evening meals - ANSbefore breakfast and before the noontime meal
"Methylphenidate hydrochloride (Ritalin) is prescribed for a 10-year-old child diagnosed with
attention deficit hyperactivity disorder, and the nurse provides instructions to the mother about
administration of the medication. The nurse determines that the mother understands the
instructions when the mother states:"
, a. I will give my child the medication at bedtime so that he will be rested and alert for school the
next day
b. I will give my child the medication after meals to obtain the full effects of the medication
c. I will give my child the medication at breakfast and lunch to prevent insomnia
d. I will give my child the medication with water to prevent kidney damage - ANSI will give my
child the medication at breakfast and lunch to prevent insomnia
Methylphenidate (Ritalin) is prescribed for a child with attention deficit hyperactivity disorder
(ADHD). The nurse provides instructions to the mother regarding the administration of the
medication. Which statement by the mother would indicate a need for further instructions?
a. I will administer the medication with the noontime meal
b. I will keep the medication tightly capped and away from direct heat
c. I should inform the school nurse that my child is taking this medication
d. I should avoid giving the medications on Saturdays and Sundays to provide a medication
holiday - ANSI should avoid giving the medications on Saturdays and Sundays to provide a
medication holiday
A client with diplopia has been given an eye patch to promote better vision and prevent injury.
The nurse teaches the client to do which of the following as part of correct use of this item?
a. wear the patch continuously, alternating eyes each day
b. wear the patch continuously, alternating eyes each week
c. use the patch only when vision is exceptionally blurry
d. put the patch on for an hour, and then take it off for an hour - ANSwear the patch
continuously, alternating eyes each day
A student nurse examines an Asian American infant's eyes and notes that the infant's eyes are
crossed. The registered nurse asks the student to interpret the finding. Which statement by the
student indicates an understanding of this assessment finding?
a. it probably isn't strabismus but appears that way because of the child;s ethnic background
b. you will want to call the pediatrician immediately because this could lead to detached retina
c. it probably is strabismus because the baby's mother has abused tranquilizers
d. strabismus isn't life threatening but it requires surgery in the first 2 months to prevent the
crossed eyes from being a life long condition - ANSit probably isn't strabismus but appears that
way because of the child;s ethnic background
A nurse notes that a client's eyes are continuously moving back and forth within the eye
sockets. The nurse documents in the medical record that the client has:
a. ataxia
b. nystagmus
c. pronator drift
d. hyperreflexia - ANSnystagmus
"A mother tells the nurse that her child does not want anything to do with toilet training and yells
"NO!" consistently when she tries to toilet train. The child is 2 years old. According to Erikson,
the nurse interprets that the child is experiencing which psychosocial crisis?"
a. autonomy vs shame and doubt
b. initiative vs guilt
c. industry vs inferiority
d. trust vs mistrust - ANSAutonomy vs shame and doubt
A 2-year-old child is admitted to the hospital with juvenile rheumatoid arthritis (JRA). During the
focused assessment, the nurse makes it a priority to note the presence of which of the
following?"
a. increased irritability and the child's insistence to be carried out
b. complaints of joint stiffness
c. history of daily temperature elevations
d. description of how difficult it is to move around after periods of inactivity - ANSincreased
irritability and the child's insistence to be carried out
A mother of a toddler who is hospitalized with mild dehydration must leave her child to go to
work. Which behavior would the nurse expect to observe in the toddler immediately after the
mother's departure?
a. silently curled in bed with a blanket
b. loudly crying and kicking both legs
c. playing quietly with a favorite toy
d. sucking thumb and rocking back and forth - ANSloudly crying and kicking both legs
"A newborn infant is diagnosed with hypospadias, and the mother asks the nurse about the
disorder. The nurse bases the response on which of the following?"
a. it is a congenital anomaly in which the actual opening of the urethra meatus is below the
normal placement on the glans penis
b. it occurs when one or both testes fail to descend through the inguinal canal into the scrotal
sac
c. it is a congenital anomaly in which the actual opening of the urethral meatus is dorsal to the
urethral opening
d. it is a congential anomaly characterized by the extrusion of the urinary bladder to the outside
of the body - ANSit is a congenital anomaly in which the actual opening of the urethra meatus is
below the normal placement on the glans penis
,A home care nurse is providing instructions to a child with cystic fibrosis about how to perform
the "huff" maneuver; the child asks the nurse about the purpose of this type of breathing. The
nurse makes which response to the child?
a. "this type of breathing is used to mobilize secretions so that they can be easily coughed out"
b. "this type of breathing prolongs inspiration time"
c. "this type of breathing moves air out of the lower lungs"
d. "this type of breathing moves air through the lungs" - ANS"this type of breathing is used to
mobilize secretions so that they can be easily coughed out"
A home care nurse is instructing the mother of a child with cystic fibrosis (CF) about the
appropriate dietary measures. The nurse tells the mother that the child needs to consume a:
a. low calorie, low fat diet
b. high calorie, high protein diet
c. low calorie, low protein diet
d. high calorie, restricted fat - ANShigh calorie, high protein diet
Breathing exercises and postural drainage is prescribed for a child with cystic fibrosis. A nurse
implements these procedures by telling the child to:
a. perform the postural drainage, then the breathing exercises
b. perform the breathing exercises, then the postural drainage
c. schedule the procedures so they are 4 hours apart
d. perform postural drainage in the morning and breathing exercises in the evening -
ANSperform the postural drainage, then the breathing exercises
A nurse is reviewing the results of a sweat test performed on a child with cystic fibrosis (CF).
The nurse would expect to note which finding?
a. a sweat sodium concentration less than 40 mEq/L
b. a sweat potassium concentration less than 40 mEq/L
c. a sweat potassium concentration greater than 40 mEq/L
d. a sweat sodium concentration greater than 60 mEq/L - ANSa sweat sodium concentration
greater than 60 mEq/L
Methylphenidate (Ritalin) is prescribed for a child with a diagnosis of attention deficit
hyperactivity disorder (ADHD). The nurse provides instructions to the mother regarding the
administration of the medication and tells the mother to administer the medication:
a. before dinner and at bedtime
b. before breakfast and before the noontime meal
c. in the morning after breakfast and at bedtime
d. at the noontime and evening meals - ANSbefore breakfast and before the noontime meal
"Methylphenidate hydrochloride (Ritalin) is prescribed for a 10-year-old child diagnosed with
attention deficit hyperactivity disorder, and the nurse provides instructions to the mother about
administration of the medication. The nurse determines that the mother understands the
instructions when the mother states:"
, a. I will give my child the medication at bedtime so that he will be rested and alert for school the
next day
b. I will give my child the medication after meals to obtain the full effects of the medication
c. I will give my child the medication at breakfast and lunch to prevent insomnia
d. I will give my child the medication with water to prevent kidney damage - ANSI will give my
child the medication at breakfast and lunch to prevent insomnia
Methylphenidate (Ritalin) is prescribed for a child with attention deficit hyperactivity disorder
(ADHD). The nurse provides instructions to the mother regarding the administration of the
medication. Which statement by the mother would indicate a need for further instructions?
a. I will administer the medication with the noontime meal
b. I will keep the medication tightly capped and away from direct heat
c. I should inform the school nurse that my child is taking this medication
d. I should avoid giving the medications on Saturdays and Sundays to provide a medication
holiday - ANSI should avoid giving the medications on Saturdays and Sundays to provide a
medication holiday
A client with diplopia has been given an eye patch to promote better vision and prevent injury.
The nurse teaches the client to do which of the following as part of correct use of this item?
a. wear the patch continuously, alternating eyes each day
b. wear the patch continuously, alternating eyes each week
c. use the patch only when vision is exceptionally blurry
d. put the patch on for an hour, and then take it off for an hour - ANSwear the patch
continuously, alternating eyes each day
A student nurse examines an Asian American infant's eyes and notes that the infant's eyes are
crossed. The registered nurse asks the student to interpret the finding. Which statement by the
student indicates an understanding of this assessment finding?
a. it probably isn't strabismus but appears that way because of the child;s ethnic background
b. you will want to call the pediatrician immediately because this could lead to detached retina
c. it probably is strabismus because the baby's mother has abused tranquilizers
d. strabismus isn't life threatening but it requires surgery in the first 2 months to prevent the
crossed eyes from being a life long condition - ANSit probably isn't strabismus but appears that
way because of the child;s ethnic background
A nurse notes that a client's eyes are continuously moving back and forth within the eye
sockets. The nurse documents in the medical record that the client has:
a. ataxia
b. nystagmus
c. pronator drift
d. hyperreflexia - ANSnystagmus
