Pediatrics HESI 2025 Questions And
Answers
1.eAe5-month-
oldeiseadmittedetoetheehospitalewithevomitingeandediarrhea.eTheepediatricianeprescribesede
xtrosee5%eande0.25%enormalesalineewithe2emEqeKCl/100emletoebeeinfusedeate25eml/hour.e
Prioretoeinitiatingetheeinfusion,etheenurseeshouldeobtainewhicheassessmentefinding?e-
eCORRECTeeANSWER-SerumeBUNeandecreatinineelevels.
addingepotassiume=eneedeadequateerenalefunctione+eurineeoutput
10.eAne18-month-
oldeiseadmittedetoetheehospitalewithepossibleeHirschsprung'sedisease.eWheneobtainingeaen
ursingehistory,etheenurseeaskseaboutebowelehabits.eWhatedescriptioneofetheedisease?e-
eCORRECTeeANSWER-Ribbon-likeeandebrown.e
Hirschsprung'seiseaemechanicaleobstructioneineparteofetheeintestineseresultingeineinadequa
teemotility.
eBile-coloredeandewaterye=egastroenteritis
eFoul-smellingeandefattye=ecysticefibrosis
eSemi-solideandeyellow=enormaleinebreastefedeneonates
11.eAe4-year-
oldegirlecontinuesetoeinterrupteheremothereduringeaeroutineeclinicevisit.eTheemothereappears
eirritatedewithetheechildeandeasksetheenurse,e"Isethisenormalebehavioreforeaechildethiseage?"e
Theenurse'seresponseeshouldebeebasedeonewhicheinformation?e-eCORRECTeeANSWER-
Childreneneedetoeretaineaesenseeofeinitiativeewithouteimpingingeonetheerightseandeprivilege
seofeothers.e
-
Childreneagede3etoe6eareeineErickson'se"Initiativeevs.eGuilt"estage,ewhicheisecharacterizede
byevigorous,eintrusiveebehavior,eenterprise,eandestrongeimagination.eAtethiseage,echildrene
developeaeconscienceeandemustelearnetoeretaineaesenseeofeinitiativeewithouteimpingingeone
theerightseofeothers
12.eTheenurseeiseassessingeae2-year-
old.eWhatebehavioreindicatesethatetheechild'selanguageedevelopmenteisewithinenormalelimit
s?e-eCORRECTeeANSWER-Halfeofechild'sespeecheiseunderstandablee(15-24emonths)
bye18emonthseisecapableeofemakingeaethreeewordesentence.e
e
3-5eyearseoldeiseableetoenameefourecolorse&ecountefiveeblocks
,13.eAe2-year-
oldechildewitheDownesyndromeeisebroughtetoetheecliniceforehiseregularephysicaleexaminatio
n.eTheenurseeknowsewhicheproblemeisefrequentlyeassociatedewitheDownesyndrome?e-
eCORRECTeeANSWER-
CongenitaleheartediseaseeisetheemostecommonedefectefoundeinethoseewitheDS
14.eTheenurseeisegivingepreoperativeeinstructionsetoeae14-year-
oldefemaleeclientewhoeisescheduledeforesurgeryetoecorrecteaespinalecurvature.eWhichestate
mentebyetheeclientebestedemonstratesethatelearningehasetakeneplace?e-
eCORRECTeeANSWER-
IeunderstandethateIewillebeeineaebodyecasteandeIewilleshoweyouehoweyouetaughtemeetoeturn
15.eAe3-month-
oldeinfantedevelopseoralethrush.eWhichepharmacologiceagenteshouldetheenurseeplanetoead
ministereforetreatmenteofethisedisorder?e-eCORRECTeeANSWER-Nystatine(Mycostatin).
16.eAefulletermeinfanteiseadmittedetoetheenewbornenursery.eAfterecarefuleassessment,etheen
urseesuspectsethatetheeinfantemayehaveeaneesophagealeatresia.eWhichesymptomseareethis
enewbornelikelyetoeexhibit?e-eCORRECTeeANSWER-Choking,ecoughing,eandecyanosis.
17.eTheenurseeiseteachingeae12-year-
oldemaleeadolescenteandehisefamilyeaboutetakingeinjectionseofegrowthehormoneeforeidiopat
hicehypopituitarism.eWhicheadverseesymptoms,ecommonlyeassociatedewithegrowthehormo
neetherapy,eshouldetheenurseeplanetoedescribeetoetheechildeandehisefamily?e-
eCORRECTeeANSWER-Polyuriaeandepolydipsia
growthehormoneecauseseincreaseeinebloodesugar
*monitoreforediabetes
18.eAseparteofetheephysicaleassessmenteofechildren,etheenurseeobserveseandepalpatesethe
efontanels.eWhichechild'sefontanelefindingeshouldebeereportedetoetheehealthcareeprovider?e
-eCORRECTeeANSWER-Ae6-month-
oldewithefailureetoethriveethatehaseaeclosedeanteriorefontanel.
19.eAenurseeprovidesetheeparentsewitheinformationeonehealthemaintenanceeforetheirechilde
withesickleecelledisease.eWhicheinformationereflectedebyetheeparentseindicateseunderstand
ingeofetheechild'secare?e-eCORRECTeeANSWER-
Plentyeofefluidseshouldebeeconsumededaily
hydratione#1epriorityetoepreventeviscosityeofeblood;esinceetheesickleecellecaneimpactetheespl
een,eliver,ekidney,eboneseandeCNSethisecaneincreaseetheeriskeforeinfectionew/edecreasedeo
renoefunctioneofetheespleeneaeroutineeimmunizationescheduleeiseneeded
2.eWhichemenueselectionebyeaechildewitheceliacediseaseeindicatesetoetheenurseethatetheechi
ldeunderstandsenecessaryedietaryeconsiderations?e-eCORRECTeeANSWER-Oven-
bakedepotatoechipseandecola
,avoid:eoats,ewheat,eryeeandebarley;eintoleranceetoeproteinegluten
20.eWhenediscussingedisciplineewithetheemothereofeae4-year-
oldechild,etheenurseeshouldeincludeewhicheguideline?e-eCORRECTeeANSWER-
Parentalecontroleshouldebeeconsistent.e
consistenteparentingewillepreventemisbehavioreofechildren;econsistenteparentsewilleprevent
emisinterpretationeoferules.
21.eTheenurseereceiveseaelabereportestatingeaechildewitheasthmaehaseaetheophyllineelevele
ofe15emcg/dl.eWhateactionewilletheenurseetake?e-eCORRECTeeANSWER-
Passetheeinformationeoneinetheereport
theophylline:e10-20emcg/dle(normalerange)
22.eAehospitalizede16-year-
oldemaleerefuseseallevisitsefromehiseclassmatesebecauseeheeiseconcernedeaboutehisedistort
edeappearance.eToeincreaseetheeclient'sesocialeinteraction,ewhateinterventioneisebesteforeth
eenurseetoeinitiate?e-eCORRECTeeANSWER-
ArrangeeforeaneInterneteconnectioneinetheeclient'seroomeforeemailecommunication.e
adolescent:ebodyeimageeandepeereacceptanceeareetheemaineconcerns;eemailecommunicat
ionewillestilleallowepeerecommunicationeandeacceptanceewhileepreservingehisebodyeimage
23.eTheemothereofeaepreschool-
agedechildeasksetheenurseeifeiteiseallerightetoeadministerePeptoeBismoletoeheresonewhenehee"
haseaetummyeache."eAftereremindingetheemotheretoechecketheelabeleofealleover-the-
counteredrugseforetheepresenceeofeaspirin,ewhicheinstructioneshouldetheenurseeincludeewh
enereplyingetoethisemother'sequestion?e-eCORRECTeeANSWER-
Doenotegiveeifetheechildehasechickenpox,etheeflu,eoreanyeothereviraleillness.e
-peptoebismol:econtainseaspirin,easpirine+eanyeviral,eflueoreinfectione=ereyesesyndrome
-->reyesesyndromee(encephalophye+ehepaticedysfunction)
24.eTheenurseeisepreparingeaehealtheteachingeprogrameforeparentseofetoddlerseandepresch
oolerseandeplansetoeincludeeinformationeaboutepreventioneofeaccidentalepoisonings.eIteise
mosteimportanteforetheenurseetoeincludeewhicheinstruction?e-eCORRECTeeANSWER-
Storeealletoxiceagentseandemedicineseinelockedecabinets.
25.eAe2-year-oldechildewithegastro-
esophagealerefluxehasedevelopedeaefeareofeeating.eWhateinstructioneshouldetheenurseeincl
udeeinetheeparents'eteachingeplan?e-eCORRECTeeANSWER-
Consistentlyefolloweaesetemealtimeeroutine
-ealwaysefolloweaeconsistentehomeeschedule
, 26.eTheevitalesignseofeae4-year-
oldechildewithepolyuriaeare:eBPe80/40,ePulsee118,eandeRespirationse24.eTheechild'sepedale
pulseseareepresentewitheaevolumeeofe+1,eandenoeedemaeiseobserved.eWhateactioneshoulde
theenurseeimplementefirst?e-eCORRECTeeANSWER-StarteaneIVeinfusioneofenormalesaline-
epatienteiseexperiencingefluidevoleedeficit
27.eTheeparentseofeae3-week-
oldeinfantereportethatetheechildeeatsewellebutevomitseaftereeachefeeding.eWhateinformationei
semosteimportanteforetheenurseetoeobtain?e-eCORRECTeeANSWER-
Descriptioneofevomitingeepisodeseinepaste24ehours.-
eassessmenteofewhatecauseevomitingeepisodeseleaningetowardsetreatment
28.eAe12-month-
oldeboyeiseadmittedewitheaerespiratoryeinfectioneandepossibleepneumonia.eHeeiseplacedeine
aemistetentewitheoxygen.eWhichenursingeinterventionehasetheegreatestepriorityeforethiseinfan
t?e-eCORRECTeeANSWER-Haveeaebulbesyringeereadilyeavailableetoeremoveesecretions.e
aepatenteairwayeisehighestepriorityeandehumidificationewilleliquefyetheenasalesecretions
29.eAe6-year-
oldeiseadmittedetoetheepediatriceuniteafterefallingeoffeaebicycle.eWhicheinterventioneshouldet
heenurseeimplementetoeassistetheechild'seadjustmentetoehospitalization?e-
eCORRECTeeANSWER-Explainehospitaleschedulesetoetheechild,esucheasemealtimes.
-
alwaysekeepeaeconsistenteschedule,eifepossibleetryetoecopyehomeeschedule.eThisewillehelpe
toedecreaseeseparationeanxiety
3.eAe3-week-oldenewborneisebroughtetoetheecliniceforefollow-
upeaftereaehomeebirth.eTheemotherereportsethateherechildebottleefeedsefore5eminuteseonlyea
ndethenefallseasleep.eTheenurseeauscultateseaeloudemurmurecharacteristiceofeaeventricular
eseptaledefecte(VSD),eandefindsetheenewborneiseacyanoticewitheaerespiratoryerateeofe64ebre
athsepereminute.eWhateinstructioneshouldetheenurseeprovideetheemotheretoeensureetheeinfa
nteisereceivingeadequateeintake?e(Selecteallethateapply.)e-eCORRECTeeANSWER-
A.eMonitoretheetheeinfant'seweighteandenumbereofewetediapersepereday.e-
echildeshouldeateleastehavee6ewetediapersepereday.
B.eIncreaseetheeinfant'seintakeeperefeedingebye1etoe2eouncesepereweek.-
echildeisealwaysefatigue,eneedetoeincreaseetoe30eozeaeday
D.eAllowetheeinfantetoeresteandere-feedeonedemandeoreeverye2ehours.-
echildeisealwaysefatigue,ethisewilleensureeadequateefeeding.e
E.eUseeaesofterenippleeoreincreaseetheesizeeofetheenippleeopening.-ethisewillesaveeenergy
30.eTheenurseeisecaringeforeae12-year-
oldewitheSyndromeeofeInappropriateeAntidiureticeHormonee(SIADH).eThisechildeshouldebee
carefullyeassessedeforewhichecomplication?e-eCORRECTeeANSWER-
Changeseineleveleofeconsciousness.
Answers
1.eAe5-month-
oldeiseadmittedetoetheehospitalewithevomitingeandediarrhea.eTheepediatricianeprescribesede
xtrosee5%eande0.25%enormalesalineewithe2emEqeKCl/100emletoebeeinfusedeate25eml/hour.e
Prioretoeinitiatingetheeinfusion,etheenurseeshouldeobtainewhicheassessmentefinding?e-
eCORRECTeeANSWER-SerumeBUNeandecreatinineelevels.
addingepotassiume=eneedeadequateerenalefunctione+eurineeoutput
10.eAne18-month-
oldeiseadmittedetoetheehospitalewithepossibleeHirschsprung'sedisease.eWheneobtainingeaen
ursingehistory,etheenurseeaskseaboutebowelehabits.eWhatedescriptioneofetheedisease?e-
eCORRECTeeANSWER-Ribbon-likeeandebrown.e
Hirschsprung'seiseaemechanicaleobstructioneineparteofetheeintestineseresultingeineinadequa
teemotility.
eBile-coloredeandewaterye=egastroenteritis
eFoul-smellingeandefattye=ecysticefibrosis
eSemi-solideandeyellow=enormaleinebreastefedeneonates
11.eAe4-year-
oldegirlecontinuesetoeinterrupteheremothereduringeaeroutineeclinicevisit.eTheemothereappears
eirritatedewithetheechildeandeasksetheenurse,e"Isethisenormalebehavioreforeaechildethiseage?"e
Theenurse'seresponseeshouldebeebasedeonewhicheinformation?e-eCORRECTeeANSWER-
Childreneneedetoeretaineaesenseeofeinitiativeewithouteimpingingeonetheerightseandeprivilege
seofeothers.e
-
Childreneagede3etoe6eareeineErickson'se"Initiativeevs.eGuilt"estage,ewhicheisecharacterizede
byevigorous,eintrusiveebehavior,eenterprise,eandestrongeimagination.eAtethiseage,echildrene
developeaeconscienceeandemustelearnetoeretaineaesenseeofeinitiativeewithouteimpingingeone
theerightseofeothers
12.eTheenurseeiseassessingeae2-year-
old.eWhatebehavioreindicatesethatetheechild'selanguageedevelopmenteisewithinenormalelimit
s?e-eCORRECTeeANSWER-Halfeofechild'sespeecheiseunderstandablee(15-24emonths)
bye18emonthseisecapableeofemakingeaethreeewordesentence.e
e
3-5eyearseoldeiseableetoenameefourecolorse&ecountefiveeblocks
,13.eAe2-year-
oldechildewitheDownesyndromeeisebroughtetoetheecliniceforehiseregularephysicaleexaminatio
n.eTheenurseeknowsewhicheproblemeisefrequentlyeassociatedewitheDownesyndrome?e-
eCORRECTeeANSWER-
CongenitaleheartediseaseeisetheemostecommonedefectefoundeinethoseewitheDS
14.eTheenurseeisegivingepreoperativeeinstructionsetoeae14-year-
oldefemaleeclientewhoeisescheduledeforesurgeryetoecorrecteaespinalecurvature.eWhichestate
mentebyetheeclientebestedemonstratesethatelearningehasetakeneplace?e-
eCORRECTeeANSWER-
IeunderstandethateIewillebeeineaebodyecasteandeIewilleshoweyouehoweyouetaughtemeetoeturn
15.eAe3-month-
oldeinfantedevelopseoralethrush.eWhichepharmacologiceagenteshouldetheenurseeplanetoead
ministereforetreatmenteofethisedisorder?e-eCORRECTeeANSWER-Nystatine(Mycostatin).
16.eAefulletermeinfanteiseadmittedetoetheenewbornenursery.eAfterecarefuleassessment,etheen
urseesuspectsethatetheeinfantemayehaveeaneesophagealeatresia.eWhichesymptomseareethis
enewbornelikelyetoeexhibit?e-eCORRECTeeANSWER-Choking,ecoughing,eandecyanosis.
17.eTheenurseeiseteachingeae12-year-
oldemaleeadolescenteandehisefamilyeaboutetakingeinjectionseofegrowthehormoneeforeidiopat
hicehypopituitarism.eWhicheadverseesymptoms,ecommonlyeassociatedewithegrowthehormo
neetherapy,eshouldetheenurseeplanetoedescribeetoetheechildeandehisefamily?e-
eCORRECTeeANSWER-Polyuriaeandepolydipsia
growthehormoneecauseseincreaseeinebloodesugar
*monitoreforediabetes
18.eAseparteofetheephysicaleassessmenteofechildren,etheenurseeobserveseandepalpatesethe
efontanels.eWhichechild'sefontanelefindingeshouldebeereportedetoetheehealthcareeprovider?e
-eCORRECTeeANSWER-Ae6-month-
oldewithefailureetoethriveethatehaseaeclosedeanteriorefontanel.
19.eAenurseeprovidesetheeparentsewitheinformationeonehealthemaintenanceeforetheirechilde
withesickleecelledisease.eWhicheinformationereflectedebyetheeparentseindicateseunderstand
ingeofetheechild'secare?e-eCORRECTeeANSWER-
Plentyeofefluidseshouldebeeconsumededaily
hydratione#1epriorityetoepreventeviscosityeofeblood;esinceetheesickleecellecaneimpactetheespl
een,eliver,ekidney,eboneseandeCNSethisecaneincreaseetheeriskeforeinfectionew/edecreasedeo
renoefunctioneofetheespleeneaeroutineeimmunizationescheduleeiseneeded
2.eWhichemenueselectionebyeaechildewitheceliacediseaseeindicatesetoetheenurseethatetheechi
ldeunderstandsenecessaryedietaryeconsiderations?e-eCORRECTeeANSWER-Oven-
bakedepotatoechipseandecola
,avoid:eoats,ewheat,eryeeandebarley;eintoleranceetoeproteinegluten
20.eWhenediscussingedisciplineewithetheemothereofeae4-year-
oldechild,etheenurseeshouldeincludeewhicheguideline?e-eCORRECTeeANSWER-
Parentalecontroleshouldebeeconsistent.e
consistenteparentingewillepreventemisbehavioreofechildren;econsistenteparentsewilleprevent
emisinterpretationeoferules.
21.eTheenurseereceiveseaelabereportestatingeaechildewitheasthmaehaseaetheophyllineelevele
ofe15emcg/dl.eWhateactionewilletheenurseetake?e-eCORRECTeeANSWER-
Passetheeinformationeoneinetheereport
theophylline:e10-20emcg/dle(normalerange)
22.eAehospitalizede16-year-
oldemaleerefuseseallevisitsefromehiseclassmatesebecauseeheeiseconcernedeaboutehisedistort
edeappearance.eToeincreaseetheeclient'sesocialeinteraction,ewhateinterventioneisebesteforeth
eenurseetoeinitiate?e-eCORRECTeeANSWER-
ArrangeeforeaneInterneteconnectioneinetheeclient'seroomeforeemailecommunication.e
adolescent:ebodyeimageeandepeereacceptanceeareetheemaineconcerns;eemailecommunicat
ionewillestilleallowepeerecommunicationeandeacceptanceewhileepreservingehisebodyeimage
23.eTheemothereofeaepreschool-
agedechildeasksetheenurseeifeiteiseallerightetoeadministerePeptoeBismoletoeheresonewhenehee"
haseaetummyeache."eAftereremindingetheemotheretoechecketheelabeleofealleover-the-
counteredrugseforetheepresenceeofeaspirin,ewhicheinstructioneshouldetheenurseeincludeewh
enereplyingetoethisemother'sequestion?e-eCORRECTeeANSWER-
Doenotegiveeifetheechildehasechickenpox,etheeflu,eoreanyeothereviraleillness.e
-peptoebismol:econtainseaspirin,easpirine+eanyeviral,eflueoreinfectione=ereyesesyndrome
-->reyesesyndromee(encephalophye+ehepaticedysfunction)
24.eTheenurseeisepreparingeaehealtheteachingeprogrameforeparentseofetoddlerseandepresch
oolerseandeplansetoeincludeeinformationeaboutepreventioneofeaccidentalepoisonings.eIteise
mosteimportanteforetheenurseetoeincludeewhicheinstruction?e-eCORRECTeeANSWER-
Storeealletoxiceagentseandemedicineseinelockedecabinets.
25.eAe2-year-oldechildewithegastro-
esophagealerefluxehasedevelopedeaefeareofeeating.eWhateinstructioneshouldetheenurseeincl
udeeinetheeparents'eteachingeplan?e-eCORRECTeeANSWER-
Consistentlyefolloweaesetemealtimeeroutine
-ealwaysefolloweaeconsistentehomeeschedule
, 26.eTheevitalesignseofeae4-year-
oldechildewithepolyuriaeare:eBPe80/40,ePulsee118,eandeRespirationse24.eTheechild'sepedale
pulseseareepresentewitheaevolumeeofe+1,eandenoeedemaeiseobserved.eWhateactioneshoulde
theenurseeimplementefirst?e-eCORRECTeeANSWER-StarteaneIVeinfusioneofenormalesaline-
epatienteiseexperiencingefluidevoleedeficit
27.eTheeparentseofeae3-week-
oldeinfantereportethatetheechildeeatsewellebutevomitseaftereeachefeeding.eWhateinformationei
semosteimportanteforetheenurseetoeobtain?e-eCORRECTeeANSWER-
Descriptioneofevomitingeepisodeseinepaste24ehours.-
eassessmenteofewhatecauseevomitingeepisodeseleaningetowardsetreatment
28.eAe12-month-
oldeboyeiseadmittedewitheaerespiratoryeinfectioneandepossibleepneumonia.eHeeiseplacedeine
aemistetentewitheoxygen.eWhichenursingeinterventionehasetheegreatestepriorityeforethiseinfan
t?e-eCORRECTeeANSWER-Haveeaebulbesyringeereadilyeavailableetoeremoveesecretions.e
aepatenteairwayeisehighestepriorityeandehumidificationewilleliquefyetheenasalesecretions
29.eAe6-year-
oldeiseadmittedetoetheepediatriceuniteafterefallingeoffeaebicycle.eWhicheinterventioneshouldet
heenurseeimplementetoeassistetheechild'seadjustmentetoehospitalization?e-
eCORRECTeeANSWER-Explainehospitaleschedulesetoetheechild,esucheasemealtimes.
-
alwaysekeepeaeconsistenteschedule,eifepossibleetryetoecopyehomeeschedule.eThisewillehelpe
toedecreaseeseparationeanxiety
3.eAe3-week-oldenewborneisebroughtetoetheecliniceforefollow-
upeaftereaehomeebirth.eTheemotherereportsethateherechildebottleefeedsefore5eminuteseonlyea
ndethenefallseasleep.eTheenurseeauscultateseaeloudemurmurecharacteristiceofeaeventricular
eseptaledefecte(VSD),eandefindsetheenewborneiseacyanoticewitheaerespiratoryerateeofe64ebre
athsepereminute.eWhateinstructioneshouldetheenurseeprovideetheemotheretoeensureetheeinfa
nteisereceivingeadequateeintake?e(Selecteallethateapply.)e-eCORRECTeeANSWER-
A.eMonitoretheetheeinfant'seweighteandenumbereofewetediapersepereday.e-
echildeshouldeateleastehavee6ewetediapersepereday.
B.eIncreaseetheeinfant'seintakeeperefeedingebye1etoe2eouncesepereweek.-
echildeisealwaysefatigue,eneedetoeincreaseetoe30eozeaeday
D.eAllowetheeinfantetoeresteandere-feedeonedemandeoreeverye2ehours.-
echildeisealwaysefatigue,ethisewilleensureeadequateefeeding.e
E.eUseeaesofterenippleeoreincreaseetheesizeeofetheenippleeopening.-ethisewillesaveeenergy
30.eTheenurseeisecaringeforeae12-year-
oldewitheSyndromeeofeInappropriateeAntidiureticeHormonee(SIADH).eThisechildeshouldebee
carefullyeassessedeforewhichecomplication?e-eCORRECTeeANSWER-
Changeseineleveleofeconsciousness.
