HESI Pediatric Nursing Exam 2025 – 70 Verified
Questions with High-Yield Answers and Detailed
Rationales | Complete Study Guide for Retake Success
Examiner’s Note to HESI Candidates
Dear Student,
This resource has been carefully developed by experienced nursing educators and examiners to reflect the rigor,
structure, and clinical relevance of the HESI Pediatric Nursing Exam 2025. Each question is designed to reinforce
high-yield pediatric concepts, promote critical thinking, and prepare you confidently for both first attempts and
retakes.
The answers provided are model responses, and the rationales are detailed to help you not only remember the
correct choices but also understand the "why" behind them — a key to long-term mastery and real-world
application.
Approach this set as a serious tool for exam readiness, not just memorization.
Wishing you clarity, confidence, and success.
— HESI Nursing Exam Review Panel
1. A 6-month-old infant is being discharged after surgery. What is the best method for the
nurse to ensure that the parents understand the discharge instructions and can care for their
infant properly at home?
Answer: The best method is to use simple, clear language and the teach-back technique,
where the parents are asked to repeat or demonstrate their understanding of the instructions.
Rationale:
Discharge instructions can be complex, especially when caring for an infant recovering from
surgery. Using medical jargon or overwhelming parents with written materials alone may lead
to misunderstanding or mistakes at home. The teach-back method is a communication
strategy that confirms comprehension by having the caregivers explain the information back to
the nurse in their own words. This allows the nurse to identify any gaps in understanding and
clarify information immediately. Using simple, jargon-free language is critical because parents
may be anxious or stressed and may not fully absorb complicated instructions. This method
has been shown to reduce readmission rates and improve patient outcomes in pediatric care.
,2. A child is admitted with epiglottitis, a rapidly progressing inflammation of the epiglottis.
What should be the nurse’s highest priority intervention?
Answer: The highest priority is to maintain airway patency and prepare for emergency airway
management if necessary.
Rationale:
Epiglottitis is a medical emergency due to potential rapid airway obstruction caused by
inflammation and swelling of the epiglottis. This condition can lead to respiratory distress and
sudden respiratory failure. The nurse must closely monitor respiratory status, ensure the child
remains calm (to avoid increased airway obstruction), and be ready to assist with emergency
interventions such as intubation or tracheostomy if airway compromise occurs. Interventions
like administering corticosteroids or humidified air are supportive but secondary to securing
and maintaining the airway. Early recognition and prompt action are vital to prevent hypoxia
and death.
3. In a toddler presenting with dehydration, what clinical signs indicate moderate dehydration,
and why are these signs important for nursing assessment?
Answer: Clinical signs of moderate dehydration include tachycardia (increased heart rate),
delayed capillary refill (more than 2 seconds), decreased urine output, and irritability or
lethargy.
Rationale:
Dehydration in toddlers can rapidly progress due to their smaller fluid reserves. Tachycardia is
an early compensatory response to maintain cardiac output when circulating volume is
reduced. Delayed capillary refill is a sign of poor peripheral perfusion, indicating volume
depletion. Decreased urine output reflects reduced kidney perfusion and fluid conservation
efforts by the body. Changes in mental status, like irritability or lethargy, suggest that
dehydration is affecting cerebral perfusion and function. Recognizing these signs promptly
allows for timely intervention such as fluid replacement to prevent progression to severe
dehydration and shock.
4. What immunization is contraindicated in a child with a history of severe allergic reaction to
neomycin, and why?
Answer: The MMR (Measles, Mumps, Rubella) vaccine is contraindicated in children with
severe neomycin allergy.
Rationale:
, The MMR vaccine contains trace amounts of neomycin as a preservative. In children with a
documented severe allergic reaction to neomycin, administering this vaccine could provoke a
life-threatening allergic reaction such as anaphylaxis. It is essential to obtain a detailed allergy
history before vaccination. Alternatives or precautions should be discussed with healthcare
providers and allergists. Other vaccines like DTaP, IPV, and varicella generally do not contain
neomycin and may be safer alternatives. Proper screening helps avoid preventable adverse
vaccine reactions.
5. Parents ask how to care for their child diagnosed with croup. What advice should the nurse
give to help relieve the child's symptoms?
Answer: The nurse should advise parents to expose the child to cool or moist air, such as from
a cool-mist humidifier or taking the child outside in cool night air, to help ease airway swelling
and breathing difficulties.
Rationale:
Croup is usually caused by viral inflammation of the upper airway, leading to swelling and the
characteristic “barking” cough and stridor. Warm steam was once recommended but recent
evidence suggests that cool mist or cool air is more effective at reducing airway edema and
easing symptoms. Cool air causes vasoconstriction in the mucous membranes, reducing
swelling and improving airflow. Antibiotics are not indicated since croup is typically viral.
Parents should be educated on signs of respiratory distress that require emergency care, such
as persistent stridor at rest, cyanosis, or increased work of breathing.
6. A child with leukemia is receiving chemotherapy. What should be the nurse’s priority
assessment during care?
Answer: The priority assessment is to monitor for signs of infection, including fever, chills, and
any localized signs of infection.
Rationale:
Chemotherapy suppresses bone marrow function, leading to neutropenia and severely
compromised immunity. Children with leukemia are at high risk for infections that can
progress rapidly to sepsis. Fever may be the only early sign of infection because inflammatory
responses are diminished. Prompt detection and treatment of infection are critical to prevent
serious complications. Regular vital signs, inspection for skin breakdown, oral ulcers, and
respiratory symptoms are essential. The nurse must educate caregivers about infection
prevention and immediate reporting of symptoms.
7. At 9 months of age, which types of foods are safe and appropriate for an infant to consume?
Questions with High-Yield Answers and Detailed
Rationales | Complete Study Guide for Retake Success
Examiner’s Note to HESI Candidates
Dear Student,
This resource has been carefully developed by experienced nursing educators and examiners to reflect the rigor,
structure, and clinical relevance of the HESI Pediatric Nursing Exam 2025. Each question is designed to reinforce
high-yield pediatric concepts, promote critical thinking, and prepare you confidently for both first attempts and
retakes.
The answers provided are model responses, and the rationales are detailed to help you not only remember the
correct choices but also understand the "why" behind them — a key to long-term mastery and real-world
application.
Approach this set as a serious tool for exam readiness, not just memorization.
Wishing you clarity, confidence, and success.
— HESI Nursing Exam Review Panel
1. A 6-month-old infant is being discharged after surgery. What is the best method for the
nurse to ensure that the parents understand the discharge instructions and can care for their
infant properly at home?
Answer: The best method is to use simple, clear language and the teach-back technique,
where the parents are asked to repeat or demonstrate their understanding of the instructions.
Rationale:
Discharge instructions can be complex, especially when caring for an infant recovering from
surgery. Using medical jargon or overwhelming parents with written materials alone may lead
to misunderstanding or mistakes at home. The teach-back method is a communication
strategy that confirms comprehension by having the caregivers explain the information back to
the nurse in their own words. This allows the nurse to identify any gaps in understanding and
clarify information immediately. Using simple, jargon-free language is critical because parents
may be anxious or stressed and may not fully absorb complicated instructions. This method
has been shown to reduce readmission rates and improve patient outcomes in pediatric care.
,2. A child is admitted with epiglottitis, a rapidly progressing inflammation of the epiglottis.
What should be the nurse’s highest priority intervention?
Answer: The highest priority is to maintain airway patency and prepare for emergency airway
management if necessary.
Rationale:
Epiglottitis is a medical emergency due to potential rapid airway obstruction caused by
inflammation and swelling of the epiglottis. This condition can lead to respiratory distress and
sudden respiratory failure. The nurse must closely monitor respiratory status, ensure the child
remains calm (to avoid increased airway obstruction), and be ready to assist with emergency
interventions such as intubation or tracheostomy if airway compromise occurs. Interventions
like administering corticosteroids or humidified air are supportive but secondary to securing
and maintaining the airway. Early recognition and prompt action are vital to prevent hypoxia
and death.
3. In a toddler presenting with dehydration, what clinical signs indicate moderate dehydration,
and why are these signs important for nursing assessment?
Answer: Clinical signs of moderate dehydration include tachycardia (increased heart rate),
delayed capillary refill (more than 2 seconds), decreased urine output, and irritability or
lethargy.
Rationale:
Dehydration in toddlers can rapidly progress due to their smaller fluid reserves. Tachycardia is
an early compensatory response to maintain cardiac output when circulating volume is
reduced. Delayed capillary refill is a sign of poor peripheral perfusion, indicating volume
depletion. Decreased urine output reflects reduced kidney perfusion and fluid conservation
efforts by the body. Changes in mental status, like irritability or lethargy, suggest that
dehydration is affecting cerebral perfusion and function. Recognizing these signs promptly
allows for timely intervention such as fluid replacement to prevent progression to severe
dehydration and shock.
4. What immunization is contraindicated in a child with a history of severe allergic reaction to
neomycin, and why?
Answer: The MMR (Measles, Mumps, Rubella) vaccine is contraindicated in children with
severe neomycin allergy.
Rationale:
, The MMR vaccine contains trace amounts of neomycin as a preservative. In children with a
documented severe allergic reaction to neomycin, administering this vaccine could provoke a
life-threatening allergic reaction such as anaphylaxis. It is essential to obtain a detailed allergy
history before vaccination. Alternatives or precautions should be discussed with healthcare
providers and allergists. Other vaccines like DTaP, IPV, and varicella generally do not contain
neomycin and may be safer alternatives. Proper screening helps avoid preventable adverse
vaccine reactions.
5. Parents ask how to care for their child diagnosed with croup. What advice should the nurse
give to help relieve the child's symptoms?
Answer: The nurse should advise parents to expose the child to cool or moist air, such as from
a cool-mist humidifier or taking the child outside in cool night air, to help ease airway swelling
and breathing difficulties.
Rationale:
Croup is usually caused by viral inflammation of the upper airway, leading to swelling and the
characteristic “barking” cough and stridor. Warm steam was once recommended but recent
evidence suggests that cool mist or cool air is more effective at reducing airway edema and
easing symptoms. Cool air causes vasoconstriction in the mucous membranes, reducing
swelling and improving airflow. Antibiotics are not indicated since croup is typically viral.
Parents should be educated on signs of respiratory distress that require emergency care, such
as persistent stridor at rest, cyanosis, or increased work of breathing.
6. A child with leukemia is receiving chemotherapy. What should be the nurse’s priority
assessment during care?
Answer: The priority assessment is to monitor for signs of infection, including fever, chills, and
any localized signs of infection.
Rationale:
Chemotherapy suppresses bone marrow function, leading to neutropenia and severely
compromised immunity. Children with leukemia are at high risk for infections that can
progress rapidly to sepsis. Fever may be the only early sign of infection because inflammatory
responses are diminished. Prompt detection and treatment of infection are critical to prevent
serious complications. Regular vital signs, inspection for skin breakdown, oral ulcers, and
respiratory symptoms are essential. The nurse must educate caregivers about infection
prevention and immediate reporting of symptoms.
7. At 9 months of age, which types of foods are safe and appropriate for an infant to consume?
