PEDIATRICS - HESI PRACTICE EXAM
The nurse is giving preoperative instructions to a 14-year old female client who is scheduled for
surgery to correct a spinal curvature. Which statement by the client best demonstrates that learning
has taken place? -
D. I understand that I will be in a body cast and I will show you how you taught me
to turn.
To take the vital signs of a 4-month old child, which order will give the most accurate results? -
A. Respiratory rate, heart rate, then rectal temperature
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. What action should the
nurse take next? -
B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
Which restraint should be used for a toddler after a cleft palate repair? -
C. elbow restraints
What preoperative nursing intervention should be included in the plan of care for an infant with
pyloric stenosis? -
D. observe for projectile vomiting.
A six-month-old returns from surgery with elbow restraints in place. What nursing care should be
included when caring for any restrained child? -
B. remove restraints one at a time and provide range of motion exercises
A 2-year old child with Down syndrome is brought to the clinic for his regular physical
examination. The nurse knows which problem is frequently associated with Down syndrome? -
A. congenital heart disease
When assessing a child with asthma, the nurse should expect intercostal retractions during -
A. inspiration
When planning the care for a child who has had a cleft lip repair, the nurse knows that crying
should be minimized because it -
D. stresses the suture line
A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects
that the infant may have an esophageal atresia. Which symptoms is this newborn likely to have
exhibited? -
A. choking, coughing, and cyanosis
Which behavior would the nurse expect a two-year-old child to exhibit? -
C. display possessiveness of toys
1
,the mother of a preschool-aged client asks the nurse if it is all right to administer Pepto Bismal to
her son when he 'has a tummy ache." After reminding the mother to check the label of all OTC
drugs for the presence of aspirin, which instruction should the nurse include when replying to this
mother's question? -
B. do not give if the child has chickenpox, the flu, or any other viral illness.
The nurse observes a 4-year old boy in a daycare setting. Which behavior should the nurse consider
normal for this client? -
C. demonstrates aggressiveness by boasting when telling a story
A burned child is brought to the emergency room. In estimating the percentage of the body burned,
the nurse uses a modified "Rule of Nines." Which part of a child's body is calculated as a larger
percentage of total body surface than an adult? -
A. head and neck
The nurse receives a lab report stating a child with asthma has a theophylline level of 15 mcg/dl.
What action will the nurse take? -
A. pass the information on in the report
A 12-month old boy is admitted with a respiratory infection and possible pneumonia. He is placed
in a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant? -
C. have a bulb syringe readily available to remove secretions
All of the following interventions can be used to evaluate the effectiveness of nursing and medical
interventions used to treat diarrhea. Which intervention is least useful in the nurse's evaluation of a
20-month-old child. -
B. assessing fontanels
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribed
dextrose 5% and 0.25% normal saline with 2 mEq KCI/100 mL to be infused at 25mL/hr. Prior to
initiating the infusion, the nurse should obtain which assessment finding? -
B. serum BUN and creatinine levels
The nurse is assigning care for a 4-year old child with otitis media and is concerned about the
child's increasing temperature over the past 24 hours. When planning care for this child, it is
important for the nurse to consider that: -
B. a tympanic measurement of temperature will provide the most accurate reading
The nurse is assessing an 8-month old child who has a medical diagnosis of Tetrology of Fallot.
Which symptom is this client most likely to exhibit? -
D. clubbed fingers
As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which
child's fontanel finding should be reported to the healthcare provider? -
A. A 5-month old with failure to thrive that has a closed anterior fontanel
A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by
which behavior? -
C. concern for body integrity
2
,An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect.
The nurse recognizes that surgical correction is designed to achieve which outcome? -
C. prevent the return of oxygenated blood to the lungs.
A three-month old boy weighing 10 lbs, 15 oz has an axillary temperature of 98.9 degrees F. The
nurse determines the daily caloric need for this child is approximately: -
C. 600 cal/day
10 lbs, 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2 (10.9/2.2) = 4.954 kg rounded
to 5 kg. an infant requires 108 cal/kg/day (108 x 5 = 540 cal/day). However this infant requires 10%
more calories because he has one degree temperature elevation. 10% of 540 is 54 and 54 + 540 =
594. This infant will require approximately 600 calories/day. Remember that a temperature
elevation necessitates consumption of more calories.
The nurse is preparing a health teaching program for parents of toddlers and preschoolers and plans
to include information about prevention of accidental poisonings. It is most important for the nurse
to include which instructions? -
B. store all toxic agents and medicines in locked cabinets.
A 6-month old infant with congestive heart failure (CHF) is receiving digoxin elixer. Which
observation by the nurse warrants immediate intervention? -
A. apical heart rate of 60.
At 8am, the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent
client with acute glomerulonephritis has a blood pressure of 210/110. The 4am BP reading was
170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night.
What action should the nurse take? -
B. administer PRN prescription of nifedipine (Procardia) sublingually.
A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus (PDA)
and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold her. Which
response should the nurse provide to the parents? -
B. the oxygen hood is holding the baby's oxygen level just at the point which is
needed. You may stroke and talk to her.
The nurse is developing a plan of care for a 3-year old who is scheduled for a cardiac
catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which
intervention is best for the nurse to implement? -
C. give the child a ride on a gurney to visit the cardiac catheterization lab and meet a
nurse who works there.
When taking the health history of a child, the nurse knows that which finding is an early indication
of hypothyroidism in children? -
D. cessation of growth in a child that had been normal.
The nurse is teaching a 12-year old male adolescent and his family about taking injections of
growth hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly associated
with growth hormone therapy should the nurse plan to describe to the child and his family? -
3
, A. polyuria and polydipsia
The nurse is caring for a 12-year old with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). This child should be carefully assessed for which complication? -
B. changes in LOC
A four-year old girl continues to interrupt her mother during a routine clinic visit. the mother
appears irritated with the child and asks the nurse, "Is this normal behavior for a child this age?"
The nurse's response should be based on which information? -
A. children need to retain a sense of initiative without impinging on the rights and
privileges of others.
a 14-year old female client tells the nurse that she is concerned about the acne she has recently
developed. Which recommendation should the nurse provide? -
C. Wash the hair and skin frequently with soap and hot water
The mother of a 2-year old boy consults the nurse about her son's increased tempter tantrums. The
mother states, "Yesterday he threw a fit in the grocery store, and I did not know what to do. I was
embarrassed. What can I do if this occurs again?" Which recommendation is best for the nurse to
provide this mother? -
D. walk away from him and ignore the behavior
During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress to
the parents the importance of obtaining which diagnostic testing? -
B. eye exam
A hospitalized 16-year old male refuses all visits from his classmates because he is concerned about
his distorted appearance. To increase the client's social interaction, what intervention is best for the
nurse to initiate? -
C. arrange for an internet connection in the client's room for email communication
The nurse is assessing a 2-year old. What behavior indicates that the child's language development
is within normal limits? -
C. is capable of making a three word sentence
When evaluating the effectiveness of interventions to improve the nutritional status of an infant
with gastro-esophageal reflux, which intervention is most important for the nurse to implement? -
A. record weight daily
Which menu selection by a child with celiac disease indicates to the nurse that the child understands
necessary dietary considerations? -
A. oven-baked potato chips and cola.
The parents of a 3-week old infant report that the child eats well but vomits after each feeding. what
information is most important for the nurse to obtain? -
A. description of vomiting episodes in the past 24 hours
A 3-month old infant develops oral thrush. Which pharmacologic agent should the nurse plan to
administer for treatment of this disorder? -
4
The nurse is giving preoperative instructions to a 14-year old female client who is scheduled for
surgery to correct a spinal curvature. Which statement by the client best demonstrates that learning
has taken place? -
D. I understand that I will be in a body cast and I will show you how you taught me
to turn.
To take the vital signs of a 4-month old child, which order will give the most accurate results? -
A. Respiratory rate, heart rate, then rectal temperature
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. What action should the
nurse take next? -
B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
Which restraint should be used for a toddler after a cleft palate repair? -
C. elbow restraints
What preoperative nursing intervention should be included in the plan of care for an infant with
pyloric stenosis? -
D. observe for projectile vomiting.
A six-month-old returns from surgery with elbow restraints in place. What nursing care should be
included when caring for any restrained child? -
B. remove restraints one at a time and provide range of motion exercises
A 2-year old child with Down syndrome is brought to the clinic for his regular physical
examination. The nurse knows which problem is frequently associated with Down syndrome? -
A. congenital heart disease
When assessing a child with asthma, the nurse should expect intercostal retractions during -
A. inspiration
When planning the care for a child who has had a cleft lip repair, the nurse knows that crying
should be minimized because it -
D. stresses the suture line
A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects
that the infant may have an esophageal atresia. Which symptoms is this newborn likely to have
exhibited? -
A. choking, coughing, and cyanosis
Which behavior would the nurse expect a two-year-old child to exhibit? -
C. display possessiveness of toys
1
,the mother of a preschool-aged client asks the nurse if it is all right to administer Pepto Bismal to
her son when he 'has a tummy ache." After reminding the mother to check the label of all OTC
drugs for the presence of aspirin, which instruction should the nurse include when replying to this
mother's question? -
B. do not give if the child has chickenpox, the flu, or any other viral illness.
The nurse observes a 4-year old boy in a daycare setting. Which behavior should the nurse consider
normal for this client? -
C. demonstrates aggressiveness by boasting when telling a story
A burned child is brought to the emergency room. In estimating the percentage of the body burned,
the nurse uses a modified "Rule of Nines." Which part of a child's body is calculated as a larger
percentage of total body surface than an adult? -
A. head and neck
The nurse receives a lab report stating a child with asthma has a theophylline level of 15 mcg/dl.
What action will the nurse take? -
A. pass the information on in the report
A 12-month old boy is admitted with a respiratory infection and possible pneumonia. He is placed
in a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant? -
C. have a bulb syringe readily available to remove secretions
All of the following interventions can be used to evaluate the effectiveness of nursing and medical
interventions used to treat diarrhea. Which intervention is least useful in the nurse's evaluation of a
20-month-old child. -
B. assessing fontanels
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribed
dextrose 5% and 0.25% normal saline with 2 mEq KCI/100 mL to be infused at 25mL/hr. Prior to
initiating the infusion, the nurse should obtain which assessment finding? -
B. serum BUN and creatinine levels
The nurse is assigning care for a 4-year old child with otitis media and is concerned about the
child's increasing temperature over the past 24 hours. When planning care for this child, it is
important for the nurse to consider that: -
B. a tympanic measurement of temperature will provide the most accurate reading
The nurse is assessing an 8-month old child who has a medical diagnosis of Tetrology of Fallot.
Which symptom is this client most likely to exhibit? -
D. clubbed fingers
As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which
child's fontanel finding should be reported to the healthcare provider? -
A. A 5-month old with failure to thrive that has a closed anterior fontanel
A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by
which behavior? -
C. concern for body integrity
2
,An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect.
The nurse recognizes that surgical correction is designed to achieve which outcome? -
C. prevent the return of oxygenated blood to the lungs.
A three-month old boy weighing 10 lbs, 15 oz has an axillary temperature of 98.9 degrees F. The
nurse determines the daily caloric need for this child is approximately: -
C. 600 cal/day
10 lbs, 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2 (10.9/2.2) = 4.954 kg rounded
to 5 kg. an infant requires 108 cal/kg/day (108 x 5 = 540 cal/day). However this infant requires 10%
more calories because he has one degree temperature elevation. 10% of 540 is 54 and 54 + 540 =
594. This infant will require approximately 600 calories/day. Remember that a temperature
elevation necessitates consumption of more calories.
The nurse is preparing a health teaching program for parents of toddlers and preschoolers and plans
to include information about prevention of accidental poisonings. It is most important for the nurse
to include which instructions? -
B. store all toxic agents and medicines in locked cabinets.
A 6-month old infant with congestive heart failure (CHF) is receiving digoxin elixer. Which
observation by the nurse warrants immediate intervention? -
A. apical heart rate of 60.
At 8am, the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent
client with acute glomerulonephritis has a blood pressure of 210/110. The 4am BP reading was
170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night.
What action should the nurse take? -
B. administer PRN prescription of nifedipine (Procardia) sublingually.
A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus (PDA)
and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold her. Which
response should the nurse provide to the parents? -
B. the oxygen hood is holding the baby's oxygen level just at the point which is
needed. You may stroke and talk to her.
The nurse is developing a plan of care for a 3-year old who is scheduled for a cardiac
catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which
intervention is best for the nurse to implement? -
C. give the child a ride on a gurney to visit the cardiac catheterization lab and meet a
nurse who works there.
When taking the health history of a child, the nurse knows that which finding is an early indication
of hypothyroidism in children? -
D. cessation of growth in a child that had been normal.
The nurse is teaching a 12-year old male adolescent and his family about taking injections of
growth hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly associated
with growth hormone therapy should the nurse plan to describe to the child and his family? -
3
, A. polyuria and polydipsia
The nurse is caring for a 12-year old with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). This child should be carefully assessed for which complication? -
B. changes in LOC
A four-year old girl continues to interrupt her mother during a routine clinic visit. the mother
appears irritated with the child and asks the nurse, "Is this normal behavior for a child this age?"
The nurse's response should be based on which information? -
A. children need to retain a sense of initiative without impinging on the rights and
privileges of others.
a 14-year old female client tells the nurse that she is concerned about the acne she has recently
developed. Which recommendation should the nurse provide? -
C. Wash the hair and skin frequently with soap and hot water
The mother of a 2-year old boy consults the nurse about her son's increased tempter tantrums. The
mother states, "Yesterday he threw a fit in the grocery store, and I did not know what to do. I was
embarrassed. What can I do if this occurs again?" Which recommendation is best for the nurse to
provide this mother? -
D. walk away from him and ignore the behavior
During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress to
the parents the importance of obtaining which diagnostic testing? -
B. eye exam
A hospitalized 16-year old male refuses all visits from his classmates because he is concerned about
his distorted appearance. To increase the client's social interaction, what intervention is best for the
nurse to initiate? -
C. arrange for an internet connection in the client's room for email communication
The nurse is assessing a 2-year old. What behavior indicates that the child's language development
is within normal limits? -
C. is capable of making a three word sentence
When evaluating the effectiveness of interventions to improve the nutritional status of an infant
with gastro-esophageal reflux, which intervention is most important for the nurse to implement? -
A. record weight daily
Which menu selection by a child with celiac disease indicates to the nurse that the child understands
necessary dietary considerations? -
A. oven-baked potato chips and cola.
The parents of a 3-week old infant report that the child eats well but vomits after each feeding. what
information is most important for the nurse to obtain? -
A. description of vomiting episodes in the past 24 hours
A 3-month old infant develops oral thrush. Which pharmacologic agent should the nurse plan to
administer for treatment of this disorder? -
4
