Pediatrics HESI Practice Exam with Well Detailed
Question & Answers Perfectly A+ Graded with Rationale
New Update
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. CORRECT ANSWER>>>>ANS: B
Intussusception, an invagination or telescoping of one portion of the intestine into another,
causes intestinal obstruction in children (usually occurs between 3 months and 5 years of age).
Nonsurgical treatment is attempted with hydrostatic pressure created by barium instillation,
which often reduces the area of bowel intussusception (B), thereby negating the need for
surgical intervention. A barium enema is likely to cause (A). A barium enema could be used to
detect (C), but this is not the reason for its use with intussusception. (D) is not a use for a
barium enema.
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. CORRECT ANSWER>>>>ANS: A
The Milwaukee brace is designed to slow the progression in spinal curvature while the
adolescent is growing. The brace should be worn 23 hours a day and removed a total of 1 hour a
day for hygiene (A). There are no specific exercises for increasing the range of motion in the
back that should be performed (B). A T shirt should be worn next to the body and the brace put
on over the T shirt to protect the skin (C). The brace will not cure the spinal curvature (D) but
should slow the progression of the scoliosis.
The nurse should teach the parents of a child with a cyanotic heart defect to perform 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.
CORRECT ANSWER>>>>ANS: C
Assuming a knee-chest position with the head and chest slightly elevated (C) will help restore
hemodynamic equilibrium. (A and B) are incorrect positions and may hinder the child's
condition. (D) may cause chest pain or a vasovagal response, with resulting hypotension.
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.
CORRECT ANSWER>>>>ANS: B
More information is needed to interpret these findings (B). The tympanic membrane is normally
pearly gray, not bulging, and moves when a client blows against resistance or when a small puff
of air is blown into the ear canal. Because these findings are not completely normal, further
assessment of history and related signs and symptoms are needed to interpret the findings
accurately. Based on the data obtained from the otoscope examination, (A, C, and D) are not
indicated.
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 CORRECT ANSWER>>>>ANS: C
Respiratory tract infections commonly occur in the pediatric population, but the child with AIDS
has a decreased ability to defend the body against these common infections. Thus, the most
typical presenting symptom of a child who contracted AIDS through vertical transmission (i.e.,
from the mother during delivery) is a persistent cold or respiratory infection (C). (A, B, and D)
are symptoms of AIDS complications that may occur later as the disease progresses.
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. CORRECT
ANSWER>>>>ANS: C
, The period of communicability of varicella is 2 days before the rash appears until all lesions are
crusted; varicella is spread by direct or indirect contact of saliva or vesicles. Strict isolation (C) is
indicated to prevent further exposure to staff and others. Staff who have had varicella or the
vaccine are not susceptible to contracting or spreading the virus and should be the only
personnel assigned to care for this client (D). (A) is not sufficient to prevent exposure to others.
(B) must be done prior to exposure.
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. CORRECT ANSWER>>>>ANS: B
When inserting a nasogastric tube into the stomach of a 3-month-old infant, which nursing
intervention is most important to implement?Rationale:
All interventions may be implemented during nasogastric tube insertion, but the most
important nursing action is to monitor the infant's heart rate (B), which may decrease because
of vagal nerve stimulation and can occur when the tube is inserted. (A, C, and D) are of lower
priority than (B).
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 CORRECT ANSWER>>>>ANS: A
The standard rule of nines is inaccurate for determining burned body surface areas with
children because a child's head and neck are proportionately larger than an adult's (A). Specially
Question & Answers Perfectly A+ Graded with Rationale
New Update
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. CORRECT ANSWER>>>>ANS: B
Intussusception, an invagination or telescoping of one portion of the intestine into another,
causes intestinal obstruction in children (usually occurs between 3 months and 5 years of age).
Nonsurgical treatment is attempted with hydrostatic pressure created by barium instillation,
which often reduces the area of bowel intussusception (B), thereby negating the need for
surgical intervention. A barium enema is likely to cause (A). A barium enema could be used to
detect (C), but this is not the reason for its use with intussusception. (D) is not a use for a
barium enema.
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. CORRECT ANSWER>>>>ANS: A
The Milwaukee brace is designed to slow the progression in spinal curvature while the
adolescent is growing. The brace should be worn 23 hours a day and removed a total of 1 hour a
day for hygiene (A). There are no specific exercises for increasing the range of motion in the
back that should be performed (B). A T shirt should be worn next to the body and the brace put
on over the T shirt to protect the skin (C). The brace will not cure the spinal curvature (D) but
should slow the progression of the scoliosis.
The nurse should teach the parents of a child with a cyanotic heart defect to perform 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.
CORRECT ANSWER>>>>ANS: C
Assuming a knee-chest position with the head and chest slightly elevated (C) will help restore
hemodynamic equilibrium. (A and B) are incorrect positions and may hinder the child's
condition. (D) may cause chest pain or a vasovagal response, with resulting hypotension.
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.
CORRECT ANSWER>>>>ANS: B
More information is needed to interpret these findings (B). The tympanic membrane is normally
pearly gray, not bulging, and moves when a client blows against resistance or when a small puff
of air is blown into the ear canal. Because these findings are not completely normal, further
assessment of history and related signs and symptoms are needed to interpret the findings
accurately. Based on the data obtained from the otoscope examination, (A, C, and D) are not
indicated.
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 CORRECT ANSWER>>>>ANS: C
Respiratory tract infections commonly occur in the pediatric population, but the child with AIDS
has a decreased ability to defend the body against these common infections. Thus, the most
typical presenting symptom of a child who contracted AIDS through vertical transmission (i.e.,
from the mother during delivery) is a persistent cold or respiratory infection (C). (A, B, and D)
are symptoms of AIDS complications that may occur later as the disease progresses.
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. CORRECT
ANSWER>>>>ANS: C
, The period of communicability of varicella is 2 days before the rash appears until all lesions are
crusted; varicella is spread by direct or indirect contact of saliva or vesicles. Strict isolation (C) is
indicated to prevent further exposure to staff and others. Staff who have had varicella or the
vaccine are not susceptible to contracting or spreading the virus and should be the only
personnel assigned to care for this client (D). (A) is not sufficient to prevent exposure to others.
(B) must be done prior to exposure.
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. CORRECT ANSWER>>>>ANS: B
When inserting a nasogastric tube into the stomach of a 3-month-old infant, which nursing
intervention is most important to implement?Rationale:
All interventions may be implemented during nasogastric tube insertion, but the most
important nursing action is to monitor the infant's heart rate (B), which may decrease because
of vagal nerve stimulation and can occur when the tube is inserted. (A, C, and D) are of lower
priority than (B).
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 CORRECT ANSWER>>>>ANS: A
The standard rule of nines is inaccurate for determining burned body surface areas with
children because a child's head and neck are proportionately larger than an adult's (A). Specially
