2025 HESI PEDIATRICS (PEDS) PRACTICE EXAM 400
PRACTICE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
A 6-month-
old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse wa
rrants immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute. - correct answer-Apical heart rate of 60.
A heart rate of 60 (A) is much lower than normal for a 6-month-
old and warrants immediate intervention. The normal heart rate for a 6-month-
old is 80 to 150 BPM when awake, and a rate of 70 while sleeping is considered within normal limits. (B an
d C) are expected symptoms of heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teachingvthe parents of a 5-year-
old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the par
ents understand?
Perform postural drainage before starting aerosol therapy.
Give respiratory treatments when the child is coughing a lot.
Administer aerosol therapy followed by postural drainage before meals.
Ensure respiratory therapy is done daily during any respiratory infection. - correct answer-
Administer aerosol therapy followed by postural drainage before meals.
Postural drainage for a child with cystic fibrosis is most effective when performed after nebulization and b
eforevmeals (C) or at least 1 hour after eating to preventvnausea and vomiting. Postural drainage uses grav
ity to promote mucous removal after nebulization (A) treatments which open the airways. Pulmonary toil
etingvor respiratory treatments should be given 3 to 4 times daily, not episodically (B and D).
Avfemale teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most impor
tant instruction for the nurse to include in this client's teaching plan?
,Use sunscreen when lying by the pool.
Cleanse the skin at least 4vtimes a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular. - correct answer-Use sunscreen when lying by the pool.
Photosensitivity isva common side effect of tetracycline HCL (Achromycin V) therapy. Severe sunburn can
occur with minimal sun exposure and clients should be instructed to avoid sunlight and to use sunscreen (
A). (B and D) are not related to tetracycline HCL (Achromycin V) therapy. (C) should be avoided because d
airy products interfere with the absorption of tetracyclines.
Whatvpreoperative nursing intervention should be included in the plan of care for an infant with pyloric st
enosis?
Monitor for signs of metabolicvacidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting. -vcorrect answer-Observe for projectile vomiting.
Projectile vomitingv(D), which contributes to metabolic alkalosis (A), is the classic sign of pyloricvstenosis. (
B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequentvvomiting.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The n
urse recognizesvthat surgical correction is designed to achieve which outcome?
Stop the flow of unoxygenated blood into systemicvcirculation.
Increase the flow of unoxygenated blood to the lungs.
Prevent the return of oxygenated blood to the lungs.
Reduce peripheral tissue hypoxia and nailbed clubbing - correct answer-
Prevent the return of oxygenated blood to the lungs.
Closurevof VSDsvstops oxygenated blood from being shunted from the left ventricle to the right ventricle (
C). VSDs are acyanotic defects, which means that no unoxygenated blood enters the systemic circulation (
Avand B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
,Av3-week-old newborn is brought tovthe clinic for follow-
upvafter a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls asle
ep. The nurse auscultates a loud murmur characteristicvof a ventricular septal defect (VSD), and finds the
newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should the nurse
provide the mother to ensure thevinfant is receiving adequate intake? (Select all that apply.)
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increasevthe infant's intake per feeding by 1 to 2 ounces per week.
C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening. - correct answer-
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of formu
la (C) because it is difficult to ensure that the total dose is consumed.
They should be monitored for weight gain and at least 6 wet diapers per day (A). A one-
month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces per
day by 4-months of age (B)
Preoperative nursingvcare for a child with Wilms' tumor should include which intervention?
Gently percuss the abdomen for evidence of trapped air.
Observe the abdomen for any noticeable discolorations.
Apply cold compresses to the abdomen to reduce edema.
Putva sign on the bed reading, "DO NOT PALPATE ABDOMEN." - correct answer-
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Prevention of abdominal palpation (D) minimizes the risk of rupturing the encapsulated tumor and subse
quent metastasis. (A) is unnecessary, and this action could traumatize the tumor in the same manner as p
alpation. (B and C) are incorrect since the abdomen is not discolored and cold compressesvare not indicat
ed.
, At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent clie
nt with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was
170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. Wha
t action should the nurse take first?
Give the client her 9 a.m. prescription for an oral diuretic early.
Administer PRN prescription of nifedipine (Procardia) sublingually.
Notify the healthcare provider and inform the nursingvsupervisor of the client's condition.
Attempt to calm the client and retake the blood pressure in thirty minutes. -vcorrect answer-
Administer PRN prescription of nifedipine (Procardia) sublingually.
Sublingual Procardia (B) lowersvblood pressure very quickly, and this should be done first. (A) may also be
done, but oral diuretics do not work as rapidly as the sublingual antihypertensive. When notifying the hea
lthcare provider, the first thing he/she will want to know is if the PRN antihypertensive has been administ
ered (C). (D) does not consider the seriousness of this finding. The nurse should stay with the client until t
he blood pressure is reduced.
The nurse is assessing an 8-month-
old child who has a medical diagnosisvof Tetrology of Fallot. Which symptom is this client most likely to ex
hibit?
Bradycardia.
Machinery murmur.
Weakvpedal pulses.
Clubbed fingers. - correct answer-Clubbed fingers.
Tetrology of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes (D) due to tissue hypoxia. T
achycardia, not (A), is a manifestation of congenital heart disease. (B) is a classic sign of ventricular septal
defect. (C) is characteristic of coarctation of the aorta.
Surgery is being delayed for an infant with undescended testes. In collaboration with the healthcare provi
der and the family, which prescription should the nurse anticipate?
Avtrial of adrenocorticotrophic hormone injections.
Frequent stimulation of the cremasteric reflex.
PRACTICE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
A 6-month-
old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse wa
rrants immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute. - correct answer-Apical heart rate of 60.
A heart rate of 60 (A) is much lower than normal for a 6-month-
old and warrants immediate intervention. The normal heart rate for a 6-month-
old is 80 to 150 BPM when awake, and a rate of 70 while sleeping is considered within normal limits. (B an
d C) are expected symptoms of heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teachingvthe parents of a 5-year-
old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the par
ents understand?
Perform postural drainage before starting aerosol therapy.
Give respiratory treatments when the child is coughing a lot.
Administer aerosol therapy followed by postural drainage before meals.
Ensure respiratory therapy is done daily during any respiratory infection. - correct answer-
Administer aerosol therapy followed by postural drainage before meals.
Postural drainage for a child with cystic fibrosis is most effective when performed after nebulization and b
eforevmeals (C) or at least 1 hour after eating to preventvnausea and vomiting. Postural drainage uses grav
ity to promote mucous removal after nebulization (A) treatments which open the airways. Pulmonary toil
etingvor respiratory treatments should be given 3 to 4 times daily, not episodically (B and D).
Avfemale teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most impor
tant instruction for the nurse to include in this client's teaching plan?
,Use sunscreen when lying by the pool.
Cleanse the skin at least 4vtimes a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular. - correct answer-Use sunscreen when lying by the pool.
Photosensitivity isva common side effect of tetracycline HCL (Achromycin V) therapy. Severe sunburn can
occur with minimal sun exposure and clients should be instructed to avoid sunlight and to use sunscreen (
A). (B and D) are not related to tetracycline HCL (Achromycin V) therapy. (C) should be avoided because d
airy products interfere with the absorption of tetracyclines.
Whatvpreoperative nursing intervention should be included in the plan of care for an infant with pyloric st
enosis?
Monitor for signs of metabolicvacidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting. -vcorrect answer-Observe for projectile vomiting.
Projectile vomitingv(D), which contributes to metabolic alkalosis (A), is the classic sign of pyloricvstenosis. (
B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequentvvomiting.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The n
urse recognizesvthat surgical correction is designed to achieve which outcome?
Stop the flow of unoxygenated blood into systemicvcirculation.
Increase the flow of unoxygenated blood to the lungs.
Prevent the return of oxygenated blood to the lungs.
Reduce peripheral tissue hypoxia and nailbed clubbing - correct answer-
Prevent the return of oxygenated blood to the lungs.
Closurevof VSDsvstops oxygenated blood from being shunted from the left ventricle to the right ventricle (
C). VSDs are acyanotic defects, which means that no unoxygenated blood enters the systemic circulation (
Avand B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
,Av3-week-old newborn is brought tovthe clinic for follow-
upvafter a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls asle
ep. The nurse auscultates a loud murmur characteristicvof a ventricular septal defect (VSD), and finds the
newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should the nurse
provide the mother to ensure thevinfant is receiving adequate intake? (Select all that apply.)
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increasevthe infant's intake per feeding by 1 to 2 ounces per week.
C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening. - correct answer-
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of formu
la (C) because it is difficult to ensure that the total dose is consumed.
They should be monitored for weight gain and at least 6 wet diapers per day (A). A one-
month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces per
day by 4-months of age (B)
Preoperative nursingvcare for a child with Wilms' tumor should include which intervention?
Gently percuss the abdomen for evidence of trapped air.
Observe the abdomen for any noticeable discolorations.
Apply cold compresses to the abdomen to reduce edema.
Putva sign on the bed reading, "DO NOT PALPATE ABDOMEN." - correct answer-
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Prevention of abdominal palpation (D) minimizes the risk of rupturing the encapsulated tumor and subse
quent metastasis. (A) is unnecessary, and this action could traumatize the tumor in the same manner as p
alpation. (B and C) are incorrect since the abdomen is not discolored and cold compressesvare not indicat
ed.
, At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent clie
nt with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was
170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. Wha
t action should the nurse take first?
Give the client her 9 a.m. prescription for an oral diuretic early.
Administer PRN prescription of nifedipine (Procardia) sublingually.
Notify the healthcare provider and inform the nursingvsupervisor of the client's condition.
Attempt to calm the client and retake the blood pressure in thirty minutes. -vcorrect answer-
Administer PRN prescription of nifedipine (Procardia) sublingually.
Sublingual Procardia (B) lowersvblood pressure very quickly, and this should be done first. (A) may also be
done, but oral diuretics do not work as rapidly as the sublingual antihypertensive. When notifying the hea
lthcare provider, the first thing he/she will want to know is if the PRN antihypertensive has been administ
ered (C). (D) does not consider the seriousness of this finding. The nurse should stay with the client until t
he blood pressure is reduced.
The nurse is assessing an 8-month-
old child who has a medical diagnosisvof Tetrology of Fallot. Which symptom is this client most likely to ex
hibit?
Bradycardia.
Machinery murmur.
Weakvpedal pulses.
Clubbed fingers. - correct answer-Clubbed fingers.
Tetrology of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes (D) due to tissue hypoxia. T
achycardia, not (A), is a manifestation of congenital heart disease. (B) is a classic sign of ventricular septal
defect. (C) is characteristic of coarctation of the aorta.
Surgery is being delayed for an infant with undescended testes. In collaboration with the healthcare provi
der and the family, which prescription should the nurse anticipate?
Avtrial of adrenocorticotrophic hormone injections.
Frequent stimulation of the cremasteric reflex.
