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Pediatrics HESI Questions and Answers
A 6-month-old infant with congestive heart failure (CHF) is
receiving digoxin elixir. Which observation by the nurse warrants
immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute.
Ans: 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 and C) are expected symptoms of
heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teaching the parents of a 5-year-old with cystic
fibrosis about respiratory treatments. Which statement indicates
to the nurse that the parents 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.
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, 2 | Page
Ans: 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 before meals (C) or at least 1 hour after
eating to prevent nausea and vomiting. Postural drainage uses gravity to
promote mucous removal after nebulization (A) treatments which open
the airways. Pulmonary toileting or respiratory treatments should be
given 3 to 4 times daily, not episodically (B and D).
A female teenager is taking oral tetracycline HCL (Achromycin V)
for acne vulgaris. What is the most important instruction for the
nurse to include in this client's teaching plan?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular.
Ans: Use sunscreen when lying by the pool.
Photosensitivity is a 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 dairy products interfere with
the absorption of tetracyclines.
What preoperative nursing intervention should be included in the
plan of care for an infant with pyloric stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting.
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, 3 | Page
Ans: Observe for projectile vomiting.
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is
the classic sign of pyloric stenosis. (B) is not indicated. (C) is dangerous,
due to the potential for aspiration with frequent vomiting.
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?
Stop the flow of unoxygenated blood into systemic circulation.
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
Ans: Prevent the return of oxygenated blood to the lungs.
Closure of VSDs stops 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 (A
and B). (D) is common with Tetrology of Fallot, which is a cyanotic
defect.
A 3-week-old newborn is brought to the clinic for follow-up after a
home birth. The mother reports that her child bottle feeds for 5
minutes only and then falls asleep. The nurse auscultates a loud
murmur characteristic of 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 the infant is receiving adequate intake? (Select
all that apply.)
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.
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.
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, 4 | Page
E. Use a softer nipple or increase the size of the nipple opening.
Ans: 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 formula (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 nursing care 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.
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Ans: 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 subsequent metastasis. (A) is unnecessary,
and this action could traumatize the tumor in the same manner as
palpation. (B and C) are incorrect since the abdomen is not discolored
and cold compresses are not indicated.
At 8 a.m. 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 4 a.m.
blood pressure reading was 170/88. The client reports to the UAP
© 2025 All rights reserved
Pediatrics HESI Questions and Answers
A 6-month-old infant with congestive heart failure (CHF) is
receiving digoxin elixir. Which observation by the nurse warrants
immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute.
Ans: 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 and C) are expected symptoms of
heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teaching the parents of a 5-year-old with cystic
fibrosis about respiratory treatments. Which statement indicates
to the nurse that the parents 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.
© 2025 All rights reserved
, 2 | Page
Ans: 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 before meals (C) or at least 1 hour after
eating to prevent nausea and vomiting. Postural drainage uses gravity to
promote mucous removal after nebulization (A) treatments which open
the airways. Pulmonary toileting or respiratory treatments should be
given 3 to 4 times daily, not episodically (B and D).
A female teenager is taking oral tetracycline HCL (Achromycin V)
for acne vulgaris. What is the most important instruction for the
nurse to include in this client's teaching plan?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular.
Ans: Use sunscreen when lying by the pool.
Photosensitivity is a 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 dairy products interfere with
the absorption of tetracyclines.
What preoperative nursing intervention should be included in the
plan of care for an infant with pyloric stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting.
© 2025 All rights reserved
, 3 | Page
Ans: Observe for projectile vomiting.
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is
the classic sign of pyloric stenosis. (B) is not indicated. (C) is dangerous,
due to the potential for aspiration with frequent vomiting.
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?
Stop the flow of unoxygenated blood into systemic circulation.
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
Ans: Prevent the return of oxygenated blood to the lungs.
Closure of VSDs stops 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 (A
and B). (D) is common with Tetrology of Fallot, which is a cyanotic
defect.
A 3-week-old newborn is brought to the clinic for follow-up after a
home birth. The mother reports that her child bottle feeds for 5
minutes only and then falls asleep. The nurse auscultates a loud
murmur characteristic of 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 the infant is receiving adequate intake? (Select
all that apply.)
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.
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.
© 2025 All rights reserved
, 4 | Page
E. Use a softer nipple or increase the size of the nipple opening.
Ans: 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 formula (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 nursing care 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.
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Ans: 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 subsequent metastasis. (A) is unnecessary,
and this action could traumatize the tumor in the same manner as
palpation. (B and C) are incorrect since the abdomen is not discolored
and cold compresses are not indicated.
At 8 a.m. 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 4 a.m.
blood pressure reading was 170/88. The client reports to the UAP
© 2025 All rights reserved
