HESI Pediatric Practice Exam with
Answers
A seven-month old infant is admitted with nonorganic failure to thrive (NFTT). To aid the child's
growth and development, which intervention is most important for the nurse to implement?
Encourage the parents to participate in a planned program of play with the infant.
Refer the parents for psychological counseling to identify parental detachment.
Demonstrate feeding strategies and infant cues that indicate hunger and satiation.
Provide instructions about formula preparation and feeding schedules. - ✔✔Demonstrate
feeding strategies and infant cues that indicate hunger and satiation.
NFTT most often occurs due to inadequate parental knowledge or a disturbance in parental-
child attachment, but the first goal for infants with NFTT is to provide nutrition to promote
"catch-up" growth. The nurse should demonstrate positive feeding strategies that reduce
parent and infant frustration, such as recognizing the infant's cues indicated by vigorous
sucking and satiation.
The nurse is triaging a child with a fever brought to the emergency department by the parents.
Which finding requires the nurse's immediate intervention?
Prolonged exhalations.
Thick yellow rhinorrhea.
Frequent nonproductive cough.
,Oxygen saturation is 95% by pulse oximeter. - ✔✔Prolonged exhalations.
Prolonged exhalation indicates breathing difficulty and requires immediate intervention.
According to the American Heart Association's Pediatric Advance Life Support (PALS) algorithm,
a prolonged expiration in a pediatric client is indicative of lower airway obstruction.
The nurse is assessing the coping behaviors of the parents whose child has been recently
diagnosed with a chronic illness. What reaction by the parents is a positive step in the ability to
cope with this new situation?
Endowing the illness with meaning.
Refusing to believe the child is ill.
Entertaining an unrealistic future plan for the child.
Placing complete faith in religion to the point of relinquishing own responsibility. -
✔✔Endowing the illness with meaning.
Coping mechanisms are behaviors directed at reducing the tension elicited by a crisis. Approach
behaviors are coping mechanisms resulting in movement toward adjustment and resolution of
the crisis. The parents' ability to assign the illness meaning within an existing medical, scientific,
or spiritual philosophy of life is a long-term coping strategy significantly related to successful
family functioning.
A 15-year-old girl tells the school nurse that she wants to have a baby. How should the nurse
respond?
"Will you be able to support the baby?"
,"Do you have plans to continue school?"
"Have you talked with your parents about this?"
"Can you tell me how your life will be if you have an infant?" - ✔✔"Can you tell me how your
life will be if you have an infant?"
Developing a dialogue with the teen is important. By using an open-ended question the nurse
will encourage communication and explanation. This question directs the teen to consider real
life experiences and allows the nurse to assess the teen's perception and reality orientation.
The nurse is caring for a premature infant who needs an IV access restarted. What action
should the nurse take when using adhesive tape?
Use solvents such as water, mineral oil, or petrolatum to remove adhesives instead of pulling
on skin.
Avoid using tape and adhesives until skin is more mature.
Use scissors carefully to remove tape instead of pulling tape off.
Use alcohol to remove the adhesives. - ✔✔Remove adhesives with water, mineral oil, or
petrolatum.
The use of adhesives should be minimized as much as possible in the treatment of preterm
neonates. They should be removed using water, mineral oil, or petrolatum. The skin of the
premature infant is fragile, delicate, and thinner compared to a full-term infant, and is easily
traumatized. Alcohol should not be used to remove adhesives.
, The nurse calculates a 4 ml dose of prescribed digoxin a 9-month-old infant. What action should
the nurse implement?
Mix dose with juice to disguise its taste.
Suspect dosage error and do not give dose.
Check heart rate and administer dose by placing it to the back and side of mouth.
Check heart rate and administer dose by letting the infant suck it through a nipple. -
✔✔Suspect dosage error and do not give dose.
Digoxin's narrow margin of safety for an infant should not exceed 1 mL (50 mcg) in one dose.
The nurse's calculation indicates a dosage error and should not be given. Digoxin is given
without mixing with any other fluids or foods because the infant may refuse to consume the
total amount, which results in an inaccurate drug dose. Generally, pediatric digoxin elixir is
available as 0.05 mg/mL. Great care must be taken in dosage calculation and should be double-
checked with another nurse prior to administration.
The parents of a toddler brought to the clinic for a well-child visit tell the nurse that their child
becomes upset if even the smallest things change in the environment. What information should
the nurse provide the parents?
A child is insecure because trust is not fostered and developed during infancy.
A toddler should be exposed to different routines to promote adapting to new experiences.
Children of this age are comfortable with ritualism and display global thinking.
Answers
A seven-month old infant is admitted with nonorganic failure to thrive (NFTT). To aid the child's
growth and development, which intervention is most important for the nurse to implement?
Encourage the parents to participate in a planned program of play with the infant.
Refer the parents for psychological counseling to identify parental detachment.
Demonstrate feeding strategies and infant cues that indicate hunger and satiation.
Provide instructions about formula preparation and feeding schedules. - ✔✔Demonstrate
feeding strategies and infant cues that indicate hunger and satiation.
NFTT most often occurs due to inadequate parental knowledge or a disturbance in parental-
child attachment, but the first goal for infants with NFTT is to provide nutrition to promote
"catch-up" growth. The nurse should demonstrate positive feeding strategies that reduce
parent and infant frustration, such as recognizing the infant's cues indicated by vigorous
sucking and satiation.
The nurse is triaging a child with a fever brought to the emergency department by the parents.
Which finding requires the nurse's immediate intervention?
Prolonged exhalations.
Thick yellow rhinorrhea.
Frequent nonproductive cough.
,Oxygen saturation is 95% by pulse oximeter. - ✔✔Prolonged exhalations.
Prolonged exhalation indicates breathing difficulty and requires immediate intervention.
According to the American Heart Association's Pediatric Advance Life Support (PALS) algorithm,
a prolonged expiration in a pediatric client is indicative of lower airway obstruction.
The nurse is assessing the coping behaviors of the parents whose child has been recently
diagnosed with a chronic illness. What reaction by the parents is a positive step in the ability to
cope with this new situation?
Endowing the illness with meaning.
Refusing to believe the child is ill.
Entertaining an unrealistic future plan for the child.
Placing complete faith in religion to the point of relinquishing own responsibility. -
✔✔Endowing the illness with meaning.
Coping mechanisms are behaviors directed at reducing the tension elicited by a crisis. Approach
behaviors are coping mechanisms resulting in movement toward adjustment and resolution of
the crisis. The parents' ability to assign the illness meaning within an existing medical, scientific,
or spiritual philosophy of life is a long-term coping strategy significantly related to successful
family functioning.
A 15-year-old girl tells the school nurse that she wants to have a baby. How should the nurse
respond?
"Will you be able to support the baby?"
,"Do you have plans to continue school?"
"Have you talked with your parents about this?"
"Can you tell me how your life will be if you have an infant?" - ✔✔"Can you tell me how your
life will be if you have an infant?"
Developing a dialogue with the teen is important. By using an open-ended question the nurse
will encourage communication and explanation. This question directs the teen to consider real
life experiences and allows the nurse to assess the teen's perception and reality orientation.
The nurse is caring for a premature infant who needs an IV access restarted. What action
should the nurse take when using adhesive tape?
Use solvents such as water, mineral oil, or petrolatum to remove adhesives instead of pulling
on skin.
Avoid using tape and adhesives until skin is more mature.
Use scissors carefully to remove tape instead of pulling tape off.
Use alcohol to remove the adhesives. - ✔✔Remove adhesives with water, mineral oil, or
petrolatum.
The use of adhesives should be minimized as much as possible in the treatment of preterm
neonates. They should be removed using water, mineral oil, or petrolatum. The skin of the
premature infant is fragile, delicate, and thinner compared to a full-term infant, and is easily
traumatized. Alcohol should not be used to remove adhesives.
, The nurse calculates a 4 ml dose of prescribed digoxin a 9-month-old infant. What action should
the nurse implement?
Mix dose with juice to disguise its taste.
Suspect dosage error and do not give dose.
Check heart rate and administer dose by placing it to the back and side of mouth.
Check heart rate and administer dose by letting the infant suck it through a nipple. -
✔✔Suspect dosage error and do not give dose.
Digoxin's narrow margin of safety for an infant should not exceed 1 mL (50 mcg) in one dose.
The nurse's calculation indicates a dosage error and should not be given. Digoxin is given
without mixing with any other fluids or foods because the infant may refuse to consume the
total amount, which results in an inaccurate drug dose. Generally, pediatric digoxin elixir is
available as 0.05 mg/mL. Great care must be taken in dosage calculation and should be double-
checked with another nurse prior to administration.
The parents of a toddler brought to the clinic for a well-child visit tell the nurse that their child
becomes upset if even the smallest things change in the environment. What information should
the nurse provide the parents?
A child is insecure because trust is not fostered and developed during infancy.
A toddler should be exposed to different routines to promote adapting to new experiences.
Children of this age are comfortable with ritualism and display global thinking.
