HESI Pediatric Practice Exam with
Answers
Which should the nurse assess last when examining a 5-year-old child?
a. Heart.
b. Lungs.
c. Throat.
d. Abdomen. - ✔✔c. Throat.
Examination of the mouth, throat, and perineum is considered to be more invasive than other
parts of a physical examination. Invasive procedures should be left for the end of the
examination for a preschooler.
The community health nurse teaches the parents of school-age children about the need for
fluoride as part of a dental health program. Which statement by the parents indicates that they
understand the teaching?
a. "Excessive amounts of fluoride will make teeth turn brittle and yellow."
b. "Having our children brush with fluoride toothpaste is not effective."
c. "Use of fluoride in water is mostly effective during initial tooth formation."
d. "Dental caries can be prevented through fluoridation of public water." - ✔✔d. "Dental caries
can be prevented through fluoridation of public water."
Dental caries can be prevented through fluoridation of public water.
The nurse is assessing an infant with diarrhea and lethargy. Which finding should the nurse
identify that is consistent with early dehydration?
,a. Tachycardia.
b. Bradycardia.
c. Dry mucous membranes.
d. Increased skin turgor. - ✔✔a. Tachycardia.
In early dehydration (during the first 2 days), fluid loss occurs first from the extracellular and
intravascular fluid spaces. Blood pressure falls and heart rate increases in response to a
diminished blood volume.
When conducting a hygiene class for adolescent girls, it is important for the nurse to include
which instruction about preventing toxic shock syndrome?
a. Wash your hands before inserting a tampon.
b. Use super absorbent tampons.
c. Wear cotton underwear.
d. Douche following menstruation. - ✔✔a. Wash your hands before inserting a tampon.
The single most effective means of preventing infection is handwashing.
The nurse is caring for an irritable, lethargic 18-month-old child who swallowed several over-
the-counter (OTC) antihistamine tablets an hour ago. Which intervention should the nurse
implement?
a. Initiate gastric lavage.
b. Administer naloxone.
c. Give a dose of ipecac syrup.
d. Encourage oral intake of water or milk. - ✔✔a. Initiate gastric lavage.
,Gastric lavage should be implemented within 2 hours of ingestion to ensure gastric removal of a
noncorrosive substance, such as an OTC antihistamine.
Which sign of malignant hyperthermia should the nurse assess for during the perioperative
period in a child receiving general anesthesia?
a. Apnea.
b. Tachypnea.
c. Bradycardia.
d. Decreased blood pressure. - ✔✔b. Tachypnea.
Malignant hyperthermia, a potentially fatal autosomal genetic myopathy, can cause a change in
vital signs that demands immediate attention in the perioperative period when these
individuals are exposed to anesthetic agents. Early symptoms of the disorder include
tachycardia and tachyarrhythmia, tachypnea, hypercarbia, and metabolic and respiratory
acidosis. An elevated temperature is a late sign of the disorder.
A child with a penetrating eye injury comes to the school clinic. Which action should the nurse
implement?
a. Remove the object impaled in the eye and then apply a regular eye patch.
b. Place an ice bag over the eye until the healthcare provider is seen
c. .Irrigate the affected eye copiously with a cool sterile saline solution.
d. Apply a Fox shield to the affected eye and any type of patch to the other eye. - ✔✔d. Apply a
Fox shield to the affected eye and any type of patch to the other eye.
The treatment for a penetrating eye injury is not to remove or manipulate the impaled object,
but to apply a Fox shield over the eye, if available (not a regular eye patch). Place an eye patch
over the unaffected eye to prevent bilateral eye movement. The child should be transported to
the emergency department immediately. If a Fox shield is not available, tape a paper cup over
the eye and object.
, 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?
a. Prolonged exhalations.
b. Thick yellow rhinorrhea.
c. Frequent nonproductive cough.
d. Oxygen saturation of 95% by pulse oximeter. - ✔✔a. 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.
A newborn who is breastfeeding is diagnosed with galactosemia. Which action should the nurse
implement?
a. Stop the infant breastfeeding.
b. Add amino acids to breast milk.
c. Give galactokinase with breast milk.
d. Substitute a lactose-containing formula. - ✔✔a. Stop the infant breastfeeding.
Galactosemia is a rare genetic disorder that involves an inborn error of carbohydrate
metabolism in which a hepatic enzyme, galactokinase, involved in the conversion of galactose
to glucose is absent. Treatment consists of eliminating all lactose-containing foods, including
breast milk, so the infant should stop breastfeeding. Soy protein formula is the feeding of
choice during infancy.
A 12-year-old male client tells the nurse that he is happy to be taking growth hormones
because now he can grow to be as tall as his friends. What response is best for the nurse to
provide?
Answers
Which should the nurse assess last when examining a 5-year-old child?
a. Heart.
b. Lungs.
c. Throat.
d. Abdomen. - ✔✔c. Throat.
Examination of the mouth, throat, and perineum is considered to be more invasive than other
parts of a physical examination. Invasive procedures should be left for the end of the
examination for a preschooler.
The community health nurse teaches the parents of school-age children about the need for
fluoride as part of a dental health program. Which statement by the parents indicates that they
understand the teaching?
a. "Excessive amounts of fluoride will make teeth turn brittle and yellow."
b. "Having our children brush with fluoride toothpaste is not effective."
c. "Use of fluoride in water is mostly effective during initial tooth formation."
d. "Dental caries can be prevented through fluoridation of public water." - ✔✔d. "Dental caries
can be prevented through fluoridation of public water."
Dental caries can be prevented through fluoridation of public water.
The nurse is assessing an infant with diarrhea and lethargy. Which finding should the nurse
identify that is consistent with early dehydration?
,a. Tachycardia.
b. Bradycardia.
c. Dry mucous membranes.
d. Increased skin turgor. - ✔✔a. Tachycardia.
In early dehydration (during the first 2 days), fluid loss occurs first from the extracellular and
intravascular fluid spaces. Blood pressure falls and heart rate increases in response to a
diminished blood volume.
When conducting a hygiene class for adolescent girls, it is important for the nurse to include
which instruction about preventing toxic shock syndrome?
a. Wash your hands before inserting a tampon.
b. Use super absorbent tampons.
c. Wear cotton underwear.
d. Douche following menstruation. - ✔✔a. Wash your hands before inserting a tampon.
The single most effective means of preventing infection is handwashing.
The nurse is caring for an irritable, lethargic 18-month-old child who swallowed several over-
the-counter (OTC) antihistamine tablets an hour ago. Which intervention should the nurse
implement?
a. Initiate gastric lavage.
b. Administer naloxone.
c. Give a dose of ipecac syrup.
d. Encourage oral intake of water or milk. - ✔✔a. Initiate gastric lavage.
,Gastric lavage should be implemented within 2 hours of ingestion to ensure gastric removal of a
noncorrosive substance, such as an OTC antihistamine.
Which sign of malignant hyperthermia should the nurse assess for during the perioperative
period in a child receiving general anesthesia?
a. Apnea.
b. Tachypnea.
c. Bradycardia.
d. Decreased blood pressure. - ✔✔b. Tachypnea.
Malignant hyperthermia, a potentially fatal autosomal genetic myopathy, can cause a change in
vital signs that demands immediate attention in the perioperative period when these
individuals are exposed to anesthetic agents. Early symptoms of the disorder include
tachycardia and tachyarrhythmia, tachypnea, hypercarbia, and metabolic and respiratory
acidosis. An elevated temperature is a late sign of the disorder.
A child with a penetrating eye injury comes to the school clinic. Which action should the nurse
implement?
a. Remove the object impaled in the eye and then apply a regular eye patch.
b. Place an ice bag over the eye until the healthcare provider is seen
c. .Irrigate the affected eye copiously with a cool sterile saline solution.
d. Apply a Fox shield to the affected eye and any type of patch to the other eye. - ✔✔d. Apply a
Fox shield to the affected eye and any type of patch to the other eye.
The treatment for a penetrating eye injury is not to remove or manipulate the impaled object,
but to apply a Fox shield over the eye, if available (not a regular eye patch). Place an eye patch
over the unaffected eye to prevent bilateral eye movement. The child should be transported to
the emergency department immediately. If a Fox shield is not available, tape a paper cup over
the eye and object.
, 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?
a. Prolonged exhalations.
b. Thick yellow rhinorrhea.
c. Frequent nonproductive cough.
d. Oxygen saturation of 95% by pulse oximeter. - ✔✔a. 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.
A newborn who is breastfeeding is diagnosed with galactosemia. Which action should the nurse
implement?
a. Stop the infant breastfeeding.
b. Add amino acids to breast milk.
c. Give galactokinase with breast milk.
d. Substitute a lactose-containing formula. - ✔✔a. Stop the infant breastfeeding.
Galactosemia is a rare genetic disorder that involves an inborn error of carbohydrate
metabolism in which a hepatic enzyme, galactokinase, involved in the conversion of galactose
to glucose is absent. Treatment consists of eliminating all lactose-containing foods, including
breast milk, so the infant should stop breastfeeding. Soy protein formula is the feeding of
choice during infancy.
A 12-year-old male client tells the nurse that he is happy to be taking growth hormones
because now he can grow to be as tall as his friends. What response is best for the nurse to
provide?
