PEDIATRICS HESI EXAM TEST GUIDE
QUESTIONS AND ANSWERS
Which measurements should be used to accurately calculate a pediatric medication
dosage? (Select all that apply.)
Child's height and weight.
Adult dosage of medication.
Body surface area of child.
Average adult's body surface area.
Average pediatric dosage of medication.
Nomogram determined mathematical constant. - ANSWER-Child's height and
weight.
Body surface area of child.
Nomogram determined mathematical constant.
Correct selections are (A, C, and F). The most accurate calculations of pediatric
dosages use the child's height and weight (A). The child's BSA is calculated using
the square root of weight in kg times height in cm divided by 3600 or the square root
of weight in lb times height in inches divided by 3131 (C), then the child's BSA is
multiplied by the recommended published dose per BSA. The nomogram (F) is used
to plot the child's height and weight, and the point at which they intersect is the BSA
mathematical constant used to calculate the child's dose. (B, D, and E) are not used
to calculate pediatric dosages.
The nurse is assessing a 2-year-old. What behavior indicates that the child's
language development is within normal limits?
Is able to name four colors.
Can count five blocks.
Is capable of making a three word sentence.
Half of child's speech is understandable. - ANSWER-Half of child's speech is
understandable.
Between approximately 15 and 24 months of age, a child's speech is only half
understandable (D). (A and B) usually occur between 3 and 5 years of age. (C) is
usually accomplished by 18 months of age.
The nurse reviews the latest laboratory results for a child who received
chemotherapy last week and identifies a reduced neutrophil count. Which nursing
diagnosis has the highest priority for this child?
Risk for infection.
Risk for hemorrhage.
Altered skin integrity.
Disturbance in body image. - ANSWER-Risk for infection.
Chemotherapy (CT) suppresses phagocytotic neutrophils and places the child at risk
for infection (A), which is the priority nursing diagnosis. (B, C, and D) may be related
to the care of a child receiving CT are not related to neutropenia.
,A child falls on the playground and is brought to the school nurse with a small
laceration on the forearm. Which action should the nurse implement first?
Slowly pour hydrogen peroxide over the open wound.
Apply ice to the area before rinsing with cold water.
Wash the wound gently with mild soap and water.
Gently cleanse with a sterile pad using povidone-iodine. - ANSWER-Wash the
wound gently with mild soap and water.
A small, superficial laceration to the skin should be washed gently with mild soap
and water (C) for several minutes, followed by thorough rinsing. (A and D) are
antiseptics that can be traumatic (painful) when cleaning fresh, open wounds.
Applying ice (B) may reduce or prevent further edema, but the wound should be
washed with mild soap and water first.
The nurse observes a 4-year-old boy in a daycare setting. Which behavior would the
nurse consider normal for this child?
Has a temper tantrum when told he must share his toys.
Plays by himself most of the day.
Demonstrates aggressiveness by boasting when telling a story.
Begins to cry and is fearful when separated from his parents. - ANSWER-
Demonstrates aggressiveness by boasting when telling a story.
Four-year-old children are aggressive in their behavior and enjoy "tale telling" (C).
Behaviors in (A and D) are typical of toddlers. The play of a preschooler is
cooperative, so playing alone (B) is not typical.
The nurse is developing a plan of care for a 3-year-old who is scheduled for a
cardiac catheterization. To assist in decreasing anxiety for the child on the day of the
procedure, which intervention is best for the nurse to implement?
Reassure the parents that 3-year-olds are cooperative and therefore are less likely
to be anxious.
Obtain a video film of a cardiac catheterization to show to the child prior to the
procedure.
Give the child a ride on a gurney to visit the cardiac catheterization lab and meet a
nurse who works there.
Obtain a cardiac catheter and demonstrate the procedure by pretending to put the
catheter in a doll or stuffed animal. - ANSWER-Give the child a ride on a gurney to
visit the cardiac catheterization lab and meet a nurse who works there.
Familiarizing the child and mother with the department (C) will help decrease anxiety
of the child and mother (who may have more anxiety than the child). Three is a
difficult age to undergo a procedure that requires cooperation. Restraints and
possibly sedation may be required (A). At three, the child is too young to understand
why this must be done, and (B) is not indicated. (D) is also not indicated because it is
likely to be interpreted as painful.
A 6-month-old boy and his mother are at the healthcare provider's office for a well-
baby check-up and routine immunizations. The healthcare provider recommends to
the mother that the child receive an influenza vaccine. What medications should the
nurse plan to administer today?
, The routine immunizations and schedule another appointment to administer the
influenza vaccine. Incorrect
All the immunizations with the influenza vaccine given at a separate site from any
other injection.
The influenza vaccine and schedule another appointment to administer the
immunizations.
The influenza vaccine and the polio vaccine and schedule another appointment to
administer the remaining immunizations. - ANSWER-All the immunizations with the
influenza vaccine given at a separate site from any other injection.
At 6-months of age, the routine immunizations include Hepatitis B, DTaP, Hib
(Haemophilus influenza type b), PCV (Pneumococcal), IPV (inactivated poliovirus)
and influenza. The influenza vaccine should be given at a separate site from any
other injection (B). Scheduling a return visit (A, B, or C) increases the risk that the
mother will not bring the child back for the immunizations.
When discussing discipline with the mother of a 4-year-old child, the nurse should
include which guideline?
Parental control should be consistent.
Children as young as 4 years rarely need reprimand or punishment.
Withdrawal of approval is effective.
Parents should enforce rigid rules to be followed without question. - ANSWER-
Parental control should be consistent.
Discipline should be a positive and necessary component of childrearing that is
started in infancy and should teach socially acceptable behavior, help children
protect themselves from danger, and channel undesirable behavior into constructive
activity. Misbehavior may result from inconsistent rules or messages, so parental
attention should be clear, reasonable, and consistent (A). (B and C) are not helpful to
the child. Children need boundaries that are firm but not rigid (D).
The nurse is teaching a mother to give 4 ml of a liquid antibiotic to a 10-month-old
infant. Which statement by the parent indicates a need for further teaching?
I will give this antibiotic to my child until it is finished.
Using a teaspoon will help me measure this correctly.
I will call the clinic if my child develops a rash or itching.
My baby should begin to feel better within a few days. - ANSWER-Using a teaspoon
will help me measure this correctly.
The prescribed medication is 4 ml per dosage and is measured with the most
accuracy using a syringe, so if the parent uses a teaspoon (B), which is equivalent to
5 ml, further teaching is indicated. (A, C, and D) indicate correct understanding and
require no further intervention by the nurse.
The nurse is planning care for school-aged children at a community care center.
Which activity is best for the children?
Building model airplanes.
Playing follow-the-leader.
Stringing large and small beads.
Playing with Playdough and clay. - ANSWER-Playing follow-the-leader.
, School-aged children strive for independence and productivity (Erikson's Industry vs.
Inferiority) and enjoy individual and group activities related to real-life situations, such
as playing follow-the-leader (B). (A) is an individual activity that could contribute to
feelings of inferiority and inadequacy if the task is too complex. Although school-
aged children enjoy crafts, (C and D) are more appropriate for pre-school children.
To assess the effectiveness of an analgesic administered to a 4-year-old, what
intervention is best for the nurse to implement?
Use a happy-face/sad-face pain scale.
Ask the mother if she thinks the analgesic is working.
Assess for changes in the child's vital signs.
Teach the child to point to a numeric pain scale. - ANSWER-Use a happy-face/sad-
face pain scale.
A 4-year-old can readily identify with simple pictures (A) to show the nurse how
he/she is feeling. (B) could be used to validate what the child is telling the nurse via
the "faces" pain scale, but it is best to elicit the child's assessment of his/her pain
level. (C) may not accurately reflect the effectiveness of pain medication as they can
also be affected by other variables, such as fear. (D) requires abstract number skills
beyond the level of a 4-year-old.
A 4-year-old girl continues to interrupt her mother during a routine clinic visit. The
mother appears irritated with the child and asks the nurse, "Is this normal behavior
for a child this age?" The nurse's response should be based on which information?
Children need to retain a sense of initiative without impinging on the rights and
privileges of others.
Negative feelings of doubt and shame are characteristic of 4-year-old children.
Role conflict is a common problem of children this age. She is just wondering where
she fits into society.
At this age children compete and like to produce and carry through with tasks. She
is just competing with her mother. - ANSWER-Children need to retain a sense of
initiative without impinging on the rights and privileges of others.
Children aged 3 to 6 are in Erickson's "Initiative vs. Guilt" stage, which is
characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At
this age, children develop a conscience and must learn to retain a sense of initiative
without impinging on the rights of others (A). (B) describes the "Autonomy vs. Shame
and Doubt," stage (1 to 3 years of age). (C) describes an adolescent (12 to 18 years
of age), the "Identity vs. Role Confusion" stage. (D) describes a child 6 to 12 years of
age, the "Industry vs. Inferiority" stage.
A child is rescued from a burning house and brought to the emergency room with
partial-thickness burns on the face and chest. Which action should the nurse
implemented first?
Insert an indwelling urinary catheter.
Administer IV pain medication.
Collect blood specimen for laboratory studies.
Assess the child's respiratory status. - ANSWER-Assess the child's respiratory
status.
QUESTIONS AND ANSWERS
Which measurements should be used to accurately calculate a pediatric medication
dosage? (Select all that apply.)
Child's height and weight.
Adult dosage of medication.
Body surface area of child.
Average adult's body surface area.
Average pediatric dosage of medication.
Nomogram determined mathematical constant. - ANSWER-Child's height and
weight.
Body surface area of child.
Nomogram determined mathematical constant.
Correct selections are (A, C, and F). The most accurate calculations of pediatric
dosages use the child's height and weight (A). The child's BSA is calculated using
the square root of weight in kg times height in cm divided by 3600 or the square root
of weight in lb times height in inches divided by 3131 (C), then the child's BSA is
multiplied by the recommended published dose per BSA. The nomogram (F) is used
to plot the child's height and weight, and the point at which they intersect is the BSA
mathematical constant used to calculate the child's dose. (B, D, and E) are not used
to calculate pediatric dosages.
The nurse is assessing a 2-year-old. What behavior indicates that the child's
language development is within normal limits?
Is able to name four colors.
Can count five blocks.
Is capable of making a three word sentence.
Half of child's speech is understandable. - ANSWER-Half of child's speech is
understandable.
Between approximately 15 and 24 months of age, a child's speech is only half
understandable (D). (A and B) usually occur between 3 and 5 years of age. (C) is
usually accomplished by 18 months of age.
The nurse reviews the latest laboratory results for a child who received
chemotherapy last week and identifies a reduced neutrophil count. Which nursing
diagnosis has the highest priority for this child?
Risk for infection.
Risk for hemorrhage.
Altered skin integrity.
Disturbance in body image. - ANSWER-Risk for infection.
Chemotherapy (CT) suppresses phagocytotic neutrophils and places the child at risk
for infection (A), which is the priority nursing diagnosis. (B, C, and D) may be related
to the care of a child receiving CT are not related to neutropenia.
,A child falls on the playground and is brought to the school nurse with a small
laceration on the forearm. Which action should the nurse implement first?
Slowly pour hydrogen peroxide over the open wound.
Apply ice to the area before rinsing with cold water.
Wash the wound gently with mild soap and water.
Gently cleanse with a sterile pad using povidone-iodine. - ANSWER-Wash the
wound gently with mild soap and water.
A small, superficial laceration to the skin should be washed gently with mild soap
and water (C) for several minutes, followed by thorough rinsing. (A and D) are
antiseptics that can be traumatic (painful) when cleaning fresh, open wounds.
Applying ice (B) may reduce or prevent further edema, but the wound should be
washed with mild soap and water first.
The nurse observes a 4-year-old boy in a daycare setting. Which behavior would the
nurse consider normal for this child?
Has a temper tantrum when told he must share his toys.
Plays by himself most of the day.
Demonstrates aggressiveness by boasting when telling a story.
Begins to cry and is fearful when separated from his parents. - ANSWER-
Demonstrates aggressiveness by boasting when telling a story.
Four-year-old children are aggressive in their behavior and enjoy "tale telling" (C).
Behaviors in (A and D) are typical of toddlers. The play of a preschooler is
cooperative, so playing alone (B) is not typical.
The nurse is developing a plan of care for a 3-year-old who is scheduled for a
cardiac catheterization. To assist in decreasing anxiety for the child on the day of the
procedure, which intervention is best for the nurse to implement?
Reassure the parents that 3-year-olds are cooperative and therefore are less likely
to be anxious.
Obtain a video film of a cardiac catheterization to show to the child prior to the
procedure.
Give the child a ride on a gurney to visit the cardiac catheterization lab and meet a
nurse who works there.
Obtain a cardiac catheter and demonstrate the procedure by pretending to put the
catheter in a doll or stuffed animal. - ANSWER-Give the child a ride on a gurney to
visit the cardiac catheterization lab and meet a nurse who works there.
Familiarizing the child and mother with the department (C) will help decrease anxiety
of the child and mother (who may have more anxiety than the child). Three is a
difficult age to undergo a procedure that requires cooperation. Restraints and
possibly sedation may be required (A). At three, the child is too young to understand
why this must be done, and (B) is not indicated. (D) is also not indicated because it is
likely to be interpreted as painful.
A 6-month-old boy and his mother are at the healthcare provider's office for a well-
baby check-up and routine immunizations. The healthcare provider recommends to
the mother that the child receive an influenza vaccine. What medications should the
nurse plan to administer today?
, The routine immunizations and schedule another appointment to administer the
influenza vaccine. Incorrect
All the immunizations with the influenza vaccine given at a separate site from any
other injection.
The influenza vaccine and schedule another appointment to administer the
immunizations.
The influenza vaccine and the polio vaccine and schedule another appointment to
administer the remaining immunizations. - ANSWER-All the immunizations with the
influenza vaccine given at a separate site from any other injection.
At 6-months of age, the routine immunizations include Hepatitis B, DTaP, Hib
(Haemophilus influenza type b), PCV (Pneumococcal), IPV (inactivated poliovirus)
and influenza. The influenza vaccine should be given at a separate site from any
other injection (B). Scheduling a return visit (A, B, or C) increases the risk that the
mother will not bring the child back for the immunizations.
When discussing discipline with the mother of a 4-year-old child, the nurse should
include which guideline?
Parental control should be consistent.
Children as young as 4 years rarely need reprimand or punishment.
Withdrawal of approval is effective.
Parents should enforce rigid rules to be followed without question. - ANSWER-
Parental control should be consistent.
Discipline should be a positive and necessary component of childrearing that is
started in infancy and should teach socially acceptable behavior, help children
protect themselves from danger, and channel undesirable behavior into constructive
activity. Misbehavior may result from inconsistent rules or messages, so parental
attention should be clear, reasonable, and consistent (A). (B and C) are not helpful to
the child. Children need boundaries that are firm but not rigid (D).
The nurse is teaching a mother to give 4 ml of a liquid antibiotic to a 10-month-old
infant. Which statement by the parent indicates a need for further teaching?
I will give this antibiotic to my child until it is finished.
Using a teaspoon will help me measure this correctly.
I will call the clinic if my child develops a rash or itching.
My baby should begin to feel better within a few days. - ANSWER-Using a teaspoon
will help me measure this correctly.
The prescribed medication is 4 ml per dosage and is measured with the most
accuracy using a syringe, so if the parent uses a teaspoon (B), which is equivalent to
5 ml, further teaching is indicated. (A, C, and D) indicate correct understanding and
require no further intervention by the nurse.
The nurse is planning care for school-aged children at a community care center.
Which activity is best for the children?
Building model airplanes.
Playing follow-the-leader.
Stringing large and small beads.
Playing with Playdough and clay. - ANSWER-Playing follow-the-leader.
, School-aged children strive for independence and productivity (Erikson's Industry vs.
Inferiority) and enjoy individual and group activities related to real-life situations, such
as playing follow-the-leader (B). (A) is an individual activity that could contribute to
feelings of inferiority and inadequacy if the task is too complex. Although school-
aged children enjoy crafts, (C and D) are more appropriate for pre-school children.
To assess the effectiveness of an analgesic administered to a 4-year-old, what
intervention is best for the nurse to implement?
Use a happy-face/sad-face pain scale.
Ask the mother if she thinks the analgesic is working.
Assess for changes in the child's vital signs.
Teach the child to point to a numeric pain scale. - ANSWER-Use a happy-face/sad-
face pain scale.
A 4-year-old can readily identify with simple pictures (A) to show the nurse how
he/she is feeling. (B) could be used to validate what the child is telling the nurse via
the "faces" pain scale, but it is best to elicit the child's assessment of his/her pain
level. (C) may not accurately reflect the effectiveness of pain medication as they can
also be affected by other variables, such as fear. (D) requires abstract number skills
beyond the level of a 4-year-old.
A 4-year-old girl continues to interrupt her mother during a routine clinic visit. The
mother appears irritated with the child and asks the nurse, "Is this normal behavior
for a child this age?" The nurse's response should be based on which information?
Children need to retain a sense of initiative without impinging on the rights and
privileges of others.
Negative feelings of doubt and shame are characteristic of 4-year-old children.
Role conflict is a common problem of children this age. She is just wondering where
she fits into society.
At this age children compete and like to produce and carry through with tasks. She
is just competing with her mother. - ANSWER-Children need to retain a sense of
initiative without impinging on the rights and privileges of others.
Children aged 3 to 6 are in Erickson's "Initiative vs. Guilt" stage, which is
characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At
this age, children develop a conscience and must learn to retain a sense of initiative
without impinging on the rights of others (A). (B) describes the "Autonomy vs. Shame
and Doubt," stage (1 to 3 years of age). (C) describes an adolescent (12 to 18 years
of age), the "Identity vs. Role Confusion" stage. (D) describes a child 6 to 12 years of
age, the "Industry vs. Inferiority" stage.
A child is rescued from a burning house and brought to the emergency room with
partial-thickness burns on the face and chest. Which action should the nurse
implemented first?
Insert an indwelling urinary catheter.
Administer IV pain medication.
Collect blood specimen for laboratory studies.
Assess the child's respiratory status. - ANSWER-Assess the child's respiratory
status.
