HESI Pediatrics Examination Review 2026/2027 |
Complete Test Bank with Practice Exam
Questions, Verified Answers and Rationales
Question 1
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir.
Which observation by the nurse warrants immediate intervention?
A. Apical heart rate of 60.
B. Sweating across the forehead.
C. Doesn't suck well.
D. Respiratory rate of 30 breaths per minute.
Answer: A
Rationale: Heart rate of 60 is bradycardic for a 6-month-old (normal 80-150 awake)
and indicates possible digoxin toxicity requiring immediate intervention. Sweating and
poor feeding are expected CHF symptoms. Respiratory rate of 30 is normal for an
infant.
Question 2
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?
A. Perform postural drainage before starting aerosol therapy.
B. Give respiratory treatments when the child is coughing a lot.
C. Administer aerosol therapy followed by postural drainage before meals.
D. Ensure respiratory therapy is done daily during any respiratory infection.
Answer: C
Rationale: Aerosol therapy opens airways first; postural drainage then uses gravity to
remove loosened secretions. Best before meals to prevent vomiting. Respiratory
treatments should be given 3-4 times daily, not just when coughing.
Question 3
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?
A. Use sunscreen when lying by the pool.
pg. 1
,B. Cleanse the skin at least 4 times a day.
C. Take the medication with a glass of milk.
D. Menstrual periods may become irregular.
Answer: A
Rationale: Tetracycline causes photosensitivity; severe sunburn can occur with
minimal sun exposure. Dairy products interfere with tetracycline absorption. Frequent
cleansing and menstrual irregularities are not related to tetracycline therapy.
Question 4
What preoperative nursing intervention should be included in the plan of care for an
infant with pyloric stenosis?
A. Monitor for signs of metabolic acidosis.
B. Estimate the quantity of diarrhea stools.
C. Place in a supine position after feeding.
D. Observe for projectile vomiting.
Answer: D
Rationale: Projectile vomiting is the classic sign of pyloric stenosis and contributes to
metabolic alkalosis (not acidosis). Supine positioning is dangerous due to aspiration risk
with frequent vomiting.
Question 5
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?
A. Stop the flow of unoxygenated blood into systemic circulation.
B. Increase the flow of unoxygenated blood to the lungs.
C. Prevent the return of oxygenated blood to the lungs.
D. Reduce peripheral tissue hypoxia and nailbed clubbing.
Answer: C
Rationale: VSD is an acyanotic defect where oxygenated blood shunts from left to right
ventricle. Surgical closure prevents oxygenated blood from returning to the lungs.
Clubbing occurs in cyanotic defects like Tetralogy of Fallot.
Question 6
A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The
pg. 2
,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 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.
E. Use a softer nipple or increase the size of the nipple opening.
Answer: A, B, D, E
Rationale: Monitor weight and wet diapers to ensure adequate intake. Increase
feeding volume gradually. Allow rest with frequent feeding due to fatigue. Softer nipple
reduces work of breathing. Do NOT mix antibiotics in full bottle as infant may not
consume full dose.
Question 7
Preoperative nursing care for a child with Wilms' tumor should include which
intervention?
A. Gently percuss the abdomen for evidence of trapped air.
B. Observe the abdomen for any noticeable discolorations.
C. Apply cold compresses to the abdomen to reduce edema.
D. Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Answer: D
Rationale: Palpation or percussion can rupture the encapsulated tumor, causing
malignant cells to spread. A sign on the bed alerts all staff to avoid abdominal palpation.
Question 8
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 that she is
upset because her boyfriend did not visit last night. What action should the nurse take
first?
A. Give the client her 9 a.m. prescription for an oral diuretic early.
B. Administer PRN prescription of nifedipine (Procardia) sublingually.
C. Notify the healthcare provider and inform the nursing supervisor of the client's
pg. 3
, condition.
D. Attempt to calm the client and retake the blood pressure in thirty minutes.
Answer: B
Rationale: Severe hypertension requires immediate intervention. Sublingual Procardia
lowers BP rapidly. Oral diuretics work too slowly. HCP will ask if PRN antihypertensive
was given, so administer it first.
Question 9
The nurse is assessing an 8-month-old child who has a medical diagnosis of Tetralogy of
Fallot. Which symptom is this client most likely to exhibit?
A. Bradycardia.
B. Machinery murmur.
C. Weak pedal pulses.
D. Clubbed fingers.
Answer: D
Rationale: Tetralogy of Fallot is a cyanotic defect causing chronic tissue hypoxia,
leading to clubbing of fingers and toes. Tachycardia (not bradycardia) occurs with
congenital heart disease. Machinery murmur suggests VSD. Weak pedal pulses suggest
coarctation of the aorta.
Question 10
Surgery is being delayed for an infant with undescended testes. In collaboration with the
healthcare provider and the family, which prescription should the nurse anticipate?
A. A trial of adrenocorticotrophic hormone injections.
B. Frequent stimulation of the cremasteric reflex.
C. A trial of human chorionic gonadotrophic hormone.
D. Frequent warm baths to gently dilate the scrotal area.
Answer: C
Rationale: HCG may stimulate testicular descent but does not replace surgical repair.
Cremasteric reflex stimulation causes testes to ascend, not descend. Warm baths may
relax the muscle but won't cause descent.
Question 11
A preschool-age child who is hospitalized for hypospadias repair is most strongly
influenced by which behavior?
pg. 4
Complete Test Bank with Practice Exam
Questions, Verified Answers and Rationales
Question 1
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir.
Which observation by the nurse warrants immediate intervention?
A. Apical heart rate of 60.
B. Sweating across the forehead.
C. Doesn't suck well.
D. Respiratory rate of 30 breaths per minute.
Answer: A
Rationale: Heart rate of 60 is bradycardic for a 6-month-old (normal 80-150 awake)
and indicates possible digoxin toxicity requiring immediate intervention. Sweating and
poor feeding are expected CHF symptoms. Respiratory rate of 30 is normal for an
infant.
Question 2
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?
A. Perform postural drainage before starting aerosol therapy.
B. Give respiratory treatments when the child is coughing a lot.
C. Administer aerosol therapy followed by postural drainage before meals.
D. Ensure respiratory therapy is done daily during any respiratory infection.
Answer: C
Rationale: Aerosol therapy opens airways first; postural drainage then uses gravity to
remove loosened secretions. Best before meals to prevent vomiting. Respiratory
treatments should be given 3-4 times daily, not just when coughing.
Question 3
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?
A. Use sunscreen when lying by the pool.
pg. 1
,B. Cleanse the skin at least 4 times a day.
C. Take the medication with a glass of milk.
D. Menstrual periods may become irregular.
Answer: A
Rationale: Tetracycline causes photosensitivity; severe sunburn can occur with
minimal sun exposure. Dairy products interfere with tetracycline absorption. Frequent
cleansing and menstrual irregularities are not related to tetracycline therapy.
Question 4
What preoperative nursing intervention should be included in the plan of care for an
infant with pyloric stenosis?
A. Monitor for signs of metabolic acidosis.
B. Estimate the quantity of diarrhea stools.
C. Place in a supine position after feeding.
D. Observe for projectile vomiting.
Answer: D
Rationale: Projectile vomiting is the classic sign of pyloric stenosis and contributes to
metabolic alkalosis (not acidosis). Supine positioning is dangerous due to aspiration risk
with frequent vomiting.
Question 5
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?
A. Stop the flow of unoxygenated blood into systemic circulation.
B. Increase the flow of unoxygenated blood to the lungs.
C. Prevent the return of oxygenated blood to the lungs.
D. Reduce peripheral tissue hypoxia and nailbed clubbing.
Answer: C
Rationale: VSD is an acyanotic defect where oxygenated blood shunts from left to right
ventricle. Surgical closure prevents oxygenated blood from returning to the lungs.
Clubbing occurs in cyanotic defects like Tetralogy of Fallot.
Question 6
A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The
pg. 2
,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 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.
E. Use a softer nipple or increase the size of the nipple opening.
Answer: A, B, D, E
Rationale: Monitor weight and wet diapers to ensure adequate intake. Increase
feeding volume gradually. Allow rest with frequent feeding due to fatigue. Softer nipple
reduces work of breathing. Do NOT mix antibiotics in full bottle as infant may not
consume full dose.
Question 7
Preoperative nursing care for a child with Wilms' tumor should include which
intervention?
A. Gently percuss the abdomen for evidence of trapped air.
B. Observe the abdomen for any noticeable discolorations.
C. Apply cold compresses to the abdomen to reduce edema.
D. Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Answer: D
Rationale: Palpation or percussion can rupture the encapsulated tumor, causing
malignant cells to spread. A sign on the bed alerts all staff to avoid abdominal palpation.
Question 8
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 that she is
upset because her boyfriend did not visit last night. What action should the nurse take
first?
A. Give the client her 9 a.m. prescription for an oral diuretic early.
B. Administer PRN prescription of nifedipine (Procardia) sublingually.
C. Notify the healthcare provider and inform the nursing supervisor of the client's
pg. 3
, condition.
D. Attempt to calm the client and retake the blood pressure in thirty minutes.
Answer: B
Rationale: Severe hypertension requires immediate intervention. Sublingual Procardia
lowers BP rapidly. Oral diuretics work too slowly. HCP will ask if PRN antihypertensive
was given, so administer it first.
Question 9
The nurse is assessing an 8-month-old child who has a medical diagnosis of Tetralogy of
Fallot. Which symptom is this client most likely to exhibit?
A. Bradycardia.
B. Machinery murmur.
C. Weak pedal pulses.
D. Clubbed fingers.
Answer: D
Rationale: Tetralogy of Fallot is a cyanotic defect causing chronic tissue hypoxia,
leading to clubbing of fingers and toes. Tachycardia (not bradycardia) occurs with
congenital heart disease. Machinery murmur suggests VSD. Weak pedal pulses suggest
coarctation of the aorta.
Question 10
Surgery is being delayed for an infant with undescended testes. In collaboration with the
healthcare provider and the family, which prescription should the nurse anticipate?
A. A trial of adrenocorticotrophic hormone injections.
B. Frequent stimulation of the cremasteric reflex.
C. A trial of human chorionic gonadotrophic hormone.
D. Frequent warm baths to gently dilate the scrotal area.
Answer: C
Rationale: HCG may stimulate testicular descent but does not replace surgical repair.
Cremasteric reflex stimulation causes testes to ascend, not descend. Warm baths may
relax the muscle but won't cause descent.
Question 11
A preschool-age child who is hospitalized for hypospadias repair is most strongly
influenced by which behavior?
pg. 4
