HESI RN PEDIATRICS V1, V2 & V3 exam
Questions and Verified Answers,
With rationales 2026\2027 update
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,───────────────────────────────────────────────────────
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1. A 4-year-old child is admitted with dehydration. The physician
orders an IV fluid bolus of 20 mL/kg of normal saline. The child
weighs 33 lbs. How many mL should the nurse administer?
A. 300 mL
B. 330 mL
C. 660 mL
D. 150 mL
Answer: A. 300 mL
Rationale: First, convert the child's weight from pounds to kilograms
by dividing by 2.2 (.2 = 15 kg). Next, multiply the weight in kg
by the volume ordered per kg (15 kg × 20 mL/kg = 300 mL).
2. A mother brings her 3-month-old infant to the clinic because the
baby "cries for no reason." Which statement by the parent indicates
a need for further education regarding infant colic?
A. "I should feed my baby in an upright position and burp
frequently."
B. "I will lay my baby across my lap on their stomach and gently rub
their back."
C. "I will give my baby a bottle of water to soothe the crying."
D. "I will try swaddling my baby and playing white noise."
Answer: C. "I will give my baby a bottle of water to soothe the
crying."
Rationale: Water should never be given to infants under 6 months of
age because it can lead to water intoxication, hyponatremia, and
malnutrition. The other interventions are appropriate for managing
colic.
3. The nurse is assessing a 2-year-old toddler. Which finding should
be reported to the healthcare provider immediately?
,A. Anterior fontanel is closed.
B. Bowel sounds are hyperactive in all four quadrants.
C. Respiratory rate of 30 breaths per minute.
D. Pulse rate of 110 beats per minute.
Answer: A. Anterior fontanel is closed.
Rationale: The anterior fontanel typically closes between 12 and 18
months of age. If it is closed at 18 months or earlier, it can indicate
premature closure of the cranial sutures (craniosynostosis), which
requires immediate medical evaluation to prevent brain growth
restriction. (Note: though closure can happen by 18 months, 2 years
is too late for it to be a new finding; however, if it is just now
closing at 24 months, it warrants evaluation). Correction: The
anterior fontanel closes by 18 months. If a 2-year-old's fontanel is
still open, it indicates a problem.
4. A child with asthma is admitted to the emergency department in
acute respiratory distress. Which assessment finding indicates the
child is experiencing status asthmaticus?
A. Wheezing on expiration.
B. Silent chest.
C. Productive cough with frothy sputum.
D. Intercostal retractions.
Answer: B. Silent chest
Rationale: A silent chest is an ominous sign in asthma. It indicates
that the airways are so severely constricted that air movement is no
longer occurring. This is a life-threatening emergency preceding
respiratory arrest. Wheezing and retractions are expected in an
asthma exacerbation, but a silent chest signifies impending failure.
5. A 6-year-old is prescribed digoxin for heart failure. Before
administering the medication, the nurse checks the apical pulse.
Which finding would be an indication to hold the medication and
notify the provider?
A. Heart rate of 90 bpm.
, B. Heart rate of 70 bpm.
C. Heart rate of 110 bpm.
D. Blood pressure of 100/60 mmHg.
Answer: B. Heart rate of 70 bpm
Rationale: For a child under 10 years of age, digoxin should be held
if the heart rate is below 70 bpm (some institutions specify 80-90
for infants). Hypotension is not a primary reason to hold digoxin in
children unless severe bradycardia is present.
6. The nurse is caring for a 4-year-old child with nephrotic
syndrome. Which dietary modification should the nurse recommend
to the parents?
A. Low protein, high carbohydrate.
B. Low sodium, moderate protein.
C. High calorie, high fat.
D. High calcium, low phosphorus.
Answer: B. Low sodium, moderate protein.
Rationale: Nephrotic syndrome is characterized by massive
proteinuria, edema, and hyperlipidemia. A low-sodium diet is
essential to help reduce fluid retention and edema. Protein should
be moderate; high protein can worsen proteinuria, while low protein
can lead to a negative nitrogen balance.
7. An 8-month-old infant is diagnosed with intussusception. Which
assessment finding is the hallmark sign of this condition?
A. Ribbon-like stools.
B. Currant jelly stools.
C. Projectile vomiting.
D. sausage-shaped mass in the upper right quadrant.
Answer: B. Currant jelly stools
Rationale: Intussusception occurs when one segment of the bowel
telescopes into another. The classic triad includes intermittent
colicky abdominal pain, a sausage-shaped mass in the abdomen,
Questions and Verified Answers,
With rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A 4-year-old child is admitted with dehydration. The physician
orders an IV fluid bolus of 20 mL/kg of normal saline. The child
weighs 33 lbs. How many mL should the nurse administer?
A. 300 mL
B. 330 mL
C. 660 mL
D. 150 mL
Answer: A. 300 mL
Rationale: First, convert the child's weight from pounds to kilograms
by dividing by 2.2 (.2 = 15 kg). Next, multiply the weight in kg
by the volume ordered per kg (15 kg × 20 mL/kg = 300 mL).
2. A mother brings her 3-month-old infant to the clinic because the
baby "cries for no reason." Which statement by the parent indicates
a need for further education regarding infant colic?
A. "I should feed my baby in an upright position and burp
frequently."
B. "I will lay my baby across my lap on their stomach and gently rub
their back."
C. "I will give my baby a bottle of water to soothe the crying."
D. "I will try swaddling my baby and playing white noise."
Answer: C. "I will give my baby a bottle of water to soothe the
crying."
Rationale: Water should never be given to infants under 6 months of
age because it can lead to water intoxication, hyponatremia, and
malnutrition. The other interventions are appropriate for managing
colic.
3. The nurse is assessing a 2-year-old toddler. Which finding should
be reported to the healthcare provider immediately?
,A. Anterior fontanel is closed.
B. Bowel sounds are hyperactive in all four quadrants.
C. Respiratory rate of 30 breaths per minute.
D. Pulse rate of 110 beats per minute.
Answer: A. Anterior fontanel is closed.
Rationale: The anterior fontanel typically closes between 12 and 18
months of age. If it is closed at 18 months or earlier, it can indicate
premature closure of the cranial sutures (craniosynostosis), which
requires immediate medical evaluation to prevent brain growth
restriction. (Note: though closure can happen by 18 months, 2 years
is too late for it to be a new finding; however, if it is just now
closing at 24 months, it warrants evaluation). Correction: The
anterior fontanel closes by 18 months. If a 2-year-old's fontanel is
still open, it indicates a problem.
4. A child with asthma is admitted to the emergency department in
acute respiratory distress. Which assessment finding indicates the
child is experiencing status asthmaticus?
A. Wheezing on expiration.
B. Silent chest.
C. Productive cough with frothy sputum.
D. Intercostal retractions.
Answer: B. Silent chest
Rationale: A silent chest is an ominous sign in asthma. It indicates
that the airways are so severely constricted that air movement is no
longer occurring. This is a life-threatening emergency preceding
respiratory arrest. Wheezing and retractions are expected in an
asthma exacerbation, but a silent chest signifies impending failure.
5. A 6-year-old is prescribed digoxin for heart failure. Before
administering the medication, the nurse checks the apical pulse.
Which finding would be an indication to hold the medication and
notify the provider?
A. Heart rate of 90 bpm.
, B. Heart rate of 70 bpm.
C. Heart rate of 110 bpm.
D. Blood pressure of 100/60 mmHg.
Answer: B. Heart rate of 70 bpm
Rationale: For a child under 10 years of age, digoxin should be held
if the heart rate is below 70 bpm (some institutions specify 80-90
for infants). Hypotension is not a primary reason to hold digoxin in
children unless severe bradycardia is present.
6. The nurse is caring for a 4-year-old child with nephrotic
syndrome. Which dietary modification should the nurse recommend
to the parents?
A. Low protein, high carbohydrate.
B. Low sodium, moderate protein.
C. High calorie, high fat.
D. High calcium, low phosphorus.
Answer: B. Low sodium, moderate protein.
Rationale: Nephrotic syndrome is characterized by massive
proteinuria, edema, and hyperlipidemia. A low-sodium diet is
essential to help reduce fluid retention and edema. Protein should
be moderate; high protein can worsen proteinuria, while low protein
can lead to a negative nitrogen balance.
7. An 8-month-old infant is diagnosed with intussusception. Which
assessment finding is the hallmark sign of this condition?
A. Ribbon-like stools.
B. Currant jelly stools.
C. Projectile vomiting.
D. sausage-shaped mass in the upper right quadrant.
Answer: B. Currant jelly stools
Rationale: Intussusception occurs when one segment of the bowel
telescopes into another. The classic triad includes intermittent
colicky abdominal pain, a sausage-shaped mass in the abdomen,
