HESI PEDIATRIC EXAM 10 FINAL PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
◉ 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?
Perform postural drainage before starting aerosol therapy.
Give respiratory treatments when the child is coughing a lot.
Administer aerosol therapy followed by postural drainage before
meals.
Ensure respiratory therapy is done daily during any respiratory
infection.
Answer: Administer aerosol therapy followed by postural drainage
before meals.
Postural drainage for a child with cystic fibrosis is most effective
when performed after nebulization and before meals (C) or at least 1
hour after eating to prevent nausea and vomiting. Postural drainage
uses gravity to promote mucous removal after nebulization (A)
treatments which open the airways. Pulmonary toileting or
respiratory treatments should be given 3 to 4 times daily, not
episodically (B and D).
,◉ 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?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular.
Answer: Use sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL
(Achromycin V) therapy. Severe sunburn can occur with minimal sun
exposure and clients should be instructed to avoid sunlight and to
use sunscreen (A). (B and D) are not related to tetracycline HCL
(Achromycin V) therapy. (C) should be avoided because dairy
products interfere with the absorption of tetracyclines.
◉ What preoperative nursing intervention should be included in the
plan of care for an infant with pyloric stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting.
Answer: Observe for projectile vomiting.
,Projectile vomiting (D), which contributes to metabolic alkalosis (A),
is the classic sign of pyloric stenosis. (B) is not indicated. (C) is
dangerous, due to the potential for aspiration with frequent
vomiting.
◉ 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?
Stop the flow of unoxygenated blood into systemic circulation.
Increase the flow of unoxygenated blood to the lungs.
Prevent the return of oxygenated blood to the lungs.
Reduce peripheral tissue hypoxia and nailbed clubbing
Answer: Prevent the return of oxygenated blood to the lungs.
Closure of VSDs stops oxygenated blood from being shunted from
the left ventricle to the right ventricle (C). VSDs are acyanotic
defects, which means that no unoxygenated blood enters the
systemic circulation (A and B). (D) is common with Tetrology of
Fallot, which is a cyanotic defect.
◉ A 3-week-old newborn is brought to the clinic for follow-up after a
home birth. The 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 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. Monitor the 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.
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.
Antibiotic prophylaxis is recommended for infants with VSDs, but
should not be mixed in a bottle of formula (C) because it is difficult
to ensure that the total dose is consumed.
They should be monitored for weight gain and at least 6 wet diapers
per day (A). A one-month old infant should ingest 2 to 4 ounces of
formula per feeding and progress to about 30 ounces per day by 4-
months of age (B)
COMPLETE QUESTIONS AND ANSWERS
◉ 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?
Perform postural drainage before starting aerosol therapy.
Give respiratory treatments when the child is coughing a lot.
Administer aerosol therapy followed by postural drainage before
meals.
Ensure respiratory therapy is done daily during any respiratory
infection.
Answer: Administer aerosol therapy followed by postural drainage
before meals.
Postural drainage for a child with cystic fibrosis is most effective
when performed after nebulization and before meals (C) or at least 1
hour after eating to prevent nausea and vomiting. Postural drainage
uses gravity to promote mucous removal after nebulization (A)
treatments which open the airways. Pulmonary toileting or
respiratory treatments should be given 3 to 4 times daily, not
episodically (B and D).
,◉ 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?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular.
Answer: Use sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL
(Achromycin V) therapy. Severe sunburn can occur with minimal sun
exposure and clients should be instructed to avoid sunlight and to
use sunscreen (A). (B and D) are not related to tetracycline HCL
(Achromycin V) therapy. (C) should be avoided because dairy
products interfere with the absorption of tetracyclines.
◉ What preoperative nursing intervention should be included in the
plan of care for an infant with pyloric stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting.
Answer: Observe for projectile vomiting.
,Projectile vomiting (D), which contributes to metabolic alkalosis (A),
is the classic sign of pyloric stenosis. (B) is not indicated. (C) is
dangerous, due to the potential for aspiration with frequent
vomiting.
◉ 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?
Stop the flow of unoxygenated blood into systemic circulation.
Increase the flow of unoxygenated blood to the lungs.
Prevent the return of oxygenated blood to the lungs.
Reduce peripheral tissue hypoxia and nailbed clubbing
Answer: Prevent the return of oxygenated blood to the lungs.
Closure of VSDs stops oxygenated blood from being shunted from
the left ventricle to the right ventricle (C). VSDs are acyanotic
defects, which means that no unoxygenated blood enters the
systemic circulation (A and B). (D) is common with Tetrology of
Fallot, which is a cyanotic defect.
◉ A 3-week-old newborn is brought to the clinic for follow-up after a
home birth. The 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 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. Monitor the 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.
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.
Antibiotic prophylaxis is recommended for infants with VSDs, but
should not be mixed in a bottle of formula (C) because it is difficult
to ensure that the total dose is consumed.
They should be monitored for weight gain and at least 6 wet diapers
per day (A). A one-month old infant should ingest 2 to 4 ounces of
formula per feeding and progress to about 30 ounces per day by 4-
months of age (B)
