HESI PEDIATRIC NURSING 2026/2027
150 High-Yield Practice Questions, Answers & Rationales
1. A 2-year-old child with a suspected diagnosis of intussusception is being assessed. Which finding
should the nurse expect?
A. Currant jelly-like stools | B. Projectile vomiting | C. Ribbon-like stools | D. Steatorrhea
Answer: A
Rationale: Intussusception causes intestinal obstruction where the bowel telescopes into itself, leading to
blood and mucus in the stool (currant jelly).
2. The nurse is preparing to administer an immunization to a 4-year-old child. Which strategy is best to
reduce the child's anxiety?
A. Hide the needle until the last second | B. Tell the child 'it won't hurt' | C. Use a puppet to explain the
procedure | D. Ask the parents to leave the room
Answer: C
Rationale: Preschoolers benefit from medical play and simple explanations using familiar objects like
puppets to reduce fear of bodily harm.
3. Which assessment finding in a newborn is most suggestive of developmental dysplasia of the hip
(DDH)?
A. Symmetrical gluteal folds | B. Positive Ortolani click | C. Equal leg length | D. Limited adduction of the hip
Answer: B
Rationale: The Ortolani maneuver checks for hip stability; a 'click' or 'clunk' indicates the femoral head is
relocating into the acetabulum.
4. A child with nephrotic syndrome is receiving prednisone. Which lab result indicates the medication
is effective?
A. Increased serum lipids | B. Decreased urine protein | C. Increased blood glucose | D. Decreased serum
albumin
Answer: B
Rationale: Prednisone reduces glomerular inflammation, stopping the leakage of protein into the urine.
Decreased proteinuria is the goal.
5. An infant with Tetralogy of Fallot is having a 'tet' spell. What is the priority nursing action?
A. Administer Digoxin | B. Place the infant in a knee-chest position | C. Provide a quiet environment | D.
Prepare for a chest X-ray
Answer: B
Rationale: The knee-chest position increases systemic vascular resistance, reducing the right-to-left shunt
and improving oxygenation.
6. Which food should be avoided in a child with Celiac disease?
A. Corn tortillas | B. Rice cereal | C. Wheat crackers | D. Fresh apples
Answer: C
Rationale: Celiac disease is a permanent intolerance to gluten (Wheat, Barley, Rye).
,7. A child is admitted with epiglottitis. Which item should the nurse ensure is at the bedside?
A. Tongue depressor | B. Tracheostomy kit | C. Steam vaporizer | D. Percussion hammer
Answer: B
Rationale: Epiglottitis is a medical emergency; sudden airway obstruction can occur, requiring an
emergency airway (tracheostomy or intubation).
8. What is the primary goal of care for a child with Sickle Cell Anemia in a vaso-occlusive crisis?
A. Preventing infection | B. Encouraging exercise | C. Providing hydration and pain relief | D. Limiting oxygen
use
Answer: C
Rationale: Hydration reduces blood viscosity to stop sickling, and pain management is vital for the extreme
pain associated with ischemia.
9. A child is suspected of having pinworms (Enterobiasis). How is this diagnosed?
A. Stool culture for ova | B. Tape test in the morning | C. Blood test for eosinophils | D. Visual inspection of the
throat
Answer: B
Rationale: The female pinworm lays eggs outside the anus at night; tape is used in the morning to collect
eggs for microscopy.
10. A 10-year-old child with Type 1 Diabetes is active in sports. What instruction should the nurse
provide?
A. Decrease calorie intake on game days | B. Eat a snack before and during exercise | C. Avoid exercise if
blood glucose is 150 mg/dL | D. Inject insulin into the leg being used for exercise
Answer: B
Rationale: Exercise lowers blood glucose; extra carbohydrates are needed to prevent hypoglycemia. Avoid
injecting into muscles being exercised as it increases absorption speed.
11. Pediatric Nursing Q11: Reye Syndrome avoidance?
A. No Aspirin for viral illness | B. No Ibuprofen | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Salicylates during viral illness (flu/chickenpox) increase Reye's risk.
12. Pediatric Nursing Q12: Nephrotic Syndrome classic symptom?
A. Generalized edema (Anasarca) | B. High BP | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Severe protein loss leads to fluid shifting into tissues.
13. Pediatric Nursing Q13: Infant vitals: Normal RR for newborn?
A. 30-60 breaths/min | B. 12-20 breaths/min | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Newborns breathe much faster than adults.
14. Pediatric Nursing Q14: Toddler safety: Water safety?
A. Constant supervision | B. Floating toys | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Drowning is a leading cause of death in toddlers; they can drown in 1 inch of water.
, 15. Pediatric Nursing Q15: Kawasaki disease: Priority check?
A. Coronary artery aneurysms | B. Ear infection | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Echocardiograms are used to monitor for cardiac vessel damage.
16. Pediatric Nursing Q16: Laryngotracheobronchitis (Croup) sound?
A. Barking cough | B. Expiratory wheeze | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: The 'seal-like' bark is classic for Croup.
17. Pediatric Nursing Q17: Wilms tumor: Nursing warning?
A. Do not palpate the abdomen | B. Encourage abdominal massage | C. Monitor intake/output | D. Document
findings
Answer: A
Rationale: Palpation can rupture the tumor capsule and spread cancer cells.
18. Pediatric Nursing Q18: Cystic Fibrosis stool type?
A. Steatorrhea (fatty/foul) | B. Constipation | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Lack of lipase leads to malabsorption of fats.
19. Pediatric Nursing Q19: Pyloric Stenosis characteristic?
A. Projectile vomiting | B. Frequent diarrhea | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Vomiting is non-bilious and forceful.
20. Pediatric Nursing Q20: Hirschsprung disease symptom?
A. Ribbon-like stools | B. High fever | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Lack of ganglion cells causes chronic constipation and narrow stools.
21. Pediatric Nursing Q21: Otitis Media prevention?
A. Upright bottle feeding | B. Smoke exposure | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Lying flat while feeding allows milk to enter Eustachian tubes.
22. Pediatric Nursing Q22: Scoliosis screening tool?
A. Adam's Forward Bend test | B. Reflex hammer | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Looking for rib hump or spinal curvature.
23. Pediatric Nursing Q23: Duchenne Muscular Dystrophy sign?
A. Gower sign | B. Positive Babinski | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Walking hands up legs to stand indicates pelvic muscle weakness.
150 High-Yield Practice Questions, Answers & Rationales
1. A 2-year-old child with a suspected diagnosis of intussusception is being assessed. Which finding
should the nurse expect?
A. Currant jelly-like stools | B. Projectile vomiting | C. Ribbon-like stools | D. Steatorrhea
Answer: A
Rationale: Intussusception causes intestinal obstruction where the bowel telescopes into itself, leading to
blood and mucus in the stool (currant jelly).
2. The nurse is preparing to administer an immunization to a 4-year-old child. Which strategy is best to
reduce the child's anxiety?
A. Hide the needle until the last second | B. Tell the child 'it won't hurt' | C. Use a puppet to explain the
procedure | D. Ask the parents to leave the room
Answer: C
Rationale: Preschoolers benefit from medical play and simple explanations using familiar objects like
puppets to reduce fear of bodily harm.
3. Which assessment finding in a newborn is most suggestive of developmental dysplasia of the hip
(DDH)?
A. Symmetrical gluteal folds | B. Positive Ortolani click | C. Equal leg length | D. Limited adduction of the hip
Answer: B
Rationale: The Ortolani maneuver checks for hip stability; a 'click' or 'clunk' indicates the femoral head is
relocating into the acetabulum.
4. A child with nephrotic syndrome is receiving prednisone. Which lab result indicates the medication
is effective?
A. Increased serum lipids | B. Decreased urine protein | C. Increased blood glucose | D. Decreased serum
albumin
Answer: B
Rationale: Prednisone reduces glomerular inflammation, stopping the leakage of protein into the urine.
Decreased proteinuria is the goal.
5. An infant with Tetralogy of Fallot is having a 'tet' spell. What is the priority nursing action?
A. Administer Digoxin | B. Place the infant in a knee-chest position | C. Provide a quiet environment | D.
Prepare for a chest X-ray
Answer: B
Rationale: The knee-chest position increases systemic vascular resistance, reducing the right-to-left shunt
and improving oxygenation.
6. Which food should be avoided in a child with Celiac disease?
A. Corn tortillas | B. Rice cereal | C. Wheat crackers | D. Fresh apples
Answer: C
Rationale: Celiac disease is a permanent intolerance to gluten (Wheat, Barley, Rye).
,7. A child is admitted with epiglottitis. Which item should the nurse ensure is at the bedside?
A. Tongue depressor | B. Tracheostomy kit | C. Steam vaporizer | D. Percussion hammer
Answer: B
Rationale: Epiglottitis is a medical emergency; sudden airway obstruction can occur, requiring an
emergency airway (tracheostomy or intubation).
8. What is the primary goal of care for a child with Sickle Cell Anemia in a vaso-occlusive crisis?
A. Preventing infection | B. Encouraging exercise | C. Providing hydration and pain relief | D. Limiting oxygen
use
Answer: C
Rationale: Hydration reduces blood viscosity to stop sickling, and pain management is vital for the extreme
pain associated with ischemia.
9. A child is suspected of having pinworms (Enterobiasis). How is this diagnosed?
A. Stool culture for ova | B. Tape test in the morning | C. Blood test for eosinophils | D. Visual inspection of the
throat
Answer: B
Rationale: The female pinworm lays eggs outside the anus at night; tape is used in the morning to collect
eggs for microscopy.
10. A 10-year-old child with Type 1 Diabetes is active in sports. What instruction should the nurse
provide?
A. Decrease calorie intake on game days | B. Eat a snack before and during exercise | C. Avoid exercise if
blood glucose is 150 mg/dL | D. Inject insulin into the leg being used for exercise
Answer: B
Rationale: Exercise lowers blood glucose; extra carbohydrates are needed to prevent hypoglycemia. Avoid
injecting into muscles being exercised as it increases absorption speed.
11. Pediatric Nursing Q11: Reye Syndrome avoidance?
A. No Aspirin for viral illness | B. No Ibuprofen | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Salicylates during viral illness (flu/chickenpox) increase Reye's risk.
12. Pediatric Nursing Q12: Nephrotic Syndrome classic symptom?
A. Generalized edema (Anasarca) | B. High BP | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Severe protein loss leads to fluid shifting into tissues.
13. Pediatric Nursing Q13: Infant vitals: Normal RR for newborn?
A. 30-60 breaths/min | B. 12-20 breaths/min | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Newborns breathe much faster than adults.
14. Pediatric Nursing Q14: Toddler safety: Water safety?
A. Constant supervision | B. Floating toys | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Drowning is a leading cause of death in toddlers; they can drown in 1 inch of water.
, 15. Pediatric Nursing Q15: Kawasaki disease: Priority check?
A. Coronary artery aneurysms | B. Ear infection | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Echocardiograms are used to monitor for cardiac vessel damage.
16. Pediatric Nursing Q16: Laryngotracheobronchitis (Croup) sound?
A. Barking cough | B. Expiratory wheeze | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: The 'seal-like' bark is classic for Croup.
17. Pediatric Nursing Q17: Wilms tumor: Nursing warning?
A. Do not palpate the abdomen | B. Encourage abdominal massage | C. Monitor intake/output | D. Document
findings
Answer: A
Rationale: Palpation can rupture the tumor capsule and spread cancer cells.
18. Pediatric Nursing Q18: Cystic Fibrosis stool type?
A. Steatorrhea (fatty/foul) | B. Constipation | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Lack of lipase leads to malabsorption of fats.
19. Pediatric Nursing Q19: Pyloric Stenosis characteristic?
A. Projectile vomiting | B. Frequent diarrhea | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Vomiting is non-bilious and forceful.
20. Pediatric Nursing Q20: Hirschsprung disease symptom?
A. Ribbon-like stools | B. High fever | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Lack of ganglion cells causes chronic constipation and narrow stools.
21. Pediatric Nursing Q21: Otitis Media prevention?
A. Upright bottle feeding | B. Smoke exposure | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Lying flat while feeding allows milk to enter Eustachian tubes.
22. Pediatric Nursing Q22: Scoliosis screening tool?
A. Adam's Forward Bend test | B. Reflex hammer | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Looking for rib hump or spinal curvature.
23. Pediatric Nursing Q23: Duchenne Muscular Dystrophy sign?
A. Gower sign | B. Positive Babinski | C. Monitor intake/output | D. Document findings
Answer: A
Rationale: Walking hands up legs to stand indicates pelvic muscle weakness.
