• HESI RN 09/11/2026
PEDIATRICS Exam
HESI RN PEDIATRICS V3 3 FULL SET EXAMS WITH
CORRECT ANSWERS (NGN-STYLE QUESTIONS &
CASE SCENARIOS) Answers with detailed
Rationale
Which class of antiinfective drugs is contraindicated for use in children under 8 years of age?
A. aminoglycosides
B. tetracyclines
C. penicillins
D. quinolones - Correct Answer :B. tetracyclines
P 1
, • HESI RN 09/11/2026
PEDIATRICS Exam
Tetracyclines cause enamel hypoplasia and tooth discoloration in children under 8 years of age. (A, C and D) are
not contraindicated for use in children.
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.
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 - Correct Answer :A. 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. (B and D) are
not related to tetracyline HCL (Achromycin V) therapy. (C) should be avoided because dairy products interfere
with the absorption of tetracyclines.
The mother of a 6-month old asks the nurse when her baby will get the first measles, mumps, and rubella (MMR)
vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease
Control, which response is accurate?
A. 3-6 months
B. 12-15 months
C. 18-24 months
D. 4-6 years - Correct Answer :B. 12-15 months
The first measles, mumps, and rubella (MMR) vaccine should be given no sooner than 12 months of age, and
ideally between 12 and 15 months of age. Children 3-6 months should not receive the vaccine due to the
presence of maternal antibodies. MMR is not routinely administered at 18-24 months, but other immunizations,
such as DTaP and Hepatitis B may be given at that time. The second dose of MMR is routinely administered at 4-
6 years, provided that at least 4 weeks have elapsed since the first dose, and if both doses were administered
beginning at or after 12 months.
Preoperative nursing care for a child with Wilm's tumor should include which intervention?
A. gently percuss the abdomen for evidence of trapped air
P 2
, • HESI RN 09/11/2026
PEDIATRICS Exam
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." - Correct Answer :D. Put a sign on the bed
reading, "DO NOT PALPATE ABDOMEN."
Prevention of abdominal palpation minimizes the risk of rupturing the encapsulated tumor and subsequent
metastasis. (A) is unnecessary and this action could traumatize the tumor in the same manner as palpation. (B
and C) are incorrect since the abdomen is not discolored and cold compresses are not indicated.
A 4-year old boy was admitted to the emergency room with a fractured right ulna and a short arm cast was
applied. When preparing the parents to take the child home, which discharge instruction has the highest priority?
A. call the healthcare provider immediately if his nail beds appear blue.
B. check his fingers hourly for the first 48 hours to see that he is able to move them without pain.
C. Be sure your child's arm remains above his heart for the first 24 hours.
D. Take his temperature every four hours for the next two days and call if an elevation is noted. - Correct Answer
:A. call the healthcare provider immediately if his nail beds appear blue.
Cyanosis indicates impaired circulation to fingers and should be reported immediately. Although the actions
described in (B, C, and D) may be indicated, they are implemented rather excessively - and might tend to frighten
the parents. It is not necessary to check the child's ability to move his fingers hourly for two days. Elevating the
arm above the heart helps to decrease swelling but (C) is stated in a frightening way. It is not necessary to take
the child's temperature q4h unless indicated by other symptoms.
An 18-month old is admitted to the hospital with possible Hirschsprung's disease. When obtaining a nursing
history, the nurse asks about bowel habits. What describes the disease?
A. foul-smelling and fatty
B. bile-colored and watery
C. semi-solid and yellow
D. ribbon-like and brown - Correct Answer :D. ribbon-like and brown
P 3
, • HESI RN 09/11/2026
PEDIATRICS Exam
Hirschsprung's disease is a mechanical obstruction caused by inadequate motility in a part of the intestines. The
condition results from failure of ganglion cells to migrate craniocaudally along the GI tract during gestation. the
lack of peristalsis in the affected bowel segment causes constipation and small diameter, brown-colored stools.
(A) is associated with cystic fibrosis. (B) is common in gastroenteritis. (C) is normal for breastfed neonates.
The nurse must prevent a 2-year old with severe eczema on the face, neck and scalp from scratching the
affected areas. Which nursing intervention is most effective in preventing further excoriation due to the pruritis?
A. obtain gloves for the child's hands
B. apply finger cots on the child's fingers
C. place elbow restraints on the child's arms
D. apply soft restraints to the child's wrists - Correct Answer :C. place elbow restraints on the child's arms
Elbow restraints prevent arm flexion and scratching of involved areas, but do not inhibit use of the hands for play
activities. (A and B) can be easily removed by the child and would restrict hand movement. (D) would be
ineffective in preventing the child from scratching because the upper body could be moved within reach of
restrained hands, and would also create the greatest restriction of hand movement.
The nurse assigning care for a 5-year old with otitis media is concerned about the child's increasing temperature
over the past 24 hours. Which statement is accurate and should be considered when planning care for the
remainder of the shift?
A. An RN should be assigned to take temperatures frequently.
B. tympanic and oral temperatures are equally accurate
C. the PN should take rectal temperatures on this child.
D. The pediatrician should decide how to assess the temperature - Correct Answer :B. tympanic and oral
temperatures are equally accurate
A tympanic membrane sensor approximates core temperatures because the hypothalamus and eardrum are
perfused by the same circulation. Tympanic readings obtained using proper technique correlated moderately to
strongly with oral temperatures in recent research studies. The sensor is unaffected by the cerumen or the
presence of suppurative or unsuppurative otitis media. A RN is not required to take the child's temperature, but
must assess readings received from assistive personnel. Although rectal readings are highly accurate, such an
invasive procedure is unnecessary and it is not necessary to contact the pediatrician.
P 4
PEDIATRICS Exam
HESI RN PEDIATRICS V3 3 FULL SET EXAMS WITH
CORRECT ANSWERS (NGN-STYLE QUESTIONS &
CASE SCENARIOS) Answers with detailed
Rationale
Which class of antiinfective drugs is contraindicated for use in children under 8 years of age?
A. aminoglycosides
B. tetracyclines
C. penicillins
D. quinolones - Correct Answer :B. tetracyclines
P 1
, • HESI RN 09/11/2026
PEDIATRICS Exam
Tetracyclines cause enamel hypoplasia and tooth discoloration in children under 8 years of age. (A, C and D) are
not contraindicated for use in children.
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.
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 - Correct Answer :A. 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. (B and D) are
not related to tetracyline HCL (Achromycin V) therapy. (C) should be avoided because dairy products interfere
with the absorption of tetracyclines.
The mother of a 6-month old asks the nurse when her baby will get the first measles, mumps, and rubella (MMR)
vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease
Control, which response is accurate?
A. 3-6 months
B. 12-15 months
C. 18-24 months
D. 4-6 years - Correct Answer :B. 12-15 months
The first measles, mumps, and rubella (MMR) vaccine should be given no sooner than 12 months of age, and
ideally between 12 and 15 months of age. Children 3-6 months should not receive the vaccine due to the
presence of maternal antibodies. MMR is not routinely administered at 18-24 months, but other immunizations,
such as DTaP and Hepatitis B may be given at that time. The second dose of MMR is routinely administered at 4-
6 years, provided that at least 4 weeks have elapsed since the first dose, and if both doses were administered
beginning at or after 12 months.
Preoperative nursing care for a child with Wilm's tumor should include which intervention?
A. gently percuss the abdomen for evidence of trapped air
P 2
, • HESI RN 09/11/2026
PEDIATRICS Exam
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." - Correct Answer :D. Put a sign on the bed
reading, "DO NOT PALPATE ABDOMEN."
Prevention of abdominal palpation minimizes the risk of rupturing the encapsulated tumor and subsequent
metastasis. (A) is unnecessary and this action could traumatize the tumor in the same manner as palpation. (B
and C) are incorrect since the abdomen is not discolored and cold compresses are not indicated.
A 4-year old boy was admitted to the emergency room with a fractured right ulna and a short arm cast was
applied. When preparing the parents to take the child home, which discharge instruction has the highest priority?
A. call the healthcare provider immediately if his nail beds appear blue.
B. check his fingers hourly for the first 48 hours to see that he is able to move them without pain.
C. Be sure your child's arm remains above his heart for the first 24 hours.
D. Take his temperature every four hours for the next two days and call if an elevation is noted. - Correct Answer
:A. call the healthcare provider immediately if his nail beds appear blue.
Cyanosis indicates impaired circulation to fingers and should be reported immediately. Although the actions
described in (B, C, and D) may be indicated, they are implemented rather excessively - and might tend to frighten
the parents. It is not necessary to check the child's ability to move his fingers hourly for two days. Elevating the
arm above the heart helps to decrease swelling but (C) is stated in a frightening way. It is not necessary to take
the child's temperature q4h unless indicated by other symptoms.
An 18-month old is admitted to the hospital with possible Hirschsprung's disease. When obtaining a nursing
history, the nurse asks about bowel habits. What describes the disease?
A. foul-smelling and fatty
B. bile-colored and watery
C. semi-solid and yellow
D. ribbon-like and brown - Correct Answer :D. ribbon-like and brown
P 3
, • HESI RN 09/11/2026
PEDIATRICS Exam
Hirschsprung's disease is a mechanical obstruction caused by inadequate motility in a part of the intestines. The
condition results from failure of ganglion cells to migrate craniocaudally along the GI tract during gestation. the
lack of peristalsis in the affected bowel segment causes constipation and small diameter, brown-colored stools.
(A) is associated with cystic fibrosis. (B) is common in gastroenteritis. (C) is normal for breastfed neonates.
The nurse must prevent a 2-year old with severe eczema on the face, neck and scalp from scratching the
affected areas. Which nursing intervention is most effective in preventing further excoriation due to the pruritis?
A. obtain gloves for the child's hands
B. apply finger cots on the child's fingers
C. place elbow restraints on the child's arms
D. apply soft restraints to the child's wrists - Correct Answer :C. place elbow restraints on the child's arms
Elbow restraints prevent arm flexion and scratching of involved areas, but do not inhibit use of the hands for play
activities. (A and B) can be easily removed by the child and would restrict hand movement. (D) would be
ineffective in preventing the child from scratching because the upper body could be moved within reach of
restrained hands, and would also create the greatest restriction of hand movement.
The nurse assigning care for a 5-year old with otitis media is concerned about the child's increasing temperature
over the past 24 hours. Which statement is accurate and should be considered when planning care for the
remainder of the shift?
A. An RN should be assigned to take temperatures frequently.
B. tympanic and oral temperatures are equally accurate
C. the PN should take rectal temperatures on this child.
D. The pediatrician should decide how to assess the temperature - Correct Answer :B. tympanic and oral
temperatures are equally accurate
A tympanic membrane sensor approximates core temperatures because the hypothalamus and eardrum are
perfused by the same circulation. Tympanic readings obtained using proper technique correlated moderately to
strongly with oral temperatures in recent research studies. The sensor is unaffected by the cerumen or the
presence of suppurative or unsuppurative otitis media. A RN is not required to take the child's temperature, but
must assess readings received from assistive personnel. Although rectal readings are highly accurate, such an
invasive procedure is unnecessary and it is not necessary to contact the pediatrician.
P 4
