HESI PEDIATRICS PRACTICE QUESTIONS AND
DETAILED SOLUTIONS
◉ A - (The respiratory rate should be taken first, A, in infants, since
touching them or performing unpleasant procedures usually makes
them cry, elevating the heart rate and making respirations difficult
to count.)
Answer: To take the vital signs of a 4-month-old child, which order
provides the most accurate results?
A) Respiratory rate, heart rate, then rectal temperature.
B) Heart rate, rectal temperature, then respiratory rate.
C) Rectal temperature, heart rate, then respiratory rate.
D) Rectal temperature, respiratory rate, then heart rate.
◉ A - (Russell's skin traction is used for fractures of the femur in
young children and adolescents whose growth plates remain open
and is applied to the lower leg using moleskin and elastic wrap
bandages, which can compress the peroneal nerve and arteries that
supply the foot. Assessment of adequare circulation, movement, and
sensation of the toes and skin distal to the application is made to
identify compromised blood flow, so cyanosis, A, should be reported
immediately.)
Answer: The nurse is assessing the neurovascular status of a child in
Russell's traction. Which finding should the nurse report to the
healthcare provider?
,A) Pale bluish coloration of the toes.
B) Skin is warm and dry to the touch.
C) Toes are wiggled upon command.
D) Capillary refill less than 3 seconds.
◉ C - (A trial of HCG,human chorionic gonadotrophic hormone, C,
may aid in testicular descent, but does not replace surgical repair for
true undescended testes. Undescended testes, cryptorchidism, may
be found in the inguinal canal due to exaggerated cremasteric reflex.
A, is not indicated. Stimulation of the cremasteric reflex causes the
testes to ascend rather than descend in the scrotum, B. D, may relax
the cremasteric muscle, but may not cause the testes to descend.)
Answer: 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.
◉ A - (Signs and symptoms of diabetes or hyperglycemia, A, need to
be reported. Those receiving growth hormone should be monitored
to detect elevated blood sugars and glucose intolerance.)
Answer: The nurse is teaching a 12-year-old male adolescent and his
family about taking injections of growth hormone for idiopathic
,hypopituitarism. Which adverse symptoms, commonly associated
with growth hormone therapy, should the nurse plan to describe to
the child and his family?
A) Polyuria and polydipsia.
B) Lethargy and fatigue.
C) Increased facial hair.
D) Facial bone structure changes.
◉ D - (The child must be monitored for signs and symptoms of
hyponatremia, which creates secondary central nervous system
alterations such as changes in level of consciousness, seizure, and
coma.)
Answer: The nurse is caring for a 12-year-old with Syndrome of
Inappropriate Antidiuretic Hormone (SIADH). This child should be
carefully assessed for which complication?
A) Poor skin turgor resulting from dehydration.
B) Changes in level of consciousness.
C) Premature aging as the disease progresses.
D) Severe edema from an excess of water and sodium.
◉ D - (Outcome of learning is best demonstrated when the client not
only verbalizes an understanding but can also provide a return
demonstration, D.)
, Answer: The nurse is giving preoperative instructions to a 14-year-
old female client who is scheduled for surgery to correct a spinal
curvature. Which statement by the client best demonstrates that
learning has taken place?
A) I will read all the literature you gave me before surgery.
B) I have had surgery before when I broke my wrist in a bike
accident, so I know what to expect.
C) All the things people have told me will help me take care of my
back.
D) I understand that I will be in a body cast and I will show you how
you taught me to turn.
◉ A - (Ototoxicity diminishes hearing acuity and causes symptoms
of tinnitus and vertigo in older children who can express subjective
symptoms, so assessing an infant's reaction to loud noises, A, helps
to determine an infant's risk for a hearing deficit related to a history
of the mother taking an ototoxic drug, such as aspirin, while
pregnant.)
Answer: The clinic nurse is taking the history for a new 6-month-old
client. The mother reports that she took a great deal of aspirin while
pregnant. Which assessment should the nurse obtain?
A) Type of reaction to loud noises.
B) Any surgeries on the ears since birth.
C) Drainage from the infant's ears.
D) Number of ear infections since birth.
DETAILED SOLUTIONS
◉ A - (The respiratory rate should be taken first, A, in infants, since
touching them or performing unpleasant procedures usually makes
them cry, elevating the heart rate and making respirations difficult
to count.)
Answer: To take the vital signs of a 4-month-old child, which order
provides the most accurate results?
A) Respiratory rate, heart rate, then rectal temperature.
B) Heart rate, rectal temperature, then respiratory rate.
C) Rectal temperature, heart rate, then respiratory rate.
D) Rectal temperature, respiratory rate, then heart rate.
◉ A - (Russell's skin traction is used for fractures of the femur in
young children and adolescents whose growth plates remain open
and is applied to the lower leg using moleskin and elastic wrap
bandages, which can compress the peroneal nerve and arteries that
supply the foot. Assessment of adequare circulation, movement, and
sensation of the toes and skin distal to the application is made to
identify compromised blood flow, so cyanosis, A, should be reported
immediately.)
Answer: The nurse is assessing the neurovascular status of a child in
Russell's traction. Which finding should the nurse report to the
healthcare provider?
,A) Pale bluish coloration of the toes.
B) Skin is warm and dry to the touch.
C) Toes are wiggled upon command.
D) Capillary refill less than 3 seconds.
◉ C - (A trial of HCG,human chorionic gonadotrophic hormone, C,
may aid in testicular descent, but does not replace surgical repair for
true undescended testes. Undescended testes, cryptorchidism, may
be found in the inguinal canal due to exaggerated cremasteric reflex.
A, is not indicated. Stimulation of the cremasteric reflex causes the
testes to ascend rather than descend in the scrotum, B. D, may relax
the cremasteric muscle, but may not cause the testes to descend.)
Answer: 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.
◉ A - (Signs and symptoms of diabetes or hyperglycemia, A, need to
be reported. Those receiving growth hormone should be monitored
to detect elevated blood sugars and glucose intolerance.)
Answer: The nurse is teaching a 12-year-old male adolescent and his
family about taking injections of growth hormone for idiopathic
,hypopituitarism. Which adverse symptoms, commonly associated
with growth hormone therapy, should the nurse plan to describe to
the child and his family?
A) Polyuria and polydipsia.
B) Lethargy and fatigue.
C) Increased facial hair.
D) Facial bone structure changes.
◉ D - (The child must be monitored for signs and symptoms of
hyponatremia, which creates secondary central nervous system
alterations such as changes in level of consciousness, seizure, and
coma.)
Answer: The nurse is caring for a 12-year-old with Syndrome of
Inappropriate Antidiuretic Hormone (SIADH). This child should be
carefully assessed for which complication?
A) Poor skin turgor resulting from dehydration.
B) Changes in level of consciousness.
C) Premature aging as the disease progresses.
D) Severe edema from an excess of water and sodium.
◉ D - (Outcome of learning is best demonstrated when the client not
only verbalizes an understanding but can also provide a return
demonstration, D.)
, Answer: The nurse is giving preoperative instructions to a 14-year-
old female client who is scheduled for surgery to correct a spinal
curvature. Which statement by the client best demonstrates that
learning has taken place?
A) I will read all the literature you gave me before surgery.
B) I have had surgery before when I broke my wrist in a bike
accident, so I know what to expect.
C) All the things people have told me will help me take care of my
back.
D) I understand that I will be in a body cast and I will show you how
you taught me to turn.
◉ A - (Ototoxicity diminishes hearing acuity and causes symptoms
of tinnitus and vertigo in older children who can express subjective
symptoms, so assessing an infant's reaction to loud noises, A, helps
to determine an infant's risk for a hearing deficit related to a history
of the mother taking an ototoxic drug, such as aspirin, while
pregnant.)
Answer: The clinic nurse is taking the history for a new 6-month-old
client. The mother reports that she took a great deal of aspirin while
pregnant. Which assessment should the nurse obtain?
A) Type of reaction to loud noises.
B) Any surgeries on the ears since birth.
C) Drainage from the infant's ears.
D) Number of ear infections since birth.
