ACTUAL RN HESI PEDIATRICS EXAMS (3 VERSIONS) 2023-2024 EACH
EXAM CONTAINS 55 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS)/ PEDIATRICS HESI RN 3 ACTUAL EXAMS (AGRADED)
RN PEDIATRICS HESI VERSION 1
The nurse is planning postoperative care for a child who has had a cleft lip repair.
What is the most important reason to minimize this child's crying during the
recovery period?
A. Tear formation increases salivation.
B. This behavior increases respirations.
C. Excessive hysteria can lead to vomiting.
D. Crying stresses the suture line - ANSWER-Rationale: choice D
Prevention of stress on the lip suture line is essential for optimum healing and the
cosmetic appearance of a cleft
lip repair. Although crying also causes options A, B, and C, these conditions do not
create a problem for the child
with a cleft lip repair.
An infant is receiving digoxin for congestive heart failure. The apical heart rate is
assessed at 80
beats/min. What intervention should the nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat. - ANSWER-Rationale:
Answer: D.
Sinus bradycardia (heart rate <90 to 110 beats/min in an infant) is an indication of
digoxin toxicity, so assessment
of the client's digoxin level has the highest priority. Option A is not indicated at
this time. Option C provides
helpful assessment data but does not address the cause of the problem and delays
needed intervention. Option D
is indicated for a serious, life-threatening overdose with digoxin.
The nurse admits a child to the intensive care unit with a possible diagnosis of
Wilms tumor - What is the
most safety precaution for child?
A. maintain NPO status
,B. Limit visitors to the immediate family
C. Place a do not palpate abdomen sign on head of
bed
d encourage ambulatory in pre operative period - ANSWER-C. Protect child from
injury; place a sign on bed stating "no abdominal palpation" (to prevent accidental
fragmentation and dislodging into the abdominal cavity). The other option choices
are not relevant at this time.
The nurse is preparing a teaching plan for the mother of a child who has been
diagnosed with celiac
disease. Choosing which lunch will be within the therapeutic management of a
child with celiac disease?
A. Turkey salad, milk, and oatmeal cookies
B. Baked chicken, coleslaw, soda, and frozen fruit
dessert
C. Tuna salad sandwich on whole wheat bread, milk, and ice cream
D. Turkey sandwich on rye bread, orange juice, and fresh fruit - ANSWER-Correct
Answer: B
Rationale:
A child with celiac disease is managed on a gluten-free diet, which eliminates food
products containing oats, wheat, rye, or barley.
A 6-month-old male infant is admitted to the postanesthesia care unit with elbow
restraints in place. He
has an endotracheal tube and is ventilator-dependent but will be extubated soon
following recovery from
anesthesia. Which nursing intervention should be included in this child's plan of
care?
A. Keep restraints on at all times to prevent unplanned extubation.
B. Remove restraints one at a time and provide range-of-motion exercises.
C. Remove all restraints simultaneously and provide play activities
D. Document the reason for application of the restraints every 72 hours. -
ANSWER-Remove restraints one at a time and provide range-of-motion exercises.
Removing restraints one at a time is safer than option C. The infant should have
the restrained extremities assessed frequently for signs of neurologic or vascular
impairment, and range-of-motion exercises should be performed with these
assessments. Under no circumstances should restraints be applied to the client
continuously. Documentation of assessment findings regarding the restrained
extremities must occur much more frequently than every 72 hours; however, the
,reason for using restraints must be justified and should be stated in the medical
record.
The nurse assigns an unlicensed assistive personnel (UP) to provide morning care
to a newly admitted
child with bacterial meningitis. What is the most important instruction for the nurse
to review with the UP?
A.Use designated isolation precautions.
B. Keep the lighting in the room dim.
C. Allow the parents to assist with care
D. Report any pain that the child experiences - ANSWER-A.
Rationale:
All these are important measures to review with the UP, but the most important is
option A. Improper use of
isolation precautions can place other staff and clients at risk for infection. Options
B. C, and D promote client
comfort and reduce anxiety but are of a lower priority than option A.
The nurse is caring for a child with intussusception who is scheduled for a barium
enema prior to a
surgical procedure. Which action should the nurse take first?
A. Evacuate the bowel of impacted feces
B. Admnister magnesium sulfate
C. Place the child on a clear liquid diet
D. Assess the stool for white color - ANSWER-C
Rationale:
Intussusception, an invagination or telescoping of one portion of the intestine into
another, causes intestinal
obstruction in children (usually occurs between 3 months and 5 years of age).
Nonsurgical treatment is attempted
with hydrostatic pressure created by barium instillation, which often reduces the
area of bowel intussusception. In
preparation for a barium enema, the client should first be placed on a clear liquid
diet for the entire day: then
magnesium sulfate is administered for bowel evacuation. A barium enema is likely
to cause option A. After the
enema, white stool may be seen as the body naturally removes any remaining
barium.
, A3-week-old infant is referred to an orthopedic clinic because the pediatrician
heard a click when flexing
the child's right hip during a routine physical examination. The orthopedic
physician suspects that the child might
have developmental dysplasia of the hip (DDH). The parents ask the nurse to
identify risk factors commonly
associated with DDH. Which response is accurate?
A. Vertex delivery
B. Male gender
C. Breech presentation
D. Second-born child - ANSWER-C.
Rationale:
Developmental dysplasia of the hip (DDH) occurs more often in infants who
present in the breech position, not the
vertex (head-first) position. Twice as many females as males present in the breech
pasition; thus, 80% of children with DDH are females, not males. Of breech
presentations, 60% occur with first-born children, not subsequent
siblings, possibly because of the unstretched uterus and compaction of the
surrounding abdominal contents,
which tend to increase compression on the uterus in the nulliparous woman.
The nurse is teaching the parents of a 2-year-old child with a congenital heart
defect about signs and
symptoms of congestive heart failure. Which information about the child is most
important for the parents to
report to the health care provider?
A. sits or squats frequently when playing outdoors
B. Exhibits a sudden and unexplained weight gain C. Is not completely toilet-
trained and has some accidents
D. Demonstrates irritation and fatigue 1 hour before bedtime - ANSWER-B
Rationale:
Sudden and unexplained weight gain can indicate fluid retention and is a sign of
congestive heart failure. Option A is used by the child to reduce chronic hypoxia,
especially during exercise. Option C is common; 2-year-olds are not expected to be
toilet-trained. Option D is normal.
A newborn female whose mother is HIV-positive is scheduled for the first follow-
up assessment with the
nurse. If the child is HIV-positive, which initial symptom is she most likely to
exhibit?
EXAM CONTAINS 55 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS)/ PEDIATRICS HESI RN 3 ACTUAL EXAMS (AGRADED)
RN PEDIATRICS HESI VERSION 1
The nurse is planning postoperative care for a child who has had a cleft lip repair.
What is the most important reason to minimize this child's crying during the
recovery period?
A. Tear formation increases salivation.
B. This behavior increases respirations.
C. Excessive hysteria can lead to vomiting.
D. Crying stresses the suture line - ANSWER-Rationale: choice D
Prevention of stress on the lip suture line is essential for optimum healing and the
cosmetic appearance of a cleft
lip repair. Although crying also causes options A, B, and C, these conditions do not
create a problem for the child
with a cleft lip repair.
An infant is receiving digoxin for congestive heart failure. The apical heart rate is
assessed at 80
beats/min. What intervention should the nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat. - ANSWER-Rationale:
Answer: D.
Sinus bradycardia (heart rate <90 to 110 beats/min in an infant) is an indication of
digoxin toxicity, so assessment
of the client's digoxin level has the highest priority. Option A is not indicated at
this time. Option C provides
helpful assessment data but does not address the cause of the problem and delays
needed intervention. Option D
is indicated for a serious, life-threatening overdose with digoxin.
The nurse admits a child to the intensive care unit with a possible diagnosis of
Wilms tumor - What is the
most safety precaution for child?
A. maintain NPO status
,B. Limit visitors to the immediate family
C. Place a do not palpate abdomen sign on head of
bed
d encourage ambulatory in pre operative period - ANSWER-C. Protect child from
injury; place a sign on bed stating "no abdominal palpation" (to prevent accidental
fragmentation and dislodging into the abdominal cavity). The other option choices
are not relevant at this time.
The nurse is preparing a teaching plan for the mother of a child who has been
diagnosed with celiac
disease. Choosing which lunch will be within the therapeutic management of a
child with celiac disease?
A. Turkey salad, milk, and oatmeal cookies
B. Baked chicken, coleslaw, soda, and frozen fruit
dessert
C. Tuna salad sandwich on whole wheat bread, milk, and ice cream
D. Turkey sandwich on rye bread, orange juice, and fresh fruit - ANSWER-Correct
Answer: B
Rationale:
A child with celiac disease is managed on a gluten-free diet, which eliminates food
products containing oats, wheat, rye, or barley.
A 6-month-old male infant is admitted to the postanesthesia care unit with elbow
restraints in place. He
has an endotracheal tube and is ventilator-dependent but will be extubated soon
following recovery from
anesthesia. Which nursing intervention should be included in this child's plan of
care?
A. Keep restraints on at all times to prevent unplanned extubation.
B. Remove restraints one at a time and provide range-of-motion exercises.
C. Remove all restraints simultaneously and provide play activities
D. Document the reason for application of the restraints every 72 hours. -
ANSWER-Remove restraints one at a time and provide range-of-motion exercises.
Removing restraints one at a time is safer than option C. The infant should have
the restrained extremities assessed frequently for signs of neurologic or vascular
impairment, and range-of-motion exercises should be performed with these
assessments. Under no circumstances should restraints be applied to the client
continuously. Documentation of assessment findings regarding the restrained
extremities must occur much more frequently than every 72 hours; however, the
,reason for using restraints must be justified and should be stated in the medical
record.
The nurse assigns an unlicensed assistive personnel (UP) to provide morning care
to a newly admitted
child with bacterial meningitis. What is the most important instruction for the nurse
to review with the UP?
A.Use designated isolation precautions.
B. Keep the lighting in the room dim.
C. Allow the parents to assist with care
D. Report any pain that the child experiences - ANSWER-A.
Rationale:
All these are important measures to review with the UP, but the most important is
option A. Improper use of
isolation precautions can place other staff and clients at risk for infection. Options
B. C, and D promote client
comfort and reduce anxiety but are of a lower priority than option A.
The nurse is caring for a child with intussusception who is scheduled for a barium
enema prior to a
surgical procedure. Which action should the nurse take first?
A. Evacuate the bowel of impacted feces
B. Admnister magnesium sulfate
C. Place the child on a clear liquid diet
D. Assess the stool for white color - ANSWER-C
Rationale:
Intussusception, an invagination or telescoping of one portion of the intestine into
another, causes intestinal
obstruction in children (usually occurs between 3 months and 5 years of age).
Nonsurgical treatment is attempted
with hydrostatic pressure created by barium instillation, which often reduces the
area of bowel intussusception. In
preparation for a barium enema, the client should first be placed on a clear liquid
diet for the entire day: then
magnesium sulfate is administered for bowel evacuation. A barium enema is likely
to cause option A. After the
enema, white stool may be seen as the body naturally removes any remaining
barium.
, A3-week-old infant is referred to an orthopedic clinic because the pediatrician
heard a click when flexing
the child's right hip during a routine physical examination. The orthopedic
physician suspects that the child might
have developmental dysplasia of the hip (DDH). The parents ask the nurse to
identify risk factors commonly
associated with DDH. Which response is accurate?
A. Vertex delivery
B. Male gender
C. Breech presentation
D. Second-born child - ANSWER-C.
Rationale:
Developmental dysplasia of the hip (DDH) occurs more often in infants who
present in the breech position, not the
vertex (head-first) position. Twice as many females as males present in the breech
pasition; thus, 80% of children with DDH are females, not males. Of breech
presentations, 60% occur with first-born children, not subsequent
siblings, possibly because of the unstretched uterus and compaction of the
surrounding abdominal contents,
which tend to increase compression on the uterus in the nulliparous woman.
The nurse is teaching the parents of a 2-year-old child with a congenital heart
defect about signs and
symptoms of congestive heart failure. Which information about the child is most
important for the parents to
report to the health care provider?
A. sits or squats frequently when playing outdoors
B. Exhibits a sudden and unexplained weight gain C. Is not completely toilet-
trained and has some accidents
D. Demonstrates irritation and fatigue 1 hour before bedtime - ANSWER-B
Rationale:
Sudden and unexplained weight gain can indicate fluid retention and is a sign of
congestive heart failure. Option A is used by the child to reduce chronic hypoxia,
especially during exercise. Option C is common; 2-year-olds are not expected to be
toilet-trained. Option D is normal.
A newborn female whose mother is HIV-positive is scheduled for the first follow-
up assessment with the
nurse. If the child is HIV-positive, which initial symptom is she most likely to
exhibit?
