2025 HESI RN Pediatric Practice Exam with 50 Multiple Choice
Questions and Verified Rationalized Answers 100% Pass Score
1. The nurse is preparing a child with an intussusception for a prescribed barium
enema. What is the main purpose of conducting this procedure prior to surgical
intervention?
A. Evacuate the bowel of impacted feces.
B. Reduce the invaginated bowel segment.
C. Locate the presence of diverticula.
D. Identify the area of esophageal atresia.: ANS: B
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 (B), thereby negating the
need for surgical intervention. A barium enema is likely to cause (A). A barium enema could
be used to detect (C), but this is not the reason for its use with intussusception. (D) is not a
use for a barium enema.
2. The nurse is teaching an adolescent girl with scoliosis about a Milwaukee brace that
her health care provider has prescribed. Which instruction should the nurse provide to
this client?
A. Remove the brace 1 hour each day for bathing only.
,B. Remove the brace only for back range-of-motion exercises.
C. Wear the brace against the bare skin to ensure a good fit.
D. Wearing the brace will cure the spinal curvature.: ANS: A
The Milwaukee brace is designed to slow the progression in spinal curvature while the
adolescent is growing. The brace should be worn 23 hours a day and removed a total of 1
hour a day for hygiene (A). There are no specific exercises for increasing the range of motion in
the back that should be performed (B). A T shirt should be worn next to the body and the
brace put on over the T shirt to protect the skin (C). The brace will not cure the spinal
curvature (D) but should slow the progression of the scoliosis.
,3. The nurse should teach the parents of a child with a cyanotic heart defect to perform
which action when a hypercyanotic spell occurs?
A. Place the child's head flat, with the knees on pillows above the level of the heart.
B. Have the child lie on the right side, with the head elevated on one pillow.
C. Allow the child to assume a knee-chest position, with the head and chest slightly
elevated.
D. Encourage the child to sit up at a 45-degree angle, drink cold water, and take deep
breaths.: ANS: C
Assuming a knee-chest position with the head and chest slightly elevated (C) will help
restore hemodynamic equilibrium. (A and B) are incorrect positions and may hinder the
child's condition. (D) may cause chest pain or a vasovagal response, with resulting
hypotension.
4. During routine screening at a school clinic, an otoscope examination of a child's ear
reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. Based
on these findings, what action should the nurse take?
A. No action is required, because this is an expected finding for a school-aged child.
B. Ask if the child has had a cold, runny nose, or any ear pain lately.
C. Send a note home advising parents to have the child evaluated by a health care
provider.
, D. Call the parents and have them take the child home from school for the rest of the day.:
ANS: B
More information is needed to interpret these findings (B). The tympanic membrane is
normally pearly gray, not bulging, and moves when a client blows against re- sistance or
when a small puff of air is blown into the ear canal. Because these findings are not
completely normal, further assessment of history and related signs and symptoms are
needed to interpret the findings accurately. Based on the data obtained from the otoscope
examination, (A, C, and D) are not indicated.
Questions and Verified Rationalized Answers 100% Pass Score
1. The nurse is preparing a child with an intussusception for a prescribed barium
enema. What is the main purpose of conducting this procedure prior to surgical
intervention?
A. Evacuate the bowel of impacted feces.
B. Reduce the invaginated bowel segment.
C. Locate the presence of diverticula.
D. Identify the area of esophageal atresia.: ANS: B
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 (B), thereby negating the
need for surgical intervention. A barium enema is likely to cause (A). A barium enema could
be used to detect (C), but this is not the reason for its use with intussusception. (D) is not a
use for a barium enema.
2. The nurse is teaching an adolescent girl with scoliosis about a Milwaukee brace that
her health care provider has prescribed. Which instruction should the nurse provide to
this client?
A. Remove the brace 1 hour each day for bathing only.
,B. Remove the brace only for back range-of-motion exercises.
C. Wear the brace against the bare skin to ensure a good fit.
D. Wearing the brace will cure the spinal curvature.: ANS: A
The Milwaukee brace is designed to slow the progression in spinal curvature while the
adolescent is growing. The brace should be worn 23 hours a day and removed a total of 1
hour a day for hygiene (A). There are no specific exercises for increasing the range of motion in
the back that should be performed (B). A T shirt should be worn next to the body and the
brace put on over the T shirt to protect the skin (C). The brace will not cure the spinal
curvature (D) but should slow the progression of the scoliosis.
,3. The nurse should teach the parents of a child with a cyanotic heart defect to perform
which action when a hypercyanotic spell occurs?
A. Place the child's head flat, with the knees on pillows above the level of the heart.
B. Have the child lie on the right side, with the head elevated on one pillow.
C. Allow the child to assume a knee-chest position, with the head and chest slightly
elevated.
D. Encourage the child to sit up at a 45-degree angle, drink cold water, and take deep
breaths.: ANS: C
Assuming a knee-chest position with the head and chest slightly elevated (C) will help
restore hemodynamic equilibrium. (A and B) are incorrect positions and may hinder the
child's condition. (D) may cause chest pain or a vasovagal response, with resulting
hypotension.
4. During routine screening at a school clinic, an otoscope examination of a child's ear
reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. Based
on these findings, what action should the nurse take?
A. No action is required, because this is an expected finding for a school-aged child.
B. Ask if the child has had a cold, runny nose, or any ear pain lately.
C. Send a note home advising parents to have the child evaluated by a health care
provider.
, D. Call the parents and have them take the child home from school for the rest of the day.:
ANS: B
More information is needed to interpret these findings (B). The tympanic membrane is
normally pearly gray, not bulging, and moves when a client blows against re- sistance or
when a small puff of air is blown into the ear canal. Because these findings are not
completely normal, further assessment of history and related signs and symptoms are
needed to interpret the findings accurately. Based on the data obtained from the otoscope
examination, (A, C, and D) are not indicated.
