Peds HESI practice
A 2-year-old child is placed in an oxygen tent. What clothes will the nurse recommend the
parents bring from home for the child?
A. An all-cotton sleeper
B. A synthetic shirt and baggy shorts
C. A polyester play outfit
D. A lightly woven wool sweater - ANS-A. An all-cotton sleeper
The child will be in an environment of cool, moist air. Cotton is a breathable fabric appropriate
for this environment. Polyester and synthetic fibers will trap the cool moisture. Wool will make
the child feel cold when it gets moist.
A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine
evaluation. Which assessment finding suggests the presence of a common complication often
experienced by those with Down syndrome?
A. Presence of a systolic murmur
B. New onset of patchy alopecia
C. Complaints of long bone pain
D. Recent projectile vomiting - ANS-A. Presence of a systolic murmur
Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down syndrome).
Defects of the atrial or ventricular septum that create systolic murmurs are the most common
heart defects associated with this congenital anomaly. Options B, C, and D are not recognized
as common complications of trisomy 21.
A 7-month-old infant with a rotavirus causing severe diarrhea is admitted for treatment. Which
action should the nurse take first?
A. Obtain a scale to weigh the infant's diapers.
B. Instruct the mother to offer Pedialyte regularly.
C. Insert an intravenous (IV) line and begin IV fluids.
D. Obtain a stool specimen for analysis. - ANS-C. Insert an intravenous (IV) line and begin IV
fluids.
An infant with severe diarrhea is at high risk for dehydration, so the nurse's priority is to initiate
IV fluids to rehydrate the infant. Options A, B, and D can then be implemented as needed.
A child admitted to the emergency department is lethargic and has a fruity aroma to the breath,
blurred vision, and a headache. What question will the nurse ask the parents first?
A. "Has your child ever been treated for diabetes before this?"
, B. "Has your child been playing outside in the heat all day?"
C. "Are any of your other children displaying these symptoms?"
D. "Has your child been exposed to other sick children?" - ANS-A. "Has your child ever been
treated for diabetes before this?"
The child is displaying signs of ketoacidosis. The fruity breath is a hallmark sign. Knowing if the
child has had diabetes will help the health care team understand the underlying cause of the
presenting symptoms and the best course of action. However, often DKA leads to the initial
diagnosis of diabetes in children.
A child is recovering from a splenectomy secondary to a diagnosis of β-Thalassemia major.
What is the most important instruction the nurse must include in the child's discharge plan?
A. Parental genetic counseling
B. Include the pneumococcal vaccine.
C. Weekly hemoglobin levels
D. Report signs of infection. - ANS-D. Report signs of infection.
The child is at risk for sepsis after a splenectomy. Report to the child's health care provider any
signs and symptoms of infection. Genetic counseling and the pneumococcal vaccine are
important, but do not pose the risk of sepsis. Weekly hemoglobin levels are not necessary.
A child presents again to the school nurse with dyspnea, wheezing, diaphoresis, and deep
dark-red lips. What is the next nursing action?
A. Call the child's parents.
B. Call 911.
C. Ask, "Do you have your inhaler?"
D. Ask, "Did you play outside today?" - ANS-C. Ask, "Do you have your inhaler?"
This child is showing signs of respiratory distress, possibly asthma (deep read lips). Rapid relief
medications such as a bronchodilator followed by steroids may help alleviate the symptoms.
Because the child presents again, indicates this child is known to the nurse. The nurse must
assess for patency of the airway. Calling the child's parents does nothing for the airway.
Emergency treatment through from paramedic may be indicated if the child does not have any
rapid relief medications. Playing outside may trigger an asthma attack, but does nothing to treat
the respiratory distress.
A child presents to the emergency department with vomiting and diarrhea for 36 hours. Which
finding is most concerning to the nurse?
A. No tears when crying
B. Urine specific gravity of 1.035
C. Pink lips and gums
D. Temperature of 99.2°F/37.3°C - ANS-B. Urine specific gravity of 1.035
A 2-year-old child is placed in an oxygen tent. What clothes will the nurse recommend the
parents bring from home for the child?
A. An all-cotton sleeper
B. A synthetic shirt and baggy shorts
C. A polyester play outfit
D. A lightly woven wool sweater - ANS-A. An all-cotton sleeper
The child will be in an environment of cool, moist air. Cotton is a breathable fabric appropriate
for this environment. Polyester and synthetic fibers will trap the cool moisture. Wool will make
the child feel cold when it gets moist.
A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine
evaluation. Which assessment finding suggests the presence of a common complication often
experienced by those with Down syndrome?
A. Presence of a systolic murmur
B. New onset of patchy alopecia
C. Complaints of long bone pain
D. Recent projectile vomiting - ANS-A. Presence of a systolic murmur
Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down syndrome).
Defects of the atrial or ventricular septum that create systolic murmurs are the most common
heart defects associated with this congenital anomaly. Options B, C, and D are not recognized
as common complications of trisomy 21.
A 7-month-old infant with a rotavirus causing severe diarrhea is admitted for treatment. Which
action should the nurse take first?
A. Obtain a scale to weigh the infant's diapers.
B. Instruct the mother to offer Pedialyte regularly.
C. Insert an intravenous (IV) line and begin IV fluids.
D. Obtain a stool specimen for analysis. - ANS-C. Insert an intravenous (IV) line and begin IV
fluids.
An infant with severe diarrhea is at high risk for dehydration, so the nurse's priority is to initiate
IV fluids to rehydrate the infant. Options A, B, and D can then be implemented as needed.
A child admitted to the emergency department is lethargic and has a fruity aroma to the breath,
blurred vision, and a headache. What question will the nurse ask the parents first?
A. "Has your child ever been treated for diabetes before this?"
, B. "Has your child been playing outside in the heat all day?"
C. "Are any of your other children displaying these symptoms?"
D. "Has your child been exposed to other sick children?" - ANS-A. "Has your child ever been
treated for diabetes before this?"
The child is displaying signs of ketoacidosis. The fruity breath is a hallmark sign. Knowing if the
child has had diabetes will help the health care team understand the underlying cause of the
presenting symptoms and the best course of action. However, often DKA leads to the initial
diagnosis of diabetes in children.
A child is recovering from a splenectomy secondary to a diagnosis of β-Thalassemia major.
What is the most important instruction the nurse must include in the child's discharge plan?
A. Parental genetic counseling
B. Include the pneumococcal vaccine.
C. Weekly hemoglobin levels
D. Report signs of infection. - ANS-D. Report signs of infection.
The child is at risk for sepsis after a splenectomy. Report to the child's health care provider any
signs and symptoms of infection. Genetic counseling and the pneumococcal vaccine are
important, but do not pose the risk of sepsis. Weekly hemoglobin levels are not necessary.
A child presents again to the school nurse with dyspnea, wheezing, diaphoresis, and deep
dark-red lips. What is the next nursing action?
A. Call the child's parents.
B. Call 911.
C. Ask, "Do you have your inhaler?"
D. Ask, "Did you play outside today?" - ANS-C. Ask, "Do you have your inhaler?"
This child is showing signs of respiratory distress, possibly asthma (deep read lips). Rapid relief
medications such as a bronchodilator followed by steroids may help alleviate the symptoms.
Because the child presents again, indicates this child is known to the nurse. The nurse must
assess for patency of the airway. Calling the child's parents does nothing for the airway.
Emergency treatment through from paramedic may be indicated if the child does not have any
rapid relief medications. Playing outside may trigger an asthma attack, but does nothing to treat
the respiratory distress.
A child presents to the emergency department with vomiting and diarrhea for 36 hours. Which
finding is most concerning to the nurse?
A. No tears when crying
B. Urine specific gravity of 1.035
C. Pink lips and gums
D. Temperature of 99.2°F/37.3°C - ANS-B. Urine specific gravity of 1.035
