PEDIATRIC'S HESI COMP BOOK EXAM
QUESTIONS WITH VERIFIED
ANSWERS
The practical nurse (PN) is caring for a child with an acute respiratory condition.
When the PN is monitoring for impending respiratory distress, what sign is the child
likely to exhibit first?
a. Cyanosis
b. Sternal retraction
c. Restlessness
d. Crowing respiration - ANSWER-c. Restlessness
Rationale:
Restlessness is an early sign of hypoxemia.
A child with poison ivy weighs 25 kg and receives a prescription for diphenhydramine
PO 5 mg/kg. The medication is available as a 125 mg/5 mL solution. How many
milliliters should the practical nurse administer?
_____________________________ mL - ANSWER-5 ml
Rationale:
First determine how much of the drug the child should get.The order is 5 mg/kg.
Multiply 5 mg by the child's weight. 5 mg × 25 kg = 125 mg.The child would get 125
mg.Next, determine how many milliliters to administer using the following
formula:Desired dose/available dose × mL/dose of available drug = mL to
administer125/125 × 5 mL = 5 mL
The practical nurse (PN) is caring for a child with a diagnosis of acquired aplastic
anemia. What should the PN expect in the child's health history that is a common
cause of this type of anemia?
a. Bacterial infections
b. A diet deficient in iron
c. Congenital heart defects
d. Exposure to certain drugs - ANSWER-d. Exposure to certain drugs
Rationale:
Aplastic anemia often follows exposure to certain drugs such as chloramphenicol,
sulfonamides, phenylbutazone, insecticides such as DDT, and chemicals, in
particular benzene.
The health care provider prescribes amoxicillin 60 mg PO three times a day for a
child who weighs 13 pounds. The pediatric dosage range is 20 to 40 mg/kg/day in
three equal doses. What is the maximum dosage in 24 hours that should be given?
________________________________ mg - ANSWER-236
Rationale:
First, convert the pounds to kg because the conversion is for kg.1 kg = 2.2 lb13
lb/(2.2 lb/kg) = 5.9 kgSecond, determine the maximum dose the child can have in 24
hours: 40 mg × 5.9 kg = 236 mg. The maximum dose the child can have is 236 mg.
,An 18-month-old child is taken to the emergency department with symptoms of
epiglottitis. The nurse anticipates which aspect will be included in the plan of care?
a. Soft diet
b. Semi-Fowler's position
c. Discourage child from sitting upright with chin out
d. Prepare to assist with bedside tracheostomy placement - ANSWER-d. Prepare to
assist with bedside tracheostomy placement
Rationale:
The nurse will need to prepare for bedside intubation or tracheostomy, as epiglottitis
can progress rapidly, causing acute airway obstruction. The child will not likely be
able to tolerate a soft diet, and if airway obstruction occurs, the child could aspirate.
The child will likely breathe more easily if allowed to sit in an upright sitting position
(not Semi-Fowler's) with the chin out, and the tongue protruding. This is sometimes
called the tripod position.
A 3 day infant has had surgery to reconstruct the anus due to an anorectal
malformation noted at birth. The nurse will implement which aspect of postoperative
care?
a. Assess the child's temperature rectally every 4 hours.
b. Position the child side-lying prone with the hips elevated.
c. Inform the parents toilet training should begin on schedule.
d. Passing stools in the urine is expected to occur after surgery. - ANSWER-b.
Position the child side-lying prone with the hips elevated.
Rationale:
The child should be positioned in the side-lying prone position with the hips elevated
to decrease pressure on the perineal sutures. No rectal temperatures should be
taken postoperatively, because this could disrupt the sutures. Toilet training is
frequently delayed and full continence may not be achieved. It is not normal for the
child to pass stools in the urine
A full-term infant is admitted to the newborn nursery. During the initial PO feeding,
the practical nurse (PN) observes the infant for possible tracheal esophageal atresia.
Which symptoms are likely to be exhibited during the feeding if this condition is
present?
a. Choking, coughing, and cyanosis
b. Projectile vomiting and cyanosis
c. Apneic spells and grunting
d. Scaphoid abdomen and anorexia - ANSWER-a. Choking, coughing, and cyanosis
Rationale:
Choking, coughing, and cyanosis are the "3 Cs" of esophageal atresia caused by the
overflow of secretions into the trachea.
A 6-year-old child arrives to the urgent care center with symptoms of an asthma
exacerbation. The child's oxygen saturation is 90%, the pulse is 120 beats/min, and
the respiratory rate 32 per minute. The nurse should prepare for which priority
intervention?
a. Administration of a long-acting bronchodilator
b. Monitoring for signs of an infection masked by steroid use
c. Administration of oxygen and subcutaneous injection of epinephrine
, d. Reviewing with the caregivers the possible triggers for an exacerbation of asthma
- ANSWER-c. Administration of oxygen and subcutaneous injection of epinephrine
Rationale:
The priority of care for an acute asthma attack is oxygen administration and
administration of epinephrine, which is a rapid-acting bronchodilator. After the acute
attack has subsided, and the child's respiratory status is stable, the nurse can
anticipate administration of a long-acting bronchodilator. Monitoring for signs of an
infection is important, but the immediate priority is oxygen administration and use of
a rapid-acting bronchodilator. Education regarding asthma triggers is also crucial, but
should take place after the child is stable.
An infant is born with a ventricular septal defect (VSD), and surgery is planned to
correct the defect. The practical nurse (PN) should understand that the surgical
correction is designed to achieve which hemodynamic outcome?
a. Stop the flow of unoxygenated blood into systemic circulation.
b. Increase the flow of unoxygenated blood to the lungs.
c. Prevent the return of oxygenated blood to the lungs.
d. Reduce peripheral tissue hypoxia and nail bed clubbing. - ANSWER-c. Prevent
the return of oxygenated blood to the lungs.
Rationale:
Closure of the VSD will stop shunting of oxygenated blood from the left ventricle
(higher pressure) to the right ventricle.
The parents of a 1-year-old child, who was recently diagnosed with hypospadias,
state that they plan to delay the corrective surgery to see if the child will outgrow the
problem. What information is best for the practical nurse (PN) to provide to these
parents?
a. The prognosis will worsen if surgery is delayed.
b. Some children do outgrow this type of problem and waiting may be beneficial.
c. Regardless of the decision, the staff is available to assist with the process.
d. Discuss the child's diagnosis with the health care provider for additional
information and clarity. - ANSWER-d. Discuss the child's diagnosis with the health
care provider for additional information and clarity.
Rationale:
The PN should first ensure that the parents have adequate and correct information.
Hypospadias is a congenital anomaly resulting in an abnormally located urethral
meatus. Surgical correction is usually done early in childhood, which is considered
the best time for the child to face surgery with the fewest fears.
The practical nurse(PN) in the clinic receives a phone call from the mother of a 6
year old child with a newly applied cast for a fracture of the femur. The master
reports that the child Is in pain and is crying and that child's foot appears swollen and
blue. Which should be the nurse's instruction to the mother?
a. Ask the child to use crutches for mobility.
b. Apply ice to the site of the fracture
c. Bring the child immediately to the clinic
d. Administer the prescribed pain medication - ANSWER-c. Bring the child
immediately to the clinic.
Rationale:
QUESTIONS WITH VERIFIED
ANSWERS
The practical nurse (PN) is caring for a child with an acute respiratory condition.
When the PN is monitoring for impending respiratory distress, what sign is the child
likely to exhibit first?
a. Cyanosis
b. Sternal retraction
c. Restlessness
d. Crowing respiration - ANSWER-c. Restlessness
Rationale:
Restlessness is an early sign of hypoxemia.
A child with poison ivy weighs 25 kg and receives a prescription for diphenhydramine
PO 5 mg/kg. The medication is available as a 125 mg/5 mL solution. How many
milliliters should the practical nurse administer?
_____________________________ mL - ANSWER-5 ml
Rationale:
First determine how much of the drug the child should get.The order is 5 mg/kg.
Multiply 5 mg by the child's weight. 5 mg × 25 kg = 125 mg.The child would get 125
mg.Next, determine how many milliliters to administer using the following
formula:Desired dose/available dose × mL/dose of available drug = mL to
administer125/125 × 5 mL = 5 mL
The practical nurse (PN) is caring for a child with a diagnosis of acquired aplastic
anemia. What should the PN expect in the child's health history that is a common
cause of this type of anemia?
a. Bacterial infections
b. A diet deficient in iron
c. Congenital heart defects
d. Exposure to certain drugs - ANSWER-d. Exposure to certain drugs
Rationale:
Aplastic anemia often follows exposure to certain drugs such as chloramphenicol,
sulfonamides, phenylbutazone, insecticides such as DDT, and chemicals, in
particular benzene.
The health care provider prescribes amoxicillin 60 mg PO three times a day for a
child who weighs 13 pounds. The pediatric dosage range is 20 to 40 mg/kg/day in
three equal doses. What is the maximum dosage in 24 hours that should be given?
________________________________ mg - ANSWER-236
Rationale:
First, convert the pounds to kg because the conversion is for kg.1 kg = 2.2 lb13
lb/(2.2 lb/kg) = 5.9 kgSecond, determine the maximum dose the child can have in 24
hours: 40 mg × 5.9 kg = 236 mg. The maximum dose the child can have is 236 mg.
,An 18-month-old child is taken to the emergency department with symptoms of
epiglottitis. The nurse anticipates which aspect will be included in the plan of care?
a. Soft diet
b. Semi-Fowler's position
c. Discourage child from sitting upright with chin out
d. Prepare to assist with bedside tracheostomy placement - ANSWER-d. Prepare to
assist with bedside tracheostomy placement
Rationale:
The nurse will need to prepare for bedside intubation or tracheostomy, as epiglottitis
can progress rapidly, causing acute airway obstruction. The child will not likely be
able to tolerate a soft diet, and if airway obstruction occurs, the child could aspirate.
The child will likely breathe more easily if allowed to sit in an upright sitting position
(not Semi-Fowler's) with the chin out, and the tongue protruding. This is sometimes
called the tripod position.
A 3 day infant has had surgery to reconstruct the anus due to an anorectal
malformation noted at birth. The nurse will implement which aspect of postoperative
care?
a. Assess the child's temperature rectally every 4 hours.
b. Position the child side-lying prone with the hips elevated.
c. Inform the parents toilet training should begin on schedule.
d. Passing stools in the urine is expected to occur after surgery. - ANSWER-b.
Position the child side-lying prone with the hips elevated.
Rationale:
The child should be positioned in the side-lying prone position with the hips elevated
to decrease pressure on the perineal sutures. No rectal temperatures should be
taken postoperatively, because this could disrupt the sutures. Toilet training is
frequently delayed and full continence may not be achieved. It is not normal for the
child to pass stools in the urine
A full-term infant is admitted to the newborn nursery. During the initial PO feeding,
the practical nurse (PN) observes the infant for possible tracheal esophageal atresia.
Which symptoms are likely to be exhibited during the feeding if this condition is
present?
a. Choking, coughing, and cyanosis
b. Projectile vomiting and cyanosis
c. Apneic spells and grunting
d. Scaphoid abdomen and anorexia - ANSWER-a. Choking, coughing, and cyanosis
Rationale:
Choking, coughing, and cyanosis are the "3 Cs" of esophageal atresia caused by the
overflow of secretions into the trachea.
A 6-year-old child arrives to the urgent care center with symptoms of an asthma
exacerbation. The child's oxygen saturation is 90%, the pulse is 120 beats/min, and
the respiratory rate 32 per minute. The nurse should prepare for which priority
intervention?
a. Administration of a long-acting bronchodilator
b. Monitoring for signs of an infection masked by steroid use
c. Administration of oxygen and subcutaneous injection of epinephrine
, d. Reviewing with the caregivers the possible triggers for an exacerbation of asthma
- ANSWER-c. Administration of oxygen and subcutaneous injection of epinephrine
Rationale:
The priority of care for an acute asthma attack is oxygen administration and
administration of epinephrine, which is a rapid-acting bronchodilator. After the acute
attack has subsided, and the child's respiratory status is stable, the nurse can
anticipate administration of a long-acting bronchodilator. Monitoring for signs of an
infection is important, but the immediate priority is oxygen administration and use of
a rapid-acting bronchodilator. Education regarding asthma triggers is also crucial, but
should take place after the child is stable.
An infant is born with a ventricular septal defect (VSD), and surgery is planned to
correct the defect. The practical nurse (PN) should understand that the surgical
correction is designed to achieve which hemodynamic outcome?
a. Stop the flow of unoxygenated blood into systemic circulation.
b. Increase the flow of unoxygenated blood to the lungs.
c. Prevent the return of oxygenated blood to the lungs.
d. Reduce peripheral tissue hypoxia and nail bed clubbing. - ANSWER-c. Prevent
the return of oxygenated blood to the lungs.
Rationale:
Closure of the VSD will stop shunting of oxygenated blood from the left ventricle
(higher pressure) to the right ventricle.
The parents of a 1-year-old child, who was recently diagnosed with hypospadias,
state that they plan to delay the corrective surgery to see if the child will outgrow the
problem. What information is best for the practical nurse (PN) to provide to these
parents?
a. The prognosis will worsen if surgery is delayed.
b. Some children do outgrow this type of problem and waiting may be beneficial.
c. Regardless of the decision, the staff is available to assist with the process.
d. Discuss the child's diagnosis with the health care provider for additional
information and clarity. - ANSWER-d. Discuss the child's diagnosis with the health
care provider for additional information and clarity.
Rationale:
The PN should first ensure that the parents have adequate and correct information.
Hypospadias is a congenital anomaly resulting in an abnormally located urethral
meatus. Surgical correction is usually done early in childhood, which is considered
the best time for the child to face surgery with the fewest fears.
The practical nurse(PN) in the clinic receives a phone call from the mother of a 6
year old child with a newly applied cast for a fracture of the femur. The master
reports that the child Is in pain and is crying and that child's foot appears swollen and
blue. Which should be the nurse's instruction to the mother?
a. Ask the child to use crutches for mobility.
b. Apply ice to the site of the fracture
c. Bring the child immediately to the clinic
d. Administer the prescribed pain medication - ANSWER-c. Bring the child
immediately to the clinic.
Rationale:
