1
HESI Exit Exam Pediatric
Respiratory Bank: Bronchiolitis,
Emergencies & Airway
Management
Table of Contents
Subtopic 1: Recognition and Early Intervention in Pediatric Respiratory
Distress............................................................................................................2
Subtopic 2: Management and Treatment Strategies in Pediatric Bronchiolitis
.......................................................................................................................11
Subtopic 3: Differential Diagnosis and Complications in Pediatric Respiratory
Infections.......................................................................................................20
Subtopic 4: Preventive Measures and Immunoprophylaxis in Pediatric
Respiratory Illnesses......................................................................................30
Subtopic 5: Airway Management and Supportive Equipment in Pediatric
Respiratory Care............................................................................................39
Subtopic 6: Pediatric Respiratory Assessment – Signs, Symptoms, and
Severity Scoring.............................................................................................48
, 2
Subtopic 1: Recognition and Early Intervention
in Pediatric Respiratory Distress
Question 1:
A 6-month-old infant is brought to the emergency department with nasal
flaring, intercostal retractions, and grunting respirations. Which action should
the nurse take first?
A. Administer a bronchodilator via nebulizer
B. Assess oxygen saturation using pulse oximetry
C. Prepare the child for chest physiotherapy
D. Encourage oral fluid intake
Correct Answer: B. Assess oxygen saturation using pulse oximetry
Rationale: The first priority in pediatric respiratory distress is assessing
oxygenation. Pulse oximetry provides a non-invasive and rapid assessment
of oxygen saturation, guiding further interventions.
Question 2:
Which clinical finding indicates a progression from mild to moderate
respiratory distress in a pediatric patient?
A. Nasal congestion
B. Mild tachypnea
C. Use of accessory muscles
D. Low-grade fever
Correct Answer: C. Use of accessory muscles
, 3
Rationale: The use of accessory muscles, such as intercostal or suprasternal
retractions, indicates increased work of breathing, which is a sign of
moderate to severe respiratory distress.
Question 3:
What is the most reliable early indicator of hypoxemia in infants?
A. Cyanosis
B. Restlessness and irritability
C. Bradycardia
D. Hypotension
Correct Answer: B. Restlessness and irritability
Rationale: Behavioral changes such as restlessness and irritability are often
early signs of hypoxemia in infants before more severe signs like cyanosis
appear.
Question 4:
The nurse is caring for a toddler who is exhibiting stridor at rest and
suprasternal retractions. What is the most appropriate next step?
A. Give acetaminophen for fever
B. Notify the healthcare provider immediately
C. Offer fluids to keep the airway moist
D. Suction the nasopharynx
Correct Answer: B. Notify the healthcare provider immediately
Rationale: Stridor at rest with suprasternal retractions indicates severe upper
airway obstruction requiring immediate intervention.
, 4
Question 5:
Which condition is most commonly associated with wheezing in infants?
A. Croup
B. Bronchiolitis
C. Epiglottitis
D. Bacterial pneumonia
Correct Answer: B. Bronchiolitis
Rationale: Bronchiolitis, primarily caused by RSV, is characterized by
wheezing, especially in infants due to inflammation of the small airways.
Question 6:
What is the most critical nursing assessment when monitoring a child with
suspected respiratory distress?
A. Bowel sounds
B. Respiratory rate and effort
C. Pedal pulses
D. Capillary refill
Correct Answer: B. Respiratory rate and effort
Rationale: Monitoring the respiratory rate and work of breathing provides key
information about a child’s respiratory status and potential deterioration.
Question 7:
HESI Exit Exam Pediatric
Respiratory Bank: Bronchiolitis,
Emergencies & Airway
Management
Table of Contents
Subtopic 1: Recognition and Early Intervention in Pediatric Respiratory
Distress............................................................................................................2
Subtopic 2: Management and Treatment Strategies in Pediatric Bronchiolitis
.......................................................................................................................11
Subtopic 3: Differential Diagnosis and Complications in Pediatric Respiratory
Infections.......................................................................................................20
Subtopic 4: Preventive Measures and Immunoprophylaxis in Pediatric
Respiratory Illnesses......................................................................................30
Subtopic 5: Airway Management and Supportive Equipment in Pediatric
Respiratory Care............................................................................................39
Subtopic 6: Pediatric Respiratory Assessment – Signs, Symptoms, and
Severity Scoring.............................................................................................48
, 2
Subtopic 1: Recognition and Early Intervention
in Pediatric Respiratory Distress
Question 1:
A 6-month-old infant is brought to the emergency department with nasal
flaring, intercostal retractions, and grunting respirations. Which action should
the nurse take first?
A. Administer a bronchodilator via nebulizer
B. Assess oxygen saturation using pulse oximetry
C. Prepare the child for chest physiotherapy
D. Encourage oral fluid intake
Correct Answer: B. Assess oxygen saturation using pulse oximetry
Rationale: The first priority in pediatric respiratory distress is assessing
oxygenation. Pulse oximetry provides a non-invasive and rapid assessment
of oxygen saturation, guiding further interventions.
Question 2:
Which clinical finding indicates a progression from mild to moderate
respiratory distress in a pediatric patient?
A. Nasal congestion
B. Mild tachypnea
C. Use of accessory muscles
D. Low-grade fever
Correct Answer: C. Use of accessory muscles
, 3
Rationale: The use of accessory muscles, such as intercostal or suprasternal
retractions, indicates increased work of breathing, which is a sign of
moderate to severe respiratory distress.
Question 3:
What is the most reliable early indicator of hypoxemia in infants?
A. Cyanosis
B. Restlessness and irritability
C. Bradycardia
D. Hypotension
Correct Answer: B. Restlessness and irritability
Rationale: Behavioral changes such as restlessness and irritability are often
early signs of hypoxemia in infants before more severe signs like cyanosis
appear.
Question 4:
The nurse is caring for a toddler who is exhibiting stridor at rest and
suprasternal retractions. What is the most appropriate next step?
A. Give acetaminophen for fever
B. Notify the healthcare provider immediately
C. Offer fluids to keep the airway moist
D. Suction the nasopharynx
Correct Answer: B. Notify the healthcare provider immediately
Rationale: Stridor at rest with suprasternal retractions indicates severe upper
airway obstruction requiring immediate intervention.
, 4
Question 5:
Which condition is most commonly associated with wheezing in infants?
A. Croup
B. Bronchiolitis
C. Epiglottitis
D. Bacterial pneumonia
Correct Answer: B. Bronchiolitis
Rationale: Bronchiolitis, primarily caused by RSV, is characterized by
wheezing, especially in infants due to inflammation of the small airways.
Question 6:
What is the most critical nursing assessment when monitoring a child with
suspected respiratory distress?
A. Bowel sounds
B. Respiratory rate and effort
C. Pedal pulses
D. Capillary refill
Correct Answer: B. Respiratory rate and effort
Rationale: Monitoring the respiratory rate and work of breathing provides key
information about a child’s respiratory status and potential deterioration.
Question 7:
