Pediatrics HESI Practice Exam with Well Detailed
Question & Answers Perfectly A+ Graded with Rationale
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which
observation by the nurse warrants immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute. CORRECT ANSWER>>>>Apical heart rate of
60.
A heart rate of 60 (A) is much lower than normal for a 6-month-old and warrants immediate
intervention. The normal heart rate for a 6-month-old is 80 to 150 BPM when awake, and a rate
of 70 while sleeping is considered within normal limits. (B and C) are expected symptoms of
heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teaching the parents of a 5-year-old with cystic fibrosis about respiratory
treatments. Which statement indicates to the nurse that the parents understand?
Perform postural drainage before starting aerosol therapy.
,Give respiratory treatments when the child is coughing a lot.
Administer aerosol therapy followed by postural drainage before meals.
Ensure respiratory therapy is done daily during any respiratory infection. CORRECT
ANSWER>>>>Administer aerosol therapy followed by postural drainage before meals.
Postural drainage for a child with cystic fibrosis is most effective when performed after
nebulization and before meals (C) or at least 1 hour after eating to prevent nausea and
vomiting. Postural drainage uses gravity to promote mucous removal after nebulization (A)
treatments which open the airways. Pulmonary toileting or respiratory treatments should be
given 3 to 4 times daily, not episodically (B and D).
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the
most important instruction for the nurse to include in this client's teaching plan?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular. CORRECT ANSWER>>>>Use sunscreen
when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe
sunburn can occur with minimal sun exposure and clients should be instructed to avoid sunlight
and to use sunscreen (A). (B and D) are not related to tetracycline HCL (Achromycin V) therapy.
(C) should be avoided because dairy products interfere with the absorption of tetracyclines.
What preoperative nursing intervention should be included in the plan of care for an infant with
pyloric stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
,Place in a supine position after feeding.
Observe for projectile vomiting. CORRECT ANSWER>>>>Observe for projectile
vomiting.
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is the classic sign of pyloric
stenosis. (B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequent
vomiting.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the
defect. The nurse recognizes that surgical correction is designed to achieve which outcome?
Stop the flow of unoxygenated blood into systemic circulation.
Increase the flow of unoxygenated blood to the lungs.
Prevent the return of oxygenated blood to the lungs.
Reduce peripheral tissue hypoxia and nailbed clubbing CORRECT
ANSWER>>>>Prevent the return of oxygenated blood to the lungs.
Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the right
ventricle (C). VSDs are acyanotic defects, which means that no unoxygenated blood enters the
systemic circulation (A and B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The mother
reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse
auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the
newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should
the nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that
apply.)
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
, C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening. CORRECT
ANSWER>>>>A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a
bottle of formula (C) because it is difficult to ensure that the total dose is consumed.
They should be monitored for weight gain and at least 6 wet diapers per day (A). A one-month
old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces
per day by 4-months of age (B)
Preoperative nursing care for a child with Wilms' tumor should include which intervention?
Gently percuss the abdomen for evidence of trapped air.
Observe the abdomen for any noticeable discolorations.
Apply cold compresses to the abdomen to reduce edema.
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN." CORRECT
ANSWER>>>>Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Prevention of abdominal palpation (D) minimizes the risk of rupturing the encapsulated tumor
and subsequent metastasis. (A) is unnecessary, and this action could traumatize the tumor in
the same manner as palpation. (B and C) are incorrect since the abdomen is not discolored and
cold compresses are not indicated.
Question & Answers Perfectly A+ Graded with Rationale
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which
observation by the nurse warrants immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute. CORRECT ANSWER>>>>Apical heart rate of
60.
A heart rate of 60 (A) is much lower than normal for a 6-month-old and warrants immediate
intervention. The normal heart rate for a 6-month-old is 80 to 150 BPM when awake, and a rate
of 70 while sleeping is considered within normal limits. (B and C) are expected symptoms of
heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teaching the parents of a 5-year-old with cystic fibrosis about respiratory
treatments. Which statement indicates to the nurse that the parents understand?
Perform postural drainage before starting aerosol therapy.
,Give respiratory treatments when the child is coughing a lot.
Administer aerosol therapy followed by postural drainage before meals.
Ensure respiratory therapy is done daily during any respiratory infection. CORRECT
ANSWER>>>>Administer aerosol therapy followed by postural drainage before meals.
Postural drainage for a child with cystic fibrosis is most effective when performed after
nebulization and before meals (C) or at least 1 hour after eating to prevent nausea and
vomiting. Postural drainage uses gravity to promote mucous removal after nebulization (A)
treatments which open the airways. Pulmonary toileting or respiratory treatments should be
given 3 to 4 times daily, not episodically (B and D).
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the
most important instruction for the nurse to include in this client's teaching plan?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular. CORRECT ANSWER>>>>Use sunscreen
when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe
sunburn can occur with minimal sun exposure and clients should be instructed to avoid sunlight
and to use sunscreen (A). (B and D) are not related to tetracycline HCL (Achromycin V) therapy.
(C) should be avoided because dairy products interfere with the absorption of tetracyclines.
What preoperative nursing intervention should be included in the plan of care for an infant with
pyloric stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
,Place in a supine position after feeding.
Observe for projectile vomiting. CORRECT ANSWER>>>>Observe for projectile
vomiting.
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is the classic sign of pyloric
stenosis. (B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequent
vomiting.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the
defect. The nurse recognizes that surgical correction is designed to achieve which outcome?
Stop the flow of unoxygenated blood into systemic circulation.
Increase the flow of unoxygenated blood to the lungs.
Prevent the return of oxygenated blood to the lungs.
Reduce peripheral tissue hypoxia and nailbed clubbing CORRECT
ANSWER>>>>Prevent the return of oxygenated blood to the lungs.
Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the right
ventricle (C). VSDs are acyanotic defects, which means that no unoxygenated blood enters the
systemic circulation (A and B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The mother
reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse
auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the
newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should
the nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that
apply.)
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
, C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening. CORRECT
ANSWER>>>>A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a
bottle of formula (C) because it is difficult to ensure that the total dose is consumed.
They should be monitored for weight gain and at least 6 wet diapers per day (A). A one-month
old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces
per day by 4-months of age (B)
Preoperative nursing care for a child with Wilms' tumor should include which intervention?
Gently percuss the abdomen for evidence of trapped air.
Observe the abdomen for any noticeable discolorations.
Apply cold compresses to the abdomen to reduce edema.
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN." CORRECT
ANSWER>>>>Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Prevention of abdominal palpation (D) minimizes the risk of rupturing the encapsulated tumor
and subsequent metastasis. (A) is unnecessary, and this action could traumatize the tumor in
the same manner as palpation. (B and C) are incorrect since the abdomen is not discolored and
cold compresses are not indicated.
