HESI Pediatric Practice Exam with
Answers
The nurse is giving preoperative instructions to a 14-year old female client who is scheduled for
surgery to correct a spinal curvature. Which statement by the client best demonstrates that
learning has taken place? - ✔✔D. I understand that I will be in a body cast and I will show you
how you taught me to turn.
To take the vital signs of a 4-month old child, which order will give the most accurate results? -
✔✔A. Respiratory rate, heart rate, then rectal temperature
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. What action should
the nurse take next? - ✔✔B. Ask the child if he/she has had a cold, runny nose, or any ear pain
lately.
Which restraint should be used for a toddler after a cleft palate repair? - ✔✔C. elbow restraints
What preoperative nursing intervention should be included in the plan of care for an infant with
pyloric stenosis? - ✔✔D. observe for projectile vomiting.
A six-month-old returns from surgery with elbow restraints in place. What nursing care should
be included when caring for any restrained child? - ✔✔B. remove restraints one at a time and
provide range of motion exercises
A 2-year old child with Down syndrome is brought to the clinic for his regular physical
examination. The nurse knows which problem is frequently associated with Down syndrome? -
✔✔A. congenital heart disease
,When assessing a child with asthma, the nurse should expect intercostal retractions during -
✔✔A. inspiration
When planning the care for a child who has had a cleft lip repair, the nurse knows that crying
should be minimized because it - ✔✔D. stresses the suture line
A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse
suspects that the infant may have an esophageal atresia. Which symptoms is this newborn
likely to have exhibited? - ✔✔A. choking, coughing, and cyanosis
Which behavior would the nurse expect a two-year-old child to exhibit? - ✔✔C. display
possessiveness of toys
the mother of a preschool-aged client asks the nurse if it is all right to administer Pepto Bismal
to her son when he 'has a tummy ache." After reminding the mother to check the label of all
OTC drugs for the presence of aspirin, which instruction should the nurse include when replying
to this mother's question? - ✔✔B. do not give if the child has chickenpox, the flu, or any other
viral illness.
The nurse observes a 4-year old boy in a daycare setting. Which behavior should the nurse
consider normal for this client? - ✔✔C. demonstrates aggressiveness by boasting when telling a
story
A burned child is brought to the emergency room. In estimating the percentage of the body
burned, the nurse uses a modified "Rule of Nines." Which part of a child's body is calculated as
a larger percentage of total body surface than an adult? - ✔✔A. head and neck
The nurse receives a lab report stating a child with asthma has a theophylline level of 15
mcg/dl. What action will the nurse take? - ✔✔A. pass the information on in the report
,A 12-month old boy is admitted with a respiratory infection and possible pneumonia. He is
placed in a mist tent with oxygen. Which nursing intervention has the greatest priority for this
infant? - ✔✔C. have a bulb syringe readily available to remove secretions
All of the following interventions can be used to evaluate the effectiveness of nursing and
medical interventions used to treat diarrhea. Which intervention is least useful in the nurse's
evaluation of a 20-month-old child. - ✔✔B. assessing fontanels
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician
prescribed dextrose 5% and 0.25% normal saline with 2 mEq KCI/100 mL to be infused at
25mL/hr. Prior to initiating the infusion, the nurse should obtain which assessment finding? -
✔✔B. serum BUN and creatinine levels
The nurse is assigning care for a 4-year old child with otitis media and is concerned about the
child's increasing temperature over the past 24 hours. When planning care for this child, it is
important for the nurse to consider that: - ✔✔B. a tympanic measurement of temperature will
provide the most accurate reading
The nurse is assessing an 8-month old child who has a medical diagnosis of Tetrology of Fallot.
Which symptom is this client most likely to exhibit? - ✔✔D. clubbed fingers
As part of the physical assessment of children, the nurse observes and palpates the fontanels.
Which child's fontanel finding should be reported to the healthcare provider? - ✔✔A. A 5-
month old with failure to thrive that has a closed anterior fontanel
A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by
which behavior? - ✔✔C. concern for body integrity
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? -
✔✔C. prevent the return of oxygenated blood to the lungs.
, A three-month old boy weighing 10 lbs, 15 oz has an axillary temperature of 98.9 degrees F. The
nurse determines the daily caloric need for this child is approximately: - ✔✔C. 600 cal/day
10 lbs, 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2 (10.9/2.2) = 4.954 kg
rounded to 5 kg. an infant requires 108 cal/kg/day (108 x 5 = 540 cal/day). However this infant
requires 10% more calories because he has one degree temperature elevation. 10% of 540 is 54
and 54 + 540 = 594. This infant will require approximately 600 calories/day. Remember that a
temperature elevation necessitates consumption of more calories.
The nurse is preparing a health teaching program for parents of toddlers and preschoolers and
plans to include information about prevention of accidental poisonings. It is most important for
the nurse to include which instructions? - ✔✔B. store all toxic agents and medicines in locked
cabinets.
A 6-month old infant with congestive heart failure (CHF) is receiving digoxin elixer. Which
observation by the nurse warrants immediate intervention? - ✔✔A. apical heart rate of 60.
At 8am, the unlicensed assistive personnel (UAP) informs the charge nurse that a female
adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4am BP
reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did
not visit last night. What action should the nurse take? - ✔✔B. administer PRN prescription of
nifedipine (Procardia) sublingually.
A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus
(PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold
her. Which response should the nurse provide to the parents? - ✔✔B. the oxygen hood is
holding the baby's oxygen level just at the point which is needed. You may stroke and talk to
her.
The nurse is developing a plan of care for a 3-year old who is scheduled for a cardiac
catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which
intervention is best for the nurse to implement? - ✔✔C. give the child a ride on a gurney to visit
the cardiac catheterization lab and meet a nurse who works there.
Answers
The nurse is giving preoperative instructions to a 14-year old female client who is scheduled for
surgery to correct a spinal curvature. Which statement by the client best demonstrates that
learning has taken place? - ✔✔D. I understand that I will be in a body cast and I will show you
how you taught me to turn.
To take the vital signs of a 4-month old child, which order will give the most accurate results? -
✔✔A. Respiratory rate, heart rate, then rectal temperature
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. What action should
the nurse take next? - ✔✔B. Ask the child if he/she has had a cold, runny nose, or any ear pain
lately.
Which restraint should be used for a toddler after a cleft palate repair? - ✔✔C. elbow restraints
What preoperative nursing intervention should be included in the plan of care for an infant with
pyloric stenosis? - ✔✔D. observe for projectile vomiting.
A six-month-old returns from surgery with elbow restraints in place. What nursing care should
be included when caring for any restrained child? - ✔✔B. remove restraints one at a time and
provide range of motion exercises
A 2-year old child with Down syndrome is brought to the clinic for his regular physical
examination. The nurse knows which problem is frequently associated with Down syndrome? -
✔✔A. congenital heart disease
,When assessing a child with asthma, the nurse should expect intercostal retractions during -
✔✔A. inspiration
When planning the care for a child who has had a cleft lip repair, the nurse knows that crying
should be minimized because it - ✔✔D. stresses the suture line
A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse
suspects that the infant may have an esophageal atresia. Which symptoms is this newborn
likely to have exhibited? - ✔✔A. choking, coughing, and cyanosis
Which behavior would the nurse expect a two-year-old child to exhibit? - ✔✔C. display
possessiveness of toys
the mother of a preschool-aged client asks the nurse if it is all right to administer Pepto Bismal
to her son when he 'has a tummy ache." After reminding the mother to check the label of all
OTC drugs for the presence of aspirin, which instruction should the nurse include when replying
to this mother's question? - ✔✔B. do not give if the child has chickenpox, the flu, or any other
viral illness.
The nurse observes a 4-year old boy in a daycare setting. Which behavior should the nurse
consider normal for this client? - ✔✔C. demonstrates aggressiveness by boasting when telling a
story
A burned child is brought to the emergency room. In estimating the percentage of the body
burned, the nurse uses a modified "Rule of Nines." Which part of a child's body is calculated as
a larger percentage of total body surface than an adult? - ✔✔A. head and neck
The nurse receives a lab report stating a child with asthma has a theophylline level of 15
mcg/dl. What action will the nurse take? - ✔✔A. pass the information on in the report
,A 12-month old boy is admitted with a respiratory infection and possible pneumonia. He is
placed in a mist tent with oxygen. Which nursing intervention has the greatest priority for this
infant? - ✔✔C. have a bulb syringe readily available to remove secretions
All of the following interventions can be used to evaluate the effectiveness of nursing and
medical interventions used to treat diarrhea. Which intervention is least useful in the nurse's
evaluation of a 20-month-old child. - ✔✔B. assessing fontanels
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician
prescribed dextrose 5% and 0.25% normal saline with 2 mEq KCI/100 mL to be infused at
25mL/hr. Prior to initiating the infusion, the nurse should obtain which assessment finding? -
✔✔B. serum BUN and creatinine levels
The nurse is assigning care for a 4-year old child with otitis media and is concerned about the
child's increasing temperature over the past 24 hours. When planning care for this child, it is
important for the nurse to consider that: - ✔✔B. a tympanic measurement of temperature will
provide the most accurate reading
The nurse is assessing an 8-month old child who has a medical diagnosis of Tetrology of Fallot.
Which symptom is this client most likely to exhibit? - ✔✔D. clubbed fingers
As part of the physical assessment of children, the nurse observes and palpates the fontanels.
Which child's fontanel finding should be reported to the healthcare provider? - ✔✔A. A 5-
month old with failure to thrive that has a closed anterior fontanel
A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by
which behavior? - ✔✔C. concern for body integrity
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? -
✔✔C. prevent the return of oxygenated blood to the lungs.
, A three-month old boy weighing 10 lbs, 15 oz has an axillary temperature of 98.9 degrees F. The
nurse determines the daily caloric need for this child is approximately: - ✔✔C. 600 cal/day
10 lbs, 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2 (10.9/2.2) = 4.954 kg
rounded to 5 kg. an infant requires 108 cal/kg/day (108 x 5 = 540 cal/day). However this infant
requires 10% more calories because he has one degree temperature elevation. 10% of 540 is 54
and 54 + 540 = 594. This infant will require approximately 600 calories/day. Remember that a
temperature elevation necessitates consumption of more calories.
The nurse is preparing a health teaching program for parents of toddlers and preschoolers and
plans to include information about prevention of accidental poisonings. It is most important for
the nurse to include which instructions? - ✔✔B. store all toxic agents and medicines in locked
cabinets.
A 6-month old infant with congestive heart failure (CHF) is receiving digoxin elixer. Which
observation by the nurse warrants immediate intervention? - ✔✔A. apical heart rate of 60.
At 8am, the unlicensed assistive personnel (UAP) informs the charge nurse that a female
adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4am BP
reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did
not visit last night. What action should the nurse take? - ✔✔B. administer PRN prescription of
nifedipine (Procardia) sublingually.
A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus
(PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold
her. Which response should the nurse provide to the parents? - ✔✔B. the oxygen hood is
holding the baby's oxygen level just at the point which is needed. You may stroke and talk to
her.
The nurse is developing a plan of care for a 3-year old who is scheduled for a cardiac
catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which
intervention is best for the nurse to implement? - ✔✔C. give the child a ride on a gurney to visit
the cardiac catheterization lab and meet a nurse who works there.
