Pediatrics HESI 170 Practice Questions and Correct
Answers with Rationales/ 2026 HESI Pediatrics Exam
Prep – 100% Correctly Answered Questions
A 6-month-old boy and his mother are at the healthcare provider's office for a well-
baby check-up and routine immunizations. The healthcare provider recommends to
the mother that the child receive an influenza vaccine. What medications should
the nurse plan to administer today? - ANSWER-All the immunizations with the
influenza vaccine given at a separate site from any other injection.
Rationale:
At 6-months of age, the routine immunizations include Hepatitis B, DTaP, Hib
(Haemophilus influenza type b) , PCV (Pneumococcal), IPV (inactivated
poliovirus) and influenza. To ensure the infant receives the influenza vaccine, it
should be given that same visit, at a separate site from any other injection site.
A 4-year-old boy is brought to the emergency department by his parent, who
reports that the child has been pointing at his stomach and saying, "It hurts so bad."
Which pain-assessment tool should the nurse use? - ANSWER-Wong-Baker
FACES Scale.
Rationale:
A pain rating scale using pictures, such as the Wong-Baker FACES Scale, allows
the child to choose a facial expression that shows "how much hurt you have now"
and should be used for a pre-school-aged child.
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? - ANSWER-Choking, coughing, and
cyanosis.
pg. 1
,Rationale:
"Choking, coughing, and cyanosis" includes the "3 Cs" of esophageal atresia
caused by the overflow of secretions into the trachea. Esophageal atresia is a
congenital birth defect in which there is no connection between upper esophagus
and the lower esophagus and stomach. The upper esophagus ends in a blind pouch.
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? - ANSWER-Congenital heart disease.
Rationale:
Congenital heart disease is the most common associated defect in children with
Down syndrome. Clients with trisomy 21 are diagnosed with Down Syndrome.
Clients affected by trisomy 13 are affected by a syndrome called "Patau's
Syndrome" and clients with trisomy 18 are affected by a syndrome called
"Edward's Syndrome". All three of these trisomy syndromes have some form of
congenital cardiac anomalies present with these chromosomal defects.
The nurse assigning care for a 5-year-old child with otitis media is concerned about
the child's increasing temperature over the past 24 hours. Which statement is
accurate and should be considered when planning care for the remainder of the
shift? - ANSWER-Tympanic and oral temperatures are equally accurate.
Rationale:
A tympanic membrane sensor approximates core temperatures because the
hypothalamus and eardrum are perfused by the same circulation. Tympanic
readings obtained using proper technique correlated moderately to strongly with
oral temperatures in recent research studies. The sensor is unaffected by cerumen
or the presence of suppurative or unsuppurative otitis media.
pg. 2
,The vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and
Respirations 24. The child's pedal pulses are present with a volume of +1, and no
edema is observed. What action should the nurse implement first? - ANSWER-
Start an IV infusion of normal saline.
Rationale:
The current blood pressure reading of 80/40 mmHg and the decreased peripheral
pulse volume indicates that the child is experiencing fluid volume deficit due to the
polyuria, so the priority action is to restore fluid volume. Normal range for blood
pressure levels for 3-5 year olds according to the American Heart Association and
the American Academy of Pediatrics if 104-116/63-74 mmHg dependent on the
height and weight of the child. The other vital signs for the child are considered
within normal limits; normal heart rate for a 3-4 year old at rest while awake is
(80-120 beats per minute) and respirations for a 3-6 year old is (22-34 respirations
per minute).
An 18-month-old is admitted to the hospital with possible Hirschsprung's disease.
When obtaining a nursing history, the nurse asks about bowel habits. What
description of the disease? - ANSWER-Ribbon-like and brown.
Rationale:
Hirschsprung's disease is a mechanical obstruction caused by inadequate motility
in a part of the intestines. The condition results from failure of ganglion cells to
migrate craniocaudally along the GI tract during gestation. The lack of peristalsis
in the affected bowel segment causes constipation and small diameter, brown-
colored stools.
Foul-smelling and fatty stool is associated with cystic fibrosis. Bile-colored and
watery stool is common in gastroenteritis. Semi-solid and yellow stool is normal in
breastfed neonates.
pg. 3
, In developing a teaching plan for a 5-year-old child with diabetes, which
component of diabetic management should the nurse plan for the child to manage
first? - ANSWER-Process of glucose testing.
Rationale:
Developmentally, a 5-year-old has the cognitive and psychomotor skills to use a
glucometer and to read the number (it is especially helpful if the nurse presents this
activity as a game).
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 -
ANSWER-a tympanic measurement of temperature will provide the most accurate
reading.
Rationale:
A tympanic membrane sensor is an excellent site because both the eardrum and
hypothalamus (temperature-regulating center) are perfused by the same circulation.
The sensor is unaffected by cerumen and the presence of suppurative or
unsuppurative otitis media does not effect measurement.
RULE OF THUMB: for management--sterile procedures should be assigned to
licensed personnel. Management skills will be tested on the NCLEX! Rectal
temperature measurement is less accurate because of the possibility of stool in the
rectum.
The nurse is assessing a 2-year-old. What behavior indicates that the child's
language development is within normal limits? - ANSWER-Half of child's speech
is understandable.
Rationale:
pg. 4
Answers with Rationales/ 2026 HESI Pediatrics Exam
Prep – 100% Correctly Answered Questions
A 6-month-old boy and his mother are at the healthcare provider's office for a well-
baby check-up and routine immunizations. The healthcare provider recommends to
the mother that the child receive an influenza vaccine. What medications should
the nurse plan to administer today? - ANSWER-All the immunizations with the
influenza vaccine given at a separate site from any other injection.
Rationale:
At 6-months of age, the routine immunizations include Hepatitis B, DTaP, Hib
(Haemophilus influenza type b) , PCV (Pneumococcal), IPV (inactivated
poliovirus) and influenza. To ensure the infant receives the influenza vaccine, it
should be given that same visit, at a separate site from any other injection site.
A 4-year-old boy is brought to the emergency department by his parent, who
reports that the child has been pointing at his stomach and saying, "It hurts so bad."
Which pain-assessment tool should the nurse use? - ANSWER-Wong-Baker
FACES Scale.
Rationale:
A pain rating scale using pictures, such as the Wong-Baker FACES Scale, allows
the child to choose a facial expression that shows "how much hurt you have now"
and should be used for a pre-school-aged child.
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? - ANSWER-Choking, coughing, and
cyanosis.
pg. 1
,Rationale:
"Choking, coughing, and cyanosis" includes the "3 Cs" of esophageal atresia
caused by the overflow of secretions into the trachea. Esophageal atresia is a
congenital birth defect in which there is no connection between upper esophagus
and the lower esophagus and stomach. The upper esophagus ends in a blind pouch.
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? - ANSWER-Congenital heart disease.
Rationale:
Congenital heart disease is the most common associated defect in children with
Down syndrome. Clients with trisomy 21 are diagnosed with Down Syndrome.
Clients affected by trisomy 13 are affected by a syndrome called "Patau's
Syndrome" and clients with trisomy 18 are affected by a syndrome called
"Edward's Syndrome". All three of these trisomy syndromes have some form of
congenital cardiac anomalies present with these chromosomal defects.
The nurse assigning care for a 5-year-old child with otitis media is concerned about
the child's increasing temperature over the past 24 hours. Which statement is
accurate and should be considered when planning care for the remainder of the
shift? - ANSWER-Tympanic and oral temperatures are equally accurate.
Rationale:
A tympanic membrane sensor approximates core temperatures because the
hypothalamus and eardrum are perfused by the same circulation. Tympanic
readings obtained using proper technique correlated moderately to strongly with
oral temperatures in recent research studies. The sensor is unaffected by cerumen
or the presence of suppurative or unsuppurative otitis media.
pg. 2
,The vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and
Respirations 24. The child's pedal pulses are present with a volume of +1, and no
edema is observed. What action should the nurse implement first? - ANSWER-
Start an IV infusion of normal saline.
Rationale:
The current blood pressure reading of 80/40 mmHg and the decreased peripheral
pulse volume indicates that the child is experiencing fluid volume deficit due to the
polyuria, so the priority action is to restore fluid volume. Normal range for blood
pressure levels for 3-5 year olds according to the American Heart Association and
the American Academy of Pediatrics if 104-116/63-74 mmHg dependent on the
height and weight of the child. The other vital signs for the child are considered
within normal limits; normal heart rate for a 3-4 year old at rest while awake is
(80-120 beats per minute) and respirations for a 3-6 year old is (22-34 respirations
per minute).
An 18-month-old is admitted to the hospital with possible Hirschsprung's disease.
When obtaining a nursing history, the nurse asks about bowel habits. What
description of the disease? - ANSWER-Ribbon-like and brown.
Rationale:
Hirschsprung's disease is a mechanical obstruction caused by inadequate motility
in a part of the intestines. The condition results from failure of ganglion cells to
migrate craniocaudally along the GI tract during gestation. The lack of peristalsis
in the affected bowel segment causes constipation and small diameter, brown-
colored stools.
Foul-smelling and fatty stool is associated with cystic fibrosis. Bile-colored and
watery stool is common in gastroenteritis. Semi-solid and yellow stool is normal in
breastfed neonates.
pg. 3
, In developing a teaching plan for a 5-year-old child with diabetes, which
component of diabetic management should the nurse plan for the child to manage
first? - ANSWER-Process of glucose testing.
Rationale:
Developmentally, a 5-year-old has the cognitive and psychomotor skills to use a
glucometer and to read the number (it is especially helpful if the nurse presents this
activity as a game).
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 -
ANSWER-a tympanic measurement of temperature will provide the most accurate
reading.
Rationale:
A tympanic membrane sensor is an excellent site because both the eardrum and
hypothalamus (temperature-regulating center) are perfused by the same circulation.
The sensor is unaffected by cerumen and the presence of suppurative or
unsuppurative otitis media does not effect measurement.
RULE OF THUMB: for management--sterile procedures should be assigned to
licensed personnel. Management skills will be tested on the NCLEX! Rectal
temperature measurement is less accurate because of the possibility of stool in the
rectum.
The nurse is assessing a 2-year-old. What behavior indicates that the child's
language development is within normal limits? - ANSWER-Half of child's speech
is understandable.
Rationale:
pg. 4
