2025 HESI PEDIATRICS (PEDS) PRACTICE EXAM 400
PRACTICE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
2025/2026
A 6-month-
old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse wa
rrants 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 an
d C) are expected symptoms of heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teachingvthe parents of a 5-year-
old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the par
ents 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 b
eforevmeals (C) or at least 1 hour after eating to preventvnausea and vomiting. Postural drainage uses grav
ity to promote mucous removal after nebulization (A) treatments which open the airways. Pulmonary toil
etingvor respiratory treatments should be given 3 to 4 times daily, not episodically (B and D).
Avfemale teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most impor
tant instruction for the nurse to include in this client's teaching plan?
,Use sunscreen when lying by the pool.
Cleanse the skin at least 4vtimes 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 isva 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 d
airy products interfere with the absorption of tetracyclines.
Whatvpreoperative nursing intervention should be included in the plan of care for an infant with pyloric st
enosis?
Monitor for signs of metabolicvacidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting. -vcorrect answer-Observe for projectile vomiting.
Projectile vomitingv(D), which contributes to metabolic alkalosis (A), is the classic sign of pyloricvstenosis. (
B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequentvvomiting.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The n
urse recognizesvthat surgical correction is designed to achieve which outcome?
Stop the flow of unoxygenated blood into systemicvcirculation.
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.
Closurevof VSDsvstops 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 (
Avand B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
,Av3-week-oldKnewbornKisKbroughtKtovtheKclinicKforKfollow-
upvafterKaKhomeKbirth.KTheKmotherKreportsKthatKherKchildKbottleKfeedsKforK5KminutesKonlyKandKthenKfallsKasle
Kep.KTheKnurseKauscultatesKaKloudKmurmurKcharacteristicvofKaKventricularKseptalKdefectK(VSD),KandKfindsKth
eKnewbornKisKacyanoticKwithKaKrespiratoryKrateKofK64KbreathsKperKminute.KWhatKinstructionKshouldKtheKnur
seKprovideKtheKmotherKtoKensureKthevinfantKisKreceivingKadequateKintake?K(SelectKallKthatKapply.)
A. MonitorKtheKtheKinfant'sKweightKandKnumberKofKwetKdiapersKperKday.
B. IncreasevtheKinfant'sKintakeKperKfeedingKbyK1KtoK2KouncesKperKweek.
C. MixKtheKdoseKofKprophylacticKantibioticKinKaKfullKbottleKofKformula.
D. AllowKtheKinfantKtoKrestKandKrefeedKonKdemandKorKeveryK2Khours.
E. UseKaKsofterKnippleKorKincreaseKtheKsizeKofKtheKnippleKopening.K-KcorrectKanswer-
A. MonitorKtheKtheKinfant'sKweightKandKnumberKofKwetKdiapersKperKday.
B. IncreaseKtheKinfant'sKintakeKperKfeedingKbyK1KtoK2KouncesKperKweek.
D. AllowKtheKinfantKtoKrestKandKrefeedKonKdemandKorKeveryK2Khours.
E. UseKaKsofterKnippleKorKincreaseKtheKsizeKofKtheKnippleKopening.
AntibioticKprophylaxisKisKrecommendedKforKinfantsKwithKVSDs,KbutKshouldKnotKbeKmixedKinKaKbottleKofKformu
KlaK(C)KbecauseKitKisKdifficultKtoKensureKthatKtheKtotalKdoseKisKconsumed.
TheyKshouldKbeKmonitoredKforKweightKgainKandKatKleastK6KwetKdiapersKperKdayK(A).KAKone-
monthKoldKinfantKshouldKingestK2KtoK4KouncesKofKformulaKperKfeedingKandKprogressKtoKaboutK30KouncesKperK
dayKbyK4-monthsKofKageK(B)
PreoperativeKnursingvcareKforKaKchildKwithKWilms'KtumorKshouldKincludeKwhichKintervention?KG
entlyKpercussKtheKabdomenKforKevidenceKofKtrappedKair.
ObserveKtheKabdomenKforKanyKnoticeableKdiscolorations.K
ApplyKcoldKcompressesKtoKtheKabdomenKtoKreduceKedema.
PutvaKsignKonKtheKbedKreading,K"DOKNOTKPALPATEKABDOMEN."K-KcorrectKanswer-
KPutKaKsignKonKtheKbedKreading,K"DOKNOTKPALPATEKABDOMEN."
PreventionKofKabdominalKpalpationK(D)KminimizesKtheKriskKofKrupturingKtheKencapsulatedKtumorKandKsubse
KquentKmetastasis.K(A)KisKunnecessary,KandKthisKactionKcouldKtraumatizeKtheKtumorKinKtheKsameKmannerKasK
pKalpation.K(BKandKC)KareKincorrectKsinceKtheKabdomenKisKnotKdiscoloredKandKcoldKcompressesvareKnotKindic
atKed.
, AtK8Ka.m.KtheKunlicensedKassistiveKpersonnelK(UAP)KinformsKtheKchargeKnurseKthatKaKfemaleKadolescentKclie
KntKwithKacuteKglomerulonephritisKhasKaKbloodKpressureKofK210/110.KTheK4Ka.m.KbloodKpressureKreadingKwa
sK170/88.KTheKclientKreportsKtoKtheKUAPKthatKsheKisKupsetKbecauseKherKboyfriendKdidKnotKvisitKlastKnight.KW
haKtKactionKshouldKtheKnurseKtakeKfirst?
GiveKtheKclientKherK9Ka.m.KprescriptionKforKanKoralKdiureticKearly.KA
dministerKPRNKprescriptionKofKnifedipineK(Procardia)Ksublingually.
NotifyKtheKhealthcareKproviderKandKinformKtheKnursingvsupervisorKofKtheKclient'sKcondition.
AttemptKtoKcalmKtheKclientKandKretakeKtheKbloodKpressureKinKthirtyKminutes.K-vcorrectKanswer-
KAdministerKPRNKprescriptionKofKnifedipineK(Procardia)Ksublingually.
SublingualKProcardiaK(B)KlowersvbloodKpressureKveryKquickly,KandKthisKshouldKbeKdoneKfirst.K(A)KmayKalsoKbe
Kdone,KbutKoralKdiureticsKdoKnotKworkKasKrapidlyKasKtheKsublingualKantihypertensive.KWhenKnotifyingKtheKhe
aKlthcareKprovider,KtheKfirstKthingKhe/sheKwillKwantKtoKknowKisKifKtheKPRNKantihypertensiveKhasKbeenKadmini
stKeredK(C).K(D)KdoesKnotKconsiderKtheKseriousnessKofKthisKfinding.KTheKnurseKshouldKstayKwithKtheKclientKunt
ilKtKheKbloodKpressureKisKreduced.
TheKnurseKisKassessingKanK8-month-
oldKchildKwhoKhasKaKmedicalKdiagnosisvofKTetrologyKofKFallot.KWhichKsymptomKisKthisKclientKmostKlikelyKtoKexK
hibit?
Bradycardia.
MachineryKmurmur.
WeakvpedalKpulses.
ClubbedKfingers.K-KcorrectKanswer-ClubbedKfingers.
TetrologyKofKFallot,KaKcyanoticKheartKdefect,KcausesKclubbingKofKfingersKandKtoesK(D)KdueKtoKtissueKhypoxia.KTKach
ycardia,KnotK(A),KisKaKmanifestationKofKcongenitalKheartKdisease.K(B)KisKaKclassicKsignKofKventricularKseptalKdefect.
K(C)KisKcharacteristicKofKcoarctationKofKtheKaorta.
SurgeryKisKbeingKdelayedKforKanKinfantKwithKundescendedKtestes.KInKcollaborationKwithKtheKhealthcareKprovi
KderKandKtheKfamily,KwhichKprescriptionKshouldKtheKnurseKanticipate?
AvtrialKofKadrenocorticotrophicKhormoneKinjections.KFreque
ntKstimulationKofKtheKcremastericKreflex.
PRACTICE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
2025/2026
A 6-month-
old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse wa
rrants 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 an
d C) are expected symptoms of heart failure in an infant. (D) is within normal limits for an infant.
The nurse is teachingvthe parents of a 5-year-
old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the par
ents 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 b
eforevmeals (C) or at least 1 hour after eating to preventvnausea and vomiting. Postural drainage uses grav
ity to promote mucous removal after nebulization (A) treatments which open the airways. Pulmonary toil
etingvor respiratory treatments should be given 3 to 4 times daily, not episodically (B and D).
Avfemale teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most impor
tant instruction for the nurse to include in this client's teaching plan?
,Use sunscreen when lying by the pool.
Cleanse the skin at least 4vtimes 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 isva 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 d
airy products interfere with the absorption of tetracyclines.
Whatvpreoperative nursing intervention should be included in the plan of care for an infant with pyloric st
enosis?
Monitor for signs of metabolicvacidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting. -vcorrect answer-Observe for projectile vomiting.
Projectile vomitingv(D), which contributes to metabolic alkalosis (A), is the classic sign of pyloricvstenosis. (
B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequentvvomiting.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The n
urse recognizesvthat surgical correction is designed to achieve which outcome?
Stop the flow of unoxygenated blood into systemicvcirculation.
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.
Closurevof VSDsvstops 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 (
Avand B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
,Av3-week-oldKnewbornKisKbroughtKtovtheKclinicKforKfollow-
upvafterKaKhomeKbirth.KTheKmotherKreportsKthatKherKchildKbottleKfeedsKforK5KminutesKonlyKandKthenKfallsKasle
Kep.KTheKnurseKauscultatesKaKloudKmurmurKcharacteristicvofKaKventricularKseptalKdefectK(VSD),KandKfindsKth
eKnewbornKisKacyanoticKwithKaKrespiratoryKrateKofK64KbreathsKperKminute.KWhatKinstructionKshouldKtheKnur
seKprovideKtheKmotherKtoKensureKthevinfantKisKreceivingKadequateKintake?K(SelectKallKthatKapply.)
A. MonitorKtheKtheKinfant'sKweightKandKnumberKofKwetKdiapersKperKday.
B. IncreasevtheKinfant'sKintakeKperKfeedingKbyK1KtoK2KouncesKperKweek.
C. MixKtheKdoseKofKprophylacticKantibioticKinKaKfullKbottleKofKformula.
D. AllowKtheKinfantKtoKrestKandKrefeedKonKdemandKorKeveryK2Khours.
E. UseKaKsofterKnippleKorKincreaseKtheKsizeKofKtheKnippleKopening.K-KcorrectKanswer-
A. MonitorKtheKtheKinfant'sKweightKandKnumberKofKwetKdiapersKperKday.
B. IncreaseKtheKinfant'sKintakeKperKfeedingKbyK1KtoK2KouncesKperKweek.
D. AllowKtheKinfantKtoKrestKandKrefeedKonKdemandKorKeveryK2Khours.
E. UseKaKsofterKnippleKorKincreaseKtheKsizeKofKtheKnippleKopening.
AntibioticKprophylaxisKisKrecommendedKforKinfantsKwithKVSDs,KbutKshouldKnotKbeKmixedKinKaKbottleKofKformu
KlaK(C)KbecauseKitKisKdifficultKtoKensureKthatKtheKtotalKdoseKisKconsumed.
TheyKshouldKbeKmonitoredKforKweightKgainKandKatKleastK6KwetKdiapersKperKdayK(A).KAKone-
monthKoldKinfantKshouldKingestK2KtoK4KouncesKofKformulaKperKfeedingKandKprogressKtoKaboutK30KouncesKperK
dayKbyK4-monthsKofKageK(B)
PreoperativeKnursingvcareKforKaKchildKwithKWilms'KtumorKshouldKincludeKwhichKintervention?KG
entlyKpercussKtheKabdomenKforKevidenceKofKtrappedKair.
ObserveKtheKabdomenKforKanyKnoticeableKdiscolorations.K
ApplyKcoldKcompressesKtoKtheKabdomenKtoKreduceKedema.
PutvaKsignKonKtheKbedKreading,K"DOKNOTKPALPATEKABDOMEN."K-KcorrectKanswer-
KPutKaKsignKonKtheKbedKreading,K"DOKNOTKPALPATEKABDOMEN."
PreventionKofKabdominalKpalpationK(D)KminimizesKtheKriskKofKrupturingKtheKencapsulatedKtumorKandKsubse
KquentKmetastasis.K(A)KisKunnecessary,KandKthisKactionKcouldKtraumatizeKtheKtumorKinKtheKsameKmannerKasK
pKalpation.K(BKandKC)KareKincorrectKsinceKtheKabdomenKisKnotKdiscoloredKandKcoldKcompressesvareKnotKindic
atKed.
, AtK8Ka.m.KtheKunlicensedKassistiveKpersonnelK(UAP)KinformsKtheKchargeKnurseKthatKaKfemaleKadolescentKclie
KntKwithKacuteKglomerulonephritisKhasKaKbloodKpressureKofK210/110.KTheK4Ka.m.KbloodKpressureKreadingKwa
sK170/88.KTheKclientKreportsKtoKtheKUAPKthatKsheKisKupsetKbecauseKherKboyfriendKdidKnotKvisitKlastKnight.KW
haKtKactionKshouldKtheKnurseKtakeKfirst?
GiveKtheKclientKherK9Ka.m.KprescriptionKforKanKoralKdiureticKearly.KA
dministerKPRNKprescriptionKofKnifedipineK(Procardia)Ksublingually.
NotifyKtheKhealthcareKproviderKandKinformKtheKnursingvsupervisorKofKtheKclient'sKcondition.
AttemptKtoKcalmKtheKclientKandKretakeKtheKbloodKpressureKinKthirtyKminutes.K-vcorrectKanswer-
KAdministerKPRNKprescriptionKofKnifedipineK(Procardia)Ksublingually.
SublingualKProcardiaK(B)KlowersvbloodKpressureKveryKquickly,KandKthisKshouldKbeKdoneKfirst.K(A)KmayKalsoKbe
Kdone,KbutKoralKdiureticsKdoKnotKworkKasKrapidlyKasKtheKsublingualKantihypertensive.KWhenKnotifyingKtheKhe
aKlthcareKprovider,KtheKfirstKthingKhe/sheKwillKwantKtoKknowKisKifKtheKPRNKantihypertensiveKhasKbeenKadmini
stKeredK(C).K(D)KdoesKnotKconsiderKtheKseriousnessKofKthisKfinding.KTheKnurseKshouldKstayKwithKtheKclientKunt
ilKtKheKbloodKpressureKisKreduced.
TheKnurseKisKassessingKanK8-month-
oldKchildKwhoKhasKaKmedicalKdiagnosisvofKTetrologyKofKFallot.KWhichKsymptomKisKthisKclientKmostKlikelyKtoKexK
hibit?
Bradycardia.
MachineryKmurmur.
WeakvpedalKpulses.
ClubbedKfingers.K-KcorrectKanswer-ClubbedKfingers.
TetrologyKofKFallot,KaKcyanoticKheartKdefect,KcausesKclubbingKofKfingersKandKtoesK(D)KdueKtoKtissueKhypoxia.KTKach
ycardia,KnotK(A),KisKaKmanifestationKofKcongenitalKheartKdisease.K(B)KisKaKclassicKsignKofKventricularKseptalKdefect.
K(C)KisKcharacteristicKofKcoarctationKofKtheKaorta.
SurgeryKisKbeingKdelayedKforKanKinfantKwithKundescendedKtestes.KInKcollaborationKwithKtheKhealthcareKprovi
KderKandKtheKfamily,KwhichKprescriptionKshouldKtheKnurseKanticipate?
AvtrialKofKadrenocorticotrophicKhormoneKinjections.KFreque
ntKstimulationKofKtheKcremastericKreflex.
