PEDS HESI practice test Questions and Answers With Verified Solutions 2025
The nurse is assessing a 2-year-old. What behavior indicates that the child's language development is
within normal limits? - ✔✔Half of child's speech is understandable.
Rationale:
Between approximately 15 and 24 months of age, a child's speech is only half understandable. A child
can begin counting and name colors usually between 3 and 5 years of age. And a child is capable of two -
four word sentences between 18 months to 24 months of age.
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 6-month-old with failure
to thrive that has a closed anterior fontanel.
Rationale:
At six months of age the anterior fontanel should be open, and it should not be closed until
approximately 18 months of age. Premature closure of the fontanels is a condition called
"craniosynostosis". The only treatment for this condition is surgery to reopen the fontanels, to allow and
accommodate the infant's growing brain, otherwise if not surgical corrected, the infant will suffer severe
neurological damage.
The nurse must prevent a 2-year-old with severe eczema on the face, neck, and scalp from scratching
the affected areas. Which nursing intervention is most effective in preventing further excoriation due to
the pruritis? - ✔✔Place elbow restraints on the child's arms.
Rationale:
Elbow restraints prevent arm flexion and the ability to reach to scratch the involved areas, but do not
inhibit use of the hands for play activities.
The nurse observes a 4-year-old boy in a daycare setting. Which behavior should the nurse consider
normal for this child? - ✔✔Demonstrates aggressiveness by boasting when telling a story.
Rationale:
,Four-year-old children are aggressive in their behavior and enjoy "tale telling"
The clinic nurse is taking the history for a new 6-month-old client. The mother reports that she took a
great deal of aspirin while pregnant. Which assessment should the nurse obtain? - ✔✔Type of reaction
to loud noises.
Rationale:
Ototoxicity diminishes hearing acuity and causes symptoms of tinnitus and vertigo in older children who
can express subjective symptoms, so assessing an infant's reaction to loud noises helps to determine an
infant's risk for a hearing deficit related to a history of the mother taking an ototoxic drug, such as
aspirin, while pregnant.
When evaluating the effectiveness of interventions to improve the nutritional status of an infant with
gastro-esophageal reflux, which intervention is most important for the nurse to implement? -
✔✔Record weight daily.
Rationale:
The most definitive measure of improved nutrition in an infant is obtaining the infant's daily weight at
the same time and ideally using the same scale and the infant fully naked.
When taking the health history of a child, the nurse knows that which finding is an early indication of
hypothyroidism in children? - ✔✔Cessation of growth in a child that had been normal.
Rationale:
Since the thyroid gland is responsible for metabolism, cessation of growth which was previously within
normal range, is the most common sign for hypothyroidism in children.
Which measurements should be used to accurately calculate a pediatric medication dosage? (Select all
that apply.) - ✔✔1. Child's height and weight.
2. Nomogram determined mathematical constant.
Rationale:
,The most accurate calculations of pediatric dosages use the child's height and weight. The child's BSA is
calculated using the square root of weight in kg times height in cm divided by 3600 or the square root of
weight in pounds times height in inches divided by 3131, then the child's BSA is multiplied by the
recommended published dose per BSA. The nomogram is used to plot the child's height and weight, and
the point at which they intersect is the BSA mathematical constant used to calculate the child's dose.
The mother of a preschool-aged child asks the nurse if it is all right to administer bismuth subsalicylate
(Pepto Bismol, Bismylate) to her son when he "has a tummy ache." After reminding the mother to check
the label of all over-the-counter drugs for the presence of aspirin, which instruction should the nurse
include when replying to this mother's question? - ✔✔Do not give if the child has chickenpox, the flu, or
any other viral illness.
Rationale:
Pepto Bismol, Bismylate contains subsalicylate and if used in the presence of a viral illness, there is the
potential of developing Reye's syndrome, a sometimes fatal condition for children.
At 8 a.m. 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 4 a.m. blood pressure 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 first? - ✔✔Administer PRN prescription of nifedipine (Procardia)
sublingually.
Rationale:
After the nurse has verified the client's elevated blood pressure, the sublingual Procardia should be
administered first because it lowers the blood pressure very quickly, before implementing any of the
other interventions.
What preoperative nursing intervention should be included in the plan of care for an infant with pyloric
stenosis? - ✔✔Observe for projectile vomiting.
Rationale:
In pyloric stenosis, the valve between stomach and small intestine enlarges blocking the passage of
food. The nurse needs to ensure suctioning equipment is closed by to help prevent aspiration from the
projectile vomiting episodes and monitor for the state of metabolic alkalosis, which is a classic sign of
pyloric stenosis.
, The nurse is teaching a 12-year-old male adolescent and his family about taking injections of growth
hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly associated with growth
hormone therapy, should the nurse plan to describe to the child and his family? - ✔✔Polyuria and
polydipsia.
Rationale:
Signs and symptoms of diabetes or hyperglycemia need to be reported. Clients who are receiving
growth hormones should be monitored to detect elevated blood sugars and glucose intolerance.
Which finding in a 19-year-old female client should trigger further assessment by the nurse? -
✔✔Menstruation has not occurred.
Rationale:
Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically
occurs between the ages of 10 to 17, so the fact the client is 18 years old and has not experience
menarche, should prompt further investigation to determine the cause of this primary amenorrhea.
During administration of a blood transfusion, a child complains of chills, headache, and nausea. Which
action should the nurse implement? - ✔✔Stop the infusion immediately and notify the healthcare
provider.
Rationale:
The child is exhibiting signs of a reaction to the blood transfusion. The blood transfusion should be
stopped immediately and the healthcare provider notified.
The nurse is assessing a 13-year-old girl with suspected hyperthyroidism. Which question is most
important for the nurse to ask her during the admission interview? - ✔✔"Are you experiencing any type
of nervousness?"
Rationale:
Assessing the client's psychophysiologic state upon admission is a priority, and nervousness,
apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism. Weight loss (even with a
hearty appetite) occurs in those with hyperthyroidism, but assessing the client's neurological state has a
higher priority.
The nurse is assessing a 2-year-old. What behavior indicates that the child's language development is
within normal limits? - ✔✔Half of child's speech is understandable.
Rationale:
Between approximately 15 and 24 months of age, a child's speech is only half understandable. A child
can begin counting and name colors usually between 3 and 5 years of age. And a child is capable of two -
four word sentences between 18 months to 24 months of age.
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 6-month-old with failure
to thrive that has a closed anterior fontanel.
Rationale:
At six months of age the anterior fontanel should be open, and it should not be closed until
approximately 18 months of age. Premature closure of the fontanels is a condition called
"craniosynostosis". The only treatment for this condition is surgery to reopen the fontanels, to allow and
accommodate the infant's growing brain, otherwise if not surgical corrected, the infant will suffer severe
neurological damage.
The nurse must prevent a 2-year-old with severe eczema on the face, neck, and scalp from scratching
the affected areas. Which nursing intervention is most effective in preventing further excoriation due to
the pruritis? - ✔✔Place elbow restraints on the child's arms.
Rationale:
Elbow restraints prevent arm flexion and the ability to reach to scratch the involved areas, but do not
inhibit use of the hands for play activities.
The nurse observes a 4-year-old boy in a daycare setting. Which behavior should the nurse consider
normal for this child? - ✔✔Demonstrates aggressiveness by boasting when telling a story.
Rationale:
,Four-year-old children are aggressive in their behavior and enjoy "tale telling"
The clinic nurse is taking the history for a new 6-month-old client. The mother reports that she took a
great deal of aspirin while pregnant. Which assessment should the nurse obtain? - ✔✔Type of reaction
to loud noises.
Rationale:
Ototoxicity diminishes hearing acuity and causes symptoms of tinnitus and vertigo in older children who
can express subjective symptoms, so assessing an infant's reaction to loud noises helps to determine an
infant's risk for a hearing deficit related to a history of the mother taking an ototoxic drug, such as
aspirin, while pregnant.
When evaluating the effectiveness of interventions to improve the nutritional status of an infant with
gastro-esophageal reflux, which intervention is most important for the nurse to implement? -
✔✔Record weight daily.
Rationale:
The most definitive measure of improved nutrition in an infant is obtaining the infant's daily weight at
the same time and ideally using the same scale and the infant fully naked.
When taking the health history of a child, the nurse knows that which finding is an early indication of
hypothyroidism in children? - ✔✔Cessation of growth in a child that had been normal.
Rationale:
Since the thyroid gland is responsible for metabolism, cessation of growth which was previously within
normal range, is the most common sign for hypothyroidism in children.
Which measurements should be used to accurately calculate a pediatric medication dosage? (Select all
that apply.) - ✔✔1. Child's height and weight.
2. Nomogram determined mathematical constant.
Rationale:
,The most accurate calculations of pediatric dosages use the child's height and weight. The child's BSA is
calculated using the square root of weight in kg times height in cm divided by 3600 or the square root of
weight in pounds times height in inches divided by 3131, then the child's BSA is multiplied by the
recommended published dose per BSA. The nomogram is used to plot the child's height and weight, and
the point at which they intersect is the BSA mathematical constant used to calculate the child's dose.
The mother of a preschool-aged child asks the nurse if it is all right to administer bismuth subsalicylate
(Pepto Bismol, Bismylate) to her son when he "has a tummy ache." After reminding the mother to check
the label of all over-the-counter drugs for the presence of aspirin, which instruction should the nurse
include when replying to this mother's question? - ✔✔Do not give if the child has chickenpox, the flu, or
any other viral illness.
Rationale:
Pepto Bismol, Bismylate contains subsalicylate and if used in the presence of a viral illness, there is the
potential of developing Reye's syndrome, a sometimes fatal condition for children.
At 8 a.m. 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 4 a.m. blood pressure 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 first? - ✔✔Administer PRN prescription of nifedipine (Procardia)
sublingually.
Rationale:
After the nurse has verified the client's elevated blood pressure, the sublingual Procardia should be
administered first because it lowers the blood pressure very quickly, before implementing any of the
other interventions.
What preoperative nursing intervention should be included in the plan of care for an infant with pyloric
stenosis? - ✔✔Observe for projectile vomiting.
Rationale:
In pyloric stenosis, the valve between stomach and small intestine enlarges blocking the passage of
food. The nurse needs to ensure suctioning equipment is closed by to help prevent aspiration from the
projectile vomiting episodes and monitor for the state of metabolic alkalosis, which is a classic sign of
pyloric stenosis.
, The nurse is teaching a 12-year-old male adolescent and his family about taking injections of growth
hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly associated with growth
hormone therapy, should the nurse plan to describe to the child and his family? - ✔✔Polyuria and
polydipsia.
Rationale:
Signs and symptoms of diabetes or hyperglycemia need to be reported. Clients who are receiving
growth hormones should be monitored to detect elevated blood sugars and glucose intolerance.
Which finding in a 19-year-old female client should trigger further assessment by the nurse? -
✔✔Menstruation has not occurred.
Rationale:
Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically
occurs between the ages of 10 to 17, so the fact the client is 18 years old and has not experience
menarche, should prompt further investigation to determine the cause of this primary amenorrhea.
During administration of a blood transfusion, a child complains of chills, headache, and nausea. Which
action should the nurse implement? - ✔✔Stop the infusion immediately and notify the healthcare
provider.
Rationale:
The child is exhibiting signs of a reaction to the blood transfusion. The blood transfusion should be
stopped immediately and the healthcare provider notified.
The nurse is assessing a 13-year-old girl with suspected hyperthyroidism. Which question is most
important for the nurse to ask her during the admission interview? - ✔✔"Are you experiencing any type
of nervousness?"
Rationale:
Assessing the client's psychophysiologic state upon admission is a priority, and nervousness,
apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism. Weight loss (even with a
hearty appetite) occurs in those with hyperthyroidism, but assessing the client's neurological state has a
higher priority.
