PEDIATRIC HESI EXIT EXAM– QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS PLUS RATIONALES |
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1. A 6-month-old infant is brought to the pediatric clinic for a routine well-child visit.
During the physical assessment, the nurse notes that the infant is able to roll from back to
abdomen, sit briefly with forward propping support, and transfer objects from one hand to
the other. Based on normal developmental milestones, how should the nurse document
these findings?
A. Appropriate development for age
B. Mild gross motor delay requiring physical therapy referral
C. Significant fine motor advancement for age
D. Delayed neurological maturation requiring immediate screening
ANSWER: A. Appropriate development for age
At 6 months of age, infants typically achieve rolling from back to abdomen, unsupported
sitting with forward propping (tripod sitting), and the ability to transfer objects between hands.
These findings are completely consistent with normal developmental milestones.
2. A 3-year-old child is admitted to the pediatric unit with a diagnosis of acute
laryngotracheobronchitis (croup). The child presents with inspiratory stridor, a barking
cough, and mild retractions. Which initial nursing intervention is most appropriate?
A. Administer humidified oxygen and keep the child in a comfortable, calm position.
B. Prepare the child immediately for emergency endotracheal intubation.
C. Perform frequent direct visualization of the epiglottis using a tongue depressor.
D. Administer oral cough suppressants and encourage heavy physical exertion.**
ANSWER: A. Administer humidified oxygen and keep the child in a comfortable, calm
position.
Keeping the child calm and administering humidified air or oxygen helps reduce mucosal
swelling in the upper airway. Agitating the child can precipitate acute, complete airway
obstruction. Direct throat inspection is contraindicated in suspected epiglottitis.
,3. The nurse is caring for an 8-year-old child diagnosed with acute post-streptococcal
glomerulonephritis (APSGN). Which laboratory finding is most characteristic of this
condition?
A. Elevated antistreptolysin-O (ASO) titer and hematuria
B. Decreased serum creatinine and profound hypoglycemia
C. Elevated platelet count and metabolic alkalosis
D. Decreased white blood cell count and hyperkalemia**
ANSWER: A. Elevated antistreptolysin-O (ASO) titer and hematuria
APSGN occurs following a recent group A beta-hemolytic streptococcal infection, reflected by
an elevated ASO titer. Typical clinical findings include gross or microscopic hematuria,
hypertension, and periorbital edema due to immune complex deposition in the glomeruli.
4. A nurse is planning care for a newly admitted 4-year-old child with a diagnosis of Wilms
tumor (nephroblastoma). Which crucial precaution must be included in the nursing care
plan?
A. Avoid abdominal palpation during nursing assessments to prevent tumor rupture.
B. Encourage daily contact sports participation to maintain normal childhood socialization.
C. Restrict all oral fluids to less than 200 mL per 24 hours.
D. Monitor closely for signs of chronic liver failure and jaundice.**
ANSWER: A. Avoid abdominal palpation during nursing assessments to prevent tumor
rupture.
Wilms tumor is an encapsulated embryonic tumor of the kidney. Palpating the abdomen can
cause the capsule to rupture, releasing malignant cells into the abdominal cavity and
worsening prognosis. A prominent sign warning should be placed above the bed.
5. A 2-month-old infant is brought to the emergency department in acute respiratory
distress with thick nasal secretions and a low-grade fever. A rapid antigen test confirms
respiratory syncytial virus (RSV) bronchiolitis. Which nursing action is highest priority?
A. Maintaining adequate airway clearance through bulb suctioning and hydration
B. Administering broad-spectrum prophylactic intravenous antibiotics immediately
C. Placing the infant in an upright prone position for unsupervised sleeping
,D. Restricting all parental contact to prevent secondary bacterial transmission**
ANSWER: A. Maintaining adequate airway clearance through bulb suctioning and
hydration
RSV causes copious, thick mucus production in infant airways leading to small airway
obstruction. Effective airway clearance via gentle suctioning and supportive hydration are
primary interventions since antibiotics are ineffective against viral infections.
6. A nurse is assessing a 10-year-old child with type 1 diabetes mellitus who presents with
fruity breath odor, Kussmaul respirations, lethargy, and a blood glucose level of 420
mg/dL. Which condition is the child most likely experiencing?
A. Diabetic ketoacidosis (DKA)
B. Hypoglycemic shock
C. Hyperosmolar hyperglycemic state (HHS)
D. Acute insulin resistance syndrome**
ANSWER: A. Diabetic ketoacidosis (DKA)
Diabetic ketoacidosis in children is characterized by severe hyperglycemia, metabolic acidosis,
ketonemia, and ketonuria, presenting with characteristic Kussmaul breathing and fruity
breath odor. It requires immediate medical management with IV fluids and regular insulin
infusion.
7. An infant is diagnosed with congenital hypothyroidism. The parents ask the nurse what
will happen if the condition is left untreated. What is the best response by the nurse?
A. Untreated congenital hypothyroidism leads to irreversible cognitive impairment and profound
developmental delays.
B. The child will outgrow the condition spontaneously by adolescence without medical
intervention.
C. It primarily causes cosmetic skin changes that resolve with topical moisturizers.
D. It results in temporary growth spurts followed by normal adult height.**
ANSWER: A. Untreated congenital hypothyroidism leads to irreversible cognitive
impairment and profound developmental delays.
, Thyroid hormone is critical for normal brain development and growth during infancy. If
congenital hypothyroidism is not diagnosed and treated promptly with thyroid hormone
replacement, it causes irreversible intellectual disability (cretinism) and stunted growth.
8. A nurse is caring for an adolescent client diagnosed with anorexia nervosa. Which
behavioral characteristic is commonly observed during the initial phases of care?
A. Preoccupation with food, rigorous calorie counting, and distorted body image
B. Binge eating large quantities of food followed by immediate self-induced vomiting
C. Complete lack of interest in weight, body shape, or nutritional intake
D. Impulsive overeating accompanied by severe emotional euphoria**
ANSWER: A. Preoccupation with food, rigorous calorie counting, and distorted body image
Anorexia nervosa is characterized by an intense fear of gaining weight, severe dietary
restriction, relentless calorie counting, ritualistic eating behaviors, and a profound distortion
of body image where the individual perceives themselves as overweight despite severe
emaciation.
9. A 5-year-old child is scheduled for a tonsillectomy and adenoidectomy. During the
immediate post-operative recovery period, which finding should alert the nurse to potential
hemorrhage?
A. Frequent swallowing or clearing of the throat while resting
B. Clear yellow urine output of 1 mL/kg/hr
C. Mild postoperative drowsiness easily arousable to verbal stimuli
D. Stable heart rate and normal blood pressure for age**
ANSWER: A. Frequent swallowing or clearing of the throat while resting
Frequent swallowing is a classic, early indicator of bleeding in a post-tonsillectomy patient
because blood trickles down the back of the throat, prompting the child to swallow repeatedly.
The nurse must inspect the posterior pharynx.
10. A nurse is assessing a newborn infant delivered 2 hours ago. Which physical finding
requires immediate reporting to the primary healthcare provider?
A. Generalized cyanosis of the hands and feet (acrocyanosis)
B. A single transverse crease across the palm of one hand
VERIFIED AND WELL DETAILED ANSWERS PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A 6-month-old infant is brought to the pediatric clinic for a routine well-child visit.
During the physical assessment, the nurse notes that the infant is able to roll from back to
abdomen, sit briefly with forward propping support, and transfer objects from one hand to
the other. Based on normal developmental milestones, how should the nurse document
these findings?
A. Appropriate development for age
B. Mild gross motor delay requiring physical therapy referral
C. Significant fine motor advancement for age
D. Delayed neurological maturation requiring immediate screening
ANSWER: A. Appropriate development for age
At 6 months of age, infants typically achieve rolling from back to abdomen, unsupported
sitting with forward propping (tripod sitting), and the ability to transfer objects between hands.
These findings are completely consistent with normal developmental milestones.
2. A 3-year-old child is admitted to the pediatric unit with a diagnosis of acute
laryngotracheobronchitis (croup). The child presents with inspiratory stridor, a barking
cough, and mild retractions. Which initial nursing intervention is most appropriate?
A. Administer humidified oxygen and keep the child in a comfortable, calm position.
B. Prepare the child immediately for emergency endotracheal intubation.
C. Perform frequent direct visualization of the epiglottis using a tongue depressor.
D. Administer oral cough suppressants and encourage heavy physical exertion.**
ANSWER: A. Administer humidified oxygen and keep the child in a comfortable, calm
position.
Keeping the child calm and administering humidified air or oxygen helps reduce mucosal
swelling in the upper airway. Agitating the child can precipitate acute, complete airway
obstruction. Direct throat inspection is contraindicated in suspected epiglottitis.
,3. The nurse is caring for an 8-year-old child diagnosed with acute post-streptococcal
glomerulonephritis (APSGN). Which laboratory finding is most characteristic of this
condition?
A. Elevated antistreptolysin-O (ASO) titer and hematuria
B. Decreased serum creatinine and profound hypoglycemia
C. Elevated platelet count and metabolic alkalosis
D. Decreased white blood cell count and hyperkalemia**
ANSWER: A. Elevated antistreptolysin-O (ASO) titer and hematuria
APSGN occurs following a recent group A beta-hemolytic streptococcal infection, reflected by
an elevated ASO titer. Typical clinical findings include gross or microscopic hematuria,
hypertension, and periorbital edema due to immune complex deposition in the glomeruli.
4. A nurse is planning care for a newly admitted 4-year-old child with a diagnosis of Wilms
tumor (nephroblastoma). Which crucial precaution must be included in the nursing care
plan?
A. Avoid abdominal palpation during nursing assessments to prevent tumor rupture.
B. Encourage daily contact sports participation to maintain normal childhood socialization.
C. Restrict all oral fluids to less than 200 mL per 24 hours.
D. Monitor closely for signs of chronic liver failure and jaundice.**
ANSWER: A. Avoid abdominal palpation during nursing assessments to prevent tumor
rupture.
Wilms tumor is an encapsulated embryonic tumor of the kidney. Palpating the abdomen can
cause the capsule to rupture, releasing malignant cells into the abdominal cavity and
worsening prognosis. A prominent sign warning should be placed above the bed.
5. A 2-month-old infant is brought to the emergency department in acute respiratory
distress with thick nasal secretions and a low-grade fever. A rapid antigen test confirms
respiratory syncytial virus (RSV) bronchiolitis. Which nursing action is highest priority?
A. Maintaining adequate airway clearance through bulb suctioning and hydration
B. Administering broad-spectrum prophylactic intravenous antibiotics immediately
C. Placing the infant in an upright prone position for unsupervised sleeping
,D. Restricting all parental contact to prevent secondary bacterial transmission**
ANSWER: A. Maintaining adequate airway clearance through bulb suctioning and
hydration
RSV causes copious, thick mucus production in infant airways leading to small airway
obstruction. Effective airway clearance via gentle suctioning and supportive hydration are
primary interventions since antibiotics are ineffective against viral infections.
6. A nurse is assessing a 10-year-old child with type 1 diabetes mellitus who presents with
fruity breath odor, Kussmaul respirations, lethargy, and a blood glucose level of 420
mg/dL. Which condition is the child most likely experiencing?
A. Diabetic ketoacidosis (DKA)
B. Hypoglycemic shock
C. Hyperosmolar hyperglycemic state (HHS)
D. Acute insulin resistance syndrome**
ANSWER: A. Diabetic ketoacidosis (DKA)
Diabetic ketoacidosis in children is characterized by severe hyperglycemia, metabolic acidosis,
ketonemia, and ketonuria, presenting with characteristic Kussmaul breathing and fruity
breath odor. It requires immediate medical management with IV fluids and regular insulin
infusion.
7. An infant is diagnosed with congenital hypothyroidism. The parents ask the nurse what
will happen if the condition is left untreated. What is the best response by the nurse?
A. Untreated congenital hypothyroidism leads to irreversible cognitive impairment and profound
developmental delays.
B. The child will outgrow the condition spontaneously by adolescence without medical
intervention.
C. It primarily causes cosmetic skin changes that resolve with topical moisturizers.
D. It results in temporary growth spurts followed by normal adult height.**
ANSWER: A. Untreated congenital hypothyroidism leads to irreversible cognitive
impairment and profound developmental delays.
, Thyroid hormone is critical for normal brain development and growth during infancy. If
congenital hypothyroidism is not diagnosed and treated promptly with thyroid hormone
replacement, it causes irreversible intellectual disability (cretinism) and stunted growth.
8. A nurse is caring for an adolescent client diagnosed with anorexia nervosa. Which
behavioral characteristic is commonly observed during the initial phases of care?
A. Preoccupation with food, rigorous calorie counting, and distorted body image
B. Binge eating large quantities of food followed by immediate self-induced vomiting
C. Complete lack of interest in weight, body shape, or nutritional intake
D. Impulsive overeating accompanied by severe emotional euphoria**
ANSWER: A. Preoccupation with food, rigorous calorie counting, and distorted body image
Anorexia nervosa is characterized by an intense fear of gaining weight, severe dietary
restriction, relentless calorie counting, ritualistic eating behaviors, and a profound distortion
of body image where the individual perceives themselves as overweight despite severe
emaciation.
9. A 5-year-old child is scheduled for a tonsillectomy and adenoidectomy. During the
immediate post-operative recovery period, which finding should alert the nurse to potential
hemorrhage?
A. Frequent swallowing or clearing of the throat while resting
B. Clear yellow urine output of 1 mL/kg/hr
C. Mild postoperative drowsiness easily arousable to verbal stimuli
D. Stable heart rate and normal blood pressure for age**
ANSWER: A. Frequent swallowing or clearing of the throat while resting
Frequent swallowing is a classic, early indicator of bleeding in a post-tonsillectomy patient
because blood trickles down the back of the throat, prompting the child to swallow repeatedly.
The nurse must inspect the posterior pharynx.
10. A nurse is assessing a newborn infant delivered 2 hours ago. Which physical finding
requires immediate reporting to the primary healthcare provider?
A. Generalized cyanosis of the hands and feet (acrocyanosis)
B. A single transverse crease across the palm of one hand
