1
HESI RN PEDIATRICS EXAM 2026-27 LATEST UPDATED
VERSION WITH QUESTIONS AND CORRECT ANSWERS
• A child comes to the school nurse complaining of itching. Further
assessment reveals that the child has impetigo. What action should the
nurse take?
A. Send the child home with the parents to see the
health care provider before returning to school.
B. Send the child home with the parents and
report this to the health department.
C. Cover the lesion with a dry gauze dressing and send the child back to class.
D. Wash the lesion with antimicrobial soap, air-dry, and
send the child back to class.
Rationale:
Impetigo is a staphylococcal infection and is transmitted by person-to-person
contact. The child should be sent home with a note to the parents explaining the
condition. Option B is not necessary because this is not a public health hazard.
Option C slows the healing process and can contribute to spread of the infection.
The lesions should be washed with soap and water, topical ointment applied, and
left open to the air to dry. This will occur at the child's home.
• The nurse expects a 2-year-old child to exhibit which behavior?
A. Build a house with blocks.
B. Ride a small tricycle 6 feet.
C. Display possessiveness with toys.
D. Look at a picture book for 15 minutes.
Rationale:
Two-year-old children are egocentric and unable to
share with other children. Options A, B, and D are
behaviors of a preschooler.
• A woman whose first child died at 6 weeks of age because of sudden infant
death syndrome (SIDS) is being discharged following the birth of her second
,2
child. The mother tells the nurse that she is fearful that this infant will also
develop SIDS. Which response is best for the nurse to provide this woman?
A. "You can prevent SIDS if your baby sleeps on the side or
back. You will have to monitor the baby carefully."
B. "The fear of losing another child to SIDS is very
realistic. Have you thought about what support you
may need?"
C. "An apnea monitor will alert you if the baby stops
breathing. This will give you the peace of mind that you
need."
D. "My neighbor's baby died of SIDS last year, and she
went to a SIDS support group. That really helped
her."
Rationale:
The most effective way to provide emotional support is to acknowledge what
clients may be feeling, be a sounding board for them so they can listen to
themselves, and allow them to discover their own solutions. Option A implies to
the mother that she can prevent SIDS from occurring, which is an unrealistic
expectation. Offering a personal opinion about what will help this client or about
what has helped a neighbor is not as effective as helping the client discover what
would be best for her.
• A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of
psychosocial development is the nurse addressing when teaching inhalation
therapy?
A. Autonomy
B. Industry
C. Trust
D. Initiative
Rationale:
Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson theory
of psychosocial development. They enjoy being active and participating in role
playing. "Autonomy vs. Shame and Doubt" occurs at 1 to 3 years of age. "Industry
vs. Inferiority" occurs at 6 to 11 years; "Trust vs. Mistrust" occurs from birth to 1
year of age.
• Which assessment findings should the nurse expect when caring for a child
with cystic fibrosis? (Select all that apply.) Select option(s), then click
Submit.
,3
A. Steatorrhea
B. Obesity
C. Foul-smelling stools
D. Delayed growth
E. Pulmonary congestion
Rationale:
Options A, C, D, and E are all common assessment findings in the client with cystic
fibrosis. Weight loss, not weight gain, is associated with cystic fibrosis.
, 4
• The nurse is taking the family history of a 2-year-old child with atopic
dermatitis (eczema). Which statement by the mother is most important in
formulating a plan of care for this child?
A. "Our first child was born with a cleft lip."
B. "We are very careful not to get sunburns in our family."
C. "My first child sometimes got a diaper rash."
D. "My husband and our daughter are both lactose intolerant."
Rationale:
Environmental exposure to allergens (milk) and a positive family history for milk
allergies are important data in planning care of the child with atopic dermatitis
because milk allergies can contribute to the child's outbreaks. Option A is not a
contributing factor. Option B is an environmental factor in other skin diseases but
does not have a strong correlation with eczema in children. Option C is not
unusual and occurs in the diaper area, whereas atopic dermatitis occurs most
often on the face and extensor aspects of the arms and legs
• The nurse is planning postoperative care for a child who has had a cleft lip
repair. What is the most important reason to minimize this child's crying during
the recovery period?
A. Tear formation increases salivation.
B. This behavior increases respirations.
C. Excessive hysteria can lead to vomiting.
D. Crying stresses the suture line
Rationale:
Prevention of stress on the lip suture line is essential for optimum healing and
the cosmetic appearance of a cleft lip repair. Although crying also causes options
A, B, and C, these conditions do not create a problem for the child with a cleft lip
repair.
• An infant is receiving digoxin for congestive heart failure. The apical
heart rate is assessed at 80 beats/min. What intervention should the
nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat.
Rationale:
Sinus bradycardia (heart rate <90 to 110 beats/min in an infant) is an indication
of digoxin toxicity, so assessment of the client's digoxin level has the highest
priority. Option A is not indicated at this time. Option C provides helpful
HESI RN PEDIATRICS EXAM 2026-27 LATEST UPDATED
VERSION WITH QUESTIONS AND CORRECT ANSWERS
• A child comes to the school nurse complaining of itching. Further
assessment reveals that the child has impetigo. What action should the
nurse take?
A. Send the child home with the parents to see the
health care provider before returning to school.
B. Send the child home with the parents and
report this to the health department.
C. Cover the lesion with a dry gauze dressing and send the child back to class.
D. Wash the lesion with antimicrobial soap, air-dry, and
send the child back to class.
Rationale:
Impetigo is a staphylococcal infection and is transmitted by person-to-person
contact. The child should be sent home with a note to the parents explaining the
condition. Option B is not necessary because this is not a public health hazard.
Option C slows the healing process and can contribute to spread of the infection.
The lesions should be washed with soap and water, topical ointment applied, and
left open to the air to dry. This will occur at the child's home.
• The nurse expects a 2-year-old child to exhibit which behavior?
A. Build a house with blocks.
B. Ride a small tricycle 6 feet.
C. Display possessiveness with toys.
D. Look at a picture book for 15 minutes.
Rationale:
Two-year-old children are egocentric and unable to
share with other children. Options A, B, and D are
behaviors of a preschooler.
• A woman whose first child died at 6 weeks of age because of sudden infant
death syndrome (SIDS) is being discharged following the birth of her second
,2
child. The mother tells the nurse that she is fearful that this infant will also
develop SIDS. Which response is best for the nurse to provide this woman?
A. "You can prevent SIDS if your baby sleeps on the side or
back. You will have to monitor the baby carefully."
B. "The fear of losing another child to SIDS is very
realistic. Have you thought about what support you
may need?"
C. "An apnea monitor will alert you if the baby stops
breathing. This will give you the peace of mind that you
need."
D. "My neighbor's baby died of SIDS last year, and she
went to a SIDS support group. That really helped
her."
Rationale:
The most effective way to provide emotional support is to acknowledge what
clients may be feeling, be a sounding board for them so they can listen to
themselves, and allow them to discover their own solutions. Option A implies to
the mother that she can prevent SIDS from occurring, which is an unrealistic
expectation. Offering a personal opinion about what will help this client or about
what has helped a neighbor is not as effective as helping the client discover what
would be best for her.
• A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of
psychosocial development is the nurse addressing when teaching inhalation
therapy?
A. Autonomy
B. Industry
C. Trust
D. Initiative
Rationale:
Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson theory
of psychosocial development. They enjoy being active and participating in role
playing. "Autonomy vs. Shame and Doubt" occurs at 1 to 3 years of age. "Industry
vs. Inferiority" occurs at 6 to 11 years; "Trust vs. Mistrust" occurs from birth to 1
year of age.
• Which assessment findings should the nurse expect when caring for a child
with cystic fibrosis? (Select all that apply.) Select option(s), then click
Submit.
,3
A. Steatorrhea
B. Obesity
C. Foul-smelling stools
D. Delayed growth
E. Pulmonary congestion
Rationale:
Options A, C, D, and E are all common assessment findings in the client with cystic
fibrosis. Weight loss, not weight gain, is associated with cystic fibrosis.
, 4
• The nurse is taking the family history of a 2-year-old child with atopic
dermatitis (eczema). Which statement by the mother is most important in
formulating a plan of care for this child?
A. "Our first child was born with a cleft lip."
B. "We are very careful not to get sunburns in our family."
C. "My first child sometimes got a diaper rash."
D. "My husband and our daughter are both lactose intolerant."
Rationale:
Environmental exposure to allergens (milk) and a positive family history for milk
allergies are important data in planning care of the child with atopic dermatitis
because milk allergies can contribute to the child's outbreaks. Option A is not a
contributing factor. Option B is an environmental factor in other skin diseases but
does not have a strong correlation with eczema in children. Option C is not
unusual and occurs in the diaper area, whereas atopic dermatitis occurs most
often on the face and extensor aspects of the arms and legs
• The nurse is planning postoperative care for a child who has had a cleft lip
repair. What is the most important reason to minimize this child's crying during
the recovery period?
A. Tear formation increases salivation.
B. This behavior increases respirations.
C. Excessive hysteria can lead to vomiting.
D. Crying stresses the suture line
Rationale:
Prevention of stress on the lip suture line is essential for optimum healing and
the cosmetic appearance of a cleft lip repair. Although crying also causes options
A, B, and C, these conditions do not create a problem for the child with a cleft lip
repair.
• An infant is receiving digoxin for congestive heart failure. The apical
heart rate is assessed at 80 beats/min. What intervention should the
nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat.
Rationale:
Sinus bradycardia (heart rate <90 to 110 beats/min in an infant) is an indication
of digoxin toxicity, so assessment of the client's digoxin level has the highest
priority. Option A is not indicated at this time. Option C provides helpful
