HESI Paediatric Nursing Practice
Examination 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A Instant
Download Pdf
1. A 7-year-old child with a history of asthma is brought to the emergency
department. He is wheezing, has a cough, and his oxygen saturation is 91% on
room air. What is the first nursing action?
A. Administer a short-acting bronchodilator via nebulizer
B. Obtain a chest X-ray to determine the severity of the exacerbation
C. Initiate intravenous access and draw blood work
D. Provide emotional support by allowing the child to play with a toy
Administer a short-acting bronchodilator via nebulizer
The priority action for an acute asthma exacerbation is to administer a short-
acting beta-agonist to quickly relieve bronchospasm and improve
oxygenation .
2. The 7-year-old child with asthma received his first albuterol nebulizer
treatment. His oxygen saturation is now 93%, but he continues to have
diffuse wheezing and complains of chest tightness. What is the next step in
his care?
A. Discharge the child with a prescription for an oral steroid
B. Administer a second nebulizer treatment and prepare to give systemic
corticosteroids
C. Prepare for immediate endotracheal intubation
D. Encourage the child to take deep breaths and drink a glass of water
,Administer a second nebulizer treatment and prepare to give systemic
corticosteroids
Since the child is not improving to baseline after the first bronchodilator, a
repeat treatment is indicated alongside systemic corticosteroids to reduce
airway inflammation .
3. A pediatric provider orders Amoxicillin 40 mg/kg/day divided into two
equal doses for a child weighing 22 lbs. The available suspension is 250 mg/5
mL. How many milliliters will the nurse administer per dose?
A. 2 mL
B. 4 mL
C. 5 mL
D. 8 mL
4 mL
The child weighs 10 kg, requiring 400 mg/day, which is 200 mg per dose;
calculating the volume using the concentration yields 4 mL per dose .
4. A 6-month-old infant with Tetralogy of Fallot suddenly becomes cyanotic,
irritable, and draws their knees up to their chest. What is the nurse's
immediate action?
A. Place the infant in a knee-chest position
B. Administer 100% oxygen via a face mask
C. Prepare the infant for emergency surgery
D. Palpate the infant's brachial pulses
Place the infant in a knee-chest position
Placing the infant in a knee-chest position increases systemic vascular
resistance, which helps force blood into the pulmonary artery and improves
pulmonary blood flow during a hypercyanotic spell .
,5. A 2-year-old is admitted to the pediatric unit and insists on choosing their
own clothes and putting on their own shoes, becoming very upset when the
parent tries to help. According to Erikson's stages of psychosocial
development, what is the best interpretation of this behavior?
A. The child is experiencing autonomy versus shame and doubt
B. The child is exhibiting signs of industry versus inferiority
C. The child is demonstrating trust versus mistrust
D. The child is displaying initiative versus guilt
The child is experiencing autonomy versus shame and doubt
Toddlers are in the autonomy versus shame and doubt stage, where they
strive for independence and control over their environment, often insisting on
doing tasks themselves .
6. The nurse is assessing a 4-month-old infant during a well-child visit. Which
finding indicates the infant is meeting expected gross motor developmental
milestones?
A. The infant sits unsupported without assistance
B. The infant holds their head steady and erect when held upright
C. The infant rolls from back to front smoothly
D. The infant bears weight on their legs when held in a standing position
The infant holds their head steady and erect when held upright
By 4 months of age, an infant should have good head control and be able to
hold their head steady when in a sitting or upright position; sitting
unsupported and rolling over typically occur later .
7. A 4-year-old child with bacterial meningitis is receiving IV ceftriaxone. Four
hours after admission, the child becomes increasingly irritable, develops a
temperature of 39.6°C (103.3°F), has a heart rate of 148/min, and begins
having generalized tonic-clonic movements. Which action should the nurse
take first?
, A. Administer the prescribed antipyretic
B. Apply oxygen and protect the child from injury during the seizure
C. Obtain a blood culture before administering additional antibiotics
D. Place the child in a darkened room and decrease environmental stimulation
Apply oxygen and protect the child from injury during the seizure
During an active seizure, airway, breathing, and injury prevention take
priority. The nurse should protect the child's head, maintain a safe
environment, provide oxygen as indicated, and avoid restraining the child or
placing anything in the mouth .
8. A 7-month-old infant with bronchiolitis has nasal flaring, intercostal
retractions, respiratory rate of 68/min, and oxygen saturation of 89% on
room air. The infant has taken only 30 mL of formula during the past 8 hours.
Which prescription should the nurse implement first?
A. Administer an oral electrolyte solution
B. Initiate supplemental oxygen
C. Obtain a nasopharyngeal culture
D. Offer small, frequent formula feedings
Initiate supplemental oxygen
The infant demonstrates significant respiratory distress and hypoxemia.
Oxygenation is the immediate priority because inadequate oxygen delivery
can rapidly lead to respiratory failure .
9. A 9-year-old child with type 1 diabetes mellitus presents with vomiting,
abdominal pain, Kussmaul respirations, glucose of 498 mg/dL, and a serum
potassium level of 5.7 mEq/L. Which intervention is most appropriate
initially?
A. Administer IV regular insulin immediately before giving fluids
B. Begin isotonic IV fluid replacement as prescribed
C. Administer IV potassium replacement
D. Give sodium bicarbonate routinely to correct the acidosis
Examination 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A Instant
Download Pdf
1. A 7-year-old child with a history of asthma is brought to the emergency
department. He is wheezing, has a cough, and his oxygen saturation is 91% on
room air. What is the first nursing action?
A. Administer a short-acting bronchodilator via nebulizer
B. Obtain a chest X-ray to determine the severity of the exacerbation
C. Initiate intravenous access and draw blood work
D. Provide emotional support by allowing the child to play with a toy
Administer a short-acting bronchodilator via nebulizer
The priority action for an acute asthma exacerbation is to administer a short-
acting beta-agonist to quickly relieve bronchospasm and improve
oxygenation .
2. The 7-year-old child with asthma received his first albuterol nebulizer
treatment. His oxygen saturation is now 93%, but he continues to have
diffuse wheezing and complains of chest tightness. What is the next step in
his care?
A. Discharge the child with a prescription for an oral steroid
B. Administer a second nebulizer treatment and prepare to give systemic
corticosteroids
C. Prepare for immediate endotracheal intubation
D. Encourage the child to take deep breaths and drink a glass of water
,Administer a second nebulizer treatment and prepare to give systemic
corticosteroids
Since the child is not improving to baseline after the first bronchodilator, a
repeat treatment is indicated alongside systemic corticosteroids to reduce
airway inflammation .
3. A pediatric provider orders Amoxicillin 40 mg/kg/day divided into two
equal doses for a child weighing 22 lbs. The available suspension is 250 mg/5
mL. How many milliliters will the nurse administer per dose?
A. 2 mL
B. 4 mL
C. 5 mL
D. 8 mL
4 mL
The child weighs 10 kg, requiring 400 mg/day, which is 200 mg per dose;
calculating the volume using the concentration yields 4 mL per dose .
4. A 6-month-old infant with Tetralogy of Fallot suddenly becomes cyanotic,
irritable, and draws their knees up to their chest. What is the nurse's
immediate action?
A. Place the infant in a knee-chest position
B. Administer 100% oxygen via a face mask
C. Prepare the infant for emergency surgery
D. Palpate the infant's brachial pulses
Place the infant in a knee-chest position
Placing the infant in a knee-chest position increases systemic vascular
resistance, which helps force blood into the pulmonary artery and improves
pulmonary blood flow during a hypercyanotic spell .
,5. A 2-year-old is admitted to the pediatric unit and insists on choosing their
own clothes and putting on their own shoes, becoming very upset when the
parent tries to help. According to Erikson's stages of psychosocial
development, what is the best interpretation of this behavior?
A. The child is experiencing autonomy versus shame and doubt
B. The child is exhibiting signs of industry versus inferiority
C. The child is demonstrating trust versus mistrust
D. The child is displaying initiative versus guilt
The child is experiencing autonomy versus shame and doubt
Toddlers are in the autonomy versus shame and doubt stage, where they
strive for independence and control over their environment, often insisting on
doing tasks themselves .
6. The nurse is assessing a 4-month-old infant during a well-child visit. Which
finding indicates the infant is meeting expected gross motor developmental
milestones?
A. The infant sits unsupported without assistance
B. The infant holds their head steady and erect when held upright
C. The infant rolls from back to front smoothly
D. The infant bears weight on their legs when held in a standing position
The infant holds their head steady and erect when held upright
By 4 months of age, an infant should have good head control and be able to
hold their head steady when in a sitting or upright position; sitting
unsupported and rolling over typically occur later .
7. A 4-year-old child with bacterial meningitis is receiving IV ceftriaxone. Four
hours after admission, the child becomes increasingly irritable, develops a
temperature of 39.6°C (103.3°F), has a heart rate of 148/min, and begins
having generalized tonic-clonic movements. Which action should the nurse
take first?
, A. Administer the prescribed antipyretic
B. Apply oxygen and protect the child from injury during the seizure
C. Obtain a blood culture before administering additional antibiotics
D. Place the child in a darkened room and decrease environmental stimulation
Apply oxygen and protect the child from injury during the seizure
During an active seizure, airway, breathing, and injury prevention take
priority. The nurse should protect the child's head, maintain a safe
environment, provide oxygen as indicated, and avoid restraining the child or
placing anything in the mouth .
8. A 7-month-old infant with bronchiolitis has nasal flaring, intercostal
retractions, respiratory rate of 68/min, and oxygen saturation of 89% on
room air. The infant has taken only 30 mL of formula during the past 8 hours.
Which prescription should the nurse implement first?
A. Administer an oral electrolyte solution
B. Initiate supplemental oxygen
C. Obtain a nasopharyngeal culture
D. Offer small, frequent formula feedings
Initiate supplemental oxygen
The infant demonstrates significant respiratory distress and hypoxemia.
Oxygenation is the immediate priority because inadequate oxygen delivery
can rapidly lead to respiratory failure .
9. A 9-year-old child with type 1 diabetes mellitus presents with vomiting,
abdominal pain, Kussmaul respirations, glucose of 498 mg/dL, and a serum
potassium level of 5.7 mEq/L. Which intervention is most appropriate
initially?
A. Administer IV regular insulin immediately before giving fluids
B. Begin isotonic IV fluid replacement as prescribed
C. Administer IV potassium replacement
D. Give sodium bicarbonate routinely to correct the acidosis
