Pediatrics HESI 2023 Complete Exam/ 350
Actual Exam Questions with Correct Detailed
Answers (Verified Answers) Graded A+
The nurse is assessing an 8-month-old child who has a medical diagnosis of
Tetralogy of Fallot. Which symptom is this client most likely to exhibit?
a. Bradycardia.
b. Machinery murmur.
c. Weak pedal pulses.
d. Clubbed fingers. - Correct Answer - Clubbed fingers.
Tetralogy of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes (D)
due to tissue hypoxia. Tachycardia, not (A), is a manifestation of congenital heart
disease. (B) is a classic sign of ventricular septal defect. (C) is characteristic of
coarctation of the aorta.
Surgery is being delayed for an infant with undescended testes. In
collaboration with the healthcare provider and the family, which prescription
should the nurse anticipate?
a. A trial of adrenocorticotrophic hormone injections.
b. Frequent stimulation of the cremasteric reflex.
c. A trial of human chorionic gonadotrophic hormone.
d. Frequent warm baths to gently dilate the scrotal area. - Correct Answer - A
trial of human chorionic gonadotrophic hormone.
A trial of HCG (human chorionic gonadotrophic hormone) (C) may aid in testicular
descent, but does not replace surgical repair for true undescended testes.
Undescended testes (cryptorchidism) may be found in the inguinal canal due to
exaggerated cremasteric reflex. (A) is not indicated. Stimulation of the cremasteric
reflex causes the testes to ascend rather than descend in the scrotum (B). (D) may
relax the cremasteric muscle, but may not cause the testes to descend.
A preschool-age child who is hospitalized for hypospadias repair is most
strongly influenced by which behavior?
pg. 1
, a. Ability to communicate verbally.
b. Response to separation from family.
c. Concern for body integrity.
d. Socialization with other children. - Correct Answer - Concern for body
integrity.
The preschooler's major stressor is concern for his body integrity (C). He fears that
his "insides will leak out." A child undergoing surgery to his genitalia is even more
concerned about body integrity. The preschooler is quite verbal, so comprehension
of the words he uses or hears may be inaccurate, while his imagination and fears
may fantasize the reality (A). (B) is a concern for all children, but of most concern to
the toddler. (D) is not a prime concern in this situation.
A six-month-old returns from surgery with elbow restraints in place. What
nursing care should be included when caring for any restrained child?
a. Keep restraints on at all times.
b. Remove restraints one at a time and provide range of motion exercises.
c. Remove all restraints simultaneously and provide play activities.
d. Renew the healthcare provider's prescription for restraints every 72 hours. -
Correct Answer - Remove restraints one at a time and provide range of
motion exercises.
Removing restraints one at a time (B) is safer than removing all of them at once (C).
The child needs to exercise and should not be kept in restraints at all times (A). The
renewal of the healthcare provider's prescription varies with hospitals (D), and it
does not really answer the question.
A child with cystic fibrosis is having stools that float and are foul smelling.
Which descriptive term should the nurse use to document the finding?
a. Diarrhea.
b. Rhinorrhea.
c. Galactorrhea.
d. Steatorrhea. - Correct Answer - Steatorrhea.
Steatorrhea (D) is defined as stools with an abnormally high fat content that are
usually foul smelling and float on water. (A, B, and C) do not describe this finding.
A 4-year-old boy was admitted to the emergency room with a fractured right
ulna and a short arm cast is applied. When preparing the parents to take the
child home, which discharge instruction has the highest priority?
pg. 2
, a. Call the healthcare provider immediately if his nail beds appear blue.
b. Check his fingers hourly for the first 48 hours to see that he is able to move
them without pain.
c. Be sure his arm remains above his heart for the first 24 hours.
d. Take his temperature q4h for the next two days and call if an elevation is
noted. - Correct Answer - Call the healthcare provider immediately if his nail
beds appear blue.
Cyanosis (A) indicates impaired circulation to fingers and should be reported
immediately. Although the actions described in (B, C, and D) may be indicated, they
are implemented rather excessively--and might tend to frighten the parents. It is not
necessary to check the child's ability to move his fingers hourly for 2 days (B).
Elevating the arm above the heart will help to decrease swelling but (C) is stated in a
frightening way. It is not necessary to take the child's temperature q4h unless
indicated by other symptoms.
The vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and
Respirations 24. The child's pedal pulses are present with a volume of +1, and
no edema is observed. What action should the nurse implement first?
a. Insert an indwelling urinary catheter.
b. Start an IV infusion of normal saline.
c. Send a specimen to the lab for urinalysis.
d. Document the child's vital signs and pulses. - Correct Answer - Start an IV
infusion of normal saline.
The current vital sign readings and the decreased peripheral pulse volume indicate
that the child is experiencing fluid volume deficit due to the polyuria, so the priority
action is to restore fluid volume (B). (A) is useful in obtaining a precise urine output
measure, but is a lower priority than restoring fluid volume at this time. (C) is not
indicated based on the current assessment data, and (D) does not recognize the
need for immediate action to combat the fluid volume deficit.
The mother of a preschool-aged child asks the nurse if it is all right to
administer Pepto Bismol 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?
a. If the child's tongue darkens, discontinue the Pepto Bismol immediately.
b. Do not give if the child has chickenpox, the flu, or any other viral illness.
c. Avoid the use of Pepto Bismol until the child is at least 16 years old.
pg. 3
, d. Pepto Bismol may cause a rebound hyperacidity, worsening the "tummy ache." -
Correct Answer - Do not give if the child has chickenpox, the flu, or any other
viral illness.
Pepto Bismol contains aspirin and there is the potential of Reye's syndrome (B). (A)
is a common effect of Pepto Bismol and does not warrant discontinuation. Pepto
Bismol can be used by children (C). Pepto Bismol does not cause rebound
hyperacidity (D), which is a complication of antacids containing calcium.
Which restraint should be used for a toddler after a cleft palate repair?
Clove hitch.
Mummy.
Elbow.
Jacket. - Correct Answer - Elbow
Elbow restraints prevent children from bending their arms and bringing their hands to
the oral surgical site. (A) restrains the hands, but the child can bend and bring their
head to their hands. (B) is used during procedures. (D) restrains the body torso and
is not appropriate.
When planning the care for a child who has had a cleft lip repair, the nurse
knows that crying should be minimized because it
a. increases salivation.
b. increases the respiratory rate.
c. leads to vomiting.
d. stresses the suture line. - Correct Answer - stresses the suture line.
Prevention of stress on the lip suture line (D) is essential for optimum healing and
the cosmetic appearance of a cleft lip repair. Although crying also causes (A, B, and
C), these conditions do not create a problem for the child with a cleft lip repair.
A 2-year-old child with Down syndrome is brought to the clinic for his regular
physical examination. The nurse knows which problem is frequently
associated with Down syndrome?
a. Congenital heart disease.
b. Fragile X chromosome.
c. Trisomy 13.
d. Pyloric stenosis. - Correct Answer - congenital heart disease.
pg. 4
Actual Exam Questions with Correct Detailed
Answers (Verified Answers) Graded A+
The nurse is assessing an 8-month-old child who has a medical diagnosis of
Tetralogy of Fallot. Which symptom is this client most likely to exhibit?
a. Bradycardia.
b. Machinery murmur.
c. Weak pedal pulses.
d. Clubbed fingers. - Correct Answer - Clubbed fingers.
Tetralogy of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes (D)
due to tissue hypoxia. Tachycardia, not (A), is a manifestation of congenital heart
disease. (B) is a classic sign of ventricular septal defect. (C) is characteristic of
coarctation of the aorta.
Surgery is being delayed for an infant with undescended testes. In
collaboration with the healthcare provider and the family, which prescription
should the nurse anticipate?
a. A trial of adrenocorticotrophic hormone injections.
b. Frequent stimulation of the cremasteric reflex.
c. A trial of human chorionic gonadotrophic hormone.
d. Frequent warm baths to gently dilate the scrotal area. - Correct Answer - A
trial of human chorionic gonadotrophic hormone.
A trial of HCG (human chorionic gonadotrophic hormone) (C) may aid in testicular
descent, but does not replace surgical repair for true undescended testes.
Undescended testes (cryptorchidism) may be found in the inguinal canal due to
exaggerated cremasteric reflex. (A) is not indicated. Stimulation of the cremasteric
reflex causes the testes to ascend rather than descend in the scrotum (B). (D) may
relax the cremasteric muscle, but may not cause the testes to descend.
A preschool-age child who is hospitalized for hypospadias repair is most
strongly influenced by which behavior?
pg. 1
, a. Ability to communicate verbally.
b. Response to separation from family.
c. Concern for body integrity.
d. Socialization with other children. - Correct Answer - Concern for body
integrity.
The preschooler's major stressor is concern for his body integrity (C). He fears that
his "insides will leak out." A child undergoing surgery to his genitalia is even more
concerned about body integrity. The preschooler is quite verbal, so comprehension
of the words he uses or hears may be inaccurate, while his imagination and fears
may fantasize the reality (A). (B) is a concern for all children, but of most concern to
the toddler. (D) is not a prime concern in this situation.
A six-month-old returns from surgery with elbow restraints in place. What
nursing care should be included when caring for any restrained child?
a. Keep restraints on at all times.
b. Remove restraints one at a time and provide range of motion exercises.
c. Remove all restraints simultaneously and provide play activities.
d. Renew the healthcare provider's prescription for restraints every 72 hours. -
Correct Answer - Remove restraints one at a time and provide range of
motion exercises.
Removing restraints one at a time (B) is safer than removing all of them at once (C).
The child needs to exercise and should not be kept in restraints at all times (A). The
renewal of the healthcare provider's prescription varies with hospitals (D), and it
does not really answer the question.
A child with cystic fibrosis is having stools that float and are foul smelling.
Which descriptive term should the nurse use to document the finding?
a. Diarrhea.
b. Rhinorrhea.
c. Galactorrhea.
d. Steatorrhea. - Correct Answer - Steatorrhea.
Steatorrhea (D) is defined as stools with an abnormally high fat content that are
usually foul smelling and float on water. (A, B, and C) do not describe this finding.
A 4-year-old boy was admitted to the emergency room with a fractured right
ulna and a short arm cast is applied. When preparing the parents to take the
child home, which discharge instruction has the highest priority?
pg. 2
, a. Call the healthcare provider immediately if his nail beds appear blue.
b. Check his fingers hourly for the first 48 hours to see that he is able to move
them without pain.
c. Be sure his arm remains above his heart for the first 24 hours.
d. Take his temperature q4h for the next two days and call if an elevation is
noted. - Correct Answer - Call the healthcare provider immediately if his nail
beds appear blue.
Cyanosis (A) indicates impaired circulation to fingers and should be reported
immediately. Although the actions described in (B, C, and D) may be indicated, they
are implemented rather excessively--and might tend to frighten the parents. It is not
necessary to check the child's ability to move his fingers hourly for 2 days (B).
Elevating the arm above the heart will help to decrease swelling but (C) is stated in a
frightening way. It is not necessary to take the child's temperature q4h unless
indicated by other symptoms.
The vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and
Respirations 24. The child's pedal pulses are present with a volume of +1, and
no edema is observed. What action should the nurse implement first?
a. Insert an indwelling urinary catheter.
b. Start an IV infusion of normal saline.
c. Send a specimen to the lab for urinalysis.
d. Document the child's vital signs and pulses. - Correct Answer - Start an IV
infusion of normal saline.
The current vital sign readings and the decreased peripheral pulse volume indicate
that the child is experiencing fluid volume deficit due to the polyuria, so the priority
action is to restore fluid volume (B). (A) is useful in obtaining a precise urine output
measure, but is a lower priority than restoring fluid volume at this time. (C) is not
indicated based on the current assessment data, and (D) does not recognize the
need for immediate action to combat the fluid volume deficit.
The mother of a preschool-aged child asks the nurse if it is all right to
administer Pepto Bismol 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?
a. If the child's tongue darkens, discontinue the Pepto Bismol immediately.
b. Do not give if the child has chickenpox, the flu, or any other viral illness.
c. Avoid the use of Pepto Bismol until the child is at least 16 years old.
pg. 3
, d. Pepto Bismol may cause a rebound hyperacidity, worsening the "tummy ache." -
Correct Answer - Do not give if the child has chickenpox, the flu, or any other
viral illness.
Pepto Bismol contains aspirin and there is the potential of Reye's syndrome (B). (A)
is a common effect of Pepto Bismol and does not warrant discontinuation. Pepto
Bismol can be used by children (C). Pepto Bismol does not cause rebound
hyperacidity (D), which is a complication of antacids containing calcium.
Which restraint should be used for a toddler after a cleft palate repair?
Clove hitch.
Mummy.
Elbow.
Jacket. - Correct Answer - Elbow
Elbow restraints prevent children from bending their arms and bringing their hands to
the oral surgical site. (A) restrains the hands, but the child can bend and bring their
head to their hands. (B) is used during procedures. (D) restrains the body torso and
is not appropriate.
When planning the care for a child who has had a cleft lip repair, the nurse
knows that crying should be minimized because it
a. increases salivation.
b. increases the respiratory rate.
c. leads to vomiting.
d. stresses the suture line. - Correct Answer - stresses the suture line.
Prevention of stress on the lip suture line (D) is essential for optimum healing and
the cosmetic appearance of a cleft lip repair. Although crying also causes (A, B, and
C), these conditions do not create a problem for the child with a cleft lip repair.
A 2-year-old child with Down syndrome is brought to the clinic for his regular
physical examination. The nurse knows which problem is frequently
associated with Down syndrome?
a. Congenital heart disease.
b. Fragile X chromosome.
c. Trisomy 13.
d. Pyloric stenosis. - Correct Answer - congenital heart disease.
pg. 4
