Pediatrics HESI PN Review, Maternity
NCLEX PN
The practical nurse (PN) is monitoring a child who is manifesting signs of shock after a motor
vehicle collision. Which finding is most important for the PN to report to the charge nurse?
a) narrowing pulse pressure
b) apprehension
c) irritability
d) thirst -
☑️Answer: A
Rationale:
As shock progresses, perfusion in the microcirculation becomes marginal despite compensatory
adjustments, and the signs of decompensated shock become pronounced, such as tachycardia and
narrowing pulse pressure (A). (The difference between systolic and diastolic blood pressure), which
should be reported immediately. (B,C, and D) are not as significant as (A).
The mother of a 9 month old male infant is concerned because he cries whenever she leaves him
with a sitter. What is the best response for the practical nurse (PN) to provide?
a) "Have you noticed whether your baby is teething?"
b) "Crying when you leave him in a healthy sign of attachment."
c) "Consider taking the baby to the doctor because he may be ill."
d) "You could consider leaving the infant more often so he can adjust." -
☑️Answer: B
Rationale:
Healthy attachment is manifested by stranger anxiety in late infancy (B). Pain from teething
expressed by the infant's cries does not occur only when the mother leaves the infant with another
person (A). The PN should evaluate the infant's developmental needs (C) before suggesting the
infant may be ill. An infant who manifests stranger anxiety is best supported by the mother if the
infant is left for shorter periods of time, not (D).
Which preoperative action is most important for the practical nurse (PN) to implement for a
newborn with meningomyelocele?
a) document vital signs
b) prevent skin breakdown
c) minimize the risk for infection
d) monitor neurologic functioning -
☑️Answer: C
Rationale:
A meningomyelocele provides a direct entry for bacteria into the central nervous system, leading to
meningitis. Measures that protect the integrity of the meningomyelocele sac and infection control
1
,measures should be implemented to minimize the risk of infection (C). (A,B, and D) should be
implemented but do not have the priority of (C).
The practical nurse is caring for a 6 year old girl who had surgery 12 hours ago. The child tells the
PN that she does not have pain but a few minutes later, tells her parents that she does. What child
development concept is relevant to this situation?
a) inconsistency in pain reporting suggests that pain not present
b) a child may have pain yet deny its presence to the nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their parents -
☑️Answer: B
Rationale:
A child may fear receiving an injection for pain or may believe that pain is a deserved punishment
for some misdeed, so the pain is denied (D) when the nurse asks the child, who then readily admits
having pain to a parent. This behavior should not be interpreted as (C) but as a valid indication of
pain. (A and C) are incorrect interpretations of this behavior.
A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst. What should the
practical nurse (PN) offer?
a) popsicle
b) lemonade
c) orange juice
d) chocolate milk -
☑️Answer: A
Rationale:
Small amounts of clear liquids without red dyes should be offered to the child. Popsicles (A) are
cold and help soothe a dry throat. Citrus drinks (B and C) are acidic and irritate the operative site in
the posterior oropharynx. Milk (D) thickens oral mucus which makes swallowing more difficult and
causes coughing.
The mother of a male newborn calls the clinic to inquire about the formation of a yellow crust over
her son's circumcision area. What information should the practical nurse (PN) provide?
a) do not remove the yellow crust from the site
b) stop using petroleum around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper -
☑️Answer: A
Rationale:
Crust formation is part of the healing process and should be removed (A). (C) is not indicated at this
time. The diaper should be fastened loosely, not tightly (D) which can place pressure on the incision
site. (B) assists in the healing process and should not be discontinued.
The mother of a child with croup is having barking, coughing episodes calls the clinic for
assistance. What action should the practical nurse (PN) recommend that the mother implement first?
2
, a) take the child outside in the cool air
b) bring the child directly to the emergency room
c) sit with the child in bathroom with a hot shower running
d) have the child drink plenty of fluids -
☑️Answer: C
Rationale:
Croup (laryngotracheobronchitis) is a viral infection that causes a "barking" cough and varying
degrees of inspiratory stridor, which often responds to a high humidity environment. Most children
can be managed at home using the stream from a hot shower in a closed bathroom (C) which often
stops laryngeal spasm. Increasing the child's fluid intake is important (D), but not a priority at this
time.Although exposure to cold air (A) also relieves stridor, parents should be encouraged to use
mist humidifier in the child's room. (B) is not necessary unless the child is having increasingly
difficulty breathing that may lead to a compromised airway.
Which finding should the practical nurse confirm with the parents of an infant who is admitted with
possible intussusception?
a) red currant jelly stools
b) clay colored stools
c) constant abdominal pain
d) projectile vomiting after meals -
☑️Answer: A
Rationale:
Red currant jelly stools (A) is a sign of intussusception, which causes a mixture of stool, mucous,
and blood as the intestines telescopes inside itself. (D) is associated with pyloric stenosis. (B) is
consistent with biliary obstruction. Infants with intussusception usually have periods of severe pain
followed by intervals in which they appear comfortable, not (C).
The practical nurse (PN) is observing a group of children at a day care center to determine whether
children are achieving developmental milestones. Which activity should the PN identify as typical
for a 2 year old child's cognitive development?
a) has a vocabulary of about 1000 words
b) uses short sentences to express self
c) initiates play with other children
d) recognizes right and wrong -
☑️Answer: B
Rationale:
Although children develop at different rates, a 2 year old typically uses short sentences to express
independence and control (B) and has a vocabulary of up to 300 words, not (A). At the age of 2
years, a toddler is developing negativism without understanding the concepts of right and wrong
(D). A 2 year old engages in solitary play and parallel play but does not initiate or cooperative with
other children (C) in play, which begins with socialization of the preschool child.
The practical nurse (PN) is interviewing a 10 year old girl about school and her extracurricular
activities. She responds, "I like school. I play the flute in the school band, and I take tennis lessons."
3
NCLEX PN
The practical nurse (PN) is monitoring a child who is manifesting signs of shock after a motor
vehicle collision. Which finding is most important for the PN to report to the charge nurse?
a) narrowing pulse pressure
b) apprehension
c) irritability
d) thirst -
☑️Answer: A
Rationale:
As shock progresses, perfusion in the microcirculation becomes marginal despite compensatory
adjustments, and the signs of decompensated shock become pronounced, such as tachycardia and
narrowing pulse pressure (A). (The difference between systolic and diastolic blood pressure), which
should be reported immediately. (B,C, and D) are not as significant as (A).
The mother of a 9 month old male infant is concerned because he cries whenever she leaves him
with a sitter. What is the best response for the practical nurse (PN) to provide?
a) "Have you noticed whether your baby is teething?"
b) "Crying when you leave him in a healthy sign of attachment."
c) "Consider taking the baby to the doctor because he may be ill."
d) "You could consider leaving the infant more often so he can adjust." -
☑️Answer: B
Rationale:
Healthy attachment is manifested by stranger anxiety in late infancy (B). Pain from teething
expressed by the infant's cries does not occur only when the mother leaves the infant with another
person (A). The PN should evaluate the infant's developmental needs (C) before suggesting the
infant may be ill. An infant who manifests stranger anxiety is best supported by the mother if the
infant is left for shorter periods of time, not (D).
Which preoperative action is most important for the practical nurse (PN) to implement for a
newborn with meningomyelocele?
a) document vital signs
b) prevent skin breakdown
c) minimize the risk for infection
d) monitor neurologic functioning -
☑️Answer: C
Rationale:
A meningomyelocele provides a direct entry for bacteria into the central nervous system, leading to
meningitis. Measures that protect the integrity of the meningomyelocele sac and infection control
1
,measures should be implemented to minimize the risk of infection (C). (A,B, and D) should be
implemented but do not have the priority of (C).
The practical nurse is caring for a 6 year old girl who had surgery 12 hours ago. The child tells the
PN that she does not have pain but a few minutes later, tells her parents that she does. What child
development concept is relevant to this situation?
a) inconsistency in pain reporting suggests that pain not present
b) a child may have pain yet deny its presence to the nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their parents -
☑️Answer: B
Rationale:
A child may fear receiving an injection for pain or may believe that pain is a deserved punishment
for some misdeed, so the pain is denied (D) when the nurse asks the child, who then readily admits
having pain to a parent. This behavior should not be interpreted as (C) but as a valid indication of
pain. (A and C) are incorrect interpretations of this behavior.
A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst. What should the
practical nurse (PN) offer?
a) popsicle
b) lemonade
c) orange juice
d) chocolate milk -
☑️Answer: A
Rationale:
Small amounts of clear liquids without red dyes should be offered to the child. Popsicles (A) are
cold and help soothe a dry throat. Citrus drinks (B and C) are acidic and irritate the operative site in
the posterior oropharynx. Milk (D) thickens oral mucus which makes swallowing more difficult and
causes coughing.
The mother of a male newborn calls the clinic to inquire about the formation of a yellow crust over
her son's circumcision area. What information should the practical nurse (PN) provide?
a) do not remove the yellow crust from the site
b) stop using petroleum around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper -
☑️Answer: A
Rationale:
Crust formation is part of the healing process and should be removed (A). (C) is not indicated at this
time. The diaper should be fastened loosely, not tightly (D) which can place pressure on the incision
site. (B) assists in the healing process and should not be discontinued.
The mother of a child with croup is having barking, coughing episodes calls the clinic for
assistance. What action should the practical nurse (PN) recommend that the mother implement first?
2
, a) take the child outside in the cool air
b) bring the child directly to the emergency room
c) sit with the child in bathroom with a hot shower running
d) have the child drink plenty of fluids -
☑️Answer: C
Rationale:
Croup (laryngotracheobronchitis) is a viral infection that causes a "barking" cough and varying
degrees of inspiratory stridor, which often responds to a high humidity environment. Most children
can be managed at home using the stream from a hot shower in a closed bathroom (C) which often
stops laryngeal spasm. Increasing the child's fluid intake is important (D), but not a priority at this
time.Although exposure to cold air (A) also relieves stridor, parents should be encouraged to use
mist humidifier in the child's room. (B) is not necessary unless the child is having increasingly
difficulty breathing that may lead to a compromised airway.
Which finding should the practical nurse confirm with the parents of an infant who is admitted with
possible intussusception?
a) red currant jelly stools
b) clay colored stools
c) constant abdominal pain
d) projectile vomiting after meals -
☑️Answer: A
Rationale:
Red currant jelly stools (A) is a sign of intussusception, which causes a mixture of stool, mucous,
and blood as the intestines telescopes inside itself. (D) is associated with pyloric stenosis. (B) is
consistent with biliary obstruction. Infants with intussusception usually have periods of severe pain
followed by intervals in which they appear comfortable, not (C).
The practical nurse (PN) is observing a group of children at a day care center to determine whether
children are achieving developmental milestones. Which activity should the PN identify as typical
for a 2 year old child's cognitive development?
a) has a vocabulary of about 1000 words
b) uses short sentences to express self
c) initiates play with other children
d) recognizes right and wrong -
☑️Answer: B
Rationale:
Although children develop at different rates, a 2 year old typically uses short sentences to express
independence and control (B) and has a vocabulary of up to 300 words, not (A). At the age of 2
years, a toddler is developing negativism without understanding the concepts of right and wrong
(D). A 2 year old engages in solitary play and parallel play but does not initiate or cooperative with
other children (C) in play, which begins with socialization of the preschool child.
The practical nurse (PN) is interviewing a 10 year old girl about school and her extracurricular
activities. She responds, "I like school. I play the flute in the school band, and I take tennis lessons."
3
