✅ 2025 HESI PN PEDIATRIC/MATERNITY REAL EXAM VERIFIED QUESTIONS,
CORRECT ANSWERS & RATIONALES
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).
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 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.
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 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).
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?
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 intestine’s 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
CORRECT ANSWERS & RATIONALES
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).
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 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.
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 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).
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?
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 intestine’s 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
