HESI Pediatric Practice Exam with
Answers
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 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.
Answers
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 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.
