HESI Pediatrics Exam Prep Questions with
Answers – WGU D120 OBJECTIVE ASSESSMENT
ACTUAL EXAM STUDY GUIDE 2025/2026
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
HESI Pediatrics Exam Prep: 100 Q&A
1. A 4-year-old child is admitted with a diagnosis of Croup. The nurse should be prepared to
administer which of the following medications?
A. Oral antihistamines
B. Inhaled beta-2 agonists
C. Intramuscular antibiotics
D. Corticosteroids
Answer: D. Corticosteroids ✓
Rationale: Croup (laryngotracheobronchitis) is often caused by a virus and leads to
inflammation and edema in the subglottic area. Corticosteroids (e.g., dexamethasone) are the
cornerstone of treatment as they reduce this inflammation, improving symptoms and reducing
the need for hospitalization.
2. The mother of a 2-month-old infant is concerned because the infant's anterior fontanel is
still open. The nurse's best response is:
A. "This is a normal finding and is expected to close between 12-18 months of age."
B. "This indicates hydrocephalus and requires immediate surgical intervention."
C. "The fontanel should have closed by 2 months; I will inform the pediatrician."
D. "This is a sign of dehydration and we need to start IV fluids."
Answer: A. "This is a normal finding and is expected to close between 12-18 months of age."
✓
Rationale: The anterior fontanel is diamond-shaped and normally closes between 12-18 months
of age. The posterior fontanel closes by 2-3 months. An open anterior fontanel at 2 months is an
expected finding.
,3. A 6-year-old child with Type 1 Diabetes Mellitus has a blood glucose level of 55 mg/dL. The
child is alert but irritable. What is the most appropriate initial action by the nurse?
A. Administer 1 mg of Glucagon intramuscularly.
B. Provide 4 oz of fruit juice or 15 grams of a simple carbohydrate.
C. Give the child their scheduled dose of insulin.
D. Have the child jog in place for 10 minutes to stimulate metabolism.
Answer: B. Provide 4 oz of fruit juice or 15 grams of a simple carbohydrate. ✓
Rationale: A blood glucose of 55 mg/dL indicates hypoglycemia. For a conscious child, the initial
treatment is to administer 15 grams of a fast-acting simple carbohydrate (e.g., 4 oz juice, 3-4
glucose tablets). Glucagon is reserved for severe hypoglycemia when the child is unconscious or
unable to swallow.
4. When teaching the parents of an infant about preventing Sudden Infant Death Syndrome
(SIDS), which instruction is most important?
A. "Place the infant in the prone position for sleep."
B. "Use a soft mattress with loose-fitting blankets."
C. "Place the infant in the supine position for every sleep."
D. "Have the infant sleep in bed with you for the first 6 months."
Answer: C. "Place the infant in the supine position for every sleep." ✓
Rationale: The "Back to Sleep" campaign, advocating for the supine sleep position, is the single
most effective intervention to reduce the risk of SIDS. Prone positioning and soft bedding are
significant risk factors.
5. A toddler with severe dehydration is ordered to receive an IV bolus of 20 mL/kg of 0.9%
Normal Saline. The toddler weighs 28 lbs. How many mL should the nurse administer? (Round
to the nearest whole number).
A. 255 mL
B. 560 mL
C. 280 mL
D. 380 mL
Answer: A. 255 mL ✓
Rationale: First, convert weight from pounds to kilograms: 28 lbs / 2.2 = 12.73 kg. Then,
calculate the bolus: 12.73 kg * 20 mL/kg = 254.6 mL, which rounds to 255 mL.
6. A preschooler is scheduled for a tonsillectomy. In the postoperative period, which finding
should alert the nurse to a potential complication?
A. Throat pain and difficulty swallowing.
B. Frequent swallowing and tachycardia.
C. A heart rate of 90 bpm and sleeping.
,D. Complaints of hunger and thirst.
Answer: B. Frequent swallowing and tachycardia. ✓
Rationale: Frequent swallowing is a classic sign of hemorrhage post-tonsillectomy, as blood
trickles down the throat and the child swallows it. Tachycardia is an early sign of shock from
blood loss. Throat pain is expected; a low heart rate and hunger are not indicative of this
specific complication.
7. The nurse is assessing a 5-year-old who presents with a barking cough, stridor, and mild
retractions. The symptoms started suddenly at night. This clinical picture is most consistent
with:
A. Epiglottitis
B. Asthma
C. Spasmodic croup
D. Bronchiolitis
Answer: C. Spasmodic croup ✓
Rationale: Spasmodic croup often occurs suddenly at night in a child who was well at bedtime.
It presents with a barking cough and stridor but typically without a fever. Epiglottitis is more
acute and severe with a high fever and drooling. Asthma presents with wheezing, and
bronchiolitis with wheezing and crackles.
8. An infant with Tetralogy of Fallot may assume a knee-chest position. The nurse understands
this position is beneficial because it:
A. Increases peripheral circulation.
B. Promotes rest and conserves energy.
C. Increases systemic vascular resistance, decreasing right-to-left shunting.
D. Decreases preload and afterload on the heart.
Answer: C. Increases systemic vascular resistance, decreasing right-to-left shunting. ✓
Rationale: In Tetralogy of Fallot, a "tet spell" (hypercyanotic episode) is caused by increased
right-to-left shunting. The knee-chest position increases systemic vascular resistance, which
forces more blood from the right ventricle to the lungs instead of through the ventricular septal
defect to the aorta, thereby improving oxygenation.
9. A school-aged child is diagnosed with Bacterial Meningitis. What is the priority nursing
intervention?
A. Administer an antipyretic for fever.
B. Initiate droplet precautions immediately.
C. Place the child in a brightly lit room to assess for photophobia.
D. Encourage oral fluids to prevent dehydration.
Answer: B. Initiate droplet precautions immediately. ✓
, Rationale: Bacterial meningitis is spread through respiratory droplets. The most immediate
action is to place the child on droplet precautions to prevent the spread of infection to other
patients and healthcare workers. Other actions are important but secondary to infection
control.
10. The parents of a child with Cystic Fibrosis ask why their child must take pancreatic
enzymes. The nurse's response should be based on the understanding that:
A. The enzymes help to digest fats, proteins, and carbohydrates.
B. They are necessary to prevent recurrent lung infections.
C. The enzymes boost the immune system's function.
D. They are required to manage the child's blood sugar levels.
Answer: A. The enzymes help to digest fats, proteins, and carbohydrates. ✓
Rationale: In Cystic Fibrosis, thick mucus blocks the pancreatic ducts, preventing pancreatic
enzymes from reaching the duodenum. This leads to malabsorption, particularly of fats and fat-
soluble vitamins. Pancreatic enzyme supplements are given with meals and snacks to facilitate
proper digestion and absorption of nutrients.
11. A 3-year-old is brought to the clinic with a one-week history of low-grade fever, irritability,
and a peeling rash on the hands and feet. The nurse suspects:
A. Measles (Rubeola)
B. Kawasaki Disease
C. Scarlet Fever
D. Atopic Dermatitis
Answer: B. Kawasaki Disease ✓
Rationale: The subacute phase of Kawasaki Disease (weeks 2-4) is characterized by
desquamation (peeling) of the skin on the fingers and toes. Other key symptoms include fever
for 5+ days, bilateral conjunctivitis, rash, and changes in the extremities and oral mucosa.
12. When administering an IM injection to a 18-month-old toddler, the nurse should use
which site?
A. Deltoid muscle
B. Dorsogluteal muscle
C. Vastus lateralis muscle
D. Rectus femoris muscle
Answer: C. Vastus lateralis muscle ✓
Rationale: The vastus lateralis is the preferred and safest site for IM injections in infants and
toddlers. It is a large, well-developed muscle with no major nerves or blood vessels nearby. The
deltoid is too small, and the dorsogluteal is not recommended due to the risk of sciatic nerve
injury.
Answers – WGU D120 OBJECTIVE ASSESSMENT
ACTUAL EXAM STUDY GUIDE 2025/2026
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
HESI Pediatrics Exam Prep: 100 Q&A
1. A 4-year-old child is admitted with a diagnosis of Croup. The nurse should be prepared to
administer which of the following medications?
A. Oral antihistamines
B. Inhaled beta-2 agonists
C. Intramuscular antibiotics
D. Corticosteroids
Answer: D. Corticosteroids ✓
Rationale: Croup (laryngotracheobronchitis) is often caused by a virus and leads to
inflammation and edema in the subglottic area. Corticosteroids (e.g., dexamethasone) are the
cornerstone of treatment as they reduce this inflammation, improving symptoms and reducing
the need for hospitalization.
2. The mother of a 2-month-old infant is concerned because the infant's anterior fontanel is
still open. The nurse's best response is:
A. "This is a normal finding and is expected to close between 12-18 months of age."
B. "This indicates hydrocephalus and requires immediate surgical intervention."
C. "The fontanel should have closed by 2 months; I will inform the pediatrician."
D. "This is a sign of dehydration and we need to start IV fluids."
Answer: A. "This is a normal finding and is expected to close between 12-18 months of age."
✓
Rationale: The anterior fontanel is diamond-shaped and normally closes between 12-18 months
of age. The posterior fontanel closes by 2-3 months. An open anterior fontanel at 2 months is an
expected finding.
,3. A 6-year-old child with Type 1 Diabetes Mellitus has a blood glucose level of 55 mg/dL. The
child is alert but irritable. What is the most appropriate initial action by the nurse?
A. Administer 1 mg of Glucagon intramuscularly.
B. Provide 4 oz of fruit juice or 15 grams of a simple carbohydrate.
C. Give the child their scheduled dose of insulin.
D. Have the child jog in place for 10 minutes to stimulate metabolism.
Answer: B. Provide 4 oz of fruit juice or 15 grams of a simple carbohydrate. ✓
Rationale: A blood glucose of 55 mg/dL indicates hypoglycemia. For a conscious child, the initial
treatment is to administer 15 grams of a fast-acting simple carbohydrate (e.g., 4 oz juice, 3-4
glucose tablets). Glucagon is reserved for severe hypoglycemia when the child is unconscious or
unable to swallow.
4. When teaching the parents of an infant about preventing Sudden Infant Death Syndrome
(SIDS), which instruction is most important?
A. "Place the infant in the prone position for sleep."
B. "Use a soft mattress with loose-fitting blankets."
C. "Place the infant in the supine position for every sleep."
D. "Have the infant sleep in bed with you for the first 6 months."
Answer: C. "Place the infant in the supine position for every sleep." ✓
Rationale: The "Back to Sleep" campaign, advocating for the supine sleep position, is the single
most effective intervention to reduce the risk of SIDS. Prone positioning and soft bedding are
significant risk factors.
5. A toddler with severe dehydration is ordered to receive an IV bolus of 20 mL/kg of 0.9%
Normal Saline. The toddler weighs 28 lbs. How many mL should the nurse administer? (Round
to the nearest whole number).
A. 255 mL
B. 560 mL
C. 280 mL
D. 380 mL
Answer: A. 255 mL ✓
Rationale: First, convert weight from pounds to kilograms: 28 lbs / 2.2 = 12.73 kg. Then,
calculate the bolus: 12.73 kg * 20 mL/kg = 254.6 mL, which rounds to 255 mL.
6. A preschooler is scheduled for a tonsillectomy. In the postoperative period, which finding
should alert the nurse to a potential complication?
A. Throat pain and difficulty swallowing.
B. Frequent swallowing and tachycardia.
C. A heart rate of 90 bpm and sleeping.
,D. Complaints of hunger and thirst.
Answer: B. Frequent swallowing and tachycardia. ✓
Rationale: Frequent swallowing is a classic sign of hemorrhage post-tonsillectomy, as blood
trickles down the throat and the child swallows it. Tachycardia is an early sign of shock from
blood loss. Throat pain is expected; a low heart rate and hunger are not indicative of this
specific complication.
7. The nurse is assessing a 5-year-old who presents with a barking cough, stridor, and mild
retractions. The symptoms started suddenly at night. This clinical picture is most consistent
with:
A. Epiglottitis
B. Asthma
C. Spasmodic croup
D. Bronchiolitis
Answer: C. Spasmodic croup ✓
Rationale: Spasmodic croup often occurs suddenly at night in a child who was well at bedtime.
It presents with a barking cough and stridor but typically without a fever. Epiglottitis is more
acute and severe with a high fever and drooling. Asthma presents with wheezing, and
bronchiolitis with wheezing and crackles.
8. An infant with Tetralogy of Fallot may assume a knee-chest position. The nurse understands
this position is beneficial because it:
A. Increases peripheral circulation.
B. Promotes rest and conserves energy.
C. Increases systemic vascular resistance, decreasing right-to-left shunting.
D. Decreases preload and afterload on the heart.
Answer: C. Increases systemic vascular resistance, decreasing right-to-left shunting. ✓
Rationale: In Tetralogy of Fallot, a "tet spell" (hypercyanotic episode) is caused by increased
right-to-left shunting. The knee-chest position increases systemic vascular resistance, which
forces more blood from the right ventricle to the lungs instead of through the ventricular septal
defect to the aorta, thereby improving oxygenation.
9. A school-aged child is diagnosed with Bacterial Meningitis. What is the priority nursing
intervention?
A. Administer an antipyretic for fever.
B. Initiate droplet precautions immediately.
C. Place the child in a brightly lit room to assess for photophobia.
D. Encourage oral fluids to prevent dehydration.
Answer: B. Initiate droplet precautions immediately. ✓
, Rationale: Bacterial meningitis is spread through respiratory droplets. The most immediate
action is to place the child on droplet precautions to prevent the spread of infection to other
patients and healthcare workers. Other actions are important but secondary to infection
control.
10. The parents of a child with Cystic Fibrosis ask why their child must take pancreatic
enzymes. The nurse's response should be based on the understanding that:
A. The enzymes help to digest fats, proteins, and carbohydrates.
B. They are necessary to prevent recurrent lung infections.
C. The enzymes boost the immune system's function.
D. They are required to manage the child's blood sugar levels.
Answer: A. The enzymes help to digest fats, proteins, and carbohydrates. ✓
Rationale: In Cystic Fibrosis, thick mucus blocks the pancreatic ducts, preventing pancreatic
enzymes from reaching the duodenum. This leads to malabsorption, particularly of fats and fat-
soluble vitamins. Pancreatic enzyme supplements are given with meals and snacks to facilitate
proper digestion and absorption of nutrients.
11. A 3-year-old is brought to the clinic with a one-week history of low-grade fever, irritability,
and a peeling rash on the hands and feet. The nurse suspects:
A. Measles (Rubeola)
B. Kawasaki Disease
C. Scarlet Fever
D. Atopic Dermatitis
Answer: B. Kawasaki Disease ✓
Rationale: The subacute phase of Kawasaki Disease (weeks 2-4) is characterized by
desquamation (peeling) of the skin on the fingers and toes. Other key symptoms include fever
for 5+ days, bilateral conjunctivitis, rash, and changes in the extremities and oral mucosa.
12. When administering an IM injection to a 18-month-old toddler, the nurse should use
which site?
A. Deltoid muscle
B. Dorsogluteal muscle
C. Vastus lateralis muscle
D. Rectus femoris muscle
Answer: C. Vastus lateralis muscle ✓
Rationale: The vastus lateralis is the preferred and safest site for IM injections in infants and
toddlers. It is a large, well-developed muscle with no major nerves or blood vessels nearby. The
deltoid is too small, and the dorsogluteal is not recommended due to the risk of sciatic nerve
injury.
