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2025 HESI Peds Exam Practice Test –
Pediatric
Nursing Question Bank + Verified
Answers and
Step-by-Step Rationales
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?
Bradycardia.
Characteristic murmur.
Strong pedal pulses.
Clubbed fingers. - ANSW✔️-Characteristic murmur.
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Tetralogy of Fallot is a cyanotic heart defect composed of 4
defects: (1) ventricular septal defect (VSD), (2) pulmonic
stenosis, (3) overriding aorta, and (4) right ventricular
hypertrophy. The child would exhibit tachycardia, a
characteristic murmur, and they could develop clubbed fingers
if the hypoxia is not controlled with oxygenation (but this is
rare). Due to the coarctation of the aorta, assessment finding
would indicate weak pedal pulses due to compromised blood
flow.
The nurse is assigning care for a 4-year-old child with otitis
media and is concerned about the child's increasing
temperature over the past 24 hours. When planning care for
this child, what should the nurse consider?
Only an RN should be assigned to monitor this child's
temperature.
A tympanic measurement of temperature in the unaffected ear
will provide the most accurate reading.
The licensed practical nurse should be instructed to obtain
rectal temperatures on this child.
The healthcare provider should be asked to prescribe the
method for measurement of the child's temperatures. -
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ANSW✔️-A tympanic measurement of temperature in the
unaffected ear will provide the most accurate reading.
A tympanic membrane sensor approximates core temperatures
because the hypothalamus and eardrum are perfused by the
same circulation. Tympanic readings obtained using proper
technique correlate moderately to strongly with oral
temperatures. The sensor can be affected by cerumen and
readings from the infected ear are not recommended. The HCP
does not need to be consulted, unless applicable, on the
method for temperature measurement. Unless absolutely
contraindicated, tympanic or oral temperatures should be the
method of choice.
The nurse is having difficulty communicating with a hospitalized
6-year-old child that has been assessed to be on track with
appropriate developmental speech and language milestones.
The nurse suspects that the child is fearful. Which approach by
the nurse is most helpful in establishing communication?
Engage the child through drawing pictures.
Suggest that the parent read a book to the child.
Provide paper and pencil for the child to keep a diary.
Ask the parent if the child is always uncommunicative. -
ANSW✔️-Engage the child through drawing pictures.
, 4|Page
Drawing pictures is a valuable form of nonverbal
communication. It is easier for a child to express their emotions
and feelings through the process of drawing than to express it
verbally. As the nurse and child look at the drawings, a verbal
story can be told that reflects the child's thinking.
A preschool-aged child who is hospitalized for hypospadias
repair is most strongly influenced by which behavior?
Ability to communicate verbally.
Response to separation from family.
Concern for body integrity.
Socialization with other children. - ANSW✔️-Concern for body
integrity.
The preschooler's major stressor is concern for his body
integrity. He fears that his "insides will leak out." A child
undergoing surgery to his genitalia is even more concerned
about body integrity.
The nurse is caring for a 12-year-old with syndrome of
inappropriate antidiuretic hormone (SIADH). This child should
be carefully assessed for which complication?
2025 HESI Peds Exam Practice Test –
Pediatric
Nursing Question Bank + Verified
Answers and
Step-by-Step Rationales
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?
Bradycardia.
Characteristic murmur.
Strong pedal pulses.
Clubbed fingers. - ANSW✔️-Characteristic murmur.
,2|Page
Tetralogy of Fallot is a cyanotic heart defect composed of 4
defects: (1) ventricular septal defect (VSD), (2) pulmonic
stenosis, (3) overriding aorta, and (4) right ventricular
hypertrophy. The child would exhibit tachycardia, a
characteristic murmur, and they could develop clubbed fingers
if the hypoxia is not controlled with oxygenation (but this is
rare). Due to the coarctation of the aorta, assessment finding
would indicate weak pedal pulses due to compromised blood
flow.
The nurse is assigning care for a 4-year-old child with otitis
media and is concerned about the child's increasing
temperature over the past 24 hours. When planning care for
this child, what should the nurse consider?
Only an RN should be assigned to monitor this child's
temperature.
A tympanic measurement of temperature in the unaffected ear
will provide the most accurate reading.
The licensed practical nurse should be instructed to obtain
rectal temperatures on this child.
The healthcare provider should be asked to prescribe the
method for measurement of the child's temperatures. -
,3|Page
ANSW✔️-A tympanic measurement of temperature in the
unaffected ear will provide the most accurate reading.
A tympanic membrane sensor approximates core temperatures
because the hypothalamus and eardrum are perfused by the
same circulation. Tympanic readings obtained using proper
technique correlate moderately to strongly with oral
temperatures. The sensor can be affected by cerumen and
readings from the infected ear are not recommended. The HCP
does not need to be consulted, unless applicable, on the
method for temperature measurement. Unless absolutely
contraindicated, tympanic or oral temperatures should be the
method of choice.
The nurse is having difficulty communicating with a hospitalized
6-year-old child that has been assessed to be on track with
appropriate developmental speech and language milestones.
The nurse suspects that the child is fearful. Which approach by
the nurse is most helpful in establishing communication?
Engage the child through drawing pictures.
Suggest that the parent read a book to the child.
Provide paper and pencil for the child to keep a diary.
Ask the parent if the child is always uncommunicative. -
ANSW✔️-Engage the child through drawing pictures.
, 4|Page
Drawing pictures is a valuable form of nonverbal
communication. It is easier for a child to express their emotions
and feelings through the process of drawing than to express it
verbally. As the nurse and child look at the drawings, a verbal
story can be told that reflects the child's thinking.
A preschool-aged child who is hospitalized for hypospadias
repair is most strongly influenced by which behavior?
Ability to communicate verbally.
Response to separation from family.
Concern for body integrity.
Socialization with other children. - ANSW✔️-Concern for body
integrity.
The preschooler's major stressor is concern for his body
integrity. He fears that his "insides will leak out." A child
undergoing surgery to his genitalia is even more concerned
about body integrity.
The nurse is caring for a 12-year-old with syndrome of
inappropriate antidiuretic hormone (SIADH). This child should
be carefully assessed for which complication?
