HESI PEDIATRIC EXAM

1. The nurse is caring for a 3-year old child who is 2 hours postop from a cardiac catheterization via the

right femoral artery. Which assessment finding is an indication of arterial obstruction?

A. Blood pressure trend is downward and pulse is rapid and irregular

B. Right foot is cool to the touch and appears pale and blanched.

C. Pulse distal to the femoral artery is weaker on the left foot than right foot.

D. The pressure dressing at right femoral area is moist and oozing blood.

2. Following a motor vehicle collision, a 3-year old girl has a spica cast applied. Which toy is best for

the nurse for this 3-year-old child?

 A. Duck that squeaks.

B. Fashion doll and clothes

C. Set of cloth and hand puppets

D. Hand held video game.

3. An infant with tetralogy of Fallot becomes acutely cyanotic and hyper apneic. Which action should

the nurse implement first?

A. Administer morphine sulphate.

B. Start IV fluids.

C. Place the infant in a knee-chest position

D. Provide 100% oxygen by face mask.

4. A child admitted with diabetic ketoacidosis is demonstrating Kussmaul’s respirations. The nurse

determines that the increased respiratory rate is a compensatory mechanism for which acid base

alteration?

A. Metabolic alkalosis.

B. Respiratory acidosis.

C. Respiratory alkalosis.

D. Metabolic acidosis

5. 7 years old is admitted to the hospital with persistent vomiting, and a nasogastric tube attached to

low intermittent suction is applied. Which finding is most important for the nurse to report to the

healthcare provider?

A. Gastric output of 100 mL in the last 8 hours.

B. Shift intake of 640 mL IV fluids plus 30 mL PO ice chips.

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C. Serum potassium of 3.0 mg/dL.

D. Serum pH of 7.45.

6. The nurse is evaluating diet teaching for a client who has non tropical sprue (celiac disease).

Choosing which food indicates that the teaching has been effective?

A. Creamed corn

B. Pancakes.

C. Rye crackers.

D. Cooked oatmeal.

7. During a well-baby check, the nurse hides a block under the baby’s blanket, and the baby looks for

the block. Which normal growth and development milestone is the baby developing?

A. Separation anxiety.

B. Associative play.

C. Object prehension.

D. Object permanence

.8. The nurse is measuring the frontal occipital circumference (FOC) of a 3-months old infant, and

notes that the FOC has increased 5 inches since birth and the child’s head appears large in relation to

body size. Which action is most important for the nurse to take next?

A. Measure the infant’s head-to-toe length.

B. Palpate the anterior fontanel for tension and bulging

C. Observe the infant for sunken eyes.

D. Plot the measurement on the infant’s growth chart.

9. The nurse is preparing a 10-year-old with a lacerated forehead for suturing. Both parents and 12-

year-old sibling are at the child’s bedside. Which instruction best supports family?

 A. While waiting for the healthcare provider, only one visitor may stay with the child.

B. All of you should leave while the healthcare provider sutures the child’s forehead.

C. It is best if the sibling goes to the waiting room until the suturing is completed.

D. Please decide who will stay when the healthcare provider begins suturing

.10. The nurse is planning for a 5-month old with gastroesophageal reflux disease whose weight has

decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease

vomiting, what instructions should the nurse provide this mother?

A. Give small amounts of baby food with each feeding.

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B. Thicken formula with cereal for each feeding

C. Dilute the child’s formula with equal parts of water.

D. Offer 10 % dextrose in water between most feedings.

11. While teaching a parenting class to new parents the nurse describes the needs of infants and

toddlers regarding discipline and limit setting. What is the most important reason for implementing

such parenting behaviors?

 A. Children need help in developing social skills.

B. This age child fears loss of self-control.

C. They provide the child with a sense of security

D. Children must to learn to deal with authority.

12. The parents of a newborn infant with hypospadias are concerned about when the surgical

correction should occur. What information should the nurse provide?

A. Repair should be done by one month to prevent bladder infection.

B. To form a proper urethra repair, it should be done after sexual maturity.

C. Repairs typically should be done before the child is potty trained.

D. Delaying the repair until school age reduces castration fears.

13. Which drink choice on a hot day indicates to the nurse that a teenager with sickle cell anemia

understands dietary consideration related to the disease?

A. Milkshake.

B. Iced tea.

C. Diet cola.

D. Lemonade.

14. The nurse is assessing an infant with diarrhea and lethargy. Which finding should thenurse identify

that is consistent with early dehydration?

A. Tachycardia

B. Bradycardia.

C. Dry mucous membrane.

D. Increased skin turgor.

15. While auscultating the lung sounds of a 5-year-old Chinese boy who recently completed antibiotic

therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest.

What action is best for the nurse to take?

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A. Identify the antibiotic used to treat the pneumonia.

B. Inquire about the use of alternative methods of treatment

C. Ask the parents if the child has been in a recent accident.

D. Report suspected child abuse to the authorities.

16. A child with acute lymphocytic leukemia (ALL) who is receiving chemotherapy via a subclavian IV

infusion, has an oral temperature of 103 degrees. In assessing the IV site, the nurse determines that

there are no signs of infection at the site. Which intervention is the most important for the nurse to

implement?

A. Obtain specimen for blood cultures

B. Assess the CBC.

C. Monitor the oral temperature every hour.

D. Administer acetaminophen as prescribed.

17. A child who weighs 25 kg is receiving IV ampicillin 300 mg/kg/24 hours in equally divided doses every

4 hours. How many mg should the nurse administer to the child for each dose?

1875mg

18. The nurse is caring for an infant scheduled for reduction of intussusceptions. The day before the

scheduled procedure the infant passes a soft-formed brown stool. Which intervention should the nurse

implement?

A. Instruct the parents that the infant needs to be NPO.

B. Notify the healthcare provider of the passage of brown stool.

C. Obtain a stool specimen for laboratory analysis.

D. Ask the parents about recent changes in the infant’s diet.

19. The mother of a 4-month old asks the nurse for advice in preventing diaper rash. What suggestion

should the nurse provide?

A. At diaper change generously powder the baby’s diaper area with talcum powder to promote dryness.

B. Wash the diaper area every 2 hours with soap and water to help prevent skin breakdown.

C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each

diaper change.

D. Place a cloth diaper inside the disposable diaper for overnight periods when increased wearing time is

likely.

20. Which statement by a school aged client going to summer camp indicates the best understanding of

the mode of transmission of Lyme disease?

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