1
PEDS HESI RN CASE STUDIES WITH
PRACTICE TEST SPECIFIC TO ACTUAL
2025/26 EXAM
• The health care provider informed a client diagnosed with stage 4 liver
cancer that the cancer has spread to their spine. The client states to the
practical nurse, "I have a cancer, but it is not malignant." What is the best
initial nursing action?
a. Encourage the client to attend a cancer education program.
b. Perform a complete history and physical assessment.
c. Ask the client to explain his understanding of the term malignancy.
d. Offer the client emotional support to deal with the diagnosis.
c. Ask the client to explain his understanding of the term malignancy.
Rationale:
The best initial action is to assess the client's knowledge of the term
malignancy when used to describe cancer. The client appears to have
inaccurate knowledge. Stage 4 cancer means the cancer has spread
(metastasized) from where it has started to another body part.
• A client with severe Parkinson disease diagnosed with anorexia, dysphagia,
drooling, generalized weakness, and slurred speech is admitted to the unit.
Which nursing action should the practical nurse implement first for this
client?
a. Provide the client with a word board.
b. Set up a suction and Yankauer at client's bedside.
c. Encourage passive and active range-of-motion exercises.
d. Offer client nutritional milkshakes every 2 hours.
b. Set up a suction and Yankauer at client's bedside.
Rationale:
Dysphagia and drooling predispose this client to aspiration. A suction
machine and Yankauer should be set up and near the client to be used to
,2
help prevent aspiration pneumonia. Aspiration is the primary concern in
this situation.
• A client diagnosed with epilepsy is admitted to the unit. What intervention
should the practical nurse (PN) implement if the client experiences a
seizure?
a. Observe the length and activity of the seizure.
b. Insert an oral airway.
c. Gently restrain the client to prevent harm.
d. Call the code team.
a. Observe the length and activity of the seizure.
Rationale:
The PN should observe the client as they have their seizure. The length of
time and movement by the client needs to be observed and then
documented once the client is stable. The client should be placed on their
side to help prevent aspiration.
• A client diagnosed with a brain tumor is receiving radiation beam
treatments to the right frontal area. The practical nurse (PN) should
observe this client for which problem during the early post-therapy days?
a. Hemiplegia
b. Headache
c. Hearing loss
d. Dysphagia
b. Headache
Rationale:
Radiotherapy is a local treatment, and most side effects are site-specific,
such as inflammation of surrounding brain tissue, swelling, headache, and
fatigue.
• The practical nurse (PN) is assigned a client diagnosed with a hemothorax
who had a chest tube inserted 36 hours ago; upon entering the room, the
PN observes the client resting comfortably in the semi-Fowler position;
respirations appear even and unlabored; the water in the suction chamber
is bubbling; and there is serous drainage noted in the collection chamber.
What is the best initial action for the PN to take?
,3
a. Measure and document in the drainage in the chamber.
b. Clamp the chest tube while assessing for air leaks.
c. "Milk" the tube to remove any excessive blood clot buildup.
d. Decrease the bubbling in the suction chamber.
d. Decrease the bubbling in the suction chamber.
Rationale:
Follow the ABC's (airway, breathing, and circulation) to determine that the
airway and breathing are stable, and the next step is to evaluate the extent
of the bleeding. It is not necessary to change the amount of bubbling in the
suction chamber.
• The nurse has reinforced teaching regarding postoperative care for a client
who has had a prostatectomy. Which statements indicate the need for
further instructions? (Select all that apply.)
a. "If I feel the need to void while the catheter is still in, I should try to void
around the catheter."
b. "I should drink about 12 glasses of water a day, once the indwelling
catheter is removed."
c. "I should only have intercourse twice weekly once I return home after
surgery."
d. "I should report bright red blood and large clots in my urine to my
surgeon."
e. "I can expect to have urine that is lightly tinged with blood when I get
home."
a. "If I feel the need to void while the catheter is still in, I should try to void
around the catheter."
c. "I should only have intercourse twice weekly once I return home after
surgery."
Rationale:
After prostatectomy, the client should not try to void around the catheter.
It is common to feel pressure inside the bladder while the irrigating
catheter is still in the bladder. The client should not have intercourse
immediately after surgery. The client should drink 12 to 14 glasses of fluid
, 4
once the catheter is removed. Urine that is lightly blood tinged is common;
bright red blood in the urine should be reported to the surgeon.
• A client is walking in the hallway and begins experiencing an acute angina
attack. Which is the first action for the nurse to take?
a. Administer a nitroglycerine tablet sublingually.
b. Notify the local emergency medical services. (EMS).
c. Assist the client to walk back to the client's room.
d. Ask the client if this attack occurred at the same time as yesterday's.
a. Administer a nitroglycerine tablet sublingually.
Rationale:
The first action is to administer nitroglycerine sublingually, in order to dilate
the coronary arteries so that more oxygenated blood can be provided to
the myocardium. It is not necessary to notify EMS unless the angina pain is
unrelieved by three nitroglycerine tablets. The client should rest
immediately, not walk back to the room. It is not a priority to determine
whether or not the attack occurred at the same time as yesterday's.
• A client has had a gastrectomy to treat stomach cancer. The nurse has
reinforced instructions on ways to prevent "dumping syndrome." Which
client statement indicates the need for further instruction?
a. "My meals need to be mostly protein."
b. "I should walk around after each meal."
c. "I should eat fewer carbohydrates."
d. "I should eat smaller, more frequent meals."
b. "I should walk around after each meal."
Rationale:
The client should lie down after meals to avoid syncope. The client should
eat more protein and less carbohydrates, and smaller more frequent meals
• An adult client is admitted to the emergency department with partial-
thickness and full-thickness burns over 40% of the body surface area
resulting from a car collision fire. After the health care provider and nurse
have intubated the client, which intervention should the practical nurse
(PN) do first?
PEDS HESI RN CASE STUDIES WITH
PRACTICE TEST SPECIFIC TO ACTUAL
2025/26 EXAM
• The health care provider informed a client diagnosed with stage 4 liver
cancer that the cancer has spread to their spine. The client states to the
practical nurse, "I have a cancer, but it is not malignant." What is the best
initial nursing action?
a. Encourage the client to attend a cancer education program.
b. Perform a complete history and physical assessment.
c. Ask the client to explain his understanding of the term malignancy.
d. Offer the client emotional support to deal with the diagnosis.
c. Ask the client to explain his understanding of the term malignancy.
Rationale:
The best initial action is to assess the client's knowledge of the term
malignancy when used to describe cancer. The client appears to have
inaccurate knowledge. Stage 4 cancer means the cancer has spread
(metastasized) from where it has started to another body part.
• A client with severe Parkinson disease diagnosed with anorexia, dysphagia,
drooling, generalized weakness, and slurred speech is admitted to the unit.
Which nursing action should the practical nurse implement first for this
client?
a. Provide the client with a word board.
b. Set up a suction and Yankauer at client's bedside.
c. Encourage passive and active range-of-motion exercises.
d. Offer client nutritional milkshakes every 2 hours.
b. Set up a suction and Yankauer at client's bedside.
Rationale:
Dysphagia and drooling predispose this client to aspiration. A suction
machine and Yankauer should be set up and near the client to be used to
,2
help prevent aspiration pneumonia. Aspiration is the primary concern in
this situation.
• A client diagnosed with epilepsy is admitted to the unit. What intervention
should the practical nurse (PN) implement if the client experiences a
seizure?
a. Observe the length and activity of the seizure.
b. Insert an oral airway.
c. Gently restrain the client to prevent harm.
d. Call the code team.
a. Observe the length and activity of the seizure.
Rationale:
The PN should observe the client as they have their seizure. The length of
time and movement by the client needs to be observed and then
documented once the client is stable. The client should be placed on their
side to help prevent aspiration.
• A client diagnosed with a brain tumor is receiving radiation beam
treatments to the right frontal area. The practical nurse (PN) should
observe this client for which problem during the early post-therapy days?
a. Hemiplegia
b. Headache
c. Hearing loss
d. Dysphagia
b. Headache
Rationale:
Radiotherapy is a local treatment, and most side effects are site-specific,
such as inflammation of surrounding brain tissue, swelling, headache, and
fatigue.
• The practical nurse (PN) is assigned a client diagnosed with a hemothorax
who had a chest tube inserted 36 hours ago; upon entering the room, the
PN observes the client resting comfortably in the semi-Fowler position;
respirations appear even and unlabored; the water in the suction chamber
is bubbling; and there is serous drainage noted in the collection chamber.
What is the best initial action for the PN to take?
,3
a. Measure and document in the drainage in the chamber.
b. Clamp the chest tube while assessing for air leaks.
c. "Milk" the tube to remove any excessive blood clot buildup.
d. Decrease the bubbling in the suction chamber.
d. Decrease the bubbling in the suction chamber.
Rationale:
Follow the ABC's (airway, breathing, and circulation) to determine that the
airway and breathing are stable, and the next step is to evaluate the extent
of the bleeding. It is not necessary to change the amount of bubbling in the
suction chamber.
• The nurse has reinforced teaching regarding postoperative care for a client
who has had a prostatectomy. Which statements indicate the need for
further instructions? (Select all that apply.)
a. "If I feel the need to void while the catheter is still in, I should try to void
around the catheter."
b. "I should drink about 12 glasses of water a day, once the indwelling
catheter is removed."
c. "I should only have intercourse twice weekly once I return home after
surgery."
d. "I should report bright red blood and large clots in my urine to my
surgeon."
e. "I can expect to have urine that is lightly tinged with blood when I get
home."
a. "If I feel the need to void while the catheter is still in, I should try to void
around the catheter."
c. "I should only have intercourse twice weekly once I return home after
surgery."
Rationale:
After prostatectomy, the client should not try to void around the catheter.
It is common to feel pressure inside the bladder while the irrigating
catheter is still in the bladder. The client should not have intercourse
immediately after surgery. The client should drink 12 to 14 glasses of fluid
, 4
once the catheter is removed. Urine that is lightly blood tinged is common;
bright red blood in the urine should be reported to the surgeon.
• A client is walking in the hallway and begins experiencing an acute angina
attack. Which is the first action for the nurse to take?
a. Administer a nitroglycerine tablet sublingually.
b. Notify the local emergency medical services. (EMS).
c. Assist the client to walk back to the client's room.
d. Ask the client if this attack occurred at the same time as yesterday's.
a. Administer a nitroglycerine tablet sublingually.
Rationale:
The first action is to administer nitroglycerine sublingually, in order to dilate
the coronary arteries so that more oxygenated blood can be provided to
the myocardium. It is not necessary to notify EMS unless the angina pain is
unrelieved by three nitroglycerine tablets. The client should rest
immediately, not walk back to the room. It is not a priority to determine
whether or not the attack occurred at the same time as yesterday's.
• A client has had a gastrectomy to treat stomach cancer. The nurse has
reinforced instructions on ways to prevent "dumping syndrome." Which
client statement indicates the need for further instruction?
a. "My meals need to be mostly protein."
b. "I should walk around after each meal."
c. "I should eat fewer carbohydrates."
d. "I should eat smaller, more frequent meals."
b. "I should walk around after each meal."
Rationale:
The client should lie down after meals to avoid syncope. The client should
eat more protein and less carbohydrates, and smaller more frequent meals
• An adult client is admitted to the emergency department with partial-
thickness and full-thickness burns over 40% of the body surface area
resulting from a car collision fire. After the health care provider and nurse
have intubated the client, which intervention should the practical nurse
(PN) do first?
