HESI MILESTONE 3 REMEDIATION 2026 ACTUAL EXAM CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A 10-year-old child has undergone a cardiac catheterization through the left femoral
artery. During a postprocedural assessment, the nurse finds the left foot is pulseless
and cool to touch. Which is the likely cause?
A. hemorrhage
B. hematoma
C. fasciculation
D. tamponade - and. hematoma
Cardiac catheterization is a routine diagnostic procedure; however, it is not without
risks. Loss of pulse in the catheterized extremity is likely due to a hematoma and
requires immediate intervention to restore circulation.
A 10-year-old client with a recent history of playing in the woods presents to the
school nurse's clinic with localized skin eruptions on the hands and feet which are
streaked, consisting of blisters discharging clear fluid that are painful and itchy. What
should the school nurse suspect to be the causative agent?
A. sunburn
B. poison ivy
C. insect bite
D. heat rash
Contact with the oil called "Urushiol" which is found in poison ivy, oak and sumac may
produce an allergic reaction. Symptoms include localized, streaked, or oozing blisters.
These skin lesions are usually painful and itchy. - ans
A 10-year-old client with asthma arrives at an urgent care clinic with apparent bronchial
constriction. Which class of drugs should the nurse expect to be administered for this
condition?
A. methylxanthines
B. anticholinergic
C. long-acting beta2 agonists
D. oral corticosteroids - ansD. oral corticosteroids
Corticosteroids are fast-acting anti-inflammatory drugs. They are used to treat reversible
airflow obstruction, control symptoms, and reduce bronchial constriction with the fewest
side effects.
A 12-month-old client is being discharged with a body spica cast. Which information
should the nurse include in the parents' discharge teaching plan?
A. foul odor from cast may indicate infection or skin
breakdown B. pillows should not be placed under cast
C. the child can safely transported in a stroller
D. use pillows to elevate the child's head - ansA. foul odor from cast may indicate
infection or skin breakdown
Care of a child in a body spica cast can be challenging for parents at home. Skin under
the cast should be protected from injury and debris, so parents should be instructed
that a foul odor from the cast can be indicative of skin breakdown or infection and to
contact their health care provider.
,HESI MILESTONE 3 REMEDIATION 2026 ACTUAL EXAM CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A 12-year-old athlete reports severe ankle pain and an audible "popping" sound in
the ankle after a fall at soccer practice. The nurse upon inspection observes
moderate swelling, bruising, and joint instability. Initial radiographs of the ankle
appear normal. Which type of injury should the nurse suspect?
A. strain
B. sprain
C. fracture
D. dislocation - ansB. Sprain
The ankle is a common site for sprain injuries. Ankle sprains can range from mild (grade
1) to severe (grade 3), with complete tearing of a ligament in the most severe sprains. A
"popping" sound is likely an indication of a partial or complete ligament tear; joint
instability may be detected at the end-ranges of passive motion.
A 15-year-old client presents with a lump and persistent pain in the right upper
thigh area, and is subsequently diagnosed with a high-grade osteosarcoma. The
nurse should anticipate which plan of treatment for this client?
A. hot/cold topical
applications B. amputation of
the limb
C. electrical stimulation therapy
D. prolonged immobilization - ansB. amputation of the limb
Osteosarcoma is the most common bone cancer in childhood and considered one of the
most fatal. Treatment generally includes chemotherapy and amputation of the affected
limb. As of today, there is no meedical set plan of care.
A child diagnosed with HIV is being enrolled in a new school. Who has the right to
inform the school of this child's HIV status?
A. doctors or nurses
B. social workers
C. parents or legal guardians
D. child welfare department - ansC. parents or legal guardians
Confidentiality is a major issue in school attendance. The parents or legal guardians
have the right to decide whether or not to inform the school of their child's HIV status.
A child has been diagnosed with chicken pox and the nurse teaches the parent not to
give the child aspirin. Which condition may result when a child with chickenpox is given
aspirin?
A. Reye's syndrome B.
Huntingtons disease c.
Raynaud syndrome
D. purpura disorder - ansA. reye's syndrome
Reye's syndrome is a rare, but serious condition that causes brain and liver damage
that has been linked with aspirin use in children, when given to treat a viral infections,
such as chicken pox. Reye's syndrome can be prevented by avoiding the use of aspirin
in children.
,HESI MILESTONE 3 REMEDIATION 2026 ACTUAL EXAM CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A child is admitted with a diagnosis of suspected acute lymphoblastic leukemia (ALL).
Which test is performed to confirm this diagnosis of childhood leukemia?
A. cerebral spinal fluid analysis
B. bone marrow aspiration
C. CBC
D. genetic testing - ansB. bone marrow aspiration
ALL is a form of cancer in which high numbers of abnormal white blood cells are
produced. A bone marrow biopsy that reveals primary blast cells is confirmation of a
leukemia.
A child is brought to the emergency department after ingesting a large amount of
household drain cleaner. Which is the nurse's first priority when caring for this client?
A. perform NG suctioning
B. Assess and maintain an open airway
C. give small amounts of water to
ingest
D. Obtain chest and abdomen radiographs - ansB. assess and maintain an open airway
Ingestion of corrosive household agents may cause airway obstruction due to rapidly
developing laryngeal edema. The first priority is to assess and monitor the client's
airway.
A child recently underwent cardiac surgery and is admitted with a suspected diagnosis
of infective endocarditis. Which presentation should the nurse expect when assessing
this client?
A. bradycardia, lethargy, speech disturbances
B. high fever, irregular movement of joints, involuntary facial grimaces c.
tachycardia, chest pain, swollen and painful joints
D. low grade fever, anorexia, splinter hemorrhages under the nails - ansD. low grade
fever, anorexia, splinter hemorrhages under the nails
Children who undergo cardiac surgery are at higher risk for infection. Common clinical
signs and symptoms of infective endocarditis are unexplained fever (low-grade and
intermittent), anorexia, malaise, and splinter hemorrhages under the nails
A child with severe burns begins to exhibit decreased level of consciousness and
lethargy four days after being admitted to the burn unit. The nurse's assessment
reveals a low-grade fever, but the client's other vital signs are stable. The nurse should
be alert for which potential complication?
A. respiratory
failure B.
dehydration
C. sepsis
D. hypovolemia - ansC. sepsis
Dead tissue and exudate associated with burned skin provides a fertile field for bacterial
growth. If the burn site is contaminated with infectious material, sepsis may occur.
Decreased level of consciousness and lethargy are early signs of sepsis.
A five-year-old client who had been prescribed amoxicillin, presents to the clinic with
urticaria. Which medication is recommended for initial treatment of this condition?
, HESI MILESTONE 3 REMEDIATION 2026 ACTUAL EXAM CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A. epinephrine
B. diphenhydramine XV
C. ibuprofen
XV
D. doxepin - ansB. diphenhydramine
XV XV XV XV
Medications are a common cause of anaphylaxis in children. Acute urticaria, also known a
XV XV XV XV XV XV XV XV XV XV XV XV XV
s hives, is a skin reaction common side effect associated with amoxicillin. First-
XV XV XV XV XV XV XV XV XV XV XV XV
line treatment consists administration of an antihistamines, such as diphenhydramine oral
XV XV XV XV XV XV XV XV XV XV
ly, followed by hydrocortisone topically dependent upon the severity of the urticaria.
XV XV XV XV XV XV XV XV XV XV XV
A mother brings in a three-year-
XV XV XV XV XV
old child who has respiratory rate of 36 breathes per minute; heart rate of 160 beats
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
per minute; weaken and thready pulse; and pale and sweaty skin. The nurse suspect
XV XV XV XV XV XV XV XV XV XV XV XV XV
s the child is going into shock which action should the nurse perform first?
XV XV XV XV XV XV XV XV XV XV XV XV XV
A. obtain ABG'sXV XV XV
B. obtain vitals C
XV XV XV
. administer O2
XV XV
D. Establish IV access - ansC. Administer oxygen
XV XV XV XV XV XV XV
When providing care to a child in shock, the nurse's priority is to ensure adequate oxyge
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
nation. The nurse should administer oxygen or provide assistance in establishing an air
XV XV XV XV XV XV XV XV XV XV XV XV
way. The best way to remember the order of priority of care to be given is the "ABCs"; a
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
irway, bleeding and circulation XV XV XV
A nurse has obtained a weight of 17.6 pounds (8 kg) for a 15-month-
XV XV XV XV XV XV XV XV XV XV XV XV XV
old child. The child's ideal body weight is 26.4 pounds (12 kg). How should be the nurs
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
e interpret this body weight?
XV XV XV XV
A. normal variation
XV XV
B. mild wasting
XV XV XV
C. moderate wasting
XV XV
D. severe wasting - ansD. severe wasting
XV XV XV XV XV XV
This child has a body weight 66% less than the ideal body weight for this age (15 months
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
). A body weight less than 70% of the ideal body weight is defined as severe wasting.
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
A nurse is assessing a three year old diagnosed with psoriasis. Which is a common treat
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
ment for most forms of psoriasis?
XV XV XV XV XV
A. exfoliation XV XV
B. cyrotherapy
XV
C. oral antibiotics
XV XV
D. phototherapy - ansD. phototherapy
XV XV XV XV
All types of psoriasis commonly respond to topical creams and phototherapy (ultraviolet li
XV XV XV XV XV XV XV XV XV XV XV XV
ght exposure) when administered 3 to 5 times a week.
XV XV XV XV XV XV XV XV XV
A pediatric client is admitted with sepsis and a high-
XV XV XV XV XV XV XV XV XV
grade fever following an episode of gastritis. The nurse's assessment reveals cool skin;
XV XV XV XV XV XV XV XV XV XV XV XV XV
normal pulse and blood pressure; decreased urinary output; and a diminished mental st
XV XV XV XV XV XV XV XV XV XV XV XV
ate. Which term describes this stage of septic shock?
XV XV XV XV XV XV XV XV
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A 10-year-old child has undergone a cardiac catheterization through the left femoral
artery. During a postprocedural assessment, the nurse finds the left foot is pulseless
and cool to touch. Which is the likely cause?
A. hemorrhage
B. hematoma
C. fasciculation
D. tamponade - and. hematoma
Cardiac catheterization is a routine diagnostic procedure; however, it is not without
risks. Loss of pulse in the catheterized extremity is likely due to a hematoma and
requires immediate intervention to restore circulation.
A 10-year-old client with a recent history of playing in the woods presents to the
school nurse's clinic with localized skin eruptions on the hands and feet which are
streaked, consisting of blisters discharging clear fluid that are painful and itchy. What
should the school nurse suspect to be the causative agent?
A. sunburn
B. poison ivy
C. insect bite
D. heat rash
Contact with the oil called "Urushiol" which is found in poison ivy, oak and sumac may
produce an allergic reaction. Symptoms include localized, streaked, or oozing blisters.
These skin lesions are usually painful and itchy. - ans
A 10-year-old client with asthma arrives at an urgent care clinic with apparent bronchial
constriction. Which class of drugs should the nurse expect to be administered for this
condition?
A. methylxanthines
B. anticholinergic
C. long-acting beta2 agonists
D. oral corticosteroids - ansD. oral corticosteroids
Corticosteroids are fast-acting anti-inflammatory drugs. They are used to treat reversible
airflow obstruction, control symptoms, and reduce bronchial constriction with the fewest
side effects.
A 12-month-old client is being discharged with a body spica cast. Which information
should the nurse include in the parents' discharge teaching plan?
A. foul odor from cast may indicate infection or skin
breakdown B. pillows should not be placed under cast
C. the child can safely transported in a stroller
D. use pillows to elevate the child's head - ansA. foul odor from cast may indicate
infection or skin breakdown
Care of a child in a body spica cast can be challenging for parents at home. Skin under
the cast should be protected from injury and debris, so parents should be instructed
that a foul odor from the cast can be indicative of skin breakdown or infection and to
contact their health care provider.
,HESI MILESTONE 3 REMEDIATION 2026 ACTUAL EXAM CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A 12-year-old athlete reports severe ankle pain and an audible "popping" sound in
the ankle after a fall at soccer practice. The nurse upon inspection observes
moderate swelling, bruising, and joint instability. Initial radiographs of the ankle
appear normal. Which type of injury should the nurse suspect?
A. strain
B. sprain
C. fracture
D. dislocation - ansB. Sprain
The ankle is a common site for sprain injuries. Ankle sprains can range from mild (grade
1) to severe (grade 3), with complete tearing of a ligament in the most severe sprains. A
"popping" sound is likely an indication of a partial or complete ligament tear; joint
instability may be detected at the end-ranges of passive motion.
A 15-year-old client presents with a lump and persistent pain in the right upper
thigh area, and is subsequently diagnosed with a high-grade osteosarcoma. The
nurse should anticipate which plan of treatment for this client?
A. hot/cold topical
applications B. amputation of
the limb
C. electrical stimulation therapy
D. prolonged immobilization - ansB. amputation of the limb
Osteosarcoma is the most common bone cancer in childhood and considered one of the
most fatal. Treatment generally includes chemotherapy and amputation of the affected
limb. As of today, there is no meedical set plan of care.
A child diagnosed with HIV is being enrolled in a new school. Who has the right to
inform the school of this child's HIV status?
A. doctors or nurses
B. social workers
C. parents or legal guardians
D. child welfare department - ansC. parents or legal guardians
Confidentiality is a major issue in school attendance. The parents or legal guardians
have the right to decide whether or not to inform the school of their child's HIV status.
A child has been diagnosed with chicken pox and the nurse teaches the parent not to
give the child aspirin. Which condition may result when a child with chickenpox is given
aspirin?
A. Reye's syndrome B.
Huntingtons disease c.
Raynaud syndrome
D. purpura disorder - ansA. reye's syndrome
Reye's syndrome is a rare, but serious condition that causes brain and liver damage
that has been linked with aspirin use in children, when given to treat a viral infections,
such as chicken pox. Reye's syndrome can be prevented by avoiding the use of aspirin
in children.
,HESI MILESTONE 3 REMEDIATION 2026 ACTUAL EXAM CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A child is admitted with a diagnosis of suspected acute lymphoblastic leukemia (ALL).
Which test is performed to confirm this diagnosis of childhood leukemia?
A. cerebral spinal fluid analysis
B. bone marrow aspiration
C. CBC
D. genetic testing - ansB. bone marrow aspiration
ALL is a form of cancer in which high numbers of abnormal white blood cells are
produced. A bone marrow biopsy that reveals primary blast cells is confirmation of a
leukemia.
A child is brought to the emergency department after ingesting a large amount of
household drain cleaner. Which is the nurse's first priority when caring for this client?
A. perform NG suctioning
B. Assess and maintain an open airway
C. give small amounts of water to
ingest
D. Obtain chest and abdomen radiographs - ansB. assess and maintain an open airway
Ingestion of corrosive household agents may cause airway obstruction due to rapidly
developing laryngeal edema. The first priority is to assess and monitor the client's
airway.
A child recently underwent cardiac surgery and is admitted with a suspected diagnosis
of infective endocarditis. Which presentation should the nurse expect when assessing
this client?
A. bradycardia, lethargy, speech disturbances
B. high fever, irregular movement of joints, involuntary facial grimaces c.
tachycardia, chest pain, swollen and painful joints
D. low grade fever, anorexia, splinter hemorrhages under the nails - ansD. low grade
fever, anorexia, splinter hemorrhages under the nails
Children who undergo cardiac surgery are at higher risk for infection. Common clinical
signs and symptoms of infective endocarditis are unexplained fever (low-grade and
intermittent), anorexia, malaise, and splinter hemorrhages under the nails
A child with severe burns begins to exhibit decreased level of consciousness and
lethargy four days after being admitted to the burn unit. The nurse's assessment
reveals a low-grade fever, but the client's other vital signs are stable. The nurse should
be alert for which potential complication?
A. respiratory
failure B.
dehydration
C. sepsis
D. hypovolemia - ansC. sepsis
Dead tissue and exudate associated with burned skin provides a fertile field for bacterial
growth. If the burn site is contaminated with infectious material, sepsis may occur.
Decreased level of consciousness and lethargy are early signs of sepsis.
A five-year-old client who had been prescribed amoxicillin, presents to the clinic with
urticaria. Which medication is recommended for initial treatment of this condition?
, HESI MILESTONE 3 REMEDIATION 2026 ACTUAL EXAM CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A. epinephrine
B. diphenhydramine XV
C. ibuprofen
XV
D. doxepin - ansB. diphenhydramine
XV XV XV XV
Medications are a common cause of anaphylaxis in children. Acute urticaria, also known a
XV XV XV XV XV XV XV XV XV XV XV XV XV
s hives, is a skin reaction common side effect associated with amoxicillin. First-
XV XV XV XV XV XV XV XV XV XV XV XV
line treatment consists administration of an antihistamines, such as diphenhydramine oral
XV XV XV XV XV XV XV XV XV XV
ly, followed by hydrocortisone topically dependent upon the severity of the urticaria.
XV XV XV XV XV XV XV XV XV XV XV
A mother brings in a three-year-
XV XV XV XV XV
old child who has respiratory rate of 36 breathes per minute; heart rate of 160 beats
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
per minute; weaken and thready pulse; and pale and sweaty skin. The nurse suspect
XV XV XV XV XV XV XV XV XV XV XV XV XV
s the child is going into shock which action should the nurse perform first?
XV XV XV XV XV XV XV XV XV XV XV XV XV
A. obtain ABG'sXV XV XV
B. obtain vitals C
XV XV XV
. administer O2
XV XV
D. Establish IV access - ansC. Administer oxygen
XV XV XV XV XV XV XV
When providing care to a child in shock, the nurse's priority is to ensure adequate oxyge
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
nation. The nurse should administer oxygen or provide assistance in establishing an air
XV XV XV XV XV XV XV XV XV XV XV XV
way. The best way to remember the order of priority of care to be given is the "ABCs"; a
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
irway, bleeding and circulation XV XV XV
A nurse has obtained a weight of 17.6 pounds (8 kg) for a 15-month-
XV XV XV XV XV XV XV XV XV XV XV XV XV
old child. The child's ideal body weight is 26.4 pounds (12 kg). How should be the nurs
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
e interpret this body weight?
XV XV XV XV
A. normal variation
XV XV
B. mild wasting
XV XV XV
C. moderate wasting
XV XV
D. severe wasting - ansD. severe wasting
XV XV XV XV XV XV
This child has a body weight 66% less than the ideal body weight for this age (15 months
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
). A body weight less than 70% of the ideal body weight is defined as severe wasting.
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
A nurse is assessing a three year old diagnosed with psoriasis. Which is a common treat
XV XV XV XV XV XV XV XV XV XV XV XV XV XV XV
ment for most forms of psoriasis?
XV XV XV XV XV
A. exfoliation XV XV
B. cyrotherapy
XV
C. oral antibiotics
XV XV
D. phototherapy - ansD. phototherapy
XV XV XV XV
All types of psoriasis commonly respond to topical creams and phototherapy (ultraviolet li
XV XV XV XV XV XV XV XV XV XV XV XV
ght exposure) when administered 3 to 5 times a week.
XV XV XV XV XV XV XV XV XV
A pediatric client is admitted with sepsis and a high-
XV XV XV XV XV XV XV XV XV
grade fever following an episode of gastritis. The nurse's assessment reveals cool skin;
XV XV XV XV XV XV XV XV XV XV XV XV XV
normal pulse and blood pressure; decreased urinary output; and a diminished mental st
XV XV XV XV XV XV XV XV XV XV XV XV
ate. Which term describes this stage of septic shock?
XV XV XV XV XV XV XV XV
