HESI OB PEDS NEWEST EXAM 2025 QUESTIONS BANK ACTUAL EXAM
COMPLETE 160 QUESTION/NEWEST UPDATE!!!
Question 1
A mother brings her 5-year-old child to the clinic because the child has been playing with a
friend diagnosed with hepatitis. Which of the following assessment findings would the nurse
identify as the least concerning for a diagnosis of hepatitis?
A) Jaundice of the sclera
B) Hepatomegaly
C) Dark-colored, frothy urine
D) Left upper abdominal quadrant (LUQ) pain
E) Pale, clay-colored stools
Correct Answer: D) Left upper abdominal quadrant (LUQ) pain
Rationale: In hepatitis, the liver becomes inflamed and enlarged. Since the liver is located in
the Right Upper Quadrant (RUQ), tenderness and pain are expected in the RUQ, not the
LUQ. Other classic findings include hepatomegaly (enlarged liver), jaundice, dark/frothy
urine (due to bilirubinuria), and clay-colored stools (due to lack of bile in the GI tract).
Question 2
A nurse is reviewing the laboratory results for an infant with suspected hypertrophic pyloric
stenosis. Which of the following acid-base imbalances is the nurse most likely to find?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
E) Mixed respiratory-metabolic acidosis
Correct Answer: B) Metabolic alkalosis
Rationale: Hypertrophic pyloric stenosis causes severe, projectile vomiting. Gastric contents
are highly acidic; the loss of hydrochloric acid through vomiting leads to a rise in serum
bicarbonate and pH, resulting in metabolic alkalosis. Additional findings often include
decreased serum potassium, sodium, and chloride.
Question 1
A 12-year-old girl is admitted with suspected appendicitis. Which of the following nursing
interventions is appropriate to implement preoperatively?
A) Apply a heating pad to the abdomen to soothe pain.
B) Administer 650 mg of acetaminophen for pain relief.
C) Place the adolescent in a fetal, side-lying position with legs drawn to the chest.
D) Perform deep palpation of the Right Lower Quadrant every hour.
E) Encourage the child to drink clear liquids until the time of surgery.
Correct Answer: C) Place the adolescent in a fetal, side-lying position with legs drawn to the
chest.
Rationale: The fetal position (legs flexed toward the chest) decreases tension on the
, 2
abdominal muscles and the peritoneum, thereby reducing pain. Heating pads are strictly
contraindicated because they can increase blood flow to the appendix and lead to rupture.
Pain medications are often withheld or used cautiously pre-op to prevent masking the signs
of rupture. The client should remain NPO.
Question 4
A preschooler with a history of cleft palate repair is being assessed at a well-child checkup.
Which of the following questions is most important for the nurse to ask to determine if the child
is experiencing a common long-term effect of this condition?
A) "Was the child recently treated for pneumonia?"
B) "Does the child play with an imaginary friend?"
C) "Is the child unresponsive when given directions?"
D) "Has the child had any difficulty swallowing food?"
E) "Does the child have frequent bouts of constipation?"
Correct Answer: C) "Is the child unresponsive when given directions?"
Rationale: Children with a history of cleft palate are at a significantly higher risk for middle
ear infections and subsequent hearing loss. Unresponsiveness to directions can be a clinical
indicator of hearing impairment. Pneumonia and dysphagia are typically acute post-op
concerns rather than common long-term developmental assessments.
Question 5
An infant is seen for projectile vomiting after feeding. The child is fussy and hungry but is
slowly losing weight. Pyloric stenosis is suspected. Which of the following prescriptions has the
highest priority?
A) Monitor strict intake and output.
B) Administer predigested formula in small amounts.
C) Administer a proton-pump inhibitor (PPI) before feeding.
D) Prepare the family and the infant for surgical intervention.
E) Perform a sweat chloride test to rule out cystic fibrosis.
Correct Answer: D) Prepare the family and the infant for surgical intervention.
Rationale: Hypertrophic pyloric stenosis is a mechanical obstruction caused by the
thickening of the pyloric sphincter. The definitive treatment is a surgical pyloromyotomy.
While I&O and stabilization are important, surgery is the priority to resolve the
obstruction and allow the infant to receive nutrition.
Question 6
A child is admitted with gastroenteritis and dehydration. The child's current weight is 17 lbs 2 oz
(7.8 kg). The parents state that the child’s weight 3 days ago was 18 lbs 4 oz (8.3 kg). Based on
weight loss alone, the nurse classifies the dehydration as:
A) Mild dehydration
B) Moderate dehydration
, 3
C) Severe dehydration
D) Acute dehydration
E) Chronic dehydration
Correct Answer: B) Moderate dehydration
Rationale: Dehydration in children is categorized by weight loss: Mild is less than 5%;
Moderate is 5-10%; and Severe is greater than 10%. This child has lost approximately 0.5
kg out of 8.3 kg, which is a 6% weight loss, placing them in the moderate category.
Question 7
A nurse is reviewing the laboratory studies for a child suspected of having iron deficiency
anemia. Which of the following results confirms this diagnosis?
A) Elevated hemoglobin levels
B) Decreased reticulocyte count
C) Red blood cells that are macrocytic and hyperchromic
D) Red blood cells that are microcytic and hypochromic
E) Elevated serum ferritin levels
Correct Answer: D) Red blood cells that are microcytic and hypochromic
Rationale: In iron deficiency anemia, the lack of iron prevents the production of adequate
hemoglobin. This results in red blood cells that are smaller than normal (microcytic) and
paler than normal (hypochromic). Total hemoglobin and hematocrit will be low.
Question 8
A child with hemophilia is complaining of severe joint pain. Hemarthrosis is suspected. Which of
the following measures should the nurse anticipate?
A) Perform passive range-of-motion (ROM) exercises to the joint immediately.
B) Apply a heating pad to the joint to promote circulation.
) C) Apply a bivalved cast or splint for joint immobilization.
D) Administer Ibuprofen (NSAID) for the pain.
E) Encourage the child to walk to prevent stiffness.
Correct Answer: C) Apply a bivalved cast or splint for joint immobilization.
Rationale: During an acute bleeding episode (hemarthrosis) in a child with hemophilia, the
joint must be immobilized (RICE: Rest, Ice, Compression, Elevation) to prevent further
bleeding and joint damage. ROM exercises and heat are contraindicated as they increase
blood flow and exacerbate bleeding. NSAIDs are avoided because they inhibit platelet
function.
Question 9
A child with hemophilia was struck in the lower back (flank region) with a baseball bat. Which
of the following is the priority assessment for the nurse?
A) Slurred speech
B) Presence of hematuria
, 4
C) Complaint of a frontal headache
D) Change in respiratory rate
E) Assessing for a positive Kernig's sign
Correct Answer: B) Presence of hematuria
Rationale: The kidneys are located in the flank region. In a child with hemophilia, trauma
to this area can lead to internal bleeding within the renal system. Hematuria is a hallmark
sign of renal trauma and must be monitored immediately. Head-trauma-related signs (A,
C) are not the priority for a back injury.
Question 10
A 12-year-old child with thalassemia exhibits delayed sexual maturation, listlessness, and frontal
bossing. Which laboratory finding should the nurse expect?
A) Macrocytosis and hyperchromia
B) Excessive mature erythrocyte proliferation
C) Increased production of Functional Hemoglobin A
D) Deficient production of functional hemoglobin
E) Low serum iron levels
Correct Answer: D) Deficient production of functional hemoglobin
Rationale: Thalassemia is a genetic disorder resulting in the deficient production of
hemoglobin polypeptide chains. This leads to the production of unstable hemoglobin and
rapid destruction of RBCs. The body attempts to compensate by overproducing immature
RBCs (not mature ones), leading to skeletal changes like frontal bossing due to bone
marrow expansion.
Question 11
A child with sickle cell anemia is in a vaso-occlusive crisis. Which of the following provider
prescriptions is the priority to assist in reversing the crisis?
A) Monitor pulse oximetry every 2 hours.
B) Administer intravenous (IV) fluids.
C) Administer oxygen by face mask at 10L.
D) Administer high-dose oral iron supplements.
E) Administer a live-virus vaccine.
Correct Answer: B) Administer intravenous (IV) fluids.
Rationale: The primary pathology in a vaso-occlusive crisis is the clumping of sickled cells,
which is worsened by high blood viscosity and dehydration. Aggressive hydration via IV
fluids reduces blood viscosity, allowing the sickled cells to flow more easily and reversing
the occlusion. While oxygen may be used, it cannot reach the tissues if the vessels are
blocked; hydration is the treatment priority.
Question 12
A nurse is collecting data on a 12-month-old child with iron deficiency anemia. Which of the
COMPLETE 160 QUESTION/NEWEST UPDATE!!!
Question 1
A mother brings her 5-year-old child to the clinic because the child has been playing with a
friend diagnosed with hepatitis. Which of the following assessment findings would the nurse
identify as the least concerning for a diagnosis of hepatitis?
A) Jaundice of the sclera
B) Hepatomegaly
C) Dark-colored, frothy urine
D) Left upper abdominal quadrant (LUQ) pain
E) Pale, clay-colored stools
Correct Answer: D) Left upper abdominal quadrant (LUQ) pain
Rationale: In hepatitis, the liver becomes inflamed and enlarged. Since the liver is located in
the Right Upper Quadrant (RUQ), tenderness and pain are expected in the RUQ, not the
LUQ. Other classic findings include hepatomegaly (enlarged liver), jaundice, dark/frothy
urine (due to bilirubinuria), and clay-colored stools (due to lack of bile in the GI tract).
Question 2
A nurse is reviewing the laboratory results for an infant with suspected hypertrophic pyloric
stenosis. Which of the following acid-base imbalances is the nurse most likely to find?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
E) Mixed respiratory-metabolic acidosis
Correct Answer: B) Metabolic alkalosis
Rationale: Hypertrophic pyloric stenosis causes severe, projectile vomiting. Gastric contents
are highly acidic; the loss of hydrochloric acid through vomiting leads to a rise in serum
bicarbonate and pH, resulting in metabolic alkalosis. Additional findings often include
decreased serum potassium, sodium, and chloride.
Question 1
A 12-year-old girl is admitted with suspected appendicitis. Which of the following nursing
interventions is appropriate to implement preoperatively?
A) Apply a heating pad to the abdomen to soothe pain.
B) Administer 650 mg of acetaminophen for pain relief.
C) Place the adolescent in a fetal, side-lying position with legs drawn to the chest.
D) Perform deep palpation of the Right Lower Quadrant every hour.
E) Encourage the child to drink clear liquids until the time of surgery.
Correct Answer: C) Place the adolescent in a fetal, side-lying position with legs drawn to the
chest.
Rationale: The fetal position (legs flexed toward the chest) decreases tension on the
, 2
abdominal muscles and the peritoneum, thereby reducing pain. Heating pads are strictly
contraindicated because they can increase blood flow to the appendix and lead to rupture.
Pain medications are often withheld or used cautiously pre-op to prevent masking the signs
of rupture. The client should remain NPO.
Question 4
A preschooler with a history of cleft palate repair is being assessed at a well-child checkup.
Which of the following questions is most important for the nurse to ask to determine if the child
is experiencing a common long-term effect of this condition?
A) "Was the child recently treated for pneumonia?"
B) "Does the child play with an imaginary friend?"
C) "Is the child unresponsive when given directions?"
D) "Has the child had any difficulty swallowing food?"
E) "Does the child have frequent bouts of constipation?"
Correct Answer: C) "Is the child unresponsive when given directions?"
Rationale: Children with a history of cleft palate are at a significantly higher risk for middle
ear infections and subsequent hearing loss. Unresponsiveness to directions can be a clinical
indicator of hearing impairment. Pneumonia and dysphagia are typically acute post-op
concerns rather than common long-term developmental assessments.
Question 5
An infant is seen for projectile vomiting after feeding. The child is fussy and hungry but is
slowly losing weight. Pyloric stenosis is suspected. Which of the following prescriptions has the
highest priority?
A) Monitor strict intake and output.
B) Administer predigested formula in small amounts.
C) Administer a proton-pump inhibitor (PPI) before feeding.
D) Prepare the family and the infant for surgical intervention.
E) Perform a sweat chloride test to rule out cystic fibrosis.
Correct Answer: D) Prepare the family and the infant for surgical intervention.
Rationale: Hypertrophic pyloric stenosis is a mechanical obstruction caused by the
thickening of the pyloric sphincter. The definitive treatment is a surgical pyloromyotomy.
While I&O and stabilization are important, surgery is the priority to resolve the
obstruction and allow the infant to receive nutrition.
Question 6
A child is admitted with gastroenteritis and dehydration. The child's current weight is 17 lbs 2 oz
(7.8 kg). The parents state that the child’s weight 3 days ago was 18 lbs 4 oz (8.3 kg). Based on
weight loss alone, the nurse classifies the dehydration as:
A) Mild dehydration
B) Moderate dehydration
, 3
C) Severe dehydration
D) Acute dehydration
E) Chronic dehydration
Correct Answer: B) Moderate dehydration
Rationale: Dehydration in children is categorized by weight loss: Mild is less than 5%;
Moderate is 5-10%; and Severe is greater than 10%. This child has lost approximately 0.5
kg out of 8.3 kg, which is a 6% weight loss, placing them in the moderate category.
Question 7
A nurse is reviewing the laboratory studies for a child suspected of having iron deficiency
anemia. Which of the following results confirms this diagnosis?
A) Elevated hemoglobin levels
B) Decreased reticulocyte count
C) Red blood cells that are macrocytic and hyperchromic
D) Red blood cells that are microcytic and hypochromic
E) Elevated serum ferritin levels
Correct Answer: D) Red blood cells that are microcytic and hypochromic
Rationale: In iron deficiency anemia, the lack of iron prevents the production of adequate
hemoglobin. This results in red blood cells that are smaller than normal (microcytic) and
paler than normal (hypochromic). Total hemoglobin and hematocrit will be low.
Question 8
A child with hemophilia is complaining of severe joint pain. Hemarthrosis is suspected. Which of
the following measures should the nurse anticipate?
A) Perform passive range-of-motion (ROM) exercises to the joint immediately.
B) Apply a heating pad to the joint to promote circulation.
) C) Apply a bivalved cast or splint for joint immobilization.
D) Administer Ibuprofen (NSAID) for the pain.
E) Encourage the child to walk to prevent stiffness.
Correct Answer: C) Apply a bivalved cast or splint for joint immobilization.
Rationale: During an acute bleeding episode (hemarthrosis) in a child with hemophilia, the
joint must be immobilized (RICE: Rest, Ice, Compression, Elevation) to prevent further
bleeding and joint damage. ROM exercises and heat are contraindicated as they increase
blood flow and exacerbate bleeding. NSAIDs are avoided because they inhibit platelet
function.
Question 9
A child with hemophilia was struck in the lower back (flank region) with a baseball bat. Which
of the following is the priority assessment for the nurse?
A) Slurred speech
B) Presence of hematuria
, 4
C) Complaint of a frontal headache
D) Change in respiratory rate
E) Assessing for a positive Kernig's sign
Correct Answer: B) Presence of hematuria
Rationale: The kidneys are located in the flank region. In a child with hemophilia, trauma
to this area can lead to internal bleeding within the renal system. Hematuria is a hallmark
sign of renal trauma and must be monitored immediately. Head-trauma-related signs (A,
C) are not the priority for a back injury.
Question 10
A 12-year-old child with thalassemia exhibits delayed sexual maturation, listlessness, and frontal
bossing. Which laboratory finding should the nurse expect?
A) Macrocytosis and hyperchromia
B) Excessive mature erythrocyte proliferation
C) Increased production of Functional Hemoglobin A
D) Deficient production of functional hemoglobin
E) Low serum iron levels
Correct Answer: D) Deficient production of functional hemoglobin
Rationale: Thalassemia is a genetic disorder resulting in the deficient production of
hemoglobin polypeptide chains. This leads to the production of unstable hemoglobin and
rapid destruction of RBCs. The body attempts to compensate by overproducing immature
RBCs (not mature ones), leading to skeletal changes like frontal bossing due to bone
marrow expansion.
Question 11
A child with sickle cell anemia is in a vaso-occlusive crisis. Which of the following provider
prescriptions is the priority to assist in reversing the crisis?
A) Monitor pulse oximetry every 2 hours.
B) Administer intravenous (IV) fluids.
C) Administer oxygen by face mask at 10L.
D) Administer high-dose oral iron supplements.
E) Administer a live-virus vaccine.
Correct Answer: B) Administer intravenous (IV) fluids.
Rationale: The primary pathology in a vaso-occlusive crisis is the clumping of sickled cells,
which is worsened by high blood viscosity and dehydration. Aggressive hydration via IV
fluids reduces blood viscosity, allowing the sickled cells to flow more easily and reversing
the occlusion. While oxygen may be used, it cannot reach the tissues if the vessels are
blocked; hydration is the treatment priority.
Question 12
A nurse is collecting data on a 12-month-old child with iron deficiency anemia. Which of the
