HESI PEDS ACTUAL EXAM
2026-2027 UPDATED VERSION
VERIFIED QUESTIONS
A - (Russell's skin traction is used for fractures of the femur in young children and adolescents
whose growth plates remain open and is applied to the lower leg using moleskin and elastic
wrap bandages, which can compress the peroneal nerve and arteries that supply the foot.
Assessment of adequare circulation, movement, and sensation of the toes and skin distal to the
application is made to identify compromised blood flow, so cyanosis, A, should be reported
immediately.) - answer- The nurse is assessing the neurovascular status of a child in
Russell's traction. Which finding should the nurse report to the healthcare provider?
A) Pale bluish coloration of the toes.
B) Skin is warm and dry to the touch.
C) Toes are wiggled upon command.
D) Capillary refill less than 3 seconds.
C - (A trial of HCG,human chorionic gonadotrophic hormone, C, may aid in testicular descent,
but does not replace surgical repair for true undescended testes. Undescended testes,
cryptorchidism, may be found in the inguinal canal due to exaggerated cremasteric reflex. A, is
not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather than
descend in the scrotum, B. D, may relax the cremasteric muscle, but may not cause the testes to
descend.) - answer- Surgery is being delayed for an infant with undescended testes. In
collaboration with the healthcare provider and the family, which prescription should the nurse
anticipate?
A) A trial of adrenocorticotrophic hormone injections.
,B) Frequent stimulation of the cremasteric reflex.
C) A trial of human chorionic gonadotrophic hormone.
D) Frequent warm baths to gently dilate the scrotal area.
A - (Celiac disease causes an intolerance to the protein gluten found in oats, rye, wheat, and
barley. The child should avoid any products containing these ingredients to avoid symptoms
such as diarrhea. A, is the selection which avoids all of these ingredients.) - answer-
Which menu selection by a child with celiac disease indicates to the nurse that the child
understands necessary dietary considerations?
A) Oven-baked potato chips and cola.
B) Peanut butter and banana sandwich.
C) Oatmeal-raisin cookies and milk.
D) Graham crackers and fruit juice.
A - (The respiratory rate should be taken first, A, in infants, since touching them or performing
unpleasant procedures usually makes them cry, elevating the heart rate and making respirations
difficult to count.) - answer- To take the vital signs of a 4-month-old child, which order
provides the most accurate results?
A) Respiratory rate, heart rate, then rectal temperature.
B) Heart rate, rectal temperature, then respiratory rate.
C) Rectal temperature, heart rate, then respiratory rate.
D) Rectal temperature, respiratory rate, then heart rate.
A - (Signs and symptoms of diabetes or hyperglycemia, A, need to be reported. Those receiving
growth hormone should be monitored to detect elevated blood sugars and glucose intolerance.)
- answer- The nurse is teaching a 12-year-old male adolescent and his family about taking
injections of growth hormone for idiopathic hypopituitarism. Which adverse symptoms,
commonly associated with growth hormone therapy, should the nurse plan to describe to the
child and his family?
A) Polyuria and polydipsia.
,B) Lethargy and fatigue.
C) Increased facial hair.
D) Facial bone structure changes.
D - (The child must be monitored for signs and symptoms of hyponatremia, which creates
secondary central nervous system alterations such as changes in level of consciousness, seizure,
and coma.) - answer- 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?
A) Poor skin turgor resulting from dehydration.
B) Changes in level of consciousness.
C) Premature aging as the disease progresses.
D) Severe edema from an excess of water and sodium.
A, C, F - (The most accurate calculations of pediatric dosages use the child's height and weight,
A. The child's BSA is calculated using the square root of weight in kg times height in cm divided
by 3600 or the square root of weight in lb times height in inches divided by 3131, C, then the
child's BSA is multiplied by the recommended published dose per BSA. The nomogram, F, is
used to plot the child's height and weight, and the point at which they intersect is the BSA
mathematical constant used to calculate the child's dose.) - answer- Which
measurements should be used to accurately calculate a pediatric medication dosage? (Select all
that apply.)
A) Child's height and weight.
B) Adult dosage of medication.
C) Body surface area of child.
D) Average adult's body surface area.
E) Average pediatric dosage of medication.
F) Nomogram determined mathematical constant.
, B - ( The only reliable way to prevent poisonings in young children is to make them inaccessible,
B. Teaching children not to taste is important, A, but ineffective for young children. C and D, will
not control a child's curiosity.) - answer- The nurse is preparing a health teaching program
for parents of toddlers and preschoolers and plans to include information about prevention of
accidental poisonings. It is most important for the nurse to include which instruction?
A) Tell children they should not taste anything but food.
B) Store all toxic agents and medicines in locked cabinets.
C) Provide special play areas in the house and restrict play in other areas.
D) Punish children if they open cabinets that contain household chemicals.
A - (Intercostal retractions result from respiratory effort to draw air into restricted airways, A) -
answer- When assessing a child with asthma, the nurse should expect intercostal
retractions during
A) inspiration.
B) coughing.
C) apneic episodes.
D) expiration.
D - (Prevention of stress on the lip suture line, D, is essential for optimum healing and the
cosmetic appearance of a cleft lip repair.) - answer- When planning the care for a child
who has had a cleft lip repair, the nurse knows that crying should be minimized because it
A) increases salivation.
B) increases the respiratory rate.
C) leads to vomiting.
D) stresses the suture line.
C - (Washing the hair and skin with soap and hot water, C, removes oil and debris from the skin
and helps prevent and treat acne. Oily skin is especially bothersome during adolescence when
hormones cause enlargement of sebaceous glands and increased glandular secretions which
2026-2027 UPDATED VERSION
VERIFIED QUESTIONS
A - (Russell's skin traction is used for fractures of the femur in young children and adolescents
whose growth plates remain open and is applied to the lower leg using moleskin and elastic
wrap bandages, which can compress the peroneal nerve and arteries that supply the foot.
Assessment of adequare circulation, movement, and sensation of the toes and skin distal to the
application is made to identify compromised blood flow, so cyanosis, A, should be reported
immediately.) - answer- The nurse is assessing the neurovascular status of a child in
Russell's traction. Which finding should the nurse report to the healthcare provider?
A) Pale bluish coloration of the toes.
B) Skin is warm and dry to the touch.
C) Toes are wiggled upon command.
D) Capillary refill less than 3 seconds.
C - (A trial of HCG,human chorionic gonadotrophic hormone, C, may aid in testicular descent,
but does not replace surgical repair for true undescended testes. Undescended testes,
cryptorchidism, may be found in the inguinal canal due to exaggerated cremasteric reflex. A, is
not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather than
descend in the scrotum, B. D, may relax the cremasteric muscle, but may not cause the testes to
descend.) - answer- Surgery is being delayed for an infant with undescended testes. In
collaboration with the healthcare provider and the family, which prescription should the nurse
anticipate?
A) A trial of adrenocorticotrophic hormone injections.
,B) Frequent stimulation of the cremasteric reflex.
C) A trial of human chorionic gonadotrophic hormone.
D) Frequent warm baths to gently dilate the scrotal area.
A - (Celiac disease causes an intolerance to the protein gluten found in oats, rye, wheat, and
barley. The child should avoid any products containing these ingredients to avoid symptoms
such as diarrhea. A, is the selection which avoids all of these ingredients.) - answer-
Which menu selection by a child with celiac disease indicates to the nurse that the child
understands necessary dietary considerations?
A) Oven-baked potato chips and cola.
B) Peanut butter and banana sandwich.
C) Oatmeal-raisin cookies and milk.
D) Graham crackers and fruit juice.
A - (The respiratory rate should be taken first, A, in infants, since touching them or performing
unpleasant procedures usually makes them cry, elevating the heart rate and making respirations
difficult to count.) - answer- To take the vital signs of a 4-month-old child, which order
provides the most accurate results?
A) Respiratory rate, heart rate, then rectal temperature.
B) Heart rate, rectal temperature, then respiratory rate.
C) Rectal temperature, heart rate, then respiratory rate.
D) Rectal temperature, respiratory rate, then heart rate.
A - (Signs and symptoms of diabetes or hyperglycemia, A, need to be reported. Those receiving
growth hormone should be monitored to detect elevated blood sugars and glucose intolerance.)
- answer- The nurse is teaching a 12-year-old male adolescent and his family about taking
injections of growth hormone for idiopathic hypopituitarism. Which adverse symptoms,
commonly associated with growth hormone therapy, should the nurse plan to describe to the
child and his family?
A) Polyuria and polydipsia.
,B) Lethargy and fatigue.
C) Increased facial hair.
D) Facial bone structure changes.
D - (The child must be monitored for signs and symptoms of hyponatremia, which creates
secondary central nervous system alterations such as changes in level of consciousness, seizure,
and coma.) - answer- 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?
A) Poor skin turgor resulting from dehydration.
B) Changes in level of consciousness.
C) Premature aging as the disease progresses.
D) Severe edema from an excess of water and sodium.
A, C, F - (The most accurate calculations of pediatric dosages use the child's height and weight,
A. The child's BSA is calculated using the square root of weight in kg times height in cm divided
by 3600 or the square root of weight in lb times height in inches divided by 3131, C, then the
child's BSA is multiplied by the recommended published dose per BSA. The nomogram, F, is
used to plot the child's height and weight, and the point at which they intersect is the BSA
mathematical constant used to calculate the child's dose.) - answer- Which
measurements should be used to accurately calculate a pediatric medication dosage? (Select all
that apply.)
A) Child's height and weight.
B) Adult dosage of medication.
C) Body surface area of child.
D) Average adult's body surface area.
E) Average pediatric dosage of medication.
F) Nomogram determined mathematical constant.
, B - ( The only reliable way to prevent poisonings in young children is to make them inaccessible,
B. Teaching children not to taste is important, A, but ineffective for young children. C and D, will
not control a child's curiosity.) - answer- The nurse is preparing a health teaching program
for parents of toddlers and preschoolers and plans to include information about prevention of
accidental poisonings. It is most important for the nurse to include which instruction?
A) Tell children they should not taste anything but food.
B) Store all toxic agents and medicines in locked cabinets.
C) Provide special play areas in the house and restrict play in other areas.
D) Punish children if they open cabinets that contain household chemicals.
A - (Intercostal retractions result from respiratory effort to draw air into restricted airways, A) -
answer- When assessing a child with asthma, the nurse should expect intercostal
retractions during
A) inspiration.
B) coughing.
C) apneic episodes.
D) expiration.
D - (Prevention of stress on the lip suture line, D, is essential for optimum healing and the
cosmetic appearance of a cleft lip repair.) - answer- When planning the care for a child
who has had a cleft lip repair, the nurse knows that crying should be minimized because it
A) increases salivation.
B) increases the respiratory rate.
C) leads to vomiting.
D) stresses the suture line.
C - (Washing the hair and skin with soap and hot water, C, removes oil and debris from the skin
and helps prevent and treat acne. Oily skin is especially bothersome during adolescence when
hormones cause enlargement of sebaceous glands and increased glandular secretions which
