HESI RN PEDS ACTUAL EXAM QUESTIONS
AND ANSWERS
Question 1
A 4-year-old girl returns to the pediatrician's office for a postoperative visit following
hospitalization for minor surgery. When observing the child in the waiting area, which
behavior should the nurse consider normal for this age child?
A - ignores other children in the play area
B - draws picture of self with facial features
C - "talks" to imaginary friend
D - sits quietly in her mother's lap
Correct Answer
C
Question 2
A breastfeeding infant, screened for congenital hypothyroidism, is found to have low
levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). What is
the BEST explanation for this finding?
A - the thyroid gland does not produce normal levels of thyroxine for several weeks
after birth
B - the thyroxine level is low because the TSH level is high
C - the TSH is high because of the low production of T4 by the thyroid
D - high thyroxine levels normally occur in breastfeeding infants
Correct Answer
C
Page 1 of 131
,Question 3
The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell
crisis. Which finding should the nurse report to the healthcare provider
IMMEDIATELY?
A - swelling in the hands/feet
B - jaundice
C - ulcers on the legs
D - chest pain
Correct Answer
D
HESI RN PEDIATRICS
1. The nurse is planning postoperative care for a child who has had
a cleft lip repair. What is the most important reason to minimize
this child's crying during the recovery period?
A. Tear formation increases salivation.
B. This behavior increases respirations.
C. Excessive hysteria can lead to vomiting.
D. Crying stresses the suture line
Rationale:
Prevention of stress on the lip suture line is essential for optimum healing and the
cosmetic appearance of a cleft lip repair. Although crying also causes options A, B,
and C, these conditions do not create a problem for the child with a cleft lip repair.
2. An infant is receiving digoxin for congestive heart failure. The
apical heart rate is assessed at 80 beats/min. What intervention
should the nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat.
Page 2 of 131
, Rationale:
Sinus bradycardia (heart rate <90 to 110 beats/min in an infant) is an indication of
digoxin toxicity, so assessment of the client's digoxin level has the highest priority.
Option A is not indicated at this time. Option C provides helpful assessment data
but does not address the cause of the problem and delays needed intervention.
Option D is indicated for a serious, life-threatening overdose with digoxin.
3. The nurse admits a child to the intensive care unit with a
possible diagnosis of Wilms tumor - What is the most safety
precaution for child?
A. maintain NPO status
B. Limit visitors to the immediate family
C. Place a do not palpate
abdomen sign on head of bed
D. Encourage ambulation in the pre-operative period
Rationale:
Protect child from injury; place a sign on bed stating "no abdominal palpation" (to
prevent accidental fragmentation and dislodging into the abdominal cavity). The
other option choices are not relevant at this time.
4. The nurse is preparing a teaching plan for the mother of a child
who has been diagnosed with celiac disease. Choosing which
lunch will be within the therapeutic management of a child with
celiac disease?
A. Turkey salad, milk, and oatmeal cookies
B. Baked chicken, coleslaw, soda,
and frozen fruit dessert
C. Tuna salad sandwich on whole
wheat bread, milk, and ice cream
Page 3 of 131
, D. Turkey sandwich on rye bread,
orange juice, and fresh fruit
Rationale:
A child with celiac disease is managed on a gluten-free diet, which eliminates food
products containing oats, wheat, rye, or barley.
5. A 6-month-old male infant is admitted to the postanesthesia
care unit with elbow restraints in place. He has an endotracheal
tube and is ventilator-dependent but will be extubated soon
following recovery from anesthesia. Which nursing intervention
should be included in this child's plan of care?
A. Keep restraints on at all
times to prevent
unplanned extubation.
B. Remove restraints one at a
time and provide range-of-
motion exercises.
C. Remove all restraints
simultaneously and provide play
activities.
D. Document the reason for
application of the restraints
every 72 hours.
Rationale:
Removing restraints one at a time is safer than option C. The infant should have
the restrained extremities assessed frequently for signs of neurologic or vascular
impairment, and range-of-motion exercises should be performed with these
assessments. Under no circumstances should restraints be applied to the client
continuously. Documentation of assessment findings regarding the restrained
extremities must occur much more frequently than every 72 hours; however, the
reason for using restraints must be justified and should be stated in the medical
record.
Page 4 of 131
AND ANSWERS
Question 1
A 4-year-old girl returns to the pediatrician's office for a postoperative visit following
hospitalization for minor surgery. When observing the child in the waiting area, which
behavior should the nurse consider normal for this age child?
A - ignores other children in the play area
B - draws picture of self with facial features
C - "talks" to imaginary friend
D - sits quietly in her mother's lap
Correct Answer
C
Question 2
A breastfeeding infant, screened for congenital hypothyroidism, is found to have low
levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). What is
the BEST explanation for this finding?
A - the thyroid gland does not produce normal levels of thyroxine for several weeks
after birth
B - the thyroxine level is low because the TSH level is high
C - the TSH is high because of the low production of T4 by the thyroid
D - high thyroxine levels normally occur in breastfeeding infants
Correct Answer
C
Page 1 of 131
,Question 3
The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell
crisis. Which finding should the nurse report to the healthcare provider
IMMEDIATELY?
A - swelling in the hands/feet
B - jaundice
C - ulcers on the legs
D - chest pain
Correct Answer
D
HESI RN PEDIATRICS
1. The nurse is planning postoperative care for a child who has had
a cleft lip repair. What is the most important reason to minimize
this child's crying during the recovery period?
A. Tear formation increases salivation.
B. This behavior increases respirations.
C. Excessive hysteria can lead to vomiting.
D. Crying stresses the suture line
Rationale:
Prevention of stress on the lip suture line is essential for optimum healing and the
cosmetic appearance of a cleft lip repair. Although crying also causes options A, B,
and C, these conditions do not create a problem for the child with a cleft lip repair.
2. An infant is receiving digoxin for congestive heart failure. The
apical heart rate is assessed at 80 beats/min. What intervention
should the nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat.
Page 2 of 131
, Rationale:
Sinus bradycardia (heart rate <90 to 110 beats/min in an infant) is an indication of
digoxin toxicity, so assessment of the client's digoxin level has the highest priority.
Option A is not indicated at this time. Option C provides helpful assessment data
but does not address the cause of the problem and delays needed intervention.
Option D is indicated for a serious, life-threatening overdose with digoxin.
3. The nurse admits a child to the intensive care unit with a
possible diagnosis of Wilms tumor - What is the most safety
precaution for child?
A. maintain NPO status
B. Limit visitors to the immediate family
C. Place a do not palpate
abdomen sign on head of bed
D. Encourage ambulation in the pre-operative period
Rationale:
Protect child from injury; place a sign on bed stating "no abdominal palpation" (to
prevent accidental fragmentation and dislodging into the abdominal cavity). The
other option choices are not relevant at this time.
4. The nurse is preparing a teaching plan for the mother of a child
who has been diagnosed with celiac disease. Choosing which
lunch will be within the therapeutic management of a child with
celiac disease?
A. Turkey salad, milk, and oatmeal cookies
B. Baked chicken, coleslaw, soda,
and frozen fruit dessert
C. Tuna salad sandwich on whole
wheat bread, milk, and ice cream
Page 3 of 131
, D. Turkey sandwich on rye bread,
orange juice, and fresh fruit
Rationale:
A child with celiac disease is managed on a gluten-free diet, which eliminates food
products containing oats, wheat, rye, or barley.
5. A 6-month-old male infant is admitted to the postanesthesia
care unit with elbow restraints in place. He has an endotracheal
tube and is ventilator-dependent but will be extubated soon
following recovery from anesthesia. Which nursing intervention
should be included in this child's plan of care?
A. Keep restraints on at all
times to prevent
unplanned extubation.
B. Remove restraints one at a
time and provide range-of-
motion exercises.
C. Remove all restraints
simultaneously and provide play
activities.
D. Document the reason for
application of the restraints
every 72 hours.
Rationale:
Removing restraints one at a time is safer than option C. The infant should have
the restrained extremities assessed frequently for signs of neurologic or vascular
impairment, and range-of-motion exercises should be performed with these
assessments. Under no circumstances should restraints be applied to the client
continuously. Documentation of assessment findings regarding the restrained
extremities must occur much more frequently than every 72 hours; however, the
reason for using restraints must be justified and should be stated in the medical
record.
Page 4 of 131
