HESI RN Pediatric (PEDS) — 250 Exam Practice
Questions &Answers with rationales | latest
update
These questions cover: respiratory emergencies, cardiac defects, oncology,
endocrinology, neurology, infectious disease, GI disorders, renal conditions,
growth & development, immunization, pain management, child abuse,
psychosocial care, pharmacology, and HESI-style clinical reasoning — aligned
with the HESI PN/RN Pediatric exam blueprint.
1. A nurse is assessing a 2-year-old child who was brought to the emergency
department. The child has a respiratory rate of 40 breaths/min, nasal flaring, and
intercostal retractions. Which action should the nurse take first?
A) Administer prescribed oral antipyretics B) Notify the healthcare provider of
findings C) Position the child upright and apply oxygen D) Obtain a chest X-ray
C) Position the child upright and apply oxygen (correct answer)
Rationale: Airway and breathing are the priority — positioning the child
upright opens the airway and reduces the work of breathing, while
,supplemental oxygen addresses hypoxia. These interventions precede
notification and diagnostics.
2. A 4-year-old is admitted with croup. The nurse hears a high-pitched inspiratory
sound on assessment. Which term accurately describes this finding?
A) Wheezing B) Stridor C) Rhonchi D) Crackles
B) Stridor (correct answer)
Rationale: Stridor is a high-pitched, harsh inspiratory sound caused by upper
airway obstruction, characteristically heard in croup due to subglottic edema.
It is a hallmark sign requiring prompt assessment.
3. A nurse is caring for a 6-week-old infant with pyloric stenosis. Which
assessment finding is most consistent with this diagnosis?
A) Watery, explosive diarrhea after feeding B) Projectile vomiting shortly after
feeding C) Abdominal distension with bile-stained vomit D) Bloody stools with
currant jelly appearance
B) Projectile vomiting shortly after feeding (correct answer)
Rationale: Pyloric stenosis causes hypertrophic narrowing of the pyloric
sphincter, leading to forceful, projectile, non-bilious vomiting after feedings.
This is the classic presentation in infants typically 2–8 weeks old.
,4. A child with sickle cell disease is admitted in vaso-occlusive crisis. Which
nursing intervention is the highest priority?
A) Administer prescribed analgesics promptly B) Encourage oral fluid intake C)
Apply warm compresses to painful areas D) Monitor oxygen saturation
continuously
A) Administer prescribed analgesics promptly (correct answer)
Rationale: Pain management is the priority in vaso-occlusive crisis. Prompt,
adequate analgesia (often IV opioids) is the cornerstone of treatment. Delayed
pain relief is harmful and increases crisis severity.
5. A nurse is teaching the parents of a newborn with phenylketonuria (PKU).
Which dietary instruction is most important?
A) Restrict all protein from the diet B) Avoid foods containing phenylalanine C)
Increase intake of high-fat foods D) Supplement with extra iron daily
B) Avoid foods containing phenylalanine (correct answer)
Rationale: PKU results from inability to metabolize phenylalanine.
Accumulation causes irreversible intellectual disability. A phenylalanine-
restricted diet — eliminating high-protein foods like meat, dairy, and using
special formula — is essential for normal neurodevelopment.
, 6. A 3-year-old child is admitted with epiglottitis. Which action should the nurse
avoid?
A) Keeping emergency airway equipment at bedside B) Allowing the child to
remain in parent's lap C) Attempting to visualize the throat with a tongue depressor
D) Administering humidified oxygen
C) Attempting to visualize the throat with a tongue depressor (correct answer)
Rationale: Using a tongue depressor in epiglottitis can trigger complete
airway obstruction and laryngospasm, causing respiratory arrest. The airway
must never be instrumented outside of a controlled setting with emergency
equipment ready.
7. A nurse is assessing a 7-month-old infant. Which developmental milestone
should the nurse expect?
A) Walking independently B) Saying 2-word phrases C) Sitting without support D)
Using a pincer grasp
C) Sitting without support (correct answer)
Rationale: By 6–8 months, most infants can sit without support. Walking
occurs around 12 months, 2-word phrases by 18–24 months, and pincer grasp
develops around 9–10 months.
Questions &Answers with rationales | latest
update
These questions cover: respiratory emergencies, cardiac defects, oncology,
endocrinology, neurology, infectious disease, GI disorders, renal conditions,
growth & development, immunization, pain management, child abuse,
psychosocial care, pharmacology, and HESI-style clinical reasoning — aligned
with the HESI PN/RN Pediatric exam blueprint.
1. A nurse is assessing a 2-year-old child who was brought to the emergency
department. The child has a respiratory rate of 40 breaths/min, nasal flaring, and
intercostal retractions. Which action should the nurse take first?
A) Administer prescribed oral antipyretics B) Notify the healthcare provider of
findings C) Position the child upright and apply oxygen D) Obtain a chest X-ray
C) Position the child upright and apply oxygen (correct answer)
Rationale: Airway and breathing are the priority — positioning the child
upright opens the airway and reduces the work of breathing, while
,supplemental oxygen addresses hypoxia. These interventions precede
notification and diagnostics.
2. A 4-year-old is admitted with croup. The nurse hears a high-pitched inspiratory
sound on assessment. Which term accurately describes this finding?
A) Wheezing B) Stridor C) Rhonchi D) Crackles
B) Stridor (correct answer)
Rationale: Stridor is a high-pitched, harsh inspiratory sound caused by upper
airway obstruction, characteristically heard in croup due to subglottic edema.
It is a hallmark sign requiring prompt assessment.
3. A nurse is caring for a 6-week-old infant with pyloric stenosis. Which
assessment finding is most consistent with this diagnosis?
A) Watery, explosive diarrhea after feeding B) Projectile vomiting shortly after
feeding C) Abdominal distension with bile-stained vomit D) Bloody stools with
currant jelly appearance
B) Projectile vomiting shortly after feeding (correct answer)
Rationale: Pyloric stenosis causes hypertrophic narrowing of the pyloric
sphincter, leading to forceful, projectile, non-bilious vomiting after feedings.
This is the classic presentation in infants typically 2–8 weeks old.
,4. A child with sickle cell disease is admitted in vaso-occlusive crisis. Which
nursing intervention is the highest priority?
A) Administer prescribed analgesics promptly B) Encourage oral fluid intake C)
Apply warm compresses to painful areas D) Monitor oxygen saturation
continuously
A) Administer prescribed analgesics promptly (correct answer)
Rationale: Pain management is the priority in vaso-occlusive crisis. Prompt,
adequate analgesia (often IV opioids) is the cornerstone of treatment. Delayed
pain relief is harmful and increases crisis severity.
5. A nurse is teaching the parents of a newborn with phenylketonuria (PKU).
Which dietary instruction is most important?
A) Restrict all protein from the diet B) Avoid foods containing phenylalanine C)
Increase intake of high-fat foods D) Supplement with extra iron daily
B) Avoid foods containing phenylalanine (correct answer)
Rationale: PKU results from inability to metabolize phenylalanine.
Accumulation causes irreversible intellectual disability. A phenylalanine-
restricted diet — eliminating high-protein foods like meat, dairy, and using
special formula — is essential for normal neurodevelopment.
, 6. A 3-year-old child is admitted with epiglottitis. Which action should the nurse
avoid?
A) Keeping emergency airway equipment at bedside B) Allowing the child to
remain in parent's lap C) Attempting to visualize the throat with a tongue depressor
D) Administering humidified oxygen
C) Attempting to visualize the throat with a tongue depressor (correct answer)
Rationale: Using a tongue depressor in epiglottitis can trigger complete
airway obstruction and laryngospasm, causing respiratory arrest. The airway
must never be instrumented outside of a controlled setting with emergency
equipment ready.
7. A nurse is assessing a 7-month-old infant. Which developmental milestone
should the nurse expect?
A) Walking independently B) Saying 2-word phrases C) Sitting without support D)
Using a pincer grasp
C) Sitting without support (correct answer)
Rationale: By 6–8 months, most infants can sit without support. Walking
occurs around 12 months, 2-word phrases by 18–24 months, and pincer grasp
develops around 9–10 months.
