**HESI PEDS Cumulative Exam Test Bank 2022: 325 Verified Questions with Answers and Rationales for
Nursing Students (100 Practice Questions)**
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**1.** A 2‑year‑old child is admitted with dehydration due to gastroenteritis. Which assessment finding
indicates severe dehydration?
A) Sunken fontanels and dry mucous membranes
B) Capillary refill of 2 seconds
C) Urine output of 2 mL/kg/hour
D) Heart rate 110 bpm
🔍 **RATIONALE** 💡-- Sunken fontanels (in infants/toddlers) and dry mucous membranes are signs of
moderate to severe dehydration. Capillary refill >3 seconds, decreased urine output (<1 mL/kg/hour),
and tachycardia are also seen in severe dehydration.
ANSWER💫✔️-- **A) Sunken fontanels and dry mucous membranes**
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**2.** A nurse is teaching parents about fever management in a 6‑month‑old infant. Which statement
indicates correct understanding?
A) “I will give my baby aspirin to reduce the fever.”
B) “I will alternate acetaminophen and ibuprofen every 2 hours.”
C) “I will dress my baby lightly and offer fluids frequently.”
D) “I will sponge my baby with cold water to bring the fever down quickly.”
🔍 **RATIONALE** 💡-- Light clothing prevents overheating; fluids prevent dehydration. Aspirin is
contraindicated in children due to Reye’s syndrome. Alternating antipyretics is acceptable but not every
2 hours (usually every 4‑6 hours). Cold water sponging can cause shivering, which raises temperature.
,ANSWER💫✔️-- **C) “I will dress my baby lightly and offer fluids frequently.”**
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**3.** A 4‑year‑old child with respiratory syncytial virus (RSV) bronchiolitis has an oxygen saturation of
88% on room air. Which intervention should the nurse implement first?
A) Administer a bronchodilator nebuli-zer
B) Suction the nares with a bulb syringe
C) Place the child in a cool mist tent
D) Apply a nasal cannula at 2 L/min
🔍 **RATIONALE** 💡-- RSV causes nasal congestion and secretions that impair oxygenation. Suctioning
the nares can dramatically improve oxygen saturation. After suctioning, oxygen may be applied if
needed.
ANSWER💫✔️-- **B) Suction the nares with a bulb syringe**
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**4.** A nurse is assessing a newborn for developmental dysplasia of the hip (DDH). Which finding is
most indicative?
A) Symmetrical gluteal folds
B) Positive Ortolani sign (audible click with abduction)
C) Full range of motion of both hips
D) Ability to move legs equally
🔍 **RATIONALE** 💡-- A positive Ortolani sign (reduction of a dislocated hip with abduction) or Barlow
sign (dislocation with adduction) is diagnostic for DDH. Symmetrical folds and full ROM are normal.
ANSWER💫✔️-- **B) Positive Ortolani sign (audible click with abduction)**
,---
**5.** A child with newly diagnosed type 1 diabetes mellitus is being discharged. The nurse should
teach the parents that which symptom indicates hypoglycemia?
A) Polyuria and polydipsia
B) Fruity breath odor
C) Sweating, shakiness, and irritability
D) Deep, rapid respirations
🔍 **RATIONALE** 💡-- Sweating, shakiness, irritability, and hunger are signs of hypoglycemia (low
blood glucose). Polyuria, polydipsia, fruity breath, and Kussmaul breathing indicate hyperglycemia or
diabetic ketoacidosis.
ANSWER💫✔️-- **C) Sweating, shakiness, and irritability**
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**6.** A nurse is caring for a 3‑year‑old child with acute lymphoblastic leukemia (ALL) who is receiving
chemotherapy. Which laboratory value requires immediate notification of the provider?
A) Hemoglobin 9.0 g/dL
B) Platelet count 20,000/mm³
C) Absolute neutrophil count (ANC) 400/mm³
D) White blood cell count 4,000/mm³
🔍 **RATIONALE** 💡-- An ANC <500/mm³ is severe neutropenia, placing the child at high risk for
life‑threatening infection. ANC of 400 requires immediate intervention (e.g., prophylactic antibiotics,
reverse isolation).
ANSWER💫✔️-- **C) Absolute neutrophil count (ANC) 400/mm³**
, ---
**7.** A 2‑month‑old infant is brought to the clinic with a fever of 100.8°F (38.2°C) and is inconsolable.
The nurse should prepare for which intervention first?
A) Administer acetaminophen (Tylenol)
B) Obtain a complete blood count and blood culture
C) Perform a lumbar puncture
D) Encourage oral fluids
🔍 **RATIONALE** 💡-- Fever in an infant <3 months is concerning for serious bacterial infection (sepsis,
meningitis). The priority is to obtain blood cultures and initiate antibiotics after cultures, but the first
step is often a full sepsis workup including CBC and blood culture.
ANSWER💫✔️-- **B) Obtain a complete blood count and blood culture**
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**8.** A nurse is educating the parents of a child with cystic fibrosis (CF) about pancreatic enzyme
replacement. Which instruction is correct?
A) “Give the enzymes with meals and snacks.”
B) “Give the enzymes on an empty stomach.”
C) “Crush the enteric‑coated beads to mix with applesauce.”
D) “Store the enzymes in the refrigerator.”
🔍 **RATIONALE** 💡-- Pancreatic enzymes should be given with all meals and snacks to aid in fat
digestion. Enteric‑coated beads should not be crushed. Room temperature storage is usually fine.
ANSWER💫✔️-- **A) “Give the enzymes with meals and snacks.”**
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Nursing Students (100 Practice Questions)**
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**1.** A 2‑year‑old child is admitted with dehydration due to gastroenteritis. Which assessment finding
indicates severe dehydration?
A) Sunken fontanels and dry mucous membranes
B) Capillary refill of 2 seconds
C) Urine output of 2 mL/kg/hour
D) Heart rate 110 bpm
🔍 **RATIONALE** 💡-- Sunken fontanels (in infants/toddlers) and dry mucous membranes are signs of
moderate to severe dehydration. Capillary refill >3 seconds, decreased urine output (<1 mL/kg/hour),
and tachycardia are also seen in severe dehydration.
ANSWER💫✔️-- **A) Sunken fontanels and dry mucous membranes**
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**2.** A nurse is teaching parents about fever management in a 6‑month‑old infant. Which statement
indicates correct understanding?
A) “I will give my baby aspirin to reduce the fever.”
B) “I will alternate acetaminophen and ibuprofen every 2 hours.”
C) “I will dress my baby lightly and offer fluids frequently.”
D) “I will sponge my baby with cold water to bring the fever down quickly.”
🔍 **RATIONALE** 💡-- Light clothing prevents overheating; fluids prevent dehydration. Aspirin is
contraindicated in children due to Reye’s syndrome. Alternating antipyretics is acceptable but not every
2 hours (usually every 4‑6 hours). Cold water sponging can cause shivering, which raises temperature.
,ANSWER💫✔️-- **C) “I will dress my baby lightly and offer fluids frequently.”**
---
**3.** A 4‑year‑old child with respiratory syncytial virus (RSV) bronchiolitis has an oxygen saturation of
88% on room air. Which intervention should the nurse implement first?
A) Administer a bronchodilator nebuli-zer
B) Suction the nares with a bulb syringe
C) Place the child in a cool mist tent
D) Apply a nasal cannula at 2 L/min
🔍 **RATIONALE** 💡-- RSV causes nasal congestion and secretions that impair oxygenation. Suctioning
the nares can dramatically improve oxygen saturation. After suctioning, oxygen may be applied if
needed.
ANSWER💫✔️-- **B) Suction the nares with a bulb syringe**
---
**4.** A nurse is assessing a newborn for developmental dysplasia of the hip (DDH). Which finding is
most indicative?
A) Symmetrical gluteal folds
B) Positive Ortolani sign (audible click with abduction)
C) Full range of motion of both hips
D) Ability to move legs equally
🔍 **RATIONALE** 💡-- A positive Ortolani sign (reduction of a dislocated hip with abduction) or Barlow
sign (dislocation with adduction) is diagnostic for DDH. Symmetrical folds and full ROM are normal.
ANSWER💫✔️-- **B) Positive Ortolani sign (audible click with abduction)**
,---
**5.** A child with newly diagnosed type 1 diabetes mellitus is being discharged. The nurse should
teach the parents that which symptom indicates hypoglycemia?
A) Polyuria and polydipsia
B) Fruity breath odor
C) Sweating, shakiness, and irritability
D) Deep, rapid respirations
🔍 **RATIONALE** 💡-- Sweating, shakiness, irritability, and hunger are signs of hypoglycemia (low
blood glucose). Polyuria, polydipsia, fruity breath, and Kussmaul breathing indicate hyperglycemia or
diabetic ketoacidosis.
ANSWER💫✔️-- **C) Sweating, shakiness, and irritability**
---
**6.** A nurse is caring for a 3‑year‑old child with acute lymphoblastic leukemia (ALL) who is receiving
chemotherapy. Which laboratory value requires immediate notification of the provider?
A) Hemoglobin 9.0 g/dL
B) Platelet count 20,000/mm³
C) Absolute neutrophil count (ANC) 400/mm³
D) White blood cell count 4,000/mm³
🔍 **RATIONALE** 💡-- An ANC <500/mm³ is severe neutropenia, placing the child at high risk for
life‑threatening infection. ANC of 400 requires immediate intervention (e.g., prophylactic antibiotics,
reverse isolation).
ANSWER💫✔️-- **C) Absolute neutrophil count (ANC) 400/mm³**
, ---
**7.** A 2‑month‑old infant is brought to the clinic with a fever of 100.8°F (38.2°C) and is inconsolable.
The nurse should prepare for which intervention first?
A) Administer acetaminophen (Tylenol)
B) Obtain a complete blood count and blood culture
C) Perform a lumbar puncture
D) Encourage oral fluids
🔍 **RATIONALE** 💡-- Fever in an infant <3 months is concerning for serious bacterial infection (sepsis,
meningitis). The priority is to obtain blood cultures and initiate antibiotics after cultures, but the first
step is often a full sepsis workup including CBC and blood culture.
ANSWER💫✔️-- **B) Obtain a complete blood count and blood culture**
---
**8.** A nurse is educating the parents of a child with cystic fibrosis (CF) about pancreatic enzyme
replacement. Which instruction is correct?
A) “Give the enzymes with meals and snacks.”
B) “Give the enzymes on an empty stomach.”
C) “Crush the enteric‑coated beads to mix with applesauce.”
D) “Store the enzymes in the refrigerator.”
🔍 **RATIONALE** 💡-- Pancreatic enzymes should be given with all meals and snacks to aid in fat
digestion. Enteric‑coated beads should not be crushed. Room temperature storage is usually fine.
ANSWER💫✔️-- **A) “Give the enzymes with meals and snacks.”**
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