HESI Pediatric Practice Exam Questions
and Answers | 2026 Final Review Practice
Pack | Grade A+
• To take the vital signs of a 4-month old child, which order will give the most
accurate results? -✓✓A. Respiratory rate, heart rate, then rectal temperature
• During routine screening at a school clinic, an otoscope examination of a child's
ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not
movable. What action should the nurse take next? -✓✓B. Ask the child if he/she
has had a cold, runny nose, or any ear pain lately.
• Which restraint should be used for a toddler after a cleft palate repair? -✓✓C.
elbow restraints
• What preoperative nursing intervention should be included in the plan of care for
an infant with pyloric stenosis? -✓✓D. observe for projectile vomiting.
• A six-month-old returns from surgery with elbow restraints in place. What
nursing care should be included when caring for any restrained child? -✓✓B.
remove restraints one at a time and provide range of motion exercises
• A 2-year old child with Down syndrome is brought to the clinic for his regular
physical examination. The nurse knows which problem is frequently associated
with Down syndrome? -✓✓A. congenital heart disease
• When assessing a child with asthma, the nurse should expect intercostal
retractions during -✓✓A. inspiration
,• When planning the care for a child who has had a cleft lip repair, the nurse knows
that crying should be minimized because it -✓✓D. stresses the suture line
• A full-term infant is admitted to the newborn nursery. After careful assessment,
the nurse suspects that the infant may have an esophageal atresia. Which symptoms
is this newborn likely to have exhibited? -✓✓A. choking, coughing, and cyanosis
• Which behavior would the nurse expect a two-year-old child to exhibit? -✓✓C.
display possessiveness of toys
• the mother of a preschool-aged client asks the nurse if it is all right to administer
Pepto Bismal to her son when he 'has a tummy ache." After reminding the mother
to check the label of all OTC drugs for the presence of aspirin, which instruction
should the nurse include when replying to this mother's question? -✓✓B. do not
give if the child has chickenpox, the flu, or any other viral illness.
• The nurse observes a 4-year old boy in a daycare setting. Which behavior should
the nurse consider normal for this client? -✓✓C. demonstrates aggressiveness by
boasting when telling a story
• A burned child is brought to the emergency room. In estimating the percentage of
the body burned, the nurse uses a modified "Rule of Nines." Which part of a child's
body is calculated as a larger percentage of total body surface than an adult? -
✓✓A. head and neck
• The nurse receives a lab report stating a child with asthma has a theophylline
level of 15 mcg/dl. What action will the nurse take? -✓✓A. pass the information
on in the report
,• A 12-month old boy is admitted with a respiratory infection and possible
pneumonia. He is placed in a mist tent with oxygen. Which nursing intervention
has the greatest priority for this infant? -✓✓C. have a bulb syringe readily
available to remove secretions
• All of the following interventions can be used to evaluate the effectiveness of
nursing and medical interventions used to treat diarrhea. Which intervention is
least useful in the nurse's evaluation of a 20-month-old child. -✓✓B. assessing
fontanels
• A 5-month-old is admitted to the hospital with vomiting and diarrhea. The
pediatrician prescribed dextrose 5% and 0.25% normal saline with 2 mEq KCI/100
mL to be infused at 25mL/hr. Prior to initiating the infusion, the nurse should
obtain which assessment finding? -✓✓B. serum BUN and creatinine levels
• The nurse is assigning care for a 4-year old child with otitis media and is
concerned about the child's increasing temperature over the past 24 hours. When
planning care for this child, it is important for the nurse to consider that: -✓✓B. a
tympanic measurement of temperature will provide the most accurate reading
• The nurse is assessing an 8-month old child who has a medical diagnosis of
Tetrology of Fallot. Which symptom is this client most likely to exhibit? -✓✓D.
clubbed fingers
• As part of the physical assessment of children, the nurse observes and palpates
the fontanels. Which child's fontanel finding should be reported to the healthcare
provider? -✓✓A. A 5-month old with failure to thrive that has a closed anterior
fontanel
, • A preschool-age child who is hospitalized for hypospadias repair is most strongly
influenced by which behavior? -✓✓C. concern for body integrity
• An infant is born with a ventricular septal defect (VSD) and surgery is planned to
correct the defect. The nurse recognizes that surgical correction is designed to
achieve which outcome? -✓✓C. prevent the return of oxygenated blood to the
lungs.
• A three-month old boy weighing 10 lbs, 15 oz has an axillary temperature of 98.9
degrees F. The nurse determines the daily caloric need for this child is
approximately: -✓✓C. 600 cal/day
10 lbs, 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2 (10.9/2.2) =
4.954 kg rounded to 5 kg. an infant requires 108 cal/kg/day (108 x 5 = 540
cal/day). However this infant requires 10% more calories because he has one
degree temperature elevation. 10% of 540 is 54 and 54 + 540 = 594. This infant
will require approximately 600 calories/day. Remember that a temperature
elevation necessitates consumption of more calories.
• 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 instructions? -
✓✓B. store all toxic agents and medicines in locked cabinets.
• A 6-month old infant with congestive heart failure (CHF) is receiving digoxin
elixer. Which observation by the nurse warrants immediate intervention? -✓✓A.
apical heart rate of 60.
• At 8am, the unlicensed assistive personnel (UAP) informs the charge nurse that a
female adolescent client with acute glomerulonephritis has a blood pressure of
210/110. The 4am BP reading was 170/88. The client reports to the UAP that she is
and Answers | 2026 Final Review Practice
Pack | Grade A+
• To take the vital signs of a 4-month old child, which order will give the most
accurate results? -✓✓A. Respiratory rate, heart rate, then rectal temperature
• During routine screening at a school clinic, an otoscope examination of a child's
ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not
movable. What action should the nurse take next? -✓✓B. Ask the child if he/she
has had a cold, runny nose, or any ear pain lately.
• Which restraint should be used for a toddler after a cleft palate repair? -✓✓C.
elbow restraints
• What preoperative nursing intervention should be included in the plan of care for
an infant with pyloric stenosis? -✓✓D. observe for projectile vomiting.
• A six-month-old returns from surgery with elbow restraints in place. What
nursing care should be included when caring for any restrained child? -✓✓B.
remove restraints one at a time and provide range of motion exercises
• A 2-year old child with Down syndrome is brought to the clinic for his regular
physical examination. The nurse knows which problem is frequently associated
with Down syndrome? -✓✓A. congenital heart disease
• When assessing a child with asthma, the nurse should expect intercostal
retractions during -✓✓A. inspiration
,• When planning the care for a child who has had a cleft lip repair, the nurse knows
that crying should be minimized because it -✓✓D. stresses the suture line
• A full-term infant is admitted to the newborn nursery. After careful assessment,
the nurse suspects that the infant may have an esophageal atresia. Which symptoms
is this newborn likely to have exhibited? -✓✓A. choking, coughing, and cyanosis
• Which behavior would the nurse expect a two-year-old child to exhibit? -✓✓C.
display possessiveness of toys
• the mother of a preschool-aged client asks the nurse if it is all right to administer
Pepto Bismal to her son when he 'has a tummy ache." After reminding the mother
to check the label of all OTC drugs for the presence of aspirin, which instruction
should the nurse include when replying to this mother's question? -✓✓B. do not
give if the child has chickenpox, the flu, or any other viral illness.
• The nurse observes a 4-year old boy in a daycare setting. Which behavior should
the nurse consider normal for this client? -✓✓C. demonstrates aggressiveness by
boasting when telling a story
• A burned child is brought to the emergency room. In estimating the percentage of
the body burned, the nurse uses a modified "Rule of Nines." Which part of a child's
body is calculated as a larger percentage of total body surface than an adult? -
✓✓A. head and neck
• The nurse receives a lab report stating a child with asthma has a theophylline
level of 15 mcg/dl. What action will the nurse take? -✓✓A. pass the information
on in the report
,• A 12-month old boy is admitted with a respiratory infection and possible
pneumonia. He is placed in a mist tent with oxygen. Which nursing intervention
has the greatest priority for this infant? -✓✓C. have a bulb syringe readily
available to remove secretions
• All of the following interventions can be used to evaluate the effectiveness of
nursing and medical interventions used to treat diarrhea. Which intervention is
least useful in the nurse's evaluation of a 20-month-old child. -✓✓B. assessing
fontanels
• A 5-month-old is admitted to the hospital with vomiting and diarrhea. The
pediatrician prescribed dextrose 5% and 0.25% normal saline with 2 mEq KCI/100
mL to be infused at 25mL/hr. Prior to initiating the infusion, the nurse should
obtain which assessment finding? -✓✓B. serum BUN and creatinine levels
• The nurse is assigning care for a 4-year old child with otitis media and is
concerned about the child's increasing temperature over the past 24 hours. When
planning care for this child, it is important for the nurse to consider that: -✓✓B. a
tympanic measurement of temperature will provide the most accurate reading
• The nurse is assessing an 8-month old child who has a medical diagnosis of
Tetrology of Fallot. Which symptom is this client most likely to exhibit? -✓✓D.
clubbed fingers
• As part of the physical assessment of children, the nurse observes and palpates
the fontanels. Which child's fontanel finding should be reported to the healthcare
provider? -✓✓A. A 5-month old with failure to thrive that has a closed anterior
fontanel
, • A preschool-age child who is hospitalized for hypospadias repair is most strongly
influenced by which behavior? -✓✓C. concern for body integrity
• An infant is born with a ventricular septal defect (VSD) and surgery is planned to
correct the defect. The nurse recognizes that surgical correction is designed to
achieve which outcome? -✓✓C. prevent the return of oxygenated blood to the
lungs.
• A three-month old boy weighing 10 lbs, 15 oz has an axillary temperature of 98.9
degrees F. The nurse determines the daily caloric need for this child is
approximately: -✓✓C. 600 cal/day
10 lbs, 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2 (10.9/2.2) =
4.954 kg rounded to 5 kg. an infant requires 108 cal/kg/day (108 x 5 = 540
cal/day). However this infant requires 10% more calories because he has one
degree temperature elevation. 10% of 540 is 54 and 54 + 540 = 594. This infant
will require approximately 600 calories/day. Remember that a temperature
elevation necessitates consumption of more calories.
• 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 instructions? -
✓✓B. store all toxic agents and medicines in locked cabinets.
• A 6-month old infant with congestive heart failure (CHF) is receiving digoxin
elixer. Which observation by the nurse warrants immediate intervention? -✓✓A.
apical heart rate of 60.
• At 8am, the unlicensed assistive personnel (UAP) informs the charge nurse that a
female adolescent client with acute glomerulonephritis has a blood pressure of
210/110. The 4am BP reading was 170/88. The client reports to the UAP that she is
