HESI Pediatric Practice Exam Questions
and Answers | 2026 Step-by-Step Review
| A+ Verified
• 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.) -✓✓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 - (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.) -✓✓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.) -✓✓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 - (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.) -✓✓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.) -✓✓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.
• D - (Outcome of learning is best demonstrated when the client not only verbalizes an
understanding but can also provide a return demonstration, D.) -✓✓The nurse is giving
preoperative instructions to a 14-year-old female client who is scheduled for surgery to
correct a spinal curvature. Which statement by the client best demonstrates that
learning has taken place?
A) I will read all the literature you gave me before surgery.
B) I have had surgery before when I broke my wrist in a bike accident, so I know what to
expect.
C) All the things people have told me will help me take care of my back.
D) I understand that I will be in a body cast and I will show you how you taught me to
turn.
• A - (Ototoxicity diminishes hearing acuity and causes symptoms of tinnitus and vertigo
in older children who can express subjective symptoms, so assessing an infant's
reaction to loud noises, A, helps to determine an infant's risk for a hearing deficit related
to a history of the mother taking an ototoxic drug, such as aspirin, while pregnant.) -
✓✓The clinic nurse is taking the history for a new 6-month-old client. The mother
reports that she took a great deal of aspirin while pregnant. Which assessment should
the nurse obtain?
A) Type of reaction to loud noises.
B) Any surgeries on the ears since birth.
C) Drainage from the infant's ears.
D) Number of ear infections since birth.
• C - (A patent airway has the highest priority. Humidification will liquefy the nasal
secretions thereby increasing the amount of secretions and making, C, the highest
priority. When asked "priority" questions, REMEMBER MASLOW! Physical needs
usually have a higher priority than psychosocial needs and an open airway is the
highest physiological need!) -✓✓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?
A) Give small, frequent feedings of fluids.
B) Accurately chart observations regarding breath sounds.
C) Have a bulb syringe readily available to remove secretions.
D) Encourage older siblings to visit.
• 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.) -✓✓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.) -✓✓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) -✓✓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.) -✓✓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.
and Answers | 2026 Step-by-Step Review
| A+ Verified
• 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.) -✓✓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 - (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.) -✓✓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.) -✓✓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 - (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.) -✓✓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.) -✓✓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.
• D - (Outcome of learning is best demonstrated when the client not only verbalizes an
understanding but can also provide a return demonstration, D.) -✓✓The nurse is giving
preoperative instructions to a 14-year-old female client who is scheduled for surgery to
correct a spinal curvature. Which statement by the client best demonstrates that
learning has taken place?
A) I will read all the literature you gave me before surgery.
B) I have had surgery before when I broke my wrist in a bike accident, so I know what to
expect.
C) All the things people have told me will help me take care of my back.
D) I understand that I will be in a body cast and I will show you how you taught me to
turn.
• A - (Ototoxicity diminishes hearing acuity and causes symptoms of tinnitus and vertigo
in older children who can express subjective symptoms, so assessing an infant's
reaction to loud noises, A, helps to determine an infant's risk for a hearing deficit related
to a history of the mother taking an ototoxic drug, such as aspirin, while pregnant.) -
✓✓The clinic nurse is taking the history for a new 6-month-old client. The mother
reports that she took a great deal of aspirin while pregnant. Which assessment should
the nurse obtain?
A) Type of reaction to loud noises.
B) Any surgeries on the ears since birth.
C) Drainage from the infant's ears.
D) Number of ear infections since birth.
• C - (A patent airway has the highest priority. Humidification will liquefy the nasal
secretions thereby increasing the amount of secretions and making, C, the highest
priority. When asked "priority" questions, REMEMBER MASLOW! Physical needs
usually have a higher priority than psychosocial needs and an open airway is the
highest physiological need!) -✓✓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?
A) Give small, frequent feedings of fluids.
B) Accurately chart observations regarding breath sounds.
C) Have a bulb syringe readily available to remove secretions.
D) Encourage older siblings to visit.
• 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.) -✓✓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.) -✓✓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) -✓✓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.) -✓✓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.
