PEDS HESI CORE MAIN EXAMINATION QUESTIONS
AND ANSWERS SURE A+
✔✔The nurse is caring for a premature infant who needs an IV access restarted. Which
action should the nurse take when using adhesive tape?
-Use solvents such as water, mineral oil, or petrolatum to remove adhesives instead of
pulling on the skin.
-Avoid using tape and adhesives until the skin is more mature.
-Use scissors carefully to remove the tape instead of pulling the tape off.
-Use alcohol to remove the adhesives. - ✔✔Use solvents such as water, mineral oil, or
petrolatum to remove adhesives instead of pulling on the skin.
The use of adhesives should be minimized as much as possible in the treatment of
preterm neonates. They should be removed using water, mineral oil, or petrolatum. The
skin of the premature infant is fragile, delicate, and thinner compared to a full-term
infant, and is easily traumatized. Alcohol should not be used to remove adhesives.
✔✔A 4-year-old boy is brought to the emergency department by his parent who reports
that the child has been pointing at his stomach and saying, "It hurts so bad." Which pain
assessment tool should the nurse use?
-Descriptor Scale.
-Brief Pain Inventory.
-A numeric rating scale.
-Wong-Baker FACES Scale. - ✔✔Wong-Baker FACES Scale
,A pain rating scale using pictures, such as the Wong-Baker FACES Scale, allows the
child to choose a facial expression that shows "how much hurt you have now" and
should be used for a preschool-aged child.
✔✔The parents of a toddler brought to the clinic for a well-child visit tell the nurse that
the child becomes upset if even the smallest things change in the environment. What
information should the nurse provide the parents?
-A child is insecure because trust is not fostered and developed during infancy.
-A toddler should be exposed to different routines to promote adapting to new
experiences.
-Children of this age are comfortable with ritualism and display global thinking.
-Objects should be frequently moved in the environment to teach the child to acclimate
to change. - ✔✔Children of this age are comfortable with ritualism and display global
thinking.
A 2-year-old is ritualistic and wants consistency and routine. Changes in the toddler's
environment or schedule is upsetting. Another mark of the toddlers' sensitivity to change
is global thinking. When there is a change in one small part of the environment, such as
a minor shift in room arrangement, or changes in the whole environment, the 2-year-
old's composure disintegrates.
✔✔A Spanish-speaking 5-year-old child starts kindergarten in an English-speaking
school. The child cries most of the time, appears helpless, and unable to function in the
new situation. After assessing the child, how should the school nurse document the
situation?
-Experiencing culture adaptation.
-Lacks the maturity needed in school.
-Refuses to participate in school activities.
-Going through minority group discrimination. - ✔✔Experiencing culture adaptation.
An inability to function may apply to persons of all ages undergoing transitions, such as
moving to a new country and adjusting to a subculture within a larger culture that is
unfamiliar. Adapting culturally describes feelings of discomfort and disorientation when
adapting to new cultural settings. Language barriers inhibit effective communication. A
child who is unable to communicate in the spoken language in the school environment
lacks the skills necessary to participate.
✔✔A 6-year-old squirms and giggles when the nurse begins to palpate the abdomen.
Which action should the nurse implement?
-Postpone the abdominal palpation until the next examination.
-Place the child's hand under the examiner's hand while palpating.
-Touch the abdomen firmly as the child takes short, quick breaths.
-Press the abdomen with the child bearing down and holding the breath. - ✔✔Place the
child's hand under the examiner's hand while palpating.
, Placing the child's hand on the abdomen with the examiner's hand on top of the child's
hand gives the child control and reduces the sensation of tickling. Abdominal palpation
is an integral part of the physical assessment and should not be postponed.
✔✔When conducting a hygiene class for adolescent girls, it is important for the nurse to
include which instruction about preventing toxic shock syndrome?
-Wash your hands before inserting a tampon.
-Use super absorbent tampons.
-Wear cotton underwear.
-Douche following menstruation. - ✔✔Wash your hands before inserting a tampon.
The single most effective means of preventing infection is handwashing.
✔✔After discussing the introduction of solid foods with the mother of a 6-month-old
infant, the nurse determines that the mother understands the information when she
states that the first food she will give the infant is from which food group?
-Fruits.
-Egg yolks.
-Rice cereal.
-Yellow vegetables. - ✔✔Rice cereal.
Solid food is usually introduced at about 6 months of age starting with rice cereal, which
is the least allergenic. New food items should be introduced one at a time with about 5
days between each different type. If the infant has a sensitivity to a particular food, it will
be easier to identify it by spacing out the introduction of each new food.
✔✔The nurse is developing a plan of care for a newborn with a colostomy due to anal
agenesis. The infant has had continuous loose stools since surgery yesterday. Which
nursing problem has the highest priority given the infant's condition?
-Fluid volume deficit.
-Alteration in bowel elimination.
-Pain due to postoperative condition.
-Anxiety of parents due to newborn's condition. - ✔✔Fluid volume deficit.
All stated nursing problems are appropriate for a postoperative colostomy client.
However, fluid balance is the priority concern for any infant and is even more of an
issue for a postoperative infant. Newborns are extremely vulnerable to fluid imbalances
due to immature body systems and a larger percentage of body weight consisting of
fluid. At birth, the total weight of an infant is 73% fluid compared with 58% in an adult.
Infants have a proportionately higher ratio of extracellular fluid than adults. An important
aspect of fluid balance is its relationship to other systems. An infant's rate of metabolism
is twice that of an adult in relation to body weight. As a result, twice as much acid is
formed, leading to more rapid development of acidosis. In addition, immature kidneys
cannot sufficiently concentrate urine to conserve body water. These factors make
infants more prone to dehydration, acidosis, and fluid imbalances.
AND ANSWERS SURE A+
✔✔The nurse is caring for a premature infant who needs an IV access restarted. Which
action should the nurse take when using adhesive tape?
-Use solvents such as water, mineral oil, or petrolatum to remove adhesives instead of
pulling on the skin.
-Avoid using tape and adhesives until the skin is more mature.
-Use scissors carefully to remove the tape instead of pulling the tape off.
-Use alcohol to remove the adhesives. - ✔✔Use solvents such as water, mineral oil, or
petrolatum to remove adhesives instead of pulling on the skin.
The use of adhesives should be minimized as much as possible in the treatment of
preterm neonates. They should be removed using water, mineral oil, or petrolatum. The
skin of the premature infant is fragile, delicate, and thinner compared to a full-term
infant, and is easily traumatized. Alcohol should not be used to remove adhesives.
✔✔A 4-year-old boy is brought to the emergency department by his parent who reports
that the child has been pointing at his stomach and saying, "It hurts so bad." Which pain
assessment tool should the nurse use?
-Descriptor Scale.
-Brief Pain Inventory.
-A numeric rating scale.
-Wong-Baker FACES Scale. - ✔✔Wong-Baker FACES Scale
,A pain rating scale using pictures, such as the Wong-Baker FACES Scale, allows the
child to choose a facial expression that shows "how much hurt you have now" and
should be used for a preschool-aged child.
✔✔The parents of a toddler brought to the clinic for a well-child visit tell the nurse that
the child becomes upset if even the smallest things change in the environment. What
information should the nurse provide the parents?
-A child is insecure because trust is not fostered and developed during infancy.
-A toddler should be exposed to different routines to promote adapting to new
experiences.
-Children of this age are comfortable with ritualism and display global thinking.
-Objects should be frequently moved in the environment to teach the child to acclimate
to change. - ✔✔Children of this age are comfortable with ritualism and display global
thinking.
A 2-year-old is ritualistic and wants consistency and routine. Changes in the toddler's
environment or schedule is upsetting. Another mark of the toddlers' sensitivity to change
is global thinking. When there is a change in one small part of the environment, such as
a minor shift in room arrangement, or changes in the whole environment, the 2-year-
old's composure disintegrates.
✔✔A Spanish-speaking 5-year-old child starts kindergarten in an English-speaking
school. The child cries most of the time, appears helpless, and unable to function in the
new situation. After assessing the child, how should the school nurse document the
situation?
-Experiencing culture adaptation.
-Lacks the maturity needed in school.
-Refuses to participate in school activities.
-Going through minority group discrimination. - ✔✔Experiencing culture adaptation.
An inability to function may apply to persons of all ages undergoing transitions, such as
moving to a new country and adjusting to a subculture within a larger culture that is
unfamiliar. Adapting culturally describes feelings of discomfort and disorientation when
adapting to new cultural settings. Language barriers inhibit effective communication. A
child who is unable to communicate in the spoken language in the school environment
lacks the skills necessary to participate.
✔✔A 6-year-old squirms and giggles when the nurse begins to palpate the abdomen.
Which action should the nurse implement?
-Postpone the abdominal palpation until the next examination.
-Place the child's hand under the examiner's hand while palpating.
-Touch the abdomen firmly as the child takes short, quick breaths.
-Press the abdomen with the child bearing down and holding the breath. - ✔✔Place the
child's hand under the examiner's hand while palpating.
, Placing the child's hand on the abdomen with the examiner's hand on top of the child's
hand gives the child control and reduces the sensation of tickling. Abdominal palpation
is an integral part of the physical assessment and should not be postponed.
✔✔When conducting a hygiene class for adolescent girls, it is important for the nurse to
include which instruction about preventing toxic shock syndrome?
-Wash your hands before inserting a tampon.
-Use super absorbent tampons.
-Wear cotton underwear.
-Douche following menstruation. - ✔✔Wash your hands before inserting a tampon.
The single most effective means of preventing infection is handwashing.
✔✔After discussing the introduction of solid foods with the mother of a 6-month-old
infant, the nurse determines that the mother understands the information when she
states that the first food she will give the infant is from which food group?
-Fruits.
-Egg yolks.
-Rice cereal.
-Yellow vegetables. - ✔✔Rice cereal.
Solid food is usually introduced at about 6 months of age starting with rice cereal, which
is the least allergenic. New food items should be introduced one at a time with about 5
days between each different type. If the infant has a sensitivity to a particular food, it will
be easier to identify it by spacing out the introduction of each new food.
✔✔The nurse is developing a plan of care for a newborn with a colostomy due to anal
agenesis. The infant has had continuous loose stools since surgery yesterday. Which
nursing problem has the highest priority given the infant's condition?
-Fluid volume deficit.
-Alteration in bowel elimination.
-Pain due to postoperative condition.
-Anxiety of parents due to newborn's condition. - ✔✔Fluid volume deficit.
All stated nursing problems are appropriate for a postoperative colostomy client.
However, fluid balance is the priority concern for any infant and is even more of an
issue for a postoperative infant. Newborns are extremely vulnerable to fluid imbalances
due to immature body systems and a larger percentage of body weight consisting of
fluid. At birth, the total weight of an infant is 73% fluid compared with 58% in an adult.
Infants have a proportionately higher ratio of extracellular fluid than adults. An important
aspect of fluid balance is its relationship to other systems. An infant's rate of metabolism
is twice that of an adult in relation to body weight. As a result, twice as much acid is
formed, leading to more rapid development of acidosis. In addition, immature kidneys
cannot sufficiently concentrate urine to conserve body water. These factors make
infants more prone to dehydration, acidosis, and fluid imbalances.
