HESI Pediatrics V3 | 2026 Q&A with
Rationale (HESI Peds Exam)
1. A 6-month-old infant is brought to the clinic for a routine check-up. According to Erikson,
which developmental task should the nurse expect this infant to be working on?
A. Autonomy versus Shame and Doubt
B. Initiative versus Guilt
C. Industry versus Inferiority
D. Trust versus Mistrust
Correct Answer: D
Rationale: The developmental task for an infant from birth to 1 year is Trust versus
Mistrust. During this stage, the infant learns to trust that their basic needs will be met by
caregivers. Consistent care and affection lead to the development of a sense of security and
hope.
2. A child is admitted with an acute asthma exacerbation. Which medication should the nurse
prepare to administer first as a rescue treatment?
A. Albuterol
B. Salmeterol
C. Fluticasone
,D. Montelukast
Correct Answer: A
Rationale: Albuterol is a short-acting beta-agonist used for the rapid relief of
bronchospasms during an asthma attack. It acts quickly to dilate the airways and improve
oxygenation. Other medications like fluticasone or montelukast are used for long-term
control and do not provide immediate relief.
3. The nurse is assessing a 4-week-old infant suspected of having hypertrophic pyloric
stenosis. Which clinical manifestation is most characteristic of this condition?
A. Projectile vomiting after feedings
B. Currant jelly-like stools
C. Ribbon-like stools
D. Abdominal distention and bile-stained emesis
Correct Answer: A
Rationale: Projectile vomiting is a classic sign of pyloric stenosis due to the thickening of
the pyloric sphincter preventing food from entering the small intestine. This usually occurs
shortly after feeding and does not contain bile. The nurse may also palpate an olive-shaped
mass in the epigastrium.
4. A child with cystic fibrosis is being educated on the use of pancreatic enzymes. When
should the nurse instruct the parents to administer these enzymes?
A. Immediately before or during all meals and snacks
,B. Exactly two hours after every meal
C. First thing in the morning on an empty stomach
D. Only when the child experiences fatty stools
Correct Answer: A
Rationale: Pancreatic enzymes must be taken with all meals and snacks to assist in the
digestion and absorption of fats and proteins. Because the ducts in the pancreas are
blocked by mucus in cystic fibrosis, these exogenous enzymes are necessary for nutritional
health. Failure to take them leads to malabsorption and steatorrhea.
5. An infant with Tetralogy of Fallot experiences a ‘tet spell’ (hypercyanotic episode) during a
blood draw. Which action should the nurse take first?
A. Place the infant in the knee-chest position
B. Administer 100 percent oxygen via face mask
C. Prepare a dose of intravenous morphine
D. Call for a STAT chest X-ray
Correct Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves pulmonary blood flow. This is the priority
intervention to alleviate the cyanosis and hypoxia. Oxygen and morphine are subsequent
interventions used if the position change does not resolve the spell.
, 6. The nurse is caring for a school-aged child with nephrotic syndrome. Which laboratory
finding should the nurse anticipate?
A. Massive proteinuria
B. Low urine specific gravity
C. High serum albumin levels
D. Negative urine ketones
Correct Answer: A
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability,
leading to massive proteinuria. This results in hypoalbuminemia as protein is lost in the
urine, causing significant edema. The nurse will also typically see hyperlipidemia and a
high urine specific gravity.
7. A 10-year-old child with sickle cell anemia is admitted in a vaso-occlusive crisis. What is the
priority nursing intervention?
A. Increasing fluid intake and hydration
B. Administering prophylactic antibiotics
C. Encouraging vigorous physical therapy
D. Applying cold compresses to painful joints
Correct Answer: A
Rationale (HESI Peds Exam)
1. A 6-month-old infant is brought to the clinic for a routine check-up. According to Erikson,
which developmental task should the nurse expect this infant to be working on?
A. Autonomy versus Shame and Doubt
B. Initiative versus Guilt
C. Industry versus Inferiority
D. Trust versus Mistrust
Correct Answer: D
Rationale: The developmental task for an infant from birth to 1 year is Trust versus
Mistrust. During this stage, the infant learns to trust that their basic needs will be met by
caregivers. Consistent care and affection lead to the development of a sense of security and
hope.
2. A child is admitted with an acute asthma exacerbation. Which medication should the nurse
prepare to administer first as a rescue treatment?
A. Albuterol
B. Salmeterol
C. Fluticasone
,D. Montelukast
Correct Answer: A
Rationale: Albuterol is a short-acting beta-agonist used for the rapid relief of
bronchospasms during an asthma attack. It acts quickly to dilate the airways and improve
oxygenation. Other medications like fluticasone or montelukast are used for long-term
control and do not provide immediate relief.
3. The nurse is assessing a 4-week-old infant suspected of having hypertrophic pyloric
stenosis. Which clinical manifestation is most characteristic of this condition?
A. Projectile vomiting after feedings
B. Currant jelly-like stools
C. Ribbon-like stools
D. Abdominal distention and bile-stained emesis
Correct Answer: A
Rationale: Projectile vomiting is a classic sign of pyloric stenosis due to the thickening of
the pyloric sphincter preventing food from entering the small intestine. This usually occurs
shortly after feeding and does not contain bile. The nurse may also palpate an olive-shaped
mass in the epigastrium.
4. A child with cystic fibrosis is being educated on the use of pancreatic enzymes. When
should the nurse instruct the parents to administer these enzymes?
A. Immediately before or during all meals and snacks
,B. Exactly two hours after every meal
C. First thing in the morning on an empty stomach
D. Only when the child experiences fatty stools
Correct Answer: A
Rationale: Pancreatic enzymes must be taken with all meals and snacks to assist in the
digestion and absorption of fats and proteins. Because the ducts in the pancreas are
blocked by mucus in cystic fibrosis, these exogenous enzymes are necessary for nutritional
health. Failure to take them leads to malabsorption and steatorrhea.
5. An infant with Tetralogy of Fallot experiences a ‘tet spell’ (hypercyanotic episode) during a
blood draw. Which action should the nurse take first?
A. Place the infant in the knee-chest position
B. Administer 100 percent oxygen via face mask
C. Prepare a dose of intravenous morphine
D. Call for a STAT chest X-ray
Correct Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves pulmonary blood flow. This is the priority
intervention to alleviate the cyanosis and hypoxia. Oxygen and morphine are subsequent
interventions used if the position change does not resolve the spell.
, 6. The nurse is caring for a school-aged child with nephrotic syndrome. Which laboratory
finding should the nurse anticipate?
A. Massive proteinuria
B. Low urine specific gravity
C. High serum albumin levels
D. Negative urine ketones
Correct Answer: A
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability,
leading to massive proteinuria. This results in hypoalbuminemia as protein is lost in the
urine, causing significant edema. The nurse will also typically see hyperlipidemia and a
high urine specific gravity.
7. A 10-year-old child with sickle cell anemia is admitted in a vaso-occlusive crisis. What is the
priority nursing intervention?
A. Increasing fluid intake and hydration
B. Administering prophylactic antibiotics
C. Encouraging vigorous physical therapy
D. Applying cold compresses to painful joints
Correct Answer: A
