Pediatrics HESI Exam 2022 - Questions And Answers
A 15-month-old is admitted to the pediatric unit with a history of a recent upper respiratory
infection. Which symptom is consistent with the diagnosis of laryngotracheobronchitis (croup)?
Select all that apply.
1.Reported inspiratory stridor which is worse at night.
2.Suprasternal retractions are present upon examination.
3.The toddler has a barking, seal-like, harsh cough.
4.Lung sounds have inspiratory wheezing.
5.Lung sounds with crackles in the bases bilaterally. Correct Ans ~ - 1,2,3
A four-year-old is presented to the urgent care center with a history of a sudden onset of a severe
sore throat. He began drooling and has difficulty swallowing. The temperature is 102.2F (39.0C).
Lung sounds are clear and there is no cough. The child is very anxious and flushed and is leaning
forward in a tripod position. Based on these symptoms, the nurse anticipates a diagnosis of:
1.Acute Asthma Attack
2.Laryngotracheomalacia
3.Acute laryngotracheobronchitis (Croup)
4.Acute Epiglottitis Correct Ans ~ - 4
Which should the nurse expect to be included in the treatment of the client experiencing acute
asthma symptoms? Select all that apply.
1.Bronchodilators
2.Corticosteroids
3.Oxygen
4.Montelukast (Singular)
5.Immediate Intubation Correct Ans ~ - 1, 2, 3
The nurse understands that in a child with cystic fibrosis (CF) which vitamin absorption is
impaired? Select all that apply.
1.A
2.B
3.C
4.D
5.E Correct Ans ~ - 1, 3, 4, 5
Which indicates the earliest sign of hemorrhage in a child who has just had a tonsillectomy?
1.Frequent swallowing
2.Labored respirations
3.Tachypnea stridor
4.Dark brown emesis Correct Ans ~ - 1
A child with chronic otitis media has bilateral myringotomy tubes placed. Which statement
would indicate that the parent understands education about myringotomy tubes?
1."The tubes have to be surgically removed in 9 months or so."
,2."The tubes were placed to equalize pressure."
3."These tubes won't affect my child being able to go swimming in the summer."
4."My child will still need to be on Amoxicillin prophylactically for six months." Correct Ans
~ -2
The nurse should instruct the parent whose child is diagnosed with respiratory syncytial virus
(RSV) to notify the healthcare provider for which issue? Select all that apply.
1.The child is not eating
2.There is a decrease in wet diapers
3.There is increased work of breathing
4.The child develops yellow drainage from the nose
5.Only when the child wheezes Correct Ans ~ - 1, 2, 3
Which are signs and symptoms of respiratory distress in a two-month-old? Select all that apply.
1.Nasal flaring
2.Intercostal retractions
3.Coughing
4.Bronchovesicular lung sounds
5.Grunting Correct Ans ~ - 1, 2, 5
You are teaching a family with a child who has cystic fibrosis (CF) about chest physiotherapy
treatment (CPT). Which of the following teaching points are correct to include? SATA
1.It should be performed three to four times a day.
2.It may cause bronchospasm.
3.It is all right to percuss over the spine or internal organs.
4.When manually percussing you should use a cupped hand.
5.CPT can be done at any time including after eating. Correct Ans ~ - 1, 2, 4
Which child does the nurse anticipate to be most at risk for being hospitalized for respiratory
syncytial virus (RSV)?
1.A three-month-old who was born at 30 weeks gestation
2.A 18-month-old with a tracheostomy
3.A four-year-old with a ventricular septal defect (VSD)
4.A five-year-old who was term but has never received any immunizations Correct Ans ~ - 1
The nursing student asks the nurse about genetic implications related to cystic fibrosis (CF).
How should the nurse respond?
1."It is inherited as an autosomal dominant trait."
2."It is a genetic defect found primarily in non-Caucasian people."
3."If it is present in a child, both parents are carriers of the defective gene."
4."There is a 50% chance the siblings of an affected child will also be affected." Correct Ans ~
-3
what is the gold standard test in cystic fibrosis Correct Ans ~ - sweat test
, A measurement of the maximum flow of air that can be forcefully exhaled in 1 second, a key
measurement of pulmonary function Correct Ans ~ - Peak expiratory flow rate
provides an objective method of evaluating the presence and degree of lung dz, as well as the
response of therapy Correct Ans ~ - Pulmonary Function Test (PFT)
cessation of breathing for more than 20 sec or for a shorter period of time when associated w/
hypoxemia or bradycardia Correct Ans ~ - apnea
a medical emergency that can result in respiratory failure and death if untreated Correct Ans ~
- status asthmaticus
involves stimulating the production of sweat w/ a special device, collecting sweat and measuring
the sweat electrolytes. Used in the diagnosis of cystic fibrosis Correct Ans ~ - sweat chloride
test
inability of the respiratory apparatus to maintain adequate oxygenation of the blood w/ or w/out
carbon dioxide retention Correct Ans ~ - respiratory failure
a serious obstructive inflammatory process in the upper airway may see absence of a cough but
drooling and agitation Correct Ans ~ - acute epiglottitis
in general applies to 2 conditions: increased work of breathing w/ near normal gas exchange
function or the inability to maintain normal blood gas tensions that develops from carbon dioxide
retention w/ subsequent hypoxemia and acidosis Correct Ans ~ - respiratory insuffuecuency
upper airway infection characterized by hoarseness and a barking cough Correct Ans ~ - croup
earliest manifestation of cystic fibrosis where the small intestine is blocked w/ thick meconium
in the newborn Correct Ans ~ - meconium ileus
the child insists on sitting upright and leaning foward w/ the chin thrust out, mouth open and
tongue protruding to facilitate breathing Correct Ans ~ - tripod
irritants such as house dust mites, tobacco smoke, mold or pets Correct Ans ~ - allergens
a serious possibly life-threatening obstructive inflammatory process of the upper trachea w/
features of croup and epiglottitis Correct Ans ~ - bacterial tracheitis
considered to be the corner stone treatment for children and adolescents w/ cystic fibrosis
Correct Ans ~ - airway clearance therapies
The nurse in the emergency department (ED) is assessing a school-age child with a new
ventriculoperitoneal (VP) shunt. The child is being seen for lethargy, irritability, vomiting,
severe headache, and a fever of 102.4°. What initial action should the nurse expect would be
taken?
A 15-month-old is admitted to the pediatric unit with a history of a recent upper respiratory
infection. Which symptom is consistent with the diagnosis of laryngotracheobronchitis (croup)?
Select all that apply.
1.Reported inspiratory stridor which is worse at night.
2.Suprasternal retractions are present upon examination.
3.The toddler has a barking, seal-like, harsh cough.
4.Lung sounds have inspiratory wheezing.
5.Lung sounds with crackles in the bases bilaterally. Correct Ans ~ - 1,2,3
A four-year-old is presented to the urgent care center with a history of a sudden onset of a severe
sore throat. He began drooling and has difficulty swallowing. The temperature is 102.2F (39.0C).
Lung sounds are clear and there is no cough. The child is very anxious and flushed and is leaning
forward in a tripod position. Based on these symptoms, the nurse anticipates a diagnosis of:
1.Acute Asthma Attack
2.Laryngotracheomalacia
3.Acute laryngotracheobronchitis (Croup)
4.Acute Epiglottitis Correct Ans ~ - 4
Which should the nurse expect to be included in the treatment of the client experiencing acute
asthma symptoms? Select all that apply.
1.Bronchodilators
2.Corticosteroids
3.Oxygen
4.Montelukast (Singular)
5.Immediate Intubation Correct Ans ~ - 1, 2, 3
The nurse understands that in a child with cystic fibrosis (CF) which vitamin absorption is
impaired? Select all that apply.
1.A
2.B
3.C
4.D
5.E Correct Ans ~ - 1, 3, 4, 5
Which indicates the earliest sign of hemorrhage in a child who has just had a tonsillectomy?
1.Frequent swallowing
2.Labored respirations
3.Tachypnea stridor
4.Dark brown emesis Correct Ans ~ - 1
A child with chronic otitis media has bilateral myringotomy tubes placed. Which statement
would indicate that the parent understands education about myringotomy tubes?
1."The tubes have to be surgically removed in 9 months or so."
,2."The tubes were placed to equalize pressure."
3."These tubes won't affect my child being able to go swimming in the summer."
4."My child will still need to be on Amoxicillin prophylactically for six months." Correct Ans
~ -2
The nurse should instruct the parent whose child is diagnosed with respiratory syncytial virus
(RSV) to notify the healthcare provider for which issue? Select all that apply.
1.The child is not eating
2.There is a decrease in wet diapers
3.There is increased work of breathing
4.The child develops yellow drainage from the nose
5.Only when the child wheezes Correct Ans ~ - 1, 2, 3
Which are signs and symptoms of respiratory distress in a two-month-old? Select all that apply.
1.Nasal flaring
2.Intercostal retractions
3.Coughing
4.Bronchovesicular lung sounds
5.Grunting Correct Ans ~ - 1, 2, 5
You are teaching a family with a child who has cystic fibrosis (CF) about chest physiotherapy
treatment (CPT). Which of the following teaching points are correct to include? SATA
1.It should be performed three to four times a day.
2.It may cause bronchospasm.
3.It is all right to percuss over the spine or internal organs.
4.When manually percussing you should use a cupped hand.
5.CPT can be done at any time including after eating. Correct Ans ~ - 1, 2, 4
Which child does the nurse anticipate to be most at risk for being hospitalized for respiratory
syncytial virus (RSV)?
1.A three-month-old who was born at 30 weeks gestation
2.A 18-month-old with a tracheostomy
3.A four-year-old with a ventricular septal defect (VSD)
4.A five-year-old who was term but has never received any immunizations Correct Ans ~ - 1
The nursing student asks the nurse about genetic implications related to cystic fibrosis (CF).
How should the nurse respond?
1."It is inherited as an autosomal dominant trait."
2."It is a genetic defect found primarily in non-Caucasian people."
3."If it is present in a child, both parents are carriers of the defective gene."
4."There is a 50% chance the siblings of an affected child will also be affected." Correct Ans ~
-3
what is the gold standard test in cystic fibrosis Correct Ans ~ - sweat test
, A measurement of the maximum flow of air that can be forcefully exhaled in 1 second, a key
measurement of pulmonary function Correct Ans ~ - Peak expiratory flow rate
provides an objective method of evaluating the presence and degree of lung dz, as well as the
response of therapy Correct Ans ~ - Pulmonary Function Test (PFT)
cessation of breathing for more than 20 sec or for a shorter period of time when associated w/
hypoxemia or bradycardia Correct Ans ~ - apnea
a medical emergency that can result in respiratory failure and death if untreated Correct Ans ~
- status asthmaticus
involves stimulating the production of sweat w/ a special device, collecting sweat and measuring
the sweat electrolytes. Used in the diagnosis of cystic fibrosis Correct Ans ~ - sweat chloride
test
inability of the respiratory apparatus to maintain adequate oxygenation of the blood w/ or w/out
carbon dioxide retention Correct Ans ~ - respiratory failure
a serious obstructive inflammatory process in the upper airway may see absence of a cough but
drooling and agitation Correct Ans ~ - acute epiglottitis
in general applies to 2 conditions: increased work of breathing w/ near normal gas exchange
function or the inability to maintain normal blood gas tensions that develops from carbon dioxide
retention w/ subsequent hypoxemia and acidosis Correct Ans ~ - respiratory insuffuecuency
upper airway infection characterized by hoarseness and a barking cough Correct Ans ~ - croup
earliest manifestation of cystic fibrosis where the small intestine is blocked w/ thick meconium
in the newborn Correct Ans ~ - meconium ileus
the child insists on sitting upright and leaning foward w/ the chin thrust out, mouth open and
tongue protruding to facilitate breathing Correct Ans ~ - tripod
irritants such as house dust mites, tobacco smoke, mold or pets Correct Ans ~ - allergens
a serious possibly life-threatening obstructive inflammatory process of the upper trachea w/
features of croup and epiglottitis Correct Ans ~ - bacterial tracheitis
considered to be the corner stone treatment for children and adolescents w/ cystic fibrosis
Correct Ans ~ - airway clearance therapies
The nurse in the emergency department (ED) is assessing a school-age child with a new
ventriculoperitoneal (VP) shunt. The child is being seen for lethargy, irritability, vomiting,
severe headache, and a fever of 102.4°. What initial action should the nurse expect would be
taken?
