PEDs HESI Practice Questions and
Answers
When inserting a nasogastric tube into the stomach of a 3-month-old infant, which
nursing intervention is most important to implement?
A.
Use a blanket as a mummy restraint.
B.
Monitor the infant's heart rate.
C.
Lubricate the catheter with saline.
D.
Explain the procedure to the parents. - ANSWER B. Monitor the infant's heart rate
Rationale:All interventions may be implemented during nasogastric tube insertion, but
the most important nursing action is to monitor the infant's heart rate, which may
decrease because of vagal nerve stimulation and can occur when the tube is inserted.
Options A, C, and D are of lower priority than option B.
A 3-month-old infant returns from surgery with elbow restraints and a Logan bow over a
cleft lip suture line. Which intervention should the nurse implement to maintain suture
line integrity during the initial postoperative period?
A.
Place the infant upright in an infant seat position.
B.
Provide mittens with the use of elbow restraints.
C.
Use soft rubber catheters for nasal suctioning.
D.
Apply water-soluble lubricant to the suture line. - ANSWER A.
Place the infant upright in an infant seat position.
Rationale:The use of an infant seat simulates a supine position with the head elevated
and also prevents aspiration. Prone positioning should be avoided to prevent disruption
of the protective Logan bow and prevent the infant from rubbing the face on the bed
surface. Mittens are not necessary and decrease the ability to provide sensory comfort,
such as hand holding. Nasal suctioning should be avoided to prevent trauma or
dislodging clots at the surgical site. Water-soluble lubricant will dry the suture line and
cause crusting, which predisposes the suture line to poor healing and scarring.
,A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine
evaluation. Which assessment finding suggests the presence of a common complication
often experienced by those with Down syndrome?
A.
Presence of a systolic murmur
B.
New onset of patchy alopecia
C.
Complaints of long bone pain
D.
Recent projectile vomiting - ANSWER A.
Presence of a systolic murmur
Rationale:Congenital heart disease occurs in 40% to 50% of children with trisomy 21
(Down syndrome). Defects of the atrial or ventricular septum that create systolic
murmurs are the most common heart defects associated with this congenital anomaly.
Options B, C, and D are not recognized as common complications of trisomy 21.
Which assessment findings should the nurse expect when caring for a child with cystic
fibrosis? (Select all that apply.)
A.
Steatorrhea
B.
Obesity
C.
Foul-smelling stools
D.
Delayed growth
E.
Pulmonary congestion - ANSWER A.
Steatorrhea
C.
Foul-smelling stools
D.
Delayed growth
E.
Pulmonary congestion
Rationale:Options A, C, D, and E are all common assessment findings in the client with
cystic fibrosis. Weight loss, not weight gain, is associated with cystic fibrosis.
The nurse is conducting an initial admission assessment of a 12-month-old child in
celiac crisis. Which intervention is most important for the nurse to implement?
, A.
Assess the child's mucous membranes and skin turgor.
B.
Contact food services about needed menu restrictions.
C.
Determine the child's food likes and dislikes.
D.
Ask the parents about the child's recent dietary intake. - ANSWER A.
Assess the child's mucous membranes and skin turgor.
Rationale:An infant having a celiac crisis has severe diarrhea and is at high risk for fluid
volume deficit. The nurse should first assess for indications of fluid volume deficit and
then implement options B, C, and D.
A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of psychosocial
development is the nurse addressing when teaching inhalation therapy?
A.
Autonomy
B.
Industry
C.
Trust
D.
Initiative - ANSWER D. Initiative
Rationale:Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson
theory of psychosocial development. They enjoy being active and participating in role
playing. "Autonomy vs. Shame and Doubt" occurs at 1 to 3 years of age. "Industry vs.
Inferiority" occurs at 6 to 11 years; "Trust vs. Mistrust" occurs from birth to 1 year of age.
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.
Based on these findings, what action should the nurse take?
A.
No action is required because this is an expected finding for a school-aged child.
B.
Ask if the child has had a cold, runny nose, or any ear pain lately.
C.
Send a note home advising parents to have the child evaluated by a health care
provider.
D.
Call the parents and have them take the child home from school for the rest of the day. -
ANSWER B.
Ask if the child has had a cold, runny nose, or any ear pain lately.
Answers
When inserting a nasogastric tube into the stomach of a 3-month-old infant, which
nursing intervention is most important to implement?
A.
Use a blanket as a mummy restraint.
B.
Monitor the infant's heart rate.
C.
Lubricate the catheter with saline.
D.
Explain the procedure to the parents. - ANSWER B. Monitor the infant's heart rate
Rationale:All interventions may be implemented during nasogastric tube insertion, but
the most important nursing action is to monitor the infant's heart rate, which may
decrease because of vagal nerve stimulation and can occur when the tube is inserted.
Options A, C, and D are of lower priority than option B.
A 3-month-old infant returns from surgery with elbow restraints and a Logan bow over a
cleft lip suture line. Which intervention should the nurse implement to maintain suture
line integrity during the initial postoperative period?
A.
Place the infant upright in an infant seat position.
B.
Provide mittens with the use of elbow restraints.
C.
Use soft rubber catheters for nasal suctioning.
D.
Apply water-soluble lubricant to the suture line. - ANSWER A.
Place the infant upright in an infant seat position.
Rationale:The use of an infant seat simulates a supine position with the head elevated
and also prevents aspiration. Prone positioning should be avoided to prevent disruption
of the protective Logan bow and prevent the infant from rubbing the face on the bed
surface. Mittens are not necessary and decrease the ability to provide sensory comfort,
such as hand holding. Nasal suctioning should be avoided to prevent trauma or
dislodging clots at the surgical site. Water-soluble lubricant will dry the suture line and
cause crusting, which predisposes the suture line to poor healing and scarring.
,A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine
evaluation. Which assessment finding suggests the presence of a common complication
often experienced by those with Down syndrome?
A.
Presence of a systolic murmur
B.
New onset of patchy alopecia
C.
Complaints of long bone pain
D.
Recent projectile vomiting - ANSWER A.
Presence of a systolic murmur
Rationale:Congenital heart disease occurs in 40% to 50% of children with trisomy 21
(Down syndrome). Defects of the atrial or ventricular septum that create systolic
murmurs are the most common heart defects associated with this congenital anomaly.
Options B, C, and D are not recognized as common complications of trisomy 21.
Which assessment findings should the nurse expect when caring for a child with cystic
fibrosis? (Select all that apply.)
A.
Steatorrhea
B.
Obesity
C.
Foul-smelling stools
D.
Delayed growth
E.
Pulmonary congestion - ANSWER A.
Steatorrhea
C.
Foul-smelling stools
D.
Delayed growth
E.
Pulmonary congestion
Rationale:Options A, C, D, and E are all common assessment findings in the client with
cystic fibrosis. Weight loss, not weight gain, is associated with cystic fibrosis.
The nurse is conducting an initial admission assessment of a 12-month-old child in
celiac crisis. Which intervention is most important for the nurse to implement?
, A.
Assess the child's mucous membranes and skin turgor.
B.
Contact food services about needed menu restrictions.
C.
Determine the child's food likes and dislikes.
D.
Ask the parents about the child's recent dietary intake. - ANSWER A.
Assess the child's mucous membranes and skin turgor.
Rationale:An infant having a celiac crisis has severe diarrhea and is at high risk for fluid
volume deficit. The nurse should first assess for indications of fluid volume deficit and
then implement options B, C, and D.
A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of psychosocial
development is the nurse addressing when teaching inhalation therapy?
A.
Autonomy
B.
Industry
C.
Trust
D.
Initiative - ANSWER D. Initiative
Rationale:Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson
theory of psychosocial development. They enjoy being active and participating in role
playing. "Autonomy vs. Shame and Doubt" occurs at 1 to 3 years of age. "Industry vs.
Inferiority" occurs at 6 to 11 years; "Trust vs. Mistrust" occurs from birth to 1 year of age.
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.
Based on these findings, what action should the nurse take?
A.
No action is required because this is an expected finding for a school-aged child.
B.
Ask if the child has had a cold, runny nose, or any ear pain lately.
C.
Send a note home advising parents to have the child evaluated by a health care
provider.
D.
Call the parents and have them take the child home from school for the rest of the day. -
ANSWER B.
Ask if the child has had a cold, runny nose, or any ear pain lately.
