PEDIATRIC'S HESI COMP BOOK EXAM
QUESTIONS WITH VERIFIED
ANSWERS
The practical nurse(PN) in the clinic receives a phone call from the mother of a 6
year old child with a newly applied cast for a fracture of the femur. The master
reports that the child Is in pain and is crying and that child's foot appears swollen and
blue. Which should be the nurse's instruction to the mother?
a. Ask the child to use crutches for mobility.
b. Apply ice to the site of the fracture
c. Bring the child immediately to the clinic
d. Administer the prescribed pain medication - ANSWER-c. Bring the child
immediately to the clinic.
Rationale:
Because the child is exhibiting indications of impaired circulation (pain and
cyanosis), the child is having altered peripheral tissue perfusion. The PN should
instruct the mother to bring the child into the clinic or emergency room immediately
for evaluation.
While examining a 6 year old visiting the clinic for fever and a rash, the practical
nurse (PN) notices several elevated 1- to 3-mm white spots on the buccal mucosa.
What other signs should the PN expect this child to exhibit?
a. Pruritic vesicular skin eruptions on trunk
b. Honey-colored crusted exudate from ruptured skin vesicles
c. Irregular red macular rash in the perianal area
d. Red blotchy macular rash on the face and neck - ANSWER-d. Red blotchy
macular rash on the face and neck
Rationale:
Elevated white spots on the oral mucosa of a child are likely Koplik's spots and are
indicative of rubeola. They are accompanied by a red blotchy rash that starts on the
face and spreads to the neck, the trunk, and the rest of the body.
The practical nurse (PN) has reviewed signs and symptoms of congestive heart
failure with the parents of a 2-year-old child with a congenital heart defect. The nurse
realizes the education has been effective if the parents identify which behavior as
most important for the parents to report to the health care provider?
a. Sits or squats frequently when playing outdoors.
b. Exhibits a sudden and unexplained weight gain.
c. Is not completely toilet trained and has some "accidents."
d. Demonstrates irritation and fatigue 1 hour before bedtime. - ANSWER-b. Exhibits
a sudden and unexplained weight gain.
Rationale:
Sudden and unexplained weight gain can indicate fluid retention and is a sign of
congestive heart failure.
,A newborn who has mild transitional (positional) clubfeet is placed in bilateral casts
in an overcorrected valgus (outward) position. What is the primary issue the practical
nurse should review with the parents during discharge teaching?
a. Prevent cast soiling and maintain the cast's edge by petaling.
b. Observe for skin and circulation compromise from the cast.
c. Manipulate the cast surfaces with the palms of the hands.
d. Support and elevate both legs on pillows continuously. - ANSWER-b. Observe for
skin and circulation compromise from the cast.
Rationale:
Reinforcing information with parents about their role in care and about vigilant
observation for potential problems of the infant at home such as skin and circulation
compromise is the most important nursing intervention
The nurse has reinforced instructions for a child who has been hospitalized with a
sickle cell crisis. The nurse realizes the instruction has been effective if the parents
make which statements?(Select all that apply.)
a. "if my child's joints are swollen and painful, I should apply ice."
b. "My child keeps wetting the bed, so I should restrict fluid intake."
c. "I will ask the physical education teacher allow extra fluid intake while exercising."
d. "If my child is having a crisis, morphine intravenously is likely going to be
necessary."
e. "If we are planning any trips, we need to make sure we do not travel to any high
altitudes." - ANSWER-c. "I will ask the physical education teacher allow extra fluid
intake while exercising."
d. "If my child is having a crisis, morphine intravenously is likely going to be
necessary."
e. "If we are planning any trips, we need to make sure we do not travel to any high
altitudes."
Rationale:
A child with sickle cell disease should have additional fluids while exercising. During
a crisis, parenteral morphine is likely necessary. The child should not travel to high
altitude areas, due to decreased oxygenation. If the child's joints are painful, warmth,
not ice packs, should be applied. Even though bedwetting is occurring, additional
fluids are still necessary to treat and prevent a crisis.
A 12-year-old child has been experiencing right lower quadrant abdominal pain and
acute appendicitis has been diagnosed. The child rates the pain level as an 8 on the
0-10 scale. An hour later, the child says the pain suddenly went away. The nurse
contacts the health care provider for which reason?
a. To report the pain has been relieved
b. To inform the on call surgical team that surgery will not be needed
c. To inform the health care provider that the pain abruptly stopped, indicating
possible rupture
d. To ask if liquids can be prescribed by mouth and to ask to change the intravenous
antibiotics to be given orally - ANSWER-c. To inform the health care provider that the
pain abruptly stopped, indicating possible rupture
Rationale:
A person experiencing a ruptured appendix will experience an abrupt relief of pain.
The nurse is contacting the health care provider because this indicates surgery will
be necessary very quickly to prevent peritonitis and sepsis. The nurse is not notifying
, the health care provider to report pain relief, or to notify the surgical team that
surgery is not needed. The child will be kept NPO (nothing by mouth status), until the
surgeon prescribes fluids after surgery. The child should not be given fluids by mouth
prior to surgery, because this could contribute to aspiration.
A 2-year-old child who is hospitalized with an acute upper respiratory infection (URI)
is crying uncontrollably because her mother went to the cafeteria for lunch. Which
action should the practical nurse implement?
a. Distract the child with a favorite toy.
b. Tell the child that her mother will return.
c. Take the child to the cafeteria.
d. Calm the child with a dietary treat. - ANSWER-a. Distract the child with a favorite
toy.
Rationale:
The best action is to refocus the child's attention by distracting with a favorite toy.
The nurse is reinforcing instructions for a child diagnosed with iron deficiency
anemia. The nurse realizes instructions were effective if the parent/child make which
statement? (Select all that apply.)
a. "If possible the iron replacement tablets should be taken on an empty stomach."
b. "I should make sure the iron tablets are taken with milk or another type of milk
product."
c. "I should try to provide five or six 8 ounce glasses of milk every day to treat the
anemia."
d. "I will need to keep this out of the reach of the younger children we have in the
home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables." - ANSWER-a. "If possible the iron replacement tablets should be taken
on an empty stomach."
d. "I will need to keep this out of the reach of the younger children we have in the
home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables."
Rationale:
The nurse should encourage the parents to try giving the iron on an empty stomach
whenever possible. Iron toxicity can be fatal, so it should be out of the reach of very
young children. The client who has iron-deficiency anemia will still need to eat foods
high in iron. The child should take in no more than 32 ounces (four 8 ounce cups) of
milk in a 24-hour period.
During a well-child visit for a 10 month old, a parent is concerned that the child's
development is not progressing as expected. Which comment is of most concern?
a. "My baby cannot walk yet."
b. "My baby cannot throw a ball overhand yet."
c. "My baby cannot sit up yet unless she is propped on something."
d. "My baby was 21 inches long at birth, but her length has not doubled yet." -
ANSWER-Rationale:
By 8 months, the child should be able to sit up unsupported. Most children are not
able to walk until 12 months. By age 18 months, the child should be able to throw a
ball overhand. Birth length usually doubles by age 4.
QUESTIONS WITH VERIFIED
ANSWERS
The practical nurse(PN) in the clinic receives a phone call from the mother of a 6
year old child with a newly applied cast for a fracture of the femur. The master
reports that the child Is in pain and is crying and that child's foot appears swollen and
blue. Which should be the nurse's instruction to the mother?
a. Ask the child to use crutches for mobility.
b. Apply ice to the site of the fracture
c. Bring the child immediately to the clinic
d. Administer the prescribed pain medication - ANSWER-c. Bring the child
immediately to the clinic.
Rationale:
Because the child is exhibiting indications of impaired circulation (pain and
cyanosis), the child is having altered peripheral tissue perfusion. The PN should
instruct the mother to bring the child into the clinic or emergency room immediately
for evaluation.
While examining a 6 year old visiting the clinic for fever and a rash, the practical
nurse (PN) notices several elevated 1- to 3-mm white spots on the buccal mucosa.
What other signs should the PN expect this child to exhibit?
a. Pruritic vesicular skin eruptions on trunk
b. Honey-colored crusted exudate from ruptured skin vesicles
c. Irregular red macular rash in the perianal area
d. Red blotchy macular rash on the face and neck - ANSWER-d. Red blotchy
macular rash on the face and neck
Rationale:
Elevated white spots on the oral mucosa of a child are likely Koplik's spots and are
indicative of rubeola. They are accompanied by a red blotchy rash that starts on the
face and spreads to the neck, the trunk, and the rest of the body.
The practical nurse (PN) has reviewed signs and symptoms of congestive heart
failure with the parents of a 2-year-old child with a congenital heart defect. The nurse
realizes the education has been effective if the parents identify which behavior as
most important for the parents to report to the health care provider?
a. Sits or squats frequently when playing outdoors.
b. Exhibits a sudden and unexplained weight gain.
c. Is not completely toilet trained and has some "accidents."
d. Demonstrates irritation and fatigue 1 hour before bedtime. - ANSWER-b. Exhibits
a sudden and unexplained weight gain.
Rationale:
Sudden and unexplained weight gain can indicate fluid retention and is a sign of
congestive heart failure.
,A newborn who has mild transitional (positional) clubfeet is placed in bilateral casts
in an overcorrected valgus (outward) position. What is the primary issue the practical
nurse should review with the parents during discharge teaching?
a. Prevent cast soiling and maintain the cast's edge by petaling.
b. Observe for skin and circulation compromise from the cast.
c. Manipulate the cast surfaces with the palms of the hands.
d. Support and elevate both legs on pillows continuously. - ANSWER-b. Observe for
skin and circulation compromise from the cast.
Rationale:
Reinforcing information with parents about their role in care and about vigilant
observation for potential problems of the infant at home such as skin and circulation
compromise is the most important nursing intervention
The nurse has reinforced instructions for a child who has been hospitalized with a
sickle cell crisis. The nurse realizes the instruction has been effective if the parents
make which statements?(Select all that apply.)
a. "if my child's joints are swollen and painful, I should apply ice."
b. "My child keeps wetting the bed, so I should restrict fluid intake."
c. "I will ask the physical education teacher allow extra fluid intake while exercising."
d. "If my child is having a crisis, morphine intravenously is likely going to be
necessary."
e. "If we are planning any trips, we need to make sure we do not travel to any high
altitudes." - ANSWER-c. "I will ask the physical education teacher allow extra fluid
intake while exercising."
d. "If my child is having a crisis, morphine intravenously is likely going to be
necessary."
e. "If we are planning any trips, we need to make sure we do not travel to any high
altitudes."
Rationale:
A child with sickle cell disease should have additional fluids while exercising. During
a crisis, parenteral morphine is likely necessary. The child should not travel to high
altitude areas, due to decreased oxygenation. If the child's joints are painful, warmth,
not ice packs, should be applied. Even though bedwetting is occurring, additional
fluids are still necessary to treat and prevent a crisis.
A 12-year-old child has been experiencing right lower quadrant abdominal pain and
acute appendicitis has been diagnosed. The child rates the pain level as an 8 on the
0-10 scale. An hour later, the child says the pain suddenly went away. The nurse
contacts the health care provider for which reason?
a. To report the pain has been relieved
b. To inform the on call surgical team that surgery will not be needed
c. To inform the health care provider that the pain abruptly stopped, indicating
possible rupture
d. To ask if liquids can be prescribed by mouth and to ask to change the intravenous
antibiotics to be given orally - ANSWER-c. To inform the health care provider that the
pain abruptly stopped, indicating possible rupture
Rationale:
A person experiencing a ruptured appendix will experience an abrupt relief of pain.
The nurse is contacting the health care provider because this indicates surgery will
be necessary very quickly to prevent peritonitis and sepsis. The nurse is not notifying
, the health care provider to report pain relief, or to notify the surgical team that
surgery is not needed. The child will be kept NPO (nothing by mouth status), until the
surgeon prescribes fluids after surgery. The child should not be given fluids by mouth
prior to surgery, because this could contribute to aspiration.
A 2-year-old child who is hospitalized with an acute upper respiratory infection (URI)
is crying uncontrollably because her mother went to the cafeteria for lunch. Which
action should the practical nurse implement?
a. Distract the child with a favorite toy.
b. Tell the child that her mother will return.
c. Take the child to the cafeteria.
d. Calm the child with a dietary treat. - ANSWER-a. Distract the child with a favorite
toy.
Rationale:
The best action is to refocus the child's attention by distracting with a favorite toy.
The nurse is reinforcing instructions for a child diagnosed with iron deficiency
anemia. The nurse realizes instructions were effective if the parent/child make which
statement? (Select all that apply.)
a. "If possible the iron replacement tablets should be taken on an empty stomach."
b. "I should make sure the iron tablets are taken with milk or another type of milk
product."
c. "I should try to provide five or six 8 ounce glasses of milk every day to treat the
anemia."
d. "I will need to keep this out of the reach of the younger children we have in the
home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables." - ANSWER-a. "If possible the iron replacement tablets should be taken
on an empty stomach."
d. "I will need to keep this out of the reach of the younger children we have in the
home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables."
Rationale:
The nurse should encourage the parents to try giving the iron on an empty stomach
whenever possible. Iron toxicity can be fatal, so it should be out of the reach of very
young children. The client who has iron-deficiency anemia will still need to eat foods
high in iron. The child should take in no more than 32 ounces (four 8 ounce cups) of
milk in a 24-hour period.
During a well-child visit for a 10 month old, a parent is concerned that the child's
development is not progressing as expected. Which comment is of most concern?
a. "My baby cannot walk yet."
b. "My baby cannot throw a ball overhand yet."
c. "My baby cannot sit up yet unless she is propped on something."
d. "My baby was 21 inches long at birth, but her length has not doubled yet." -
ANSWER-Rationale:
By 8 months, the child should be able to sit up unsupported. Most children are not
able to walk until 12 months. By age 18 months, the child should be able to throw a
ball overhand. Birth length usually doubles by age 4.
