HESI COMPREHENSIVE NCLEX-RN PRACTICE (PEDIATRICS) EXAM 2025 UPDATE QUESTIONS
AND CORRECT VERIFIED ANSWERS ALREADY GRADED A+ (BRAND NEW VISION)
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 - answersA
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.
A burned child is brought to the emergency department, and the nurse uses a modified rule of
nines to estimate the percentage of the body burned. When calculating the percentage of burn,
which parts of the child's body are proportionally larger than an adult's?
A. Head and neck
B. Arms and chest
C. Legs and abdomen
D. Back and abdomen - answersA
Rationale:
The standard rule of nines is inaccurate for determining burned body surface areas with
children because a child's head and neck are proportionately larger than an adult's. Specially
,designed charts are commonly used to measure the percentage of burn in children. Options B,
C, and D are not proportionately different
The nurse is caring for a child with intussusception who is scheduled for a barium enema prior
to a surgical procedure. Which action should the nurse take first?
A. Evacuate the bowel of impacted feces
B. Administer magnesium sulfate
C. Place the child on a clear liquid diet
D. Assess the stool for white color - answersC
Rationale:
Intussusception, an invagination or telescoping of one portion of the intestine into another,
causes intestinal obstruction in children (usually occurs between 3 months and 5 years of age).
Nonsurgical treatment is attempted with hydrostatic pressure created by barium instillation,
which often reduces the area of bowel intussusception. In preparation for a barium enema, the
client should first be placed on a clear liquid diet for the entire day; then magnesium sulfate is
administered for bowel evacuation. A barium enema is likely to cause option A. After the
enema, white stool may be seen as the body naturally removes any remaining barium.
A woman whose first child died at 6 weeks of age because of sudden infant death syndrome
(SIDS) is being discharged following the birth of her second child. The mother tells the nurse
that she is fearful that this infant will also develop SIDS. Which response is best for the nurse to
provide this woman?
A."You can prevent SIDS if your baby sleeps on the side or back. You will have to monitor the
baby carefully."
B. "The fear of losing another child to SIDS is very realistic. Have you thought about what
support you may need?"
C. "An apnea monitor will alert you if the baby stops breathing. This will give you the peace of
mind that you need."
,D. "My neighbor's baby died of SIDS last year, and she went to a SIDS support group. That really
helped her." - answersB
Rationale:
The most effective way to provide emotional support is to acknowledge what clients may be
feeling, be a sounding board for them so they can listen to themselves, and allow them to
discover their own solutions. Option A implies to the mother that she can prevent SIDS from
occurring, which is an unrealistic expectation. Offering a personal opinion about what will help
this client or about what has helped a neighbor is not as effective as helping the client discover
what would be best for her.
The nurse admits a child to the intensive care unit with a diagnosis of acquired aplastic anemia.
What is the most common cause of this type of anemia?
A. Bacterial infections
B. A diet deficient in iron
C. Heart-lung congenital defects
D. Exposure to certain drugs - answersD
Rationale:
Aplastic anemia often follows exposure to certain drugs such as chloramphenicol, sulfonamides,
and phenylbutazone (Butazolidin), insecticides such as DDT, and chemicals, especially, benzene.
Options A and C are not related to the development of anemia. Option B is related to iron
deficiency anemia.
Following the administration of immunizations to a 6-month-old girl, the nurse provides the
family with home care instructions. Which statement by the mother indicates that further
teaching is needed?
A."I will give her a baby aspirin every 4 hours as needed for fever."
B. "I will call the clinic if her cry becomes high-pitched or unusual."
C. "I know I can expect her to be irritable over the next 2 days."
, D. "I will exercise her legs regularly to decrease the soreness." - answersA
Rationale:
Although fever may occur, non-aspirin-containing medications should be used because of the
risk of Reye syndrome. Option B indicates a severe reaction, whereas option C is a common side
effect. Option D decreases soreness in the thigh injection site.
A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F. What caloric
amount does this child need?
A. 400 calories/day
B. 500 calories/day
C. 600 calories/day
D. 700 calories/day - answersC
Rationale:
An infant requires 108 calories/kg/day. The first step is to change 10 lb 15 oz to 10.9 lb. Then
convert pounds to kilograms by dividing pounds by 2.2, which is 10.9/2.2 = 4.954 kg, rounded to
5 kg. The second step is to multiply 108 calories/kg/day (108 × 5 = 540 calories/day). However,
this infant requires 10% more calories because of the 1° F temperature elevation. Ten percent of
540 (calories/day) is 54, and 540 + 54 = 594. This infant will require approximately 600
calories/day. Options A, B, and D are incorrect.
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. - answersA
AND CORRECT VERIFIED ANSWERS ALREADY GRADED A+ (BRAND NEW VISION)
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 - answersA
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.
A burned child is brought to the emergency department, and the nurse uses a modified rule of
nines to estimate the percentage of the body burned. When calculating the percentage of burn,
which parts of the child's body are proportionally larger than an adult's?
A. Head and neck
B. Arms and chest
C. Legs and abdomen
D. Back and abdomen - answersA
Rationale:
The standard rule of nines is inaccurate for determining burned body surface areas with
children because a child's head and neck are proportionately larger than an adult's. Specially
,designed charts are commonly used to measure the percentage of burn in children. Options B,
C, and D are not proportionately different
The nurse is caring for a child with intussusception who is scheduled for a barium enema prior
to a surgical procedure. Which action should the nurse take first?
A. Evacuate the bowel of impacted feces
B. Administer magnesium sulfate
C. Place the child on a clear liquid diet
D. Assess the stool for white color - answersC
Rationale:
Intussusception, an invagination or telescoping of one portion of the intestine into another,
causes intestinal obstruction in children (usually occurs between 3 months and 5 years of age).
Nonsurgical treatment is attempted with hydrostatic pressure created by barium instillation,
which often reduces the area of bowel intussusception. In preparation for a barium enema, the
client should first be placed on a clear liquid diet for the entire day; then magnesium sulfate is
administered for bowel evacuation. A barium enema is likely to cause option A. After the
enema, white stool may be seen as the body naturally removes any remaining barium.
A woman whose first child died at 6 weeks of age because of sudden infant death syndrome
(SIDS) is being discharged following the birth of her second child. The mother tells the nurse
that she is fearful that this infant will also develop SIDS. Which response is best for the nurse to
provide this woman?
A."You can prevent SIDS if your baby sleeps on the side or back. You will have to monitor the
baby carefully."
B. "The fear of losing another child to SIDS is very realistic. Have you thought about what
support you may need?"
C. "An apnea monitor will alert you if the baby stops breathing. This will give you the peace of
mind that you need."
,D. "My neighbor's baby died of SIDS last year, and she went to a SIDS support group. That really
helped her." - answersB
Rationale:
The most effective way to provide emotional support is to acknowledge what clients may be
feeling, be a sounding board for them so they can listen to themselves, and allow them to
discover their own solutions. Option A implies to the mother that she can prevent SIDS from
occurring, which is an unrealistic expectation. Offering a personal opinion about what will help
this client or about what has helped a neighbor is not as effective as helping the client discover
what would be best for her.
The nurse admits a child to the intensive care unit with a diagnosis of acquired aplastic anemia.
What is the most common cause of this type of anemia?
A. Bacterial infections
B. A diet deficient in iron
C. Heart-lung congenital defects
D. Exposure to certain drugs - answersD
Rationale:
Aplastic anemia often follows exposure to certain drugs such as chloramphenicol, sulfonamides,
and phenylbutazone (Butazolidin), insecticides such as DDT, and chemicals, especially, benzene.
Options A and C are not related to the development of anemia. Option B is related to iron
deficiency anemia.
Following the administration of immunizations to a 6-month-old girl, the nurse provides the
family with home care instructions. Which statement by the mother indicates that further
teaching is needed?
A."I will give her a baby aspirin every 4 hours as needed for fever."
B. "I will call the clinic if her cry becomes high-pitched or unusual."
C. "I know I can expect her to be irritable over the next 2 days."
, D. "I will exercise her legs regularly to decrease the soreness." - answersA
Rationale:
Although fever may occur, non-aspirin-containing medications should be used because of the
risk of Reye syndrome. Option B indicates a severe reaction, whereas option C is a common side
effect. Option D decreases soreness in the thigh injection site.
A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F. What caloric
amount does this child need?
A. 400 calories/day
B. 500 calories/day
C. 600 calories/day
D. 700 calories/day - answersC
Rationale:
An infant requires 108 calories/kg/day. The first step is to change 10 lb 15 oz to 10.9 lb. Then
convert pounds to kilograms by dividing pounds by 2.2, which is 10.9/2.2 = 4.954 kg, rounded to
5 kg. The second step is to multiply 108 calories/kg/day (108 × 5 = 540 calories/day). However,
this infant requires 10% more calories because of the 1° F temperature elevation. Ten percent of
540 (calories/day) is 54, and 540 + 54 = 594. This infant will require approximately 600
calories/day. Options A, B, and D are incorrect.
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. - answersA
