Pediatrics HESI EXAM 2024-2025 QUESTIONS AND ANSWERS 100 % PASS
SOLUTION A+ GRADE
The nurse is assessing a 13-year-old girl with suspected hyperthyroidism. Which question is most
important for the nurse to ask her during the admission interview?
Have you lost any weight in the last month?
Are you experiencing any type of nervousness?
When was the last time you took your synthroid?
Are you having any problems with your vision? - answer>>Are you experiencing any type of
nervousness?
Assessing the client's physiological state upon admission is a priority, and nervousness,
apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism (B). Weight loss
(even with a hearty appetite) (A) occurs in those with hyperthyroidism, but assessing the
client's neurological state has a higher priority. Hormone replacement is not administered to a
client who is already producing too much thyroid (C). The client may have exophthalmus
(bulging eyes) but hyperthyroidism does not cause vision problems (D).
During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress
to the parents the importance of obtaining which diagnostic testing?
Hearing tests.
Eye exams.
Chest x-rays.
Fasting blood glucose tests. - answer>>Eye exams.
Visual changes leading to blindness can occur in children with JRA. Regular eye exams (B) can
help to prevent this complication. (A, C, and D) are not routinely necessary for management of
JRA.
The nurse is preparing a health teaching program for parents of toddlers and preschoolers and
plans to include information about prevention of accidental poisonings. It is most important for
the nurse to include which instruction?
Tell children they should not taste anything but food.
Store all toxic agents and medicines in locked cabinets.
Provide special play areas in the house and restrict play in other areas.
Punish children if they open cabinets that contain household chemicals. - answer>>Store all
toxic agents and medicines in locked cabinets.
The only reliable way to prevent poisonings in young children is to make them inaccessible (B).
Teaching children not to taste is important (A), but ineffective for young children. (C and D)
will not control a child's curiosity.
,The nurse is assessing the neurovascular status of a child in Russell's traction. Which finding
should the nurse report to the healthcare provider?
Pale bluish coloration of the toes.
Skin is warm and dry to the touch.
Toes are wiggled upon command.
Capillary refill less than 3 seconds. - answer>>Pale bluish coloration of the toes.
Russell's skin traction is used for fractures of the femur in young children and adolescents
whose growth plates remain open and is applied to the lower leg using moleskin and elastic
wrap bandages, which can compress the peroneal nerve and arteries that supply the foot.
Assessment of adequare circulation, movement, and sensation of the toes and skin distal to
the application is made to identify compromised blood flow, so cyanosis (A) should be
reported immediately. (B, C and D) are normal findings.
A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus
(PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold
her. Which response should the nurse provide to the parents?
Studies have shown that handling a sick newborn is not good for the baby and upsets the
parents.
The oxygen hood is holding the baby's oxygen level just at the point which is needed. You
may stroke and talk to her.
Since your baby has been doing well under oxygen for 24 hours, I can let you hold the baby
without oxygen.
You can hold the baby with the oxygen blowing in the baby's face since the level is very close to
room air. - answer>>The oxygen hood is holding the baby's oxygen level just at the point which
is needed. You may stroke and talk to her.
The baby is at 35% which is much more than room air (21%) and at this time the baby should
not be moved from under the hood. The nurse should offer the parents an alternative such as
to stroke and reassure the infant (B). Holding sick babies benefits the infant and the parents
(A). The first consideration now has to be the infant's oxygenation. The nurse should not take
the baby out from under the hood without a prescription from the healthcare provider, as this
could severely compromise the infant (C). A PO2 of 35% cannot be readily achieved with "blow
by" oxygen (D).
The mother of a 6-month-old asks the nurse when her baby will get the first measles, mumps,
and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule
published by the Centers for Disease Control, which response is accurate?
3 to 6 months.
12 to 15 months.
18 to 24 months.
4 to 6 years. - answer>>12 to 15 months.
,The first measles, mumps, and rubella (MMR) vaccine should be given no sooner than 12
months of age, and ideally between 12 and 15 months of age (B). (A) should not receive the
MMR vaccine due to the presence of maternal antibodies. MMR is not routinely administered
at (C), but other immunizations, such as DTaP and Hepatitis B may be given at that time. The
second dose of MMR is routinely administered at (D), provided that at least 4 weeks have
elapsed since the first dose, and if both doses were administered beginning at or after 12
months.
The nurse is teaching a 12-year-old male adolescent and his family about taking injections of
growth hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly
associated with growth hormone therapy, should the nurse plan to describe to the child and his
family?
Polyuria and polydipsia.
Lethargy and fatigue.
Increased facial hair.
Facial bone structure changes. - answer>>Polyuria and polydipsia.
Signs and symptoms of diabetes or hyperglycemia (A) need to be reported. Those receiving
growth hormone should be monitored to detect elevated blood sugars and glucose
intolerance. (B) is associated with any number of heath alterations, but is not associated with
the growth hormone therapy. (C and D) are normal changes that occur with 12-year-old
males.
A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The
adolescent's last tetanus toxoid booster was received eight years ago. What action should the
nurse take?
Dispense a tetanus antitoxin.
Prepare human tetanus immune globulin.
Administer tetanus toxoid booster.
Delay the tetanus toxoid booster until due. - answer>>Administer tetanus toxoid booster.
After the completion of the initial tetanus immunization schedule, the recommended booster
for an adolescent or adult is every ten years or less if a traumatic injury occurs that is
contaminated by dirt, feces, soil, or saliva, such as puncture or crushing injuries, avulsions,
wounds from missiles, burns, or frostbite. The adolescent's injury is considered a contaminated
wound requiring prophylactic therapy, so the tetanus toxoid booster should be administered
(C). (A, B, and D) are not indicated.
The mother of a 4-year-old child asks the nurse what she can do to help her other children cope
with their sibling's repeated hospitalizations. Which is the best response that the nurse should
offer?
, Inform the parent that the child is too young to visit the hospital.
Suggest that the child visit a grandmother until the sibling returns home.
Ask the mother if the child asks when the sibling will be discharged.
Encourage the mother to have the children visit the hospitalized sibling. - answer>>Encourage
the mother to have the children visit the hospitalized sibling.
Needs of a sibling will be better met with factual information and contact with the ill child, so
sibling visitation should be encouraged (D). Parents are experts on their children and should
determine when their children are old enough to visit (A) in the hospital. Separation from
family and home (B) may intensify fear and anxiety. Children may have difficulty expressing
questions (C), so the support of parents and other caregivers are needed to help alleviate their
fears.
Which growth and development characteristic should the nurse consider when monitoring the
effects of a topical medication for an infant?
A lower sensitivity reactions to skin irritants.
A thin stratum corneum that increases topical absorption.
A smaller percentage of muscle mass.
A greater body surface area that requires larger dosages. - answer>>A thin stratum corneum
that increases topical absorption.
Infants have a thin outer skin layer (stratum corneum), so the nurse should monitor the infant
for a prompt onset and response to the application of topical medication (B). (A, C, and D) are
unrelated to topical medication administration.
The clinic nurse is taking the history for a new 6-month-old client. The mother reports that she
took a great deal of aspirin while pregnant. Which assessment should the nurse obtain?
Type of reaction to loud noises.
Any surgeries on the ears since birth.
Drainage from the infant's ears.
Number of ear infections since birth. - answer>>Type of reaction to loud noises.
Ototoxicity diminishes hearing acuity and causes symptoms of tinnitus and vertigo in older
children who can express subjective symptoms, so assessing an infant's reaction to loud noises
(A) helps to determine an infant's risk for a hearing deficit related to a history of the mother
taking an ototoxic drug, such as aspirin, while pregnant. (B, C, and D) are not associated with
exposure to aspirin in utero.
3. A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The mother
reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse
auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the
newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should
SOLUTION A+ GRADE
The nurse is assessing a 13-year-old girl with suspected hyperthyroidism. Which question is most
important for the nurse to ask her during the admission interview?
Have you lost any weight in the last month?
Are you experiencing any type of nervousness?
When was the last time you took your synthroid?
Are you having any problems with your vision? - answer>>Are you experiencing any type of
nervousness?
Assessing the client's physiological state upon admission is a priority, and nervousness,
apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism (B). Weight loss
(even with a hearty appetite) (A) occurs in those with hyperthyroidism, but assessing the
client's neurological state has a higher priority. Hormone replacement is not administered to a
client who is already producing too much thyroid (C). The client may have exophthalmus
(bulging eyes) but hyperthyroidism does not cause vision problems (D).
During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress
to the parents the importance of obtaining which diagnostic testing?
Hearing tests.
Eye exams.
Chest x-rays.
Fasting blood glucose tests. - answer>>Eye exams.
Visual changes leading to blindness can occur in children with JRA. Regular eye exams (B) can
help to prevent this complication. (A, C, and D) are not routinely necessary for management of
JRA.
The nurse is preparing a health teaching program for parents of toddlers and preschoolers and
plans to include information about prevention of accidental poisonings. It is most important for
the nurse to include which instruction?
Tell children they should not taste anything but food.
Store all toxic agents and medicines in locked cabinets.
Provide special play areas in the house and restrict play in other areas.
Punish children if they open cabinets that contain household chemicals. - answer>>Store all
toxic agents and medicines in locked cabinets.
The only reliable way to prevent poisonings in young children is to make them inaccessible (B).
Teaching children not to taste is important (A), but ineffective for young children. (C and D)
will not control a child's curiosity.
,The nurse is assessing the neurovascular status of a child in Russell's traction. Which finding
should the nurse report to the healthcare provider?
Pale bluish coloration of the toes.
Skin is warm and dry to the touch.
Toes are wiggled upon command.
Capillary refill less than 3 seconds. - answer>>Pale bluish coloration of the toes.
Russell's skin traction is used for fractures of the femur in young children and adolescents
whose growth plates remain open and is applied to the lower leg using moleskin and elastic
wrap bandages, which can compress the peroneal nerve and arteries that supply the foot.
Assessment of adequare circulation, movement, and sensation of the toes and skin distal to
the application is made to identify compromised blood flow, so cyanosis (A) should be
reported immediately. (B, C and D) are normal findings.
A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus
(PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold
her. Which response should the nurse provide to the parents?
Studies have shown that handling a sick newborn is not good for the baby and upsets the
parents.
The oxygen hood is holding the baby's oxygen level just at the point which is needed. You
may stroke and talk to her.
Since your baby has been doing well under oxygen for 24 hours, I can let you hold the baby
without oxygen.
You can hold the baby with the oxygen blowing in the baby's face since the level is very close to
room air. - answer>>The oxygen hood is holding the baby's oxygen level just at the point which
is needed. You may stroke and talk to her.
The baby is at 35% which is much more than room air (21%) and at this time the baby should
not be moved from under the hood. The nurse should offer the parents an alternative such as
to stroke and reassure the infant (B). Holding sick babies benefits the infant and the parents
(A). The first consideration now has to be the infant's oxygenation. The nurse should not take
the baby out from under the hood without a prescription from the healthcare provider, as this
could severely compromise the infant (C). A PO2 of 35% cannot be readily achieved with "blow
by" oxygen (D).
The mother of a 6-month-old asks the nurse when her baby will get the first measles, mumps,
and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule
published by the Centers for Disease Control, which response is accurate?
3 to 6 months.
12 to 15 months.
18 to 24 months.
4 to 6 years. - answer>>12 to 15 months.
,The first measles, mumps, and rubella (MMR) vaccine should be given no sooner than 12
months of age, and ideally between 12 and 15 months of age (B). (A) should not receive the
MMR vaccine due to the presence of maternal antibodies. MMR is not routinely administered
at (C), but other immunizations, such as DTaP and Hepatitis B may be given at that time. The
second dose of MMR is routinely administered at (D), provided that at least 4 weeks have
elapsed since the first dose, and if both doses were administered beginning at or after 12
months.
The nurse is teaching a 12-year-old male adolescent and his family about taking injections of
growth hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly
associated with growth hormone therapy, should the nurse plan to describe to the child and his
family?
Polyuria and polydipsia.
Lethargy and fatigue.
Increased facial hair.
Facial bone structure changes. - answer>>Polyuria and polydipsia.
Signs and symptoms of diabetes or hyperglycemia (A) need to be reported. Those receiving
growth hormone should be monitored to detect elevated blood sugars and glucose
intolerance. (B) is associated with any number of heath alterations, but is not associated with
the growth hormone therapy. (C and D) are normal changes that occur with 12-year-old
males.
A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The
adolescent's last tetanus toxoid booster was received eight years ago. What action should the
nurse take?
Dispense a tetanus antitoxin.
Prepare human tetanus immune globulin.
Administer tetanus toxoid booster.
Delay the tetanus toxoid booster until due. - answer>>Administer tetanus toxoid booster.
After the completion of the initial tetanus immunization schedule, the recommended booster
for an adolescent or adult is every ten years or less if a traumatic injury occurs that is
contaminated by dirt, feces, soil, or saliva, such as puncture or crushing injuries, avulsions,
wounds from missiles, burns, or frostbite. The adolescent's injury is considered a contaminated
wound requiring prophylactic therapy, so the tetanus toxoid booster should be administered
(C). (A, B, and D) are not indicated.
The mother of a 4-year-old child asks the nurse what she can do to help her other children cope
with their sibling's repeated hospitalizations. Which is the best response that the nurse should
offer?
, Inform the parent that the child is too young to visit the hospital.
Suggest that the child visit a grandmother until the sibling returns home.
Ask the mother if the child asks when the sibling will be discharged.
Encourage the mother to have the children visit the hospitalized sibling. - answer>>Encourage
the mother to have the children visit the hospitalized sibling.
Needs of a sibling will be better met with factual information and contact with the ill child, so
sibling visitation should be encouraged (D). Parents are experts on their children and should
determine when their children are old enough to visit (A) in the hospital. Separation from
family and home (B) may intensify fear and anxiety. Children may have difficulty expressing
questions (C), so the support of parents and other caregivers are needed to help alleviate their
fears.
Which growth and development characteristic should the nurse consider when monitoring the
effects of a topical medication for an infant?
A lower sensitivity reactions to skin irritants.
A thin stratum corneum that increases topical absorption.
A smaller percentage of muscle mass.
A greater body surface area that requires larger dosages. - answer>>A thin stratum corneum
that increases topical absorption.
Infants have a thin outer skin layer (stratum corneum), so the nurse should monitor the infant
for a prompt onset and response to the application of topical medication (B). (A, C, and D) are
unrelated to topical medication administration.
The clinic nurse is taking the history for a new 6-month-old client. The mother reports that she
took a great deal of aspirin while pregnant. Which assessment should the nurse obtain?
Type of reaction to loud noises.
Any surgeries on the ears since birth.
Drainage from the infant's ears.
Number of ear infections since birth. - answer>>Type of reaction to loud noises.
Ototoxicity diminishes hearing acuity and causes symptoms of tinnitus and vertigo in older
children who can express subjective symptoms, so assessing an infant's reaction to loud noises
(A) helps to determine an infant's risk for a hearing deficit related to a history of the mother
taking an ototoxic drug, such as aspirin, while pregnant. (B, C, and D) are not associated with
exposure to aspirin in utero.
3. A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The mother
reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse
auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the
newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should
