HESI PN Pediatric Exam 2025/2026 –
Actual Exam 75 Questions with
Verified Correct Answers and
Rationales
Question 1
A 4-year-old child is admitted with suspected bacterial meningitis. Which assessment finding
should the practical nurse (PN) report immediately?
A. Fever of 101°F (38.3°C).
B. Nuchal rigidity.
C. Irritability.
D. Poor appetite.
Rationale: Nuchal rigidity indicates meningeal irritation, a hallmark of bacterial meningitis,
which is a medical emergency requiring prompt intervention to prevent complications like
seizures or brain damage. Other symptoms are less specific and expected in this condition.
Question 2
The PN is teaching parents of a newborn about car seat safety. Which instruction is most
important?
A. Place the car seat in the front passenger seat.
B. Use a rear-facing car seat until at least 2 years of age.
C. Use a booster seat for infants under 1 year.
D. Secure the car seat with a lap belt only.
Rationale: Rear-facing car seats provide optimal protection for infants’ heads and necks until at
least age 2 or until they exceed the seat’s weight/height limits, per AAP guidelines. Other
options are unsafe or incorrect.
Question 3
A 6-month-old infant is brought to the clinic with a fever and rash. The PN suspects roseola.
Which symptom is most characteristic of this condition?
,A. Persistent cough.
B. High fever followed by a rash after fever subsides.
C. Koplik spots in the mouth.
D. Vesicular rash on the trunk.
Rationale: Roseola (sixth disease) typically presents with a high fever (up to 104°F) for 3-5
days, followed by a maculopapular rash once the fever resolves. Other symptoms are not specific
to roseola.
Question 4
The PN is administering oral amoxicillin to a 3-year-old with otitis media. The child weighs 15
kg, and the dose is 40 mg/kg/day in three divided doses. How much should the PN give per
dose?
A. 100 mg.
B. 200 mg.
C. 300 mg.
D. 400 mg.
Rationale: Daily dose: 40 mg/kg × 15 kg = 600 mg. Divided by 3 doses = 200 mg per dose.
Accurate dosing ensures therapeutic levels while avoiding toxicity.
Question 5
A 10-year-old with type 1 diabetes reports feeling shaky and sweaty. The PN checks the blood
glucose, which is 50 mg/dL. What is the first action?
A. Administer insulin.
B. Give 15 g of fast-acting carbohydrate.
C. Encourage water intake.
D. Notify the provider immediately.
Rationale: Hypoglycemia (<70 mg/dL) requires immediate treatment with 15 g of fast-acting
carbohydrates (e.g., juice) to raise blood glucose. Insulin would worsen the condition, and
notification can follow treatment.
Question 6
The PN is caring for a toddler with croup. Which intervention is most appropriate during an
acute episode?
A. Administer oral steroids.
B. Provide cool mist humidification.
, C. Encourage coughing exercises.
D. Place in a supine position.
Rationale: Cool mist humidification reduces airway swelling in croup, easing stridor and
respiratory distress. Steroids are for long-term control, and coughing or supine positioning may
worsen symptoms.
Question 7
A 2-year-old is admitted with dehydration due to gastroenteritis. Which assessment finding
indicates severe dehydration?
A. Slightly dry mucous membranes.
B. Sunken fontanelles and absent tears.
C. Heart rate of 100 bpm.
D. Normal skin turgor.
Rationale: Sunken fontanelles and absent tears indicate severe fluid loss (10% body weight) in
infants, requiring urgent IV fluid resuscitation. Other findings suggest milder dehydration.
Question 8
The PN is preparing to administer a hepatitis B vaccine to a newborn. Where should the injection
be given?
A. Deltoid muscle.
B. Vastus lateralis muscle.
C. Gluteal muscle.
D. Subcutaneous arm tissue.
Rationale: The vastus lateralis is the preferred IM site for newborns due to its muscle mass and
lack of major nerves/vessels. Deltoid and gluteal sites are unsafe in this age group.
Question 9
A 5-year-old with asthma is prescribed albuterol via nebulizer. What should the PN monitor
during treatment?
A. Blood pressure.
B. Heart rate and respiratory status.
C. Temperature.
D. Urine output.
Rationale: Albuterol, a beta-agonist, can cause tachycardia and improve respiratory status (e.g.,
reduced wheezing). Monitoring these ensures efficacy and detects adverse effects.
Actual Exam 75 Questions with
Verified Correct Answers and
Rationales
Question 1
A 4-year-old child is admitted with suspected bacterial meningitis. Which assessment finding
should the practical nurse (PN) report immediately?
A. Fever of 101°F (38.3°C).
B. Nuchal rigidity.
C. Irritability.
D. Poor appetite.
Rationale: Nuchal rigidity indicates meningeal irritation, a hallmark of bacterial meningitis,
which is a medical emergency requiring prompt intervention to prevent complications like
seizures or brain damage. Other symptoms are less specific and expected in this condition.
Question 2
The PN is teaching parents of a newborn about car seat safety. Which instruction is most
important?
A. Place the car seat in the front passenger seat.
B. Use a rear-facing car seat until at least 2 years of age.
C. Use a booster seat for infants under 1 year.
D. Secure the car seat with a lap belt only.
Rationale: Rear-facing car seats provide optimal protection for infants’ heads and necks until at
least age 2 or until they exceed the seat’s weight/height limits, per AAP guidelines. Other
options are unsafe or incorrect.
Question 3
A 6-month-old infant is brought to the clinic with a fever and rash. The PN suspects roseola.
Which symptom is most characteristic of this condition?
,A. Persistent cough.
B. High fever followed by a rash after fever subsides.
C. Koplik spots in the mouth.
D. Vesicular rash on the trunk.
Rationale: Roseola (sixth disease) typically presents with a high fever (up to 104°F) for 3-5
days, followed by a maculopapular rash once the fever resolves. Other symptoms are not specific
to roseola.
Question 4
The PN is administering oral amoxicillin to a 3-year-old with otitis media. The child weighs 15
kg, and the dose is 40 mg/kg/day in three divided doses. How much should the PN give per
dose?
A. 100 mg.
B. 200 mg.
C. 300 mg.
D. 400 mg.
Rationale: Daily dose: 40 mg/kg × 15 kg = 600 mg. Divided by 3 doses = 200 mg per dose.
Accurate dosing ensures therapeutic levels while avoiding toxicity.
Question 5
A 10-year-old with type 1 diabetes reports feeling shaky and sweaty. The PN checks the blood
glucose, which is 50 mg/dL. What is the first action?
A. Administer insulin.
B. Give 15 g of fast-acting carbohydrate.
C. Encourage water intake.
D. Notify the provider immediately.
Rationale: Hypoglycemia (<70 mg/dL) requires immediate treatment with 15 g of fast-acting
carbohydrates (e.g., juice) to raise blood glucose. Insulin would worsen the condition, and
notification can follow treatment.
Question 6
The PN is caring for a toddler with croup. Which intervention is most appropriate during an
acute episode?
A. Administer oral steroids.
B. Provide cool mist humidification.
, C. Encourage coughing exercises.
D. Place in a supine position.
Rationale: Cool mist humidification reduces airway swelling in croup, easing stridor and
respiratory distress. Steroids are for long-term control, and coughing or supine positioning may
worsen symptoms.
Question 7
A 2-year-old is admitted with dehydration due to gastroenteritis. Which assessment finding
indicates severe dehydration?
A. Slightly dry mucous membranes.
B. Sunken fontanelles and absent tears.
C. Heart rate of 100 bpm.
D. Normal skin turgor.
Rationale: Sunken fontanelles and absent tears indicate severe fluid loss (10% body weight) in
infants, requiring urgent IV fluid resuscitation. Other findings suggest milder dehydration.
Question 8
The PN is preparing to administer a hepatitis B vaccine to a newborn. Where should the injection
be given?
A. Deltoid muscle.
B. Vastus lateralis muscle.
C. Gluteal muscle.
D. Subcutaneous arm tissue.
Rationale: The vastus lateralis is the preferred IM site for newborns due to its muscle mass and
lack of major nerves/vessels. Deltoid and gluteal sites are unsafe in this age group.
Question 9
A 5-year-old with asthma is prescribed albuterol via nebulizer. What should the PN monitor
during treatment?
A. Blood pressure.
B. Heart rate and respiratory status.
C. Temperature.
D. Urine output.
Rationale: Albuterol, a beta-agonist, can cause tachycardia and improve respiratory status (e.g.,
reduced wheezing). Monitoring these ensures efficacy and detects adverse effects.
