Peds HESI Spring 2021
1. The nurse plans to screen only the highest risk children for scoliosis. Which group of children
should the nurse screen FIRST?
a. Boys between ages 10 and 14
b. Girls between 10 and 14
c. Boys and girls between ages 8 and 12
d. Boys and girls between ages 12 and 14
Answer: b. Girls between 10 and 14
2. A 9 year old with celiac disease is admitted to the paediatrics unit following an appendectomy.
Which food should the nurse remove from this child’s meal tray?
a. Turkey
b. Chicken rice soup
c. Fruit cup
d. Crackers
Answer: d. Crackers
3. An infant is admitted for surgery who has a Wilms tumor. Which nursing intervention should
the nurse implement during the preoperative period?
a. Include the prone position in the q2h turning schedule.
b. Give antiemetic medications to prevent nausea and vomiting.
c. Administer pain medication FACE pain scale.
d. Careful bathing and handling that avoids abdominal manipulation.
Answer: d. Careful bathing and handling that avoids abdominal manipulation.
4. Mother of a one-month infant call the clinic to report that the back of her infant’s head is flat.
How should the nurse respond?
a. Turn the infant on the left side brace against the crib when sleeping.
b. Place a small pillow under the infant’s head while lying on the back.
c. Prop the infant in a sitting position with a cushion when not sleeping.
d. Position the infant on the stomach occasionally when awake and active.
Answer: d. Position the infant on the stomach occasionally when awake and active.
5. Which nursing intervention is MOST important to assess in detecting hypopituitarism and
hyperpituitarism in children?
a. Performing head circumference measurements of infants under 1 year old.
b. Noting a marked weight gain without a gain in height on a growth chart.
c. Assessing for behavioral problems at home and school by interviewing the parents.
d. Carefully recording the height and weight of children to detect inappropriate growth rate.
Answer: d. Carefully recording the height and weight of children to detect inappropriate growth
rate.
6. A6 year old child is brought into the health care providers’ office after stepping on a rusty nail.
Upon inspection, the nurse notes the nail went through the shoes and pierced the bottom of the
child’s foot. Which action should the nurse implement FIRST?
a. Cleanse the foot with soap and water and apply an antibiotic ointment as prescribed.
b. Have the parent check the child temperature q4h for the next 24 hours.
c. Transfer the child to the emergency department to receive a gamma globulin injection.
d. Provide teaching about the need for a tetanus booster to be given within the next 72 hours.
Answer: d. Provide teaching about the need for a tetanus booster to be given within the next 72
hours.
7. The mother of a 6 year old is concerned about her child obesity. The child’s weight plots at the
75 percentile, and height at the 25 percentile. The child’s body mass index (BMI) is at the 85
percentile for the age and gender. Which intervention should the nurse implement? (Select all
that apply).
a. Tell the mother that girls hit the growth spurt before boys so eating more is expected.
b. Inquire as to whether or not the school has a physical education program.
c. Determine the child’s usual physical activity patterns.
d. Explain that the child is likely to grow into her weight.
e. Obtain the child’s 3-day diet history base on mother input
Answer: b. Inquire as to whether or not the school has a physical education program.
c. Determine the child’s usual physical activity patterns.
e. Obtain the child’s 3-day diet history base on mother input
8. The nurse is assessing a 3-year-old boy who attends a daycare centre. Following an upper
respiratory tract infection, he develop acute otitis media. Which factor place this child of greater
risk for developing acute otitis media?
a. A child’s eustachian tube is shorter and straighter than an adult’s eustachian tube.
b. Attending a daycare causes frequent exposure to other children respiratory infection.
c. A child’s inner ear is more narrow than an adult’s and does not protect him from infection.
d. The immunity he received at birth from his mother is no longer effective.
Answer: a. A child’s eustachian tube is shorter and straighter than an adult’s eustachian tube.
9. a 6 year old girl is being admitted to the hospital for a repair of the umbilical hernia. Which
information collected by the admitting nurse is particularly helpful in planning care of the child?
a. A history of rubella, rubeola, or chicken pox.
b. Reaction to any previous hospitalization
c. List of achievement timeline for developmental milestone.
d. Mother’s use of alcohol drugs, cigarettes during pregnancy
Answer: b. Reaction to any previous hospitalization
10. During a well-baby clinic visit, the mother of a 6-month-old infant ask the nurse if she can
have a prescription of poly Vi Sol fluoride. Though the infant is still breast feeding, the mother
provides the child with supplement feedings. Which assessment MOST important for the nurse
to obtain?
a. Water source used with supplement feedings.
b. The newborn’s gestational age assessment
c. The infant’s current haemoglobin and haematocrit.
d. Weight gain and type of formula taken daily.
Answer: a. Water source used with supplement feedings.
1. The nurse is caring for a 6 year old child with leukaemia who had a recent bone marrow
aspiration to evaluate response to chemotherapy. Laboratory results reveal a platelet count of
24,500 cells/mm (24.5x10L). Which intervention should the nurse implement?
a. Place the child neutropenic precautions.
b. Initiate bleeding precautions due to myelosuppression.
c. Start contact precaution for blood borne infections.
d. Wear a mask to ensure droplet transmission precaution.
Answer: a. Place the child neutropenic precautions.
2. A 10 year old girl was bitten by tick during a camping trip receives a prescription for
tetracycline for Lyme’s disease. Which information should the nurse provide to ensure the client
understand?
a. Do not take tetracyclines with milk or antacids
b. Inspect all areas of skin daily for tick attachment while camping in wooded areas.
c. Apply insect repellent to skin and clothes when expose to vectors is likely.
d. Wear sunglasses when outside during the day.
Answer: a. Do not take tetracyclines with milk or antacids
3. The nurse in the emergency centre triaging an 8-year-old boy who fell from a tree. The child is
crying and complaining of pain in the left forearm. Which intervention should the nurse
implement FIRST?
a. Check capillary refills of the nail beds.
b. Apply a cold pack to his left forearm
c. Assess the pain level using FACES scale.
d. Elevate the child’s left arm on a pillow.
Answer: b. Apply a cold pack to his left forearm
4. When screening a five-year-old for strabismus, what action should the nurse take?
a. Observe the child for blank, sunken eyes.
b. Inspect the child for the setting sun sign.
c. Direct the child to the six cardinal positions of gaze.
d. Have the child identify coloured patterns on polychromatic cards.
Answer: c. Direct the child to the six cardinal positions of gaze.
5. _____ week old infant is schedule for a cleft lip repair. Which information is MOST important
to the nurse to convey to the surgeon before transporting the infant_______ surgical suite?
a. White blood cell count of 10;000/mm (10x10/L)
b. Weight gain of 2 pounds (0.91kg) since birth.
c. Urine specific gravity is 1.011.
d. Red blood cells count of 2.3 million/mm (2.3 x 10/L)
Answer: c. Urine specific gravity is 1.011.
6. The nurse is giving instructions to the mother of a 10-year-old boy who is newly diagnosed
with type 1 diabetes mellitus (DM). When attempting to teach the mother how to administer
subcutaneous insulin injections to the child, the mother tells the nurse that she is afraid of
needles and cannot perform the procedure. Which intervention should the nurse implement?
a. Determine if the child can administer the insulin.
b. Assess the mother’s parenting skills.
c. Ask if the father can help with the injections.
d. Encourage the mother to handle the needles.
Answer: d. Encourage the mother to handle the needles.
7. During the routine physical exam, a male adolescent client tell the nurse, “ sometimes my
mother gets angry because I want to be with my own friends.” Which is the best initial response
by the nurse?
a. Offer to discuss his concerns together with his mother.
b. Ask about the client’s response to his mothers’ anger
c. Determine if his friends are engaged in unsafe behaviours.
d. Offer reassurance mother’s concern is normal.
Answer: b. Ask about the client’s response to his mothers’ anger
8. The parents of a 14-month-old child who is hospitalize due to febrile seizures tell the nurse
that they fear their child will have lifelong seizures. Which________ should the nurse ____ to
these parents?
a. Provide the child with a sponge bath for temperatures over 100.6 F (38.1 C.
b. Avoid excessive visual stimuli because it can precipitate seizure activity.
c. Ibuprofen should be used prophylactically to prevent febrile seizures.
d. Reassure the parents that febrile seizures decrease as the child grows older.
Answer: d. Reassure the parents that febrile seizures decrease as the child grows older.
9. A 3-year-old boy is receiving a weekly chemotherapy treatment. Which toy is BEST for the
nurse to provide for this child?
a. Duck that squeals.
b. Bouncy ball
c. Remote control car
d. Colouring book with crayons
Answer: c. Remote control car
10. While obtaining the vital signs of a 10-year-old child who had a tonsillectomy this morning.
The nurse observes the child swallowing every 2 to 3 minutes. Which assessment should the
nurse implement?
a. Touch the tonsillar pillars to stimulate the gag reflex
b. Assess for teeth clenching or grinding.
c. Inspect the posterior oropharynx.
d. Ask the child to speak to evaluate change in voice tone
Answer: a. Touch the tonsillar pillars to stimulate the gag reflex
11. During a well-baby visit, the parent explain that a soft bulge appears in the groin of their 4month-old son. When he cries and strain during stooling. The infant is schedule for surgical
repair of the inguinal hernia in two weeks. The parents should he instructed to take which
measure of the hernia becomes incarcerated prior surgery?
a. Gently manipulate the hernia for reduction.
b. Offer oral electrolyte fluids for comfort.
c. Give acetaminophen or aspirin for crying.
d. Use a rectal thermometer for straining on stool
Answer: d. Use a rectal thermometer for straining on stool
12. A 16 year old adolescent with acute myelocytic leukaemia is receiving chemotherapy via
implanted medication port at the outpatient oncology clinic. What ____ should the nurse
implement when the infusion is complete?
a. Administer ondansetron
b. Flush the Medi port with saline and a heparin solution
c. Initiate an infusion of normal saline.
d. Obtain blood sample of RBCs, WBCs, and platelets
Answer: b. Flush the Medi port with saline and a heparin solution
13. Adolescent in admitted to the hospital with chronic renal failure receives a prescription from
the healthcare provider for furosemide. Which action should the nurse implement PRIOR to
administering the medication?
a. Test reflex responses bilaterally.
b. Determine the last time meal was consumed.
c. Examine the colour of the sclera.
d. Review blood urea nitrogen and creatinine levels.
Answer: d. Review blood urea nitrogen and creatinine levels.
14. A mother brings her 3 year old to the emergency room and tells the nurse that he had an
upper …… rectal temp 102. He is drooling and becoming increasingly more restless. What
action should the nurse take first?
a. Put a cold cloth on head and admin acetaminophen
b. Assist the child to lie down and examine his throat
c. Listen to lung sounds and place him in a mist tent
d. Notify the healthcare provider and obtain a tracheostomy tray
Answer: d. Notify the healthcare provider and obtain a tracheostomy tray
15. the nurse is caring for an infant scheduled for reduction of an intussusception. The day before
the scheduled procedure that infant passes a soft formed Brown stool which intervention should
the nurse implement?
a. Notify the healthcare provider of the passage of brown stool
b. Ask the parents about recent changes in the infants diet
c. Instruct the parent that the infant needs to be NPO
d. Obtain a stool specimen for laboratory analysis
Answer: a. Notify the healthcare provider of the passage of brown stool
16. When assessing an infant with severe diarrhoea the nurse should observe for which potential
change in breathing pattern?
a. Kussmaul respirations
b. Expiratory wheezing
c. Cheyne stokes respirations
d. Audible rhonchi
Answer: a. Kussmaul respirations
17. The parent of a 4 week old infant phone the paediatrics clinic to report that their infant eats
well but vomits after each feeding. To differentiate between normal regurgitation and pyloric
stenosis, which information is most important for the nurse to obtain?
a. Odor and texture associated with emesis
b. Position of infant when vomiting occurs
c. Degree of forcefulness of vomiting episodes
d. Level of infant distress after vomiting
Answer: c. Degree of forcefulness of vomiting episodes
18. While auscultating the lung sounds of a 5 year old Chinese boy who recently completed
antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on
his chest. What action is best for the nurse to take?
a. Report child abuse to the proper authority
b. Identify the antibiotic used to treat the pneumonia
c. Inquire about the use of alternative methods of treatment
d. Ask the parent if the child has been in a recent accident
Answer: c. Inquire about the use of alternative methods of treatment
19. A child who weighs 55 pounds receive a prescription for hydrochlorothiazide 3mg/kg/day by
mouth every 8 hours. The medication is available in 5mg tablet. Hoe many tablets should the
nurse administer with each dose? ( Enter numerical value only.)
Answer: 1 tab
20. The parent of a 4 week old phone the paediatrics clinic to report that their infant eats well but
vomits after each feeding.to differentiate between normal regulation and pyloric stenosis, which
information is MOST important for the nurse to obtain?
a. Odor and texture associate with emesis
b. Position of the infant when vomiting occurs.
c. Degree of forcefulness of vomiting episodes
d. Level of infant’s distress vomiting
Answer: c. Degree of forcefulness of vomiting episodes
21. The health care provider prescribed cephalexin 350mg by mouth every 6 hours. For a child
the weight 88lbs. the available suspension is labelled, cephalexin suspension 125 mg/5ml. The
recommended safe dose is 25-50mg/kg/24 in a divided doses. How many nurses administer is
based on the child weight? (Enter numerical value only. If rounding is required, Round to the
nearest whole number)
Answer: 10
22. Penicillin G procaine 240,000 units intramuscularly is prescribing for a 4 year old child who
has a streptococcal respiratory infection. The medication vial is labelled 1,200,000 units/2 ml.
How many ml should the nurse administer? (Enter numeric value only. If rounding is required
round to the nearest tenth.)
Answer: 0.4L
23. A clinic nurse is assessing infant and toddlers for fine and gross motor development. Which
child should the nurse refer to the health care provider for further evaluation?
a. 5 months old with use of whole hand grasp
b. 3 ½ months old with diminished Moro reflex
c. 3-year-old performing to walk on the tip toe.
d. 1 ½ year old attempting to scribble on paper.
Answer: c. 3-year-old performing to walk on the tip toe.
24. A 4 year old girl returns to the paediatrician office for a postoperative visit following
hospitalization for a minor surgery. When observing the child in the waiting area, which behavior
should the nurse consider normal for this age child?
a. Sits quietly in her mother’s lap
b. Ignores other children in the play area
c. Draws picture of self with facial features
d. Talks to an imaginary friend
Answer: d. Talks to an imaginary friend
25. A Toddler is hospitalized Kawasaki’s disease. Pharmacological management Includes aspirin
therapy. Which is the primary benefit of aspirin?
a. Manage irritability
b. Control high fever
c. Minimize vascular inflammation
d. Reduce joint swelling
Answer: c. Minimize vascular inflammation
26. Which response demonstrates that the mother of a young girl with a urinary tract infection
(UTI) understands home care for the child?
a. I will make sure she wipes back to front after she uses the bathroom
b. I will give the antibiotics until she does not complain of burning anymore.
c. I will refill the prescription for antibiotics if her symptoms are still present after taking these.
d. I will bring her back to the doctor’s office for another urine test.
Answer: d. I will bring her back to the doctor’s office for another urine test.
27. The nurse observes a mother giving her 11-month-old ferrous sulphate (iron drops), followed
by 2 ounces of orange juice. What should the nurse do next?
a. Give the mother positive feedback about the way she admin the med
b. Suggest placing the iron drop in OJ and then feeding to infant
c. Instruct the mother to feed the infant nothing for 30 min after giving the iron drops
d. Tell the mother to follow the iron drops with infant formula instead of OJ
Answer: a. Give the mother positive feedback about the way she admin the med
28. A neonate who has congenital adrenal hypoplasia (CAH) presents with ambiguous genitalia.
What is the primary nursing consideration when supporting the parents of a child with this
anomaly?
a. Explain that corrective surgical procedures consistent with sex assignment can be changed
b. Offer information about ultrasonography and genotyping to determine sex assignment
c. Support the parent decision to assign sex of their child according to their preference
d. Discuss the need for cortisol and aldosterone replacement therapy after discharge
Answer: b. Offer information about ultrasonography and genotyping to determine sex
assignment
29. A 5-year-old child is admitted to the paediatrics unit fever and pain secondary to a sickle cell
crisis. Which intervention should the nurse implement first?
a. Obtain culture of any sputum or wound drainage
b. Initiate normal saline IV at 50ml/hr
c. Administer a loading dose of penicillin IM
d. Administer the initial dose of folic acid PO
Answer: b. Initiate normal saline IV at 50ml/hr
30. During a routine clinic visit, the nurse determines that 5-year-old girl's systolic blood
pressure is greater than the 90th percentile. What action should the nurse implement next?
a. Refer child to the healthcare provider and schedule evaluation of bp in two weeks
b. Measure the bp 3 times during visit
c. Take the blood pressure two more time during the visit and determine the average of the three
readings
d. Conduct a head to toe assessment
Answer: c. Take the blood pressure two more time during the visit and determine the average of
the three readings
31. The nurse administers digoxin (Lanoxin) to a 9-month-old infant with an apical heart rate of
160 beats per minute. Which apical pulse rate indicates that therapeutic effect of the medication
has been achieved?
a. 180 beats per minute
b. 80 beats per minute
c. 120 beats per minute
d. 60 beats per minute
Answer: c. 120 beats per minute
32. An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin
intravenously. Which finding indicate to the nurse that the child is manifesting a therapeutic
response?
a. Decreased periorbital edema
b. Weight gain of 0.5kg/day
c. Decreased urine output
d. Increased periods of rest
Answer: a. Decreased periorbital edema
33. A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea
(sudden aimless movements of the arms and legs). Which information should the nurse provide
to the parents?
a. Permanent life style changes need to be made to promote safety in the home
b. Consistent discipline is needed to help the child control the movements
c. Muscle tension is decreased with the fine motor skills
d. The chorea or movements are temporary and will eventually disappear.
Answer: d. The chorea or movements are temporary and will eventually disappear.
34. A 17 year old male student with cystic fibrosis talks with the school nurse about his disease
and wonders how it will affect getting married and having children. Which relevant information
will the nurse include in this discussion.
a. If the father is a carrier, 50% of the offspring will have cystic fibrosis
b. Impotence is a frequent problem for males with cystic fibrosis
c. He is likely to have infertility problems and needs further evaluation
d. He should undergo cystic fibrosis screening before having children
Answer: c. He is likely to have infertility problems and needs further evaluation
35. The nurse is caring for a one month-old Infant admitted for suspected congenital
hypothyroidism. Which diagnostic test results should the nurse report to the healthcare provider?
a. Luteinizing hormone levels
b. Follicle stimulating hormone levels
c. Growth hormone levels
d. thyroxine
Answer: d. thyroxine
36. The nurse is evaluating the effects of thyroid therapy used to treat a 5 month old with
hypothyroidism. Which behavior indicates that the treatment has been effective?
a. Can lift head, but not chest when lying on abdomen
b. Laughs readily, turns from back to side
c. Keeps fists clenched, opens hands when grasping an object
d. Has strong more and tonic neck reflexes
Answer: b. Laughs readily, turns from back to side
37. Which nutritional information should the nurse plan to provide the mother of a 6 month old
regarding introduction of solid foods?
a. Begin introducing solid foods at 1 year
b. Introduce fruit and vegetable simultaneously into diet
c. Foods are best introduced by mixing them with formula and feeding them with a bottle
d. Foods should be introduced into a child’s diet one at a time, at 4 to 7 day intervals
Answer: d. Foods should be introduced into a child’s diet one at a time, at 4 to 7 day intervals
38. The mother of an infant born with hypospadias is concerned because she has been told that
her child cannot be circumcised according to her Jewish faith tradition. Which response is best
for the nurse to provide?
a. I understand your concern. Will you like to talk to the paediatrician
b. During the surgery, part of the foreskin is used to repair the meatus
c. Your faith is important but correcting this problem is the priority for your son
d. Circumcising the penis now may contribute to frequent use.
Answer: b. During the surgery, part of the foreskin is used to repair the meatus
39. The nurse is planning care for a 16 year old, who has juvenile idiopathic a thrills (JIA.. The
nurse includes activities strengthen and mobilize the joints and rounding muscle .Which physical
therapy regimen should the nurse encourage the adolescent to implement?
a. Exercise in the swimming pool
b. Begin a training program lifting weights and running
c. Perform passive range of motion exercises twice daily
d. Splint affected joints during activity
Answer: a. Exercise in the swimming pool
40. When administering indomethacin to premature infant who has patent ductus arteriosus, the
nurse should anticipate which outcome?
a. Decreased urinary output
b. Increased respiratory effort
c. Increased number of red blood cells
d. Decreased cardiac murmur
Answer: d. Decreased cardiac murmur
41. In assessing a child with suspected bacterial meningitis, the nurse should anticipate a recent
history of which problem?
a. Chicken pox
b. Ear ache
c. Stomach upset
d. fracture
Answer: b. Ear ache
42. The nurse is providing discharge teaching to the mother of premature infant. which statement
mother would indicate that she understands the important of making sure that her baby gets the
monthly synagis injection ?
a. Synagis will prevent the development of retinopathy of prematurity
b. Synagis will help with the neurological and physical development
c. The meds will protect my baby from respiratory syncytial virus
d. The monthly injections will help my baby’s lungs mature
Answer: c. The meds will protect my baby from respiratory syncytial virus
43. A 3 Year old male child is seen in the outpatient clinic with reddish vesicles on his legs. The
medical diagnosis is impetigo contagious. The child’s mother is concerned about the long term
effects of the condition. The nurse should inform the mother of which probable outcome?
a. Deep pitted scaring
b. No scarring
c. Slightly reddened scarring
d. Pigmented scarring
Answer: b. No scarring
44. To maintain patency of the ductus arteriosus, the nurse administers a prescribed of
prostaglandin IV to a week-old infant diagnosed with transposition of Based assessment finding
should the nurse stop the medication administration immediately
a. Blood pressure of 80/50
b. Pulse ox 95%
c. RR 34/min
d. Hears rate 50 beats/minute
Answer: d. Hears rate 50 beats/minute
45. The nurse is caring for a child with attention deficit hyperactivity disorder. Which outcome is
most important for the nurse to include in the plan of care?
a. Verbalizes personal strengths and feelings of self-worth
b. Identifies effective ways to cope when angry or frustrated
c. Describes success in school and social interactions
d. Adapts to developmental transitions within the family unit
Answer: b. Identifies effective ways to cope when angry or frustrated
