2024 PEDIATRIC HESI PRACTICE
EXAM QUESTIONS WITH
CORRECT ANSWERS
The nurse is examining a male child experiencing an exacerbation of juvenile
rheumatoid arthritis (JRA) and notes that his mobility is greatly reduced.
What is the most likely cause of the child's impaired mobility?
A.Pathologic fractures
B.Poor alignment of joints
C.Dyspnea on exertion
D.Joint inflammation - CORRECT ANSWERS-ANS: D
Joint inflammation and pain are the typical manifestations of an exacerbation
of JRA (D). (A, B, and C) are not specifically related to JRA.
The nurse is preparing a child with an intussusception for a prescribed
barium enema. What is the main purpose of conducting this procedure prior
to surgical intervention?
A.Evacuate the bowel of impacted feces.
B.Reduce the invaginated bowel segment.
C.Locate the presence of diverticula.
D.Identify the area of esophageal atresia. - CORRECT ANSWERS-ANS: B
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 (B), thereby negating the need for surgical
intervention. A barium enema is likely to cause (A). A barium enema could be
used to detect (C), but this is not the reason for its use with intussusception.
(D) is not a use for a barium enema.
,When inserting a nasogastric tube into the stomach of a 3-month-old infant,
which nursing intervention is most important to implement?
A.Use a blanket as a mummy restraint.
B.Monitor the infant's heart rate.
C.Lubricate the catheter with saline.
D.Explain the procedure to the parents. - CORRECT ANSWERS-ANS: B
When inserting a nasogastric tube into the stomach of a 3-month-old infant,
which nursing intervention is most important to implement?Rationale:
All interventions may be implemented during nasogastric tube insertion, but
the most important nursing action is to monitor the infant's heart rate (B),
which may decrease because of vagal nerve stimulation and can occur when
the tube is inserted. (A, C, and D) are of lower priority than (B).
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 is
proportionally larger than an adult's?
A.Head and neck
B.Arms and chest
C.Legs and abdomen
D.Back and abdomen - CORRECT ANSWERS-ANS: A
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 (A). Specially designed charts are commonly used to
measure the percentage of burn in children. (B, C, and D) are not
proportionately different.
A 4-year-old child has cystic fibrosis. Which stage of Erikson's theory of
psychosocial development is the nurse addressing when teaching inhalation
therapy?
A.Autonomy
B.Industry
C.Trust
, D.Initiative - CORRECT ANSWERS-ANS: D
Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson's
theory of psychosocial development (D). They enjoy being active and
participating in role playing. "Autonomy vs. Shame and Doubt" occurs at 1 to
3 years of age (A). "Industry vs. Inferiority" occurs at 6 to 11 years (B); "Trust
vs. Mistrust" (C) occurs from birth to 1 year of age.
The nurse is teaching an adolescent girl with scoliosis about a Milwaukee
brace that her health care provider has prescribed. Which instruction should
the nurse provide to this client?
A.Remove the brace 1 hour each day for bathing only.
B.Remove the brace only for back range-of-motion exercises.
C.Wear the brace against the bare skin to ensure a good fit.
D.Wearing the brace will cure the spinal curvature. - CORRECT ANSWERS-
ANS: A
The Milwaukee brace is designed to slow the progression in spinal curvature
while the adolescent is growing. The brace should be worn 23 hours a day
and removed a total of 1 hour a day for hygiene (A). There are no specific
exercises for increasing the range of motion in the back that should be
performed (B). A T shirt should be worn next to the body and the brace put
on over the T shirt to protect the skin (C). The brace will not cure the spinal
curvature (D) but should slow the progression of the scoliosis.
The nurse should teach the parents of a child with a cyanotic heart defect to
perform which action when a hypercyanotic spell occurs?
A.Place the child's head flat, with the knees on pillows above the level of the
heart.
B.Have the child lie on the right side, with the head elevated on one pillow.
C.Allow the child to assume a knee-chest position, with the head and chest
slightly elevated.
D.Encourage the child to sit up at a 45-degree angle, drink cold water, and
take deep breaths. - CORRECT ANSWERS-ANS: C
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