Pediatric HESI Practice Questions with
correct Answers
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. - Answer -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.
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. - Answer -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. - Answer -ANS: C
Assuming a knee-chest position with the head and chest slightly elevated (C) will help
restore hemodynamic equilibrium. (A and B) are incorrect positions and may hinder the
child's condition. (D) may cause chest pain or a vasovagal response, with resulting
hypotension.
During routine screening at a school clinic, an otoscope examination of a child's ear
reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable.
Based on these findings, what action should the nurse take?
A.No action is required, because this is an expected finding for a school-aged child.
B.Ask if the child has had a cold, runny nose, or any ear pain lately.
C.Send a note home advising parents to have the child evaluated by a health care
provider.
D.Call the parents and have them take the child home from school for the rest of the
day. - Answer -ANS: B
More information is needed to interpret these findings (B). The tympanic membrane is
normally pearly gray, not bulging, and moves when a client blows against resistance or
when a small puff of air is blown into the ear canal. Because these findings are not
completely normal, further assessment of history and related signs and symptoms are
needed to interpret the findings accurately. Based on the data obtained from the
otoscope examination, (A, C, and D) are not indicated.
A newborn female whose mother is HIV-positive is scheduled for the first follow-up
assessment with the nurse. If the child is HIV-positive, which initial symptom is she most
likely to exhibit?
A.Shortness of breath
B.Joint pain
, C.Persistent cold
D.Organomegaly - Answer -ANS: C
Respiratory tract infections commonly occur in the pediatric population, but the child
with AIDS has a decreased ability to defend the body against these common infections.
Thus, the most typical presenting symptom of a child who contracted AIDS through
vertical transmission (i.e., from the mother during delivery) is a persistent cold or
respiratory infection (C). (A, B, and D) are symptoms of AIDS complications that may
occur later as the disease progresses.
A child breaks out with varicella infection (chickenpox) while hospitalized for a minor
surgical procedure. Which intervention should the nurse implement first?
A.Place a mask on the child before transporting the child outside the room.
B.Immunize exposed family members with the varicella vaccine.
C.Place the child in strict isolation to prevent an outbreak on the unit.
D.Determine which staff have had varicella before making assignments. - Answer -ANS:
C
The period of communicability of varicella is 2 days before the rash appears until all
lesions are crusted; varicella is spread by direct or indirect contact of saliva or vesicles.
Strict isolation (C) is indicated to prevent further exposure to staff and others. Staff who
have had varicella or the vaccine are not susceptible to contracting or spreading the
virus and should be the only personnel assigned to care for this client (D). (A) is not
sufficient to prevent exposure to others. (B) must be done prior to exposure.
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. - Answer -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
correct Answers
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. - Answer -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.
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. - Answer -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. - Answer -ANS: C
Assuming a knee-chest position with the head and chest slightly elevated (C) will help
restore hemodynamic equilibrium. (A and B) are incorrect positions and may hinder the
child's condition. (D) may cause chest pain or a vasovagal response, with resulting
hypotension.
During routine screening at a school clinic, an otoscope examination of a child's ear
reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable.
Based on these findings, what action should the nurse take?
A.No action is required, because this is an expected finding for a school-aged child.
B.Ask if the child has had a cold, runny nose, or any ear pain lately.
C.Send a note home advising parents to have the child evaluated by a health care
provider.
D.Call the parents and have them take the child home from school for the rest of the
day. - Answer -ANS: B
More information is needed to interpret these findings (B). The tympanic membrane is
normally pearly gray, not bulging, and moves when a client blows against resistance or
when a small puff of air is blown into the ear canal. Because these findings are not
completely normal, further assessment of history and related signs and symptoms are
needed to interpret the findings accurately. Based on the data obtained from the
otoscope examination, (A, C, and D) are not indicated.
A newborn female whose mother is HIV-positive is scheduled for the first follow-up
assessment with the nurse. If the child is HIV-positive, which initial symptom is she most
likely to exhibit?
A.Shortness of breath
B.Joint pain
, C.Persistent cold
D.Organomegaly - Answer -ANS: C
Respiratory tract infections commonly occur in the pediatric population, but the child
with AIDS has a decreased ability to defend the body against these common infections.
Thus, the most typical presenting symptom of a child who contracted AIDS through
vertical transmission (i.e., from the mother during delivery) is a persistent cold or
respiratory infection (C). (A, B, and D) are symptoms of AIDS complications that may
occur later as the disease progresses.
A child breaks out with varicella infection (chickenpox) while hospitalized for a minor
surgical procedure. Which intervention should the nurse implement first?
A.Place a mask on the child before transporting the child outside the room.
B.Immunize exposed family members with the varicella vaccine.
C.Place the child in strict isolation to prevent an outbreak on the unit.
D.Determine which staff have had varicella before making assignments. - Answer -ANS:
C
The period of communicability of varicella is 2 days before the rash appears until all
lesions are crusted; varicella is spread by direct or indirect contact of saliva or vesicles.
Strict isolation (C) is indicated to prevent further exposure to staff and others. Staff who
have had varicella or the vaccine are not susceptible to contracting or spreading the
virus and should be the only personnel assigned to care for this client (D). (A) is not
sufficient to prevent exposure to others. (B) must be done prior to exposure.
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. - Answer -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
