HESI PEDIATRIC EXAM COMPLETE WITH VERIFIED ANSWERS AND RATIONALES
LATEST 2021
Toddlers
A nurse bases the plan of care for a 15-month-old toddler with celiac disease on the pathophysiology of the
disorder, which is characterized by an:
Inability to metabolize gluten
A parent tells a nurse at the clinic, "Each morning I offer my 24-month-old juice, and all I hear is 'No.'
What should I do? I know she needs fluid!" What is the best response by the nurse?
Offer the child a choice of two juices.
Antibiotic prophylaxis is prescribed for a 2-year-old child with a cardiac malformation who is awaiting
corrective surgery. The nurse explains to the child's parents that the antibiotic will prevent:
Subacute bacterial endocarditis
A nurse is teaching dietary management to the parents of a toddler who is undergoing chelation therapy to
treat lead poisoning. What should be included in the discussion of the dietary plan?
Ensuring adequate fluid intake
A toddler who was physically abused is admitted to the pediatric unit. What behavior does the nurse expect
when approaching the child?
Exhibiting fear of physical contact initiated by anyone
A nurse is observing two 18-month-old children playing side by side in a sandbox. Although they watch
each other, neither interacts with the other. What type of play does the nurse identify?
Parallel
A nurse is caring for a toddler who has undergone bone marrow transplantation. What clinical finding(s)
should the nurse anticipate if an infection develops?
Fever and lethargy
An 18-month-old toddler requires an intramuscular injection. As the nurse enters the room with the
medication, the child begins to scream and flail about on the bed. The father is sitting at the child's bedside
and gets up to leave. What action should the nurse take to best handle this situation?
Ask the father to stay to comfort the child while the injection is being given.
How should a nurse respond to parents who are concerned about separation anxiety in their 15-month-old
toddler?
This is an expected developmental reaction."
A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and
asks what to do. What is the best response by the nurse?
Call the Poison Control Center.
What does a nurse identify as the priority short-term goal for a toddler with dehydration caused by
diarrhea?
Improvement of fluid balance
A mother tells her neighbor, a nurse, that her toddler has been found to have parasites (worms) and that the
whole family will need to be treated. She asks the nurse what kind of worm it is. What is the most likely
type of worm infestation?
Pinworm (Enterobius)
The mother of a 2-year-old child tells the nurse that she is concerned about her child's vision. What
behavior when the child is tired leads the nurse to suspect strabismus?
One eye moves inward
,A nurse explains to the parents of a toddler why 2-year-old children are at risk for lead poisoning. What
major risk factor does the nurse includes in the discussion?
They explore the environment by touching and tasting.
A nurse is assessing a toddler with plumbism (lead poisoning). Which organ system is of most concern
because of the condition's irreversible effects?
Nervous
A 2-year-old child with previously diagnosed hemophilia is admitted to the pediatric unit for observation
after a motor vehicle collision. The toddler has several bruises but no other apparent injuries. What is the
nurse's specific concern regarding this child?
Undetected injury
The mother of a 2-year-old toddler tells the nurse that her child is frequently constipated. The nurse asks
the mother how she handles the child's toileting. Which response indicates to the nurse that the mother
requires further education?
I schedule my child's toileting for before each meal."
A toddler with hemophilia A is receiving factor VIII. The mother asks the nurse, "If my son hurts himself,
I'll give him 2 children's Advil. Is that right?" How should the nurse respond?
Give him Tylenol. Advil may cause bleeding."
What is the priority nursing care in the immediate postoperative period for a toddler with a newly applied
hip spica cast?
Checking the toddler's peripheral circulation
A 30-month-old boy who was transferred to a regional hospital has not seen his parents for 2 weeks. He
now responds to the staff with friendliness and affection. When his mother visits he turns away from her
and ignores her. What should the nurse explain to the mother?
Your little boy misses you very much; give him time and he'll reach for you."
A nurse is obtaining a health history from the mother of a 15-month-old toddler with celiac disease. The
nurse expects the mother to indicate that her toddler:
Has bulky, foul, frothy stools
An unconscious toddler requires intermittent nasogastric feedings. When should the nurse check placement
of the tube?
Before each feeding
The nurse notes that a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure.
What is the priority nursing responsibility at this time?
Protecting the child from self-injury
The mother of a 2-year-old child calls her neighbor, who is a nurse, exclaiming that her child just ate some
automatic dishwasher powder. What should the nurse tell the mother to do first?
Call the Poison Control Center.
After a prolonged period in a regional hospital far from home to which the parents were unable to travel, an
18-month-old toddler becomes depressed, withdrawn, and apathetic. Eventually the toddler begins playing
with toys and relating to others, even strangers. When the parents visit, the child ignores them. The parents
tell the nurse that their child has forgotten them. The nurse explains that their child's behavior:
Signifies typical behavior in toddlers who are separated from their parents for prolonged periods and that
their child will need special attention from them
The parents of a toddler tell the nurse the family has been living in a very old building. The nurse should
carefully assess the child for the irreversible effects of possible lead poisoning by focusing on the:
Central nervous system
, During a well-child visit the parents tell a nurse, "Our 3-year-old doesn't listen to us when we speak—he
ignores us!" An auditory screening reveals that the child has a mild hearing loss. What should the nurse
explain to the parents about this degree of hearing loss?
Speech therapy in addition to hearing aids may be required.
What is the priority nursing responsibility in the care of a young toddler after a circumcision?
Watching for bleeding around the penis
A 13-month-old child is undergoing lumbar puncture for confirmation of a diagnosis of bacterial
meningitis. During the procedure the nurse notes that the spinal fluid is cloudy. What does this finding
indicate?
Increased white blood cell (WBC) count
A child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the
best initial action by the nurse?
Placing the child on the floor
The parents of a 2½-year-old child whose older sibling recently died tell a nurse in the pediatric well-child
clinic that their child has started to hit them and refuses to go to bed at night. What is the best explanation
the nurse can give for this behavior?
This is an appropriate reaction to anxiety within the household.
A nurse is reviewing how 18-month-old children with no hearing impairment usually communicate. What
form of interaction does the nurse expect?
Using at least six words
During a nap, a 3-year-old hospitalized child wets the bed. What is the best response by the nurse?
Change the child's clothes without discussing the incident.
A 2-year-old toddler has hearing loss caused by recurrent otitis media. What treatment does the nurse
anticipate that the practitioner will recommend?
Myringotomy
A nurse is conducting an assessment of a 1-year-old in the well-baby clinic. What activity does the nurse
expect the infant to have accomplished?
Attempting to climb stairs
An 18-month-old child has received all required immunizations. What immunization should the nurse
explain to a parent will be one of the vaccines required between 4 and 6 years of age?
Inactivated poliovirus
What foods should a nurse order for a 30-month-old toddler on a regular diet?
Macaroni and cheese and Cheerios
A nurse teaches the mother of a 2-year-old child who has celiac disease which foods to avoid. Which foods
identified by the mother indicate that she understands the teaching?
Macaroni and cheese
A child with β-thalassemia (Cooley anemia) is admitted to the ambulatory care unit for a transfusion. What
instruction should the nurse include in the plan of care?
Protect from infections.
What is an important nursing intervention in the care of a hospitalized toddler with cystic fibrosis?
Performing postural drainage
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