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2026 HESI PEDIATRICS (PEDS) PRACTICE EXAM
200+ PRACTICE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS)
- Surgery is being delayed for an infant with undescended testes. In collaboration
with the healthcare provider and the family, which prescription should the nurse anticipate?• A trial of adrenocorticotrophic hormone injections.• Frequent stimulation of the cremasteric reflex.• A trial of human chorionic gonadotrophic hormone.• Frequent warm baths to gently dilate the scrotal area.
Correct Answer: A trial of human chorionic gonadotrophic hormone.
Rationale: A trial of HCG (human chorionic gonadotrophic hormone) may aid in testicular descent, but does not replace surgical repair for true undescended testes. Undescended testes (cryptorchidism) may be found in the inguinal canal due to exaggerated cremasteric reflex. Stimulation of the cremasteric reflex causes the testes to ascend rather than descend in the scrotum.
- The nurse is assessing an 8-month-old child who has a medical diagnosis of
Tetrology of Fallot. Which symptom is this client most likely to exhibit?• Bradycardia.• Machinery murmur.• Weak pedal pulses.• Clubbed fingers.
Correct Answer: Clubbed fingers.
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Rationale: Tetrology of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes due to tissue hypoxia. Tachycardia is a manifestation of congenital heart disease.Machinery murmur is a classic sign of ventricular septal defect. Weak pedal pulses are characteristic of coarctation of the aorta.
- At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a
female adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take first?• Give the client her 9 a.m. prescription for an oral diuretic early.• Administer PRN prescription of nifedipine (Procardia) sublingually.• Notify the healthcare provider and inform the nursing supervisor of the client's condition.• Attempt to calm the client and retake the blood pressure in thirty minutes.Correct Answer: Administer PRN prescription of nifedipine (Procardia) sublingually.Rationale: Sublingual Procardia lowers blood pressure very quickly, and this should be done first. Oral diuretics do not work as rapidly as the sublingual antihypertensive. When notifying the healthcare provider, the first thing he/she will want to know is if the PRN antihypertensive has been administered.
- Preoperative nursing care for a child with Wilms' tumor should include which
intervention?• Gently percuss the abdomen for evidence of trapped air.• Observe the abdomen for any noticeable discolorations.• Apply cold compresses to the abdomen to reduce edema.• Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN." Correct Answer: Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
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Rationale: Prevention of abdominal palpation minimizes the risk of rupturing the encapsulated tumor and subsequent metastasis. Percussion is unnecessary, and this action could traumatize the tumor in the same manner as palpation.
- A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The
mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the newborn is acyanotic with a respiratory rate of 64 breaths per minute.What instruction should the nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.) • A. Monitor the the infant's weight and number of wet diapers per day.• B. Increase the infant's intake per feeding by 1 to 2 ounces per week.• C. Mix the dose of prophylactic antibiotic in a full bottle of formula.• D. Allow the infant to rest and refeed on demand or every 2 hours.• E. Use a softer nipple or increase the size of the nipple opening.
Correct Answer: A, B, D, E
Rationale: They should be monitored for weight gain and at least 6 wet diapers per day (A).A one-month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces per day by 4-months of age (B). Antibiotic prophylaxis should not be mixed in a bottle of formula (C) because it is difficult to ensure that the total dose is consumed.
- An infant is born with a ventricular septal defect (VSD) and surgery is planned to
correct the defect. The nurse recognizes that surgical correction is designed to achieve which outcome?• Stop the flow of unoxygenated blood into systemic circulation.• Increase the flow of unoxygenated blood to the lungs.• Prevent the return of oxygenated blood to the lungs.• Reduce peripheral tissue hypoxia and nailbed clubbing
Correct Answer: Prevent the return of oxygenated blood to the lungs.
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Rationale: Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the right ventricle. VSDs are acyanotic defects, which means that no unoxygenated blood enters the systemic circulation.
- What preoperative nursing intervention should be included in the plan of care for an
infant with pyloric stenosis?• Monitor for signs of metabolic acidosis.• Estimate the quantity of diarrhea stools.• Place in a supine position after feeding.• Observe for projectile vomiting.
Correct Answer: Observe for projectile vomiting.
Rationale: Projectile vomiting, which contributes to metabolic alkalosis (not acidosis), is the classic sign of pyloric stenosis. Placing supine is dangerous due to the potential for aspiration with frequent vomiting.
- A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris.
What is the most important instruction for the nurse to include in this client's teaching plan?• Use sunscreen when lying by the pool.• Cleanse the skin at least 4 times a day.• Take the medication with a glass of milk.• Menstrual periods may become irregular.
Correct Answer: Use sunscreen when lying by the pool.
Rationale: Photosensitivity is a common side effect of tetracycline HCL therapy. Severe sunburn can occur with minimal sun exposure. Dairy products should be avoided because they interfere with the absorption of tetracyclines.
