HESI Peds

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Sample questions from HESI Peds

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 6-year-old is admitted to the pediatric unit with pneumonia. The child is febrile, has an oxygen saturation of 89% on room air, and is using accessory muscles. Which task should the registered nurse delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess the child's respiratory effort after oxygen is applied
   • B.Obtain and document the child's routine oral temperature
   • C.Teach the parent how to use the incentive spirometer
   • D.Evaluate whether the prescribed antibiotic is improving the child's condition

   Rationale: Obtaining a routine temperature is a predictable task that can be delegated to a trained UAP. Respiratory assessment, teaching, and evaluation of treatment response require nursing judgment and remain the RN's responsibility. Delegate stable, routine tasks while the RN manages assessment and evaluation.

2. 2.A 4-year-old in the emergency department has a barking cough, inspiratory stridor at rest, and suprasternal retractions. The child is sitting upright with a parent and has an oxygen saturation of 92%. Which action should the nurse take first?

   • A.Obtain a throat culture using a tongue depressor
   • B.Keep the child calm and prepare for nebulized epinephrine
   • C.Encourage oral fluids to thin respiratory secretions
   • D.Place the child supine for a complete respiratory examination

   Rationale: Stridor at rest and retractions indicate significant upper-airway obstruction, so minimizing distress and preparing ordered nebulized epinephrine are priorities. A throat culture may worsen obstruction, fluids do not address the immediate airway threat, and lying supine can increase respiratory distress. In a child with croup, protect the airway and avoid agitation.

3. 3.A 10-year-old with type 1 diabetes is admitted with vomiting, deep rapid respirations, and a blood glucose of 468 mg/dL. The nurse receives four prescriptions. Which prescription should the nurse implement first?

   • A.Begin isotonic intravenous fluid replacement
   • B.Administer intravenous regular insulin as a bolus
   • C.Give oral potassium chloride
   • D.Restrict fluids until the serum sodium is available

   Rationale: The child has likely diabetic ketoacidosis with dehydration, and initial isotonic fluid replacement supports circulation before insulin therapy. An insulin bolus is not the initial intervention, oral potassium is inappropriate during vomiting and requires laboratory guidance, and fluid restriction worsens dehydration. Stabilize perfusion and follow the prescribed DKA protocol.

4. 4.A 7-year-old with a new seizure disorder is being discharged from the pediatric unit. The parent says, 'I am not sure I can remember everything about the medicine.' Which nursing action is best?

   • A.Provide all medication instructions in a single written handout
   • B.Ask the parent to explain the dosing schedule using teach-back
   • C.Tell the parent to call the clinic if any questions arise
   • D.Have the child describe how the parent should give the medicine

   Answer and rationale are in the full material.

5. 5.A 3-year-old with acute gastroenteritis has a heart rate of 148/min, dry mucous membranes, and capillary refill of 4 seconds. The provider prescribes an isotonic fluid bolus. Which action is most appropriate for the nurse?

   • A.Ask the UAP to determine the bolus rate and start the infusion
   • B.Administer the prescribed bolus and reassess perfusion frequently
   • C.Wait for the child to urinate before beginning intravenous fluids
   • D.Give maintenance fluids first and reassess the child in 4 hours

   Answer and rationale are in the full material.