HESI Pediatric and Women's Health
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Free HESI Pediatric and Women's Health Questions
An newborn born two days ago is vomiting bilious fluids and has not passed a meconium stool. What ought the nurse to do first?
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Monitor strict urinary output
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Gather supplies for an IV infusion
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Measure abdominal circumference
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Prepare for anorectal manometry
Explanation
The Correct Answer is:
C. Measure abdominal circumference
Failure to pass meconium within 24–48 hours and bilious vomiting suggest an intestinal obstruction, such as Hirschsprung disease or meconium ileus. Measuring abdominal circumference helps assess for progressive distention, which indicates worsening obstruction and guides the urgency of intervention. This assessment should be performed immediately while preparing for diagnostic and supportive measures such as IV access and possible surgical consultation.
While checking the vital signs of a 10-year-old child who underwent a tonsillectomy earlier in the day, the nurse notices the child swallowing every 2 to 3 minutes. What action should the nurse take next?
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Check for signs of teeth clenching or grinding
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Inspect the back of the throat
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Stimulate the gag reflex by touching the tonsillar pillars
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Ask the child to speak to assess for any changes in voice tone
Explanation
The Correct Answer is:
B. Inspect the back of the throat
Detailed Explanation:
Frequent swallowing following a tonsillectomy is a classic early sign of postoperative bleeding. The child may be swallowing blood that trickles down the throat instead of spitting it out. The nurse should immediately inspect the back of the throat using a flashlight to check for fresh bleeding, oozing, or bright red secretions. If bleeding is observed, it is a medical emergency, and the healthcare provider must be notified at once.
The nurse begins collecting the medical history of a child when the child screams and tries to hide behind the parent, dropping a stuffed toy. What intervention should the nurse implement?
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Obtain the essential information as quickly as possible.
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Include the child’s toy in the collection of information
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Document interactions between the parent and the child.
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Ignore the child’s behavior, directing questions to a parent
Explanation
The Correct Answer is:
B. Include the child’s toy in the collection of information.
Detailed Explanation:
Including the child’s toy in the interaction helps establish rapport and reduce fear. Young children often use familiar objects like stuffed toys as sources of comfort and security. The nurse can engage the toy in conversation or play to help the child feel safe and involved in the process. This approach builds trust, eases anxiety, and encourages cooperation during the assessment, aligning with therapeutic communication principles for pediatric care.
An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin 500 mg PO daily and metronidazole 500 mg IV piggy back (IVBP) twice daily (BID). She asks the nurse, "Why do I have to be in the hospital? Why can't I get my treatment at home?" Which purpose should the nurse provide that supports an effective outcome?
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Collection of serial anaerobic cultures of vaginal discharge.
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Detection of early symptoms of Jarisch-Herxheimer reaction.
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Administration of a supervised parenteral antibiotic protocol.
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Implementation of contact precautions to prevent spread of infection.
Explanation
The Correct Answer is:
C. Administration of a supervised parenteral antibiotic protocol
Hospitalization ensures close monitoring and intravenous administration of antibiotics when oral therapy fails or symptoms persist. Pelvic inflammatory disease can lead to serious complications such as infertility, abscess formation, or sepsis if not aggressively treated. Inpatient care allows clinicians to assess treatment response, manage pain, monitor vital signs, and adjust antibiotics based on culture results for effective recovery and prevention of long-term reproductive damage.
A client at 28-weeks gestation whose hemoglobin level is 10.7 g/dL (107 g/L) and hematocrit is 32% (0.32 volume fraction), tells
the nurse that she eats plenty of green vegetables. When the client asks the nurse how the low level value might affect her
pregnancy, which information should the nurse provide?
Reference range:
Hemoglobin 12 to 16 g/dl (120 to 160 g/L): pregnant greater than 11 g/dl (110 g/L)
Hematocrit 37% to 47% (0.37 to 0.47 volume fraction): pregnant greater than 33% (0.33 volume fraction)
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It might be necessary to take an iron supplement twice daily
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Plasma volume increases, making the blood count appear low.
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Increasing intake of protein might improve these values.
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Almost all women at 28-weeks gestation have anemia.
Explanation
The Correct Answer is:
B. Plasma volume increases, making the blood count appear low
During pregnancy, plasma volume expands more than red blood cell mass, causing hemodilution known as physiologic anemia of pregnancy. This leads to slightly lower hemoglobin and hematocrit values, which are normal and not harmful when mild. The client’s levels (Hgb 10.7 g/dL, Hct 32%) reflect this physiologic change. Iron supplementation may still be prescribed, but this finding primarily results from normal plasma volume expansion, not true iron-deficiency anemia.
The nurse is assessing a 6-month-old infant. Which response requires further evaluation by the nurse?
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Demonstrates startle reflex
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Plays “peek-a-boo”
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Has doubled birth weight
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Turns head to locate sound
Explanation
The Correct Answer is:
A. Demonstrates startle reflex.
Detailed Explanation:
The startle (Moro) reflex is a primitive reflex that normally disappears by 4 months of age as the infant’s nervous system matures. Persistence of this reflex at 6 months suggests possible neurologic immaturity or damage, warranting further evaluation. The nurse should report this finding for additional assessment of developmental and neurologic status to rule out conditions affecting brain or spinal cord function.
Patient Data
History and Physical
The client is a 4-year-old male with a history of
prematurity, short gut syndrome, and liver and
bowel transplant. He has been hospitalized for
the past 8 months, 6 of those were spent in the
pediatric intensive care unit. He is currently in
the pediatric unit for observation as his
posttransplant medications are stabilized for
discharga.
Nurses' Notes
The child's mother has been staying at the hospital since the child's last admission. She reported that her mother has an
illness and will have to be away a few days. When she left, the child screamed and clung to her, causing his blood pressure
to increase to 120/81 mm Hg and pulse 140 beats/minute. Notified the healthcare provider.(HCP) of the vital sign change.
He cried for approximately 1 hour after his mother left, but he is sleeping now.
Day 2
The child's mom returned for a brief visit and received an update from the HCP. A child life specialist came to the bedside
when the mother left for distraction technique. The child screamed loudly and attempted to hit the child life specialist. He is
resting now with music playing.
Day 3
No visit from the mother.
Day 4
The child is refusing to participate in physical therapy. He will not speak to staff, which is unusual. He says he is sad and, misses Mommy”
Review H and P, and nurse's note.
Which action(s) is/are appropriate for the nurse caring for this child? Select
all that apply.
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Develop a trusting relationship with the child.
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Facilitate phone conversations between the child and his mother.
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Avoid mentioning anything about the mother to the child.
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Notify the mother that social services will be notified if she does not visit regularly
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Ask the mother to bring a familiar object from home.
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Have the child sign a treatment contract stating he will participate in therapy.
Explanation
The Correct Answers are:
A. Develop a trusting relationship with the child.
B. Facilitate phone conversations between the child and his mother.
E. Ask the mother to bring a familiar object from home.
A. Develop a trusting relationship with the child
Establishing trust helps the child feel secure and supported during a prolonged hospitalization. Consistent, compassionate care builds emotional safety, especially when separation anxiety is intensified by illness and prolonged hospital stays.
B. Facilitate phone conversations between the child and his mother
Maintaining contact with the primary caregiver reduces the child’s fear of abandonment and provides emotional reassurance. Hearing the mother’s voice supports attachment and helps ease the distress caused by her absence.
E. Ask the mother to bring a familiar object from home
Familiar items such as a blanket, stuffed animal, or toy provide comfort and a sense of stability in an unfamiliar hospital environment, helping reduce anxiety and promote emotional adjustment.
A mother brings her 2-month-old to the well-baby clinic.
She mentions that when she kisses her baby, the infant’s skin tastes salty.
What standard diagnostic test should the nurse prepare the mother for to screen for cystic fibrosis (CF)?
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Fecal-fat test.
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Sweat-chloride test.
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Pulmonary-function test.
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Potassium chloride test.
Explanation
The Correct Answer is:
B. Sweat-chloride test.
Detailed Explanation:
The sweat-chloride test is the gold standard for diagnosing cystic fibrosis. It measures the concentration of chloride in the infant’s sweat. In CF, a defective CFTR gene causes abnormal chloride transport, leading to excessive salt in sweat, thick mucus production, and multisystem complications. A chloride level above 60 mmol/L confirms the diagnosis. The test is noninvasive and typically performed once the infant is at least two weeks old and adequately hydrated.
A client in labor exhibits fluctuating deceleration, which the nurse records on the fetal monitor. What should be the first thing the nurse does?
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Turn off the oxytocin infusion.
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Assess cervical dilatation
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Change the client's position.
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Administer oxygen via facemask
Explanation
The Correct Answer is:
C. Change the client's position
Variable decelerations are usually caused by umbilical cord compression, which temporarily decreases blood flow to the fetus. The first action is to reposition the client—such as turning to the side, knee-chest, or Trendelenburg position—to relieve pressure on the cord and restore oxygenation. If decelerations persist, the nurse may then stop oxytocin, administer oxygen, and notify the healthcare provider for further evaluation or intervention.
The nurse is evaluating a child with acute glomerulonephritis who presents at the clinic with increased fatigue, facial swelling, and decreased appetite. The child’s urine sample is dark yellow. What additional finding should the nurse report to the healthcare provider?
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Blood pressure 88/50 mmHg
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Weight loss
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Maculopapular rash over the trunk of the body
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Positive rapid strep test of the oropharynx
Explanation
The Correct Answer is:
D. Positive rapid strep test of the oropharynx.
Detailed Explanation:
A positive rapid strep test indicates an active group A beta-hemolytic Streptococcus (GAS) infection, which can worsen or prolong acute glomerulonephritis. This finding should be promptly reported because antibiotic therapy may be needed to eliminate the infection and prevent further renal damage. Post-streptococcal glomerulonephritis often follows a recent strep infection, so an active infection requires immediate medical management to avoid complications such as hypertension or kidney failure.
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