HESI RN
Pediatric HESI Questions
Question 1 of 5
A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?
Correct Answer: B
Rationale: When a child with Graves' disease is prescribed propranolol (Inderal), the nurse should monitor for a decreased heart rate as a therapeutic response. Propranolol is a beta-blocker that acts to slow down the heart rate, which is beneficial in managing the symptoms of Graves' disease, such as tachycardia and other cardiovascular manifestations.
Question 2 of 5
A male adolescent who is newly diagnosed with a seizure disorder receives a prescription for an anticonvulsant. Which statement indicates the client is at risk for non-compliance with life-long medication management?
Correct Answer: B
Rationale: The statement 'My friends will think I am a freak if I take these pills' indicates concerns about peer perception, which can lead to non-compliance in adolescents. Peer pressure and fear of social stigma can significantly impact medication adherence in this age group, making option B the most concerning response regarding the client's compliance with life-long medication management.
Question 3 of 5
What is the recommended analgesia for a practical nurse to use in preparing a school-age child for a lumbar puncture (LP)?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) EMLA (eutectic mixtures of local anesthetics) 2.5 hours before the procedure. EMLA is a topical anesthetic cream that contains lidocaine and prilocaine, which can provide effective local anesthesia to numb the skin before a painful procedure like a lumbar puncture. Option A) Ondansetron (Zofran) is an antiemetic, used to prevent nausea and vomiting, not for pain relief. Option B) Codeine is an opioid analgesic, which may not be suitable for a child due to the risk of respiratory depression and other side effects. Option C) Transdermal fentanyl (Duragesic) patch is a potent opioid that is not typically used for procedural pain in a school-age child due to its strength and potential side effects. Educationally, it is important for practical nurses to be knowledgeable about appropriate pain management strategies in pediatric patients to ensure their comfort and well-being during procedures. Using EMLA cream can help alleviate pain and reduce anxiety in children undergoing procedures like a lumbar puncture. Understanding the appropriate use of different analgesic options in pediatric patients is crucial for safe and effective nursing care.
Question 4 of 5
The nurse is conducting an admission assessment of an 11-month-old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) The lumen of the aorta reduces the volume of the blood flow to the lower extremities. This finding is indicative of a coarctation of the aorta, a congenital heart defect where there is a narrowing of the aorta, leading to decreased blood flow to the lower part of the body. This narrowing results in higher blood pressure in the arms compared to the lower extremities, as well as the described pulse findings. Option A is incorrect because an aortic semilunar valve issue would not typically present with the specific findings described in the question. Option C is incorrect as it refers to a pulmonic valve issue, which would not cause the blood pressure and pulse discrepancies noted. Option D is incorrect as an atrial septal defect would not directly cause the blood flow differences between the arms and lower extremities. Educationally, understanding the pathophysiology of congenital heart defects like coarctation of the aorta is crucial for pediatric nurses. Recognizing the clinical manifestations and implications of these conditions is essential for providing appropriate care and interventions to pediatric patients with complex cardiac issues. This knowledge helps nurses assess, plan, and implement care effectively in order to promote positive outcomes for pediatric patients with congenital heart defects.
Question 5 of 5
What information should the nurse provide to parents of a 3-year-old boy with Duchenne muscular dystrophy who inquire about the disease and future children?
Correct Answer: A
Rationale: Duchenne muscular dystrophy is an X-linked recessive disorder caused by mutations in the DMD gene on the X chromosome. This disorder primarily affects males because they have one X chromosome, inherited from their mothers, who may be carriers of the mutated gene. Females have two X chromosomes, providing a protective effect as the normal gene on one X chromosome can compensate for the mutated gene on the other. Therefore, the nurse should explain to the parents that Duchenne muscular dystrophy is an inherited X-linked recessive disorder, which is why their son has the disease and why there is a risk of passing it on to future sons.