HESI RN
HESI Pediatric Practice Exam Questions
Question 1 of 5
The healthcare provider is preparing a teaching plan for the parents of a 6-month-old infant with GERD. What instruction should the healthcare provider include when teaching the parents measures to promote adequate nutrition?
Correct Answer: B
Rationale: In the context of caring for a 6-month-old infant with GERD (gastroesophageal reflux disease), it is crucial for healthcare providers to provide accurate and effective education to parents regarding measures to promote adequate nutrition. The correct answer, option B, which suggests mixing the formula with rice cereal, is the most appropriate choice. Rice cereal is often recommended for infants with GERD because it can help thicken the formula, making it less likely to reflux back into the esophagus. This can reduce symptoms of GERD and improve the infant's ability to keep the feedings down. By thickening the formula with rice cereal, parents can help their infant receive adequate nutrition without experiencing as much discomfort or reflux. Regarding the incorrect options: A) Alternating glucose water with formula is not recommended as it does not address the underlying issue of GERD and may not provide adequate nutrition for the infant. C) Adding multivitamins with iron to the formula may not directly address the reflux issue and could potentially complicate the infant's digestion further. D) Using water to dilute the formula can lead to inadequate nutrition for the infant and may worsen GERD symptoms due to increased fluid intake. Educationally, it is important for healthcare providers to explain the rationale behind each recommendation to parents, ensuring they understand the impact of their actions on their child's health. By providing clear and evidence-based guidance, healthcare providers empower parents to make informed decisions that support their infant's well-being.
Question 2 of 5
The nurse is assessing a 4-year-old child who is brought to the clinic for a routine checkup. The child's parent reports that the child has been more irritable and less active over the past week. The nurse notes a petechial rash on the child's trunk and extremities. What should the nurse do first?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) Notify the healthcare provider immediately. The presence of a petechial rash in a child, along with a history of increased irritability and decreased activity, raises concerns for potentially serious underlying conditions such as meningitis or sepsis. Petechiae are small, pinpoint, red or purple spots on the skin that can indicate bleeding under the skin, which can be a sign of a significant medical issue. Option A) Asking about recent exposure to contagious diseases is not the priority in this case as the child's symptoms are more indicative of a serious medical condition requiring immediate attention. Option B) Reviewing the child's immunization record is important but not the first step when a child presents with concerning symptoms like petechial rash and changes in behavior. Option C) Measuring the child's temperature is a routine assessment but does not take precedence over the urgent need to address the petechial rash and the child's overall condition. Educationally, this question highlights the importance of recognizing concerning signs and symptoms in pediatric patients and the need for prompt action in such situations. Nurses must be able to prioritize assessments and interventions based on the child's presentation to ensure timely and appropriate care. This case emphasizes the critical role of nurses in early identification and management of potentially serious conditions in pediatric patients.
Question 3 of 5
A 6-year-old child with a history of asthma is brought to the clinic with complaints of wheezing and shortness of breath. The nurse notes that the child is using accessory muscles to breathe. What should the nurse do first?
Correct Answer: A
Rationale: In this scenario, the correct action for the nurse to take first is to administer a bronchodilator (option A). When a child with a history of asthma presents with wheezing, shortness of breath, and the use of accessory muscles to breathe, it indicates an acute exacerbation of asthma. Administering a bronchodilator, such as albuterol, is crucial in managing bronchospasm and improving airway patency, which can rapidly relieve the child's respiratory distress. Obtaining a peak flow reading (option B) would be important to assess the severity of the asthma exacerbation, but it is not the first priority in this acute situation. Applying oxygen (option C) may be necessary later if the child's oxygen saturation is low, but addressing the underlying bronchospasm with a bronchodilator takes precedence. Performing a complete respiratory assessment (option D) is important but should come after initiating immediate treatment to address the child's distress. In the educational context, understanding the appropriate prioritization of interventions in the management of pediatric asthma exacerbations is crucial for nurses caring for children with asthma. Recognizing respiratory distress signs and symptoms and knowing the prompt administration of bronchodilators can prevent respiratory compromise and improve outcomes for pediatric patients with asthma.
Question 4 of 5
A 7-year-old child with cystic fibrosis is admitted to the hospital with a respiratory infection. The nurse is teaching the child's parents about the importance of chest physiotherapy (CPT). Which statement by the parents indicates they need further teaching?
Correct Answer: C
Rationale: In this scenario, option C, "We should perform CPT right after the child eats," indicates a need for further teaching by the parents. The correct timing for performing chest physiotherapy (CPT) in a child with cystic fibrosis is before meals. Performing CPT after eating can lead to discomfort, vomiting, or aspiration due to the pressure applied during the procedure. Option A, "We should perform CPT before meals," is correct because performing CPT before meals helps in clearing the airways effectively without the risk of complications. Option B, "CPT will help loosen mucus in the lungs," is also correct as CPT is aimed at helping to mobilize and remove mucus from the lungs. Option D, "CPT is an important part of our child's treatment," is true as CPT plays a crucial role in managing cystic fibrosis by preventing lung infections and maintaining lung function. Educationally, it is important for parents of children with cystic fibrosis to understand the correct timing and technique for CPT to ensure its effectiveness and safety. Providing clear instructions and reinforcing the importance of proper CPT can help parents in managing their child's condition at home effectively.
Question 5 of 5
An adolescent female who is leaning forward with her hands on her knees to breathe tells the practical nurse that she has been using triamcinolone (Azmacort) inhalation aerosol before coming to the clinic. Which action should the PN implement?
Correct Answer: A
Rationale: When a patient presents with breathing difficulties, the first action should be to assess vital signs and breath sounds to evaluate the severity of the condition. This assessment will provide crucial information to determine the appropriate course of action and treatment. Collecting a blood sample for a white blood cell count, giving a nebulizer treatment, or administering another dose of Azmacort would not be the initial priority in this situation.