The nurse is assessing a 4-month-old infant who has just received routine immunizations. The mother reports that the baby has been fussy and has a low-grade fever since the immunizations. What is the best response by the nurse?

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Pediatric HESI Questions

Question 1 of 5

The nurse is assessing a 4-month-old infant who has just received routine immunizations. The mother reports that the baby has been fussy and has a low-grade fever since the immunizations. What is the best response by the nurse?

Correct Answer: A

Rationale: Fussiness and low-grade fever are common side effects of immunizations in infants and usually resolve on their own. It is important for the nurse to educate the mother about these expected reactions to help ease her concerns. Immediate evaluation or giving aspirin to an infant for fever is not necessary or safe, as aspirin can be harmful to infants.

Question 2 of 5

The healthcare provider is preparing to administer a scheduled dose of digoxin to a 4-year-old child with heart failure. The healthcare provider notes that the child's heart rate is 70 beats per minute. What should the healthcare provider do next?

Correct Answer: B

Rationale: In pediatric patients, digoxin administration is guided by the heart rate. If the child's heart rate is below the established threshold, which is typically 90-100 beats per minute in a 4-year-old, the medication should be withheld, and the healthcare provider should be notified for further evaluation and instructions.

Question 3 of 5

A 6-year-old child with a history of asthma is brought to the emergency department with difficulty breathing and a severe cough. The nurse notes that the child is using accessory muscles to breathe and has a peak flow reading in the red zone. What should the nurse do first?

Correct Answer: A

Rationale: In a 6-year-old child with asthma experiencing difficulty breathing and using accessory muscles to breathe with a peak flow reading in the red zone, the priority intervention is to administer a nebulized bronchodilator first. Nebulized bronchodilators help open the airways quickly, providing immediate relief and improving breathing. This intervention aims to address the acute respiratory distress the child is experiencing before considering other assessments or interventions such as obtaining arterial blood gases, starting oxygen therapy, or contacting the healthcare provider.

Question 4 of 5

A 16-year-old adolescent with cystic fibrosis is admitted to the hospital with a respiratory infection. The nurse is teaching the adolescent about the importance of airway clearance techniques. Which statement by the adolescent indicates a need for further teaching?

Correct Answer: B

Rationale: The correct answer is B. Airway clearance exercises are essential for individuals with cystic fibrosis to prevent mucus buildup in their lungs. It is crucial to perform these exercises regularly, even when feeling well, to maintain lung health and prevent complications. Therefore, the statement indicating that the exercises are not needed if feeling okay shows a misunderstanding and requires further teaching.

Question 5 of 5

The parents of a 2-year-old child with a history of febrile seizures are being taught by the healthcare provider. Which statement by the parents indicates a need for further teaching?

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

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