HESI RN
Pediatric HESI Questions
Question 1 of 9
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.
Question 2 of 9
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 3 of 9
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 4 of 9
A 4-month-old girl is brought to the clinic by her mother because she has had a cold for 2 to 3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress?
Correct Answer: D
Rationale: Flaring of the nares is a clinical sign of acute respiratory distress in infants. It indicates an increased effort to breathe and is a crucial finding that requires immediate attention, as it signifies the child is having difficulty breathing and may be in respiratory distress.
Question 5 of 9
What is the nurse's priority action for a 2-year-old child with croup presenting with a barking cough and stridor?
Correct Answer: C
Rationale: The priority action for a 2-year-old child with croup and stridor is to administer nebulized epinephrine. This intervention helps reduce airway swelling, alleviate symptoms, and improve breathing by causing vasoconstriction and reducing upper airway edema.
Question 6 of 9
The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours; it is now 76 bpm, whereas the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider?
Correct Answer: D
Rationale: A significant drop in heart rate and blood pressure should be reported immediately as it may indicate worsening of the congenital heart defect. A decrease in blood pressure to 70/40 is a critical finding that suggests potential cardiovascular compromise and requires urgent attention to prevent further deterioration.
Question 7 of 9
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 8 of 9
The child is hospitalized with dehydration and is receiving IV fluids. What is the best indicator that the child's dehydration is improving?
Correct Answer: A
Rationale: An increase in urine output is a reliable indicator of improving dehydration in a child. It signifies that the kidneys are functioning better, helping to restore fluid balance in the body. Monitoring urine output is crucial in assessing hydration status and response to treatment.
Question 9 of 9
The parents of a 3-year-old boy who has Duchenne muscular dystrophy ask, 'How can our son have this disease? We are wondering if we should have any more children.' What information should the nurse provide to parents?
Correct Answer: A
Rationale: The correct answer is A. Duchenne muscular dystrophy is an X-linked recessive disorder that primarily affects males. It is crucial for the nurse to explain to the parents that this condition follows an inheritance pattern where the gene mutation responsible for the disorder is located on the X chromosome. Males have only one X chromosome, so if they inherit the mutated gene, they will develop the disease. Females, on the other hand, have two X chromosomes, providing a backup copy that can compensate for the mutation. Understanding this inheritance pattern is essential for family planning decisions, as the risk of passing on the disorder to future children can be explained based on this genetic inheritance.