HESI RN
HESI Pediatric Practice Exam
1. 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?
- A. Administer a bronchodilator
- B. Obtain a peak flow reading
- C. Apply oxygen
- D. Perform a complete respiratory assessment
Correct answer: A
Rationale: Administering a bronchodilator is the initial priority as it helps open the child's airways, reducing the wheezing and shortness of breath. This intervention aims to provide immediate relief and improve the child's respiratory distress. Obtaining a peak flow reading or applying oxygen may be necessary after administering the bronchodilator, but the priority is to address the acute symptoms of wheezing and shortness of breath first. Performing a complete respiratory assessment can be done after the immediate intervention of administering the bronchodilator to further evaluate the child's respiratory status.
2. The caregiver is caring for a 3-year-old child with a diagnosis of gastroenteritis. The child has had several episodes of vomiting and diarrhea over the past 24 hours. What is the caregiver's priority assessment?
- A. Monitor the child's weight
- B. Assess the child's hydration status
- C. Evaluate the child's nutritional intake
- D. Check the child's temperature
Correct answer: B
Rationale: The correct answer is B: Assess the child's hydration status. In children with gastroenteritis, assessing hydration status is crucial as they are at risk of dehydration due to vomiting and diarrhea. Monitoring hydration helps prevent complications and guides appropriate interventions to maintain the child's fluid balance. Monitoring the child's weight (Choice A) is not the priority in this situation compared to assessing hydration status. Evaluating nutritional intake (Choice C) is important but not the priority when the child is at risk of dehydration. Checking the child's temperature (Choice D) is relevant but not the priority over assessing hydration status in a child with gastroenteritis.
3. A 6-year-old child with sickle cell anemia presents to the emergency department with severe pain in the legs and abdomen. The child is crying and states that the pain is unbearable. What is the nurse’s priority action?
- A. Apply warm compresses to the painful areas
- B. Administer prescribed pain medication
- C. Encourage the child to drink fluids
- D. Monitor the child’s oxygen saturation
Correct answer: B
Rationale: In a sickle cell crisis, pain management is a priority to alleviate the child's suffering. Administering the prescribed pain medication is crucial to address the severe pain experienced by the child. Warm compresses, encouraging fluid intake, and monitoring oxygen saturation are important interventions but should follow the priority of pain management in this situation.
4. The caregiver is caring for a 10-year-old child with a history of frequent ear infections. The parents are concerned about their child’s hearing and speech development. What is the caregiver’s best response?
- A. Let’s schedule a hearing test and refer to a speech therapist if needed
- B. Most children outgrow ear infections and speech delays
- C. There is no need to worry unless the infections persist into adolescence
- D. Your child’s hearing and speech should be normal by now
Correct answer: A
Rationale: The appropriate response for the caregiver is to address the parents' concerns by suggesting scheduling a hearing test and potentially referring the child to a speech therapist if necessary. This proactive approach can help evaluate and support the child's hearing and speech development effectively. Choice B is incorrect as assuming that most children outgrow ear infections and speech delays may overlook potential issues that need intervention. Choice C is wrong because waiting until adolescence to address concerns may lead to missed opportunities for early intervention. Choice D is incorrect as it dismisses the parents' valid concerns without offering a solution or further evaluation.
5. The mother calls the clinic and tells the practical nurse (PN) that her child cannot swallow a prescribed tablet that was dispensed by the local pharmacy as a whole tablet. How should the PN respond?
- A. You can crush the tablet and mix it with food.
- B. You should not force the child to swallow the tablets by holding her nose closed.
- C. If a liquid form is available, the pharmacist can be contacted for a prescription change.
- D. Do not advise the child to chew the tablet if she cannot swallow it.
Correct answer: C
Rationale: When a child is unable to swallow a tablet, the appropriate response is to consider if a liquid form of the medication is available. This is a safer and more effective alternative than forcing the child to swallow or chew the tablet. Contacting the pharmacist for a prescription change can provide a suitable solution that ensures the child receives the medication in a more manageable form. Choices A, B, and D are incorrect because crushing the tablet and mixing it with food may alter the medication's effectiveness or taste, forcing the child to swallow or holding her nose closed can be distressing and ineffective, and advising the child to chew the tablet is not recommended as an alternative to swallowing it.
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