HESI RN
HESI Pediatric Practice Exam
1. When planning care for a child diagnosed with rheumatic fever, what is the primary goal of nursing care?
- A. Reduce fever.
- B. Maintain fluid and electrolyte balance.
- C. Prevent cardiac damage.
- D. Maintain joint mobility and function.
Correct answer: C
Rationale: The primary goal of nursing care for a child diagnosed with rheumatic fever is to prevent cardiac damage. Rheumatic fever can lead to complications affecting the heart, making it crucial to monitor and prevent cardiac involvement to avoid long-term consequences. While addressing fever and joint pain are important aspects of care, preventing cardiac damage takes precedence in managing rheumatic fever. Therefore, choices A, B, and D are not the primary goals of nursing care in this case.
2. A child who is admitted to the hospital with anemia is anxious, fearful, and hyperventilating. The nurse anticipates the child developing which acid-base imbalance?
- A. Metabolic acidosis
- B. Respiratory acidosis
- C. Respiratory alkalosis
- D. Metabolic alkalosis
Correct answer: C
Rationale: In this scenario, the child is hyperventilating, which leads to excessive loss of carbon dioxide. This loss of carbon dioxide causes respiratory alkalosis due to a decrease in the partial pressure of carbon dioxide in the blood. Therefore, the correct answer is respiratory alkalosis. Choices A, B, and D are incorrect. Metabolic acidosis is characterized by a decrease in pH and bicarbonate levels due to conditions like kidney disease. Respiratory acidosis is caused by retention of carbon dioxide, leading to an increase in the partial pressure of carbon dioxide. Metabolic alkalosis results from a loss of acid or an increase in bicarbonate levels.
3. A 14-year-old client with type 1 diabetes is participating in a school sports event. The nurse provides education to the client about managing blood glucose levels during physical activity. Which statement by the client indicates a need for further teaching?
- A. I should check my blood sugar before and after exercise
- B. I need to eat a snack before I start playing
- C. If my blood sugar is high, I should skip my insulin dose before exercise
- D. I should carry a fast-acting carbohydrate with me during sports
Correct answer: C
Rationale: The correct answer is C. Skipping the insulin dose when blood sugar is high before exercise can be harmful. It is essential to manage blood glucose levels carefully during physical activity, which may require adjustments to insulin doses but skipping doses is not recommended. Checking blood sugar before and after exercise (Choice A) helps in monitoring and managing blood glucose levels. Eating a snack before playing (Choice B) can help maintain blood sugar levels during physical activity. Carrying a fast-acting carbohydrate (Choice D) is important in case of low blood sugar during sports to quickly raise glucose levels. Therefore, the client needs further teaching on the importance of not skipping insulin doses even if blood sugar is high before exercise.
4. A 4-year-old child is brought to the clinic with complaints of ear pain and fever. The practical nurse suspects otitis media. Which symptom supports this suspicion?
- A. Clear nasal discharge.
- B. Dry, hacking cough.
- C. Tugging at the ear.
- D. Sore throat.
Correct answer: C
Rationale: Tugging at the ear is a common symptom in children with otitis media. It often indicates discomfort or pain in the ear, suggesting inflammation or infection in the middle ear. This behavior is frequently observed in young children who are unable to express their discomfort verbally, making it a significant clinical indicator for otitis media in this age group. Clear nasal discharge (Choice A) is more indicative of a cold or allergies, while a dry, hacking cough (Choice B) is not typically associated with otitis media. Although a sore throat (Choice D) can sometimes accompany ear infections, tugging at the ear is a more specific and reliable symptom in this case.
5. 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.
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