HESI RN
HESI Pediatric Practice Exam
1. An adolescent's mother calls the primary HCP's office to inquire about the results of her daughter's serum test that was drawn last week. Since it is the teenager's 18th birthday, how should the nurse respond to this mother's inquiry?
- A. Ask when the adolescent was last seen at the clinic
- B. Tell the mother to have the teenager call the clinic
- C. Provide the mother with the findings
- D. Explain that the information cannot be released without the 18-year-old's permission
Correct answer: D
Rationale: The correct response is to explain to the mother that the information cannot be released without the 18-year-old's permission. When an individual turns 18, they are legally considered an adult, and privacy laws mandate that their consent is required before sharing their medical information with others. It is crucial to respect the adolescent's autonomy and privacy rights. Choices A and C are incorrect because they involve disclosing the information without the individual's consent. Choice B is incorrect as it does not address the legal requirement for the adolescent's permission before sharing medical information.
2. An adolescent female who comes to the school clinic is reluctant to confide her concerns to the practical nurse (PN). The PN tells the teen that confidentiality and privacy are maintained unless a life-threatening situation arises. Which principle supports the PN's response?
- A. The adolescent should be encouraged to seek help outside of the school clinic.
- B. Disclosures from the adolescent should be kept confidential.
- C. Honest information ensures establishing a trusting relationship.
- D. Minor adolescents should not be encouraged to disclose private concerns.
Correct answer: C
Rationale: The correct principle supporting the practical nurse's response is that honest information ensures establishing a trusting relationship. By assuring confidentiality and privacy to the adolescent unless there is a life-threatening situation, the practical nurse fosters an environment where the teen feels safe to share their concerns openly. This approach helps build trust, encouraging effective communication and support for the adolescent's well-being. Choices A, B, and D are incorrect because encouraging seeking help outside the school clinic, keeping disclosures confidential, and discouraging minor adolescents from sharing private concerns do not address the immediate need to build trust and ensure the well-being of the adolescent in a school setting.
3. In a 7-year-old child with a history of asthma experiencing an acute asthma exacerbation and displaying wheezing and the use of accessory muscles to breathe, what is the nurse’s priority intervention?
- A. Administer a nebulized bronchodilator
- B. Obtain an arterial blood gas
- C. Start the child on oxygen therapy
- D. Notify the healthcare provider
Correct answer: A
Rationale: The correct answer is to administer a nebulized bronchodilator. During an acute asthma exacerbation in a child with wheezing and increased work of breathing, the priority intervention is to provide immediate bronchodilation to dilate the airways, relieve bronchospasm, and improve breathing. This intervention aims to manage the acute asthma attack effectively and prevent further respiratory distress. Obtaining an arterial blood gas, starting oxygen therapy, or notifying the healthcare provider are important actions, but administering a bronchodilator takes precedence in addressing the acute respiratory compromise.
4. A mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2°F. Which intervention should the nurse implement?
- A. Ask the mother if the child has had a runny nose
- B. Cleanse purulent exudate from the affected ear canal
- C. Apply a topical antibiotic to the periauricular area
- D. Provide parent education to prevent recurrence
Correct answer: A
Rationale: In a child presenting with ear pain and fever, asking if the child has had a runny nose is crucial in assessing possible causes of an ear infection. Respiratory infections can lead to secondary ear infections, so exploring symptoms related to upper respiratory tract infections, like a runny nose, can help in the evaluation and management of the child's condition. Choice B is incorrect because cleansing purulent exudate should be done by a healthcare provider, not a nurse, and only if necessary. Choice C is incorrect because applying a topical antibiotic without proper evaluation and prescription is not within the nurse's scope of practice. Choice D is incorrect because while parent education may be necessary, addressing the immediate concern of evaluating possible causes of the ear pain and fever takes priority.
5. A 2-year-old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure?
- A. Describe the side-lying, knees to chest position that must be assumed during the procedure.
- B. Tell the child to expect loud clicking noises during the procedure that may be slightly annoying.
- C. Reassure the child that there will be no restrictions on activity after the procedure is completed.
- D. Explain that fluids cannot be taken for 8 hours before the procedure and for 4 hours after the procedure.
Correct answer: A
Rationale: The correct answer is A. Describing the side-lying, knees to chest position that must be assumed during the lumbar puncture procedure is essential as it helps the child understand what to expect, promotes cooperation, and reduces anxiety. This position is necessary for the procedure to be performed safely and effectively. Choice B is incorrect because mentioning loud clicking noises may increase the child's anxiety. Choice C is incorrect because there may be restrictions on activity after the procedure, depending on individual cases. Choice D is also incorrect as it provides information about fluid intake restrictions that are not directly related to the procedure itself.
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