HESI RN
HESI Practice Test Pediatrics
1. A 2-year-old child with heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 bpm. What action should the nurse take?
- A. Determine the pulse deficit.
- B. Administer the scheduled dose.
- C. Calculate the safe dose range.
- D. Review the serum digoxin level.
Correct answer: B
Rationale: Administering the scheduled dose is appropriate in this scenario since the heart rate of 128 bpm is within an acceptable range for a 2-year-old child with heart failure. Monitoring for signs of digoxin toxicity is important; however, the immediate action required is to administer the scheduled dose as prescribed based on the heart rate assessment.
2. What information should the nurse provide the parents of a 3-year-old boy with Duchenne muscular dystrophy (DMD) who are concerned about having more children?
- A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family.
- B. The male infant had a viral infection that went unnoticed and untreated, leading to muscle damage.
- C. The mother's lack of the protein dystrophin can impact the XXXX muscle groups in males.
- D. Birth trauma during a breech vaginal birth can damage the spinal cord, resulting in muscle weakness.
Correct answer: A
Rationale: The correct answer is A. Duchenne muscular dystrophy is an inherited X-linked recessive disorder that primarily affects male children in the family. Since it is X-linked, sons inherit the mutation from their mothers who are carriers of the abnormal gene. Therefore, the nurse should explain to the parents that any future sons they have would have a 50% chance of inheriting the mutation and having DMD, while daughters would have a 50% chance of being carriers like the mother.
3. The caregiver is caring for a 2-month-old infant with a diagnosis of bronchiolitis. Which assessment finding would be most concerning to the caregiver?
- A. Nasal flaring and grunting
- B. Coughing and wheezing
- C. Poor feeding and irritability
- D. Increased respiratory rate
Correct answer: A
Rationale: Nasal flaring and grunting are indicative of respiratory distress, suggesting the infant is having difficulty breathing. This finding requires immediate attention as it signifies a more severe respiratory compromise compared to the other symptoms listed.
4. When observing a distraught mother scolding her 3-year-old son for wetting his pants in the hallway of a pediatric unit, what initial action should the nurse take?
- A. Suggest that the mother consult a pediatric nephrologist.
- B. Provide disposable training pants while calming the mother.
- C. Refer the mother to a community parent education program.
- D. Inform the mother that toilet training is slower for boys.
Correct answer: B
Rationale: In this situation, the nurse's initial action should be to provide disposable training pants to manage the immediate issue of wetting while also calming the mother. This approach addresses the current distressing situation and offers a practical solution to alleviate the mother's concerns.
5. A mother reports to the nurse at the pediatric clinic that her toddler has had a fever and sore throat for the past two days. The nurse observes several swollen red spots on the child's body, some of which are fluid-filled blisters. What action should the nurse take?
- A. Obtain a fluid culture from the blisters
- B. Administer a fever-reducing medication
- C. Cover the draining vesicles with a dressing
- D. Implement transmission precautions
Correct answer: D
Rationale: The presence of swollen red spots and fluid-filled blisters may indicate a contagious condition. Implementing transmission precautions is crucial to prevent the spread of the infection to others in the clinic setting.
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