HESI RN
Pediatric HESI
1. In a hospitalized child receiving IV fluids for dehydration, what is the best indicator that the child’s dehydration is improving?
- A. The child’s urine output increases
- B. The child’s skin turgor is normal
- C. The child’s weight increases
- D. The child’s vital signs are stable
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. Choices B, C, and D are not the best indicators of improving dehydration. Normal skin turgor is helpful but may not change immediately with improving hydration. Weight increase may reflect retained fluids rather than improved hydration status. Stable vital signs are important but may not always indicate improving dehydration.
2. What action should the nurse implement after the infusion is complete for a 16-year-old with acute myelocytic leukemia receiving chemotherapy via an implanted medication port at the outpatient oncology clinic?
- A. Administer Zofran
- B. Obtain blood samples for RBCs, WBCs, and platelets
- C. Flush the mediport with saline and heparin solution
- D. Initiate an infusion of normal saline
Correct answer: C
Rationale: After completing the chemotherapy infusion via the implanted medication port, the nurse should flush the mediport with saline and heparin solution. This action helps prevent clot formation in the port, ensuring its patency for future use and reducing the risk of complications associated with catheter occlusion. Administering Zofran (Choice A) is used for managing chemotherapy-induced nausea and vomiting, not for post-infusion care. Obtaining blood samples for RBCs, WBCs, and platelets (Choice B) is important for monitoring the patient's blood count but is not the immediate post-infusion priority. Initiating an infusion of normal saline (Choice D) is not necessary after completing the chemotherapy infusion.
3. 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?
- A. Increased weight gain
- B. Decreased heart rate
- C. Reduced headaches
- D. Diminished fatigue
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. Choices A, C, and D are incorrect because propranolol is not typically associated with increased weight gain, reduced headaches, or diminished fatigue as its primary therapeutic effect in this context.
4. When caring for a 5-year-old child with a history of seizures who suddenly begins to have a tonic-clonic seizure, what should the nurse do first?
- A. Administer oxygen
- B. Insert an oral airway
- C. Turn the child to the side
- D. Start an IV line
Correct answer: C
Rationale: During a tonic-clonic seizure, the priority action is to turn the child to the side. This helps maintain an open airway and prevents aspiration of secretions or vomitus. It also helps in keeping the airway clear and promotes safety during the seizure episode. Administering oxygen, inserting an oral airway, and starting an IV line are important interventions but should follow the initial step of positioning the child to prevent airway obstruction.
5. During a well-baby check, the nurse hides a block under the baby's blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing?
- A. Separation anxiety.
- B. Associative play.
- C. Object prehension.
- D. Object permanence.
Correct answer: D
Rationale: When a baby looks for a hidden object, it demonstrates the development of object permanence. This milestone is significant as it signifies the baby's understanding that objects continue to exist even when they are not visible. It is a crucial aspect of cognitive development in infancy. Choice A, separation anxiety, refers to distress when separated from a primary caregiver and is not demonstrated in this scenario. Choice B, associative play, involves interactive play with others and is not relevant to object search. Choice C, object prehension, refers to the ability to grasp and hold objects, which is not specifically demonstrated by looking for a hidden object in this context.
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