HESI RN
Pediatric HESI
1. When should the surgical correction of hypospadias in a newborn infant typically be done?
- A. Repair should be done by one month to prevent bladder infection.
- B. To form a proper urethra repair, it should be done after sexual maturity.
- C. Repairs typically should be done before the child is potty trained.
- D. Delaying the repair until school age reduces castration fears.
Correct answer: C
Rationale: Surgical repairs for hypospadias are typically recommended to be performed before the child is potty trained. This timing helps in avoiding complications, ensures better outcomes, and makes the surgical process smoother. Early correction also minimizes the psychological impact on the child regarding genital differences and can improve long-term psychological well-being. Choices A, B, and D are incorrect because repairing hypospadias at one month to prevent bladder infection, after sexual maturity to form a proper urethra, or delaying the repair until school age to reduce castration fears are not the standard recommendations. The optimal timing for surgical correction is before the child is potty trained to achieve the best results and psychological outcomes.
2. What action should the nurse implement when the infusion of chemotherapy via an implanted medication port is complete for a 16-year-old with acute myelocytic leukemia at the outpatient oncology clinic?
- A. Administer Zofran
- B. Obtain blood samples for RBCs, WBCs, and platelets
- C. Flush mediport with saline and heparin solution
- D. Initiate an infusion of normal saline
Correct answer: C
Rationale: The correct action for the nurse to implement when the chemotherapy infusion is complete is to flush the mediport with saline and heparin solution. This process helps prevent clotting and ensures the patency of the port, which is essential for future medication administrations and blood draws. Administering Zofran (Choice A) is not necessary after completing the chemotherapy infusion. Obtaining blood samples (Choice B) for RBCs, WBCs, and platelets is important but not the immediate action after completing the infusion. Initiating an infusion of normal saline (Choice D) is not required unless there is a specific indication for it.
3. In a 6-year-old child with asthma experiencing difficulty breathing and using accessory muscles to breathe with a peak flow reading in the red zone, what should the nurse do first?
- A. Administer a nebulized bronchodilator
- B. Obtain an arterial blood gas
- C. Start the child on oxygen therapy
- D. Contact the healthcare provider
Correct answer: A
Rationale: The correct action for a 6-year-old child with asthma who is experiencing difficulty breathing, using accessory muscles to breathe, and has a peak flow reading in the red zone is to administer a nebulized bronchodilator first. Nebulized bronchodilators work rapidly to open up the airways, providing immediate relief and improving breathing. This intervention is crucial in addressing the acute respiratory distress the child is facing. Obtaining an arterial blood gas, starting oxygen therapy, or contacting the healthcare provider can be considered after the initial administration of the bronchodilator, as they are not the primary interventions needed to manage the child's acute respiratory distress.
4. A 3-year-old with a congenital heart defect has had a steady decrease in heart rate, now at 76 bpm from 110 bpm four hours ago. Which additional finding should be reported immediately to a healthcare provider?
- A. Oxygen saturation of 94%.
- B. Respiratory rate of 25 breaths/minute.
- C. Urine output of 20 mL/hr.
- D. Blood pressure of 70/40.
Correct answer: D
Rationale: A significant drop in heart rate and blood pressure should be reported immediately as it may indicate worsening of the congenital heart defect. The blood pressure of 70/40 is dangerously low and requires immediate attention to prevent further complications. Oxygen saturation of 94% is within an acceptable range and does not indicate immediate danger. A respiratory rate of 25 breaths/minute is slightly elevated but not a critical finding. Urine output of 20 mL/hr is low but may not be the most concerning finding in this scenario compared to the drop in blood pressure.
5. A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist agent albuterol (Proventil). The child's mother tells the nurse that she uses this medication to open her son's airway when he is having trouble breathing. What is the nurse's best response?
- A. Recommend that the mother bring the child in for immediate evaluation
- B. Advise the mother that overuse of the drug may cause chronic bronchitis
- C. Assure the mother that she is using the medication correctly
- D. Confirm that the medication helps to reduce airway inflammation
Correct answer: C
Rationale: The nurse's priority is to reassure the mother that she is using albuterol correctly to open her son's airways during episodes of difficulty breathing. This reassurance helps build trust and ensures that the child receives the intended benefit of the medication. The answer choice recommending immediate evaluation (A) is not appropriate at this point as the mother is using the medication as prescribed. Advising about overuse causing chronic bronchitis (B) is incorrect and may cause unnecessary alarm. Confirming that the medication helps reduce airway inflammation (D) is not the best response because albuterol is a beta-adrenergic agonist used primarily for bronchodilation in acute asthma exacerbations, rather than for reducing inflammation.
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