HESI RN
Pediatric HESI
1. The parents of a 4-year-old child who has just been diagnosed with celiac disease are being educated by a healthcare provider. Which statement by the parents indicates a correct understanding of the condition?
- A. We can give our child small amounts of gluten occasionally
- B. We need to avoid giving our child foods containing wheat, barley, and rye
- C. We should limit our child’s intake of dairy products
- D. Our child will need to take gluten-free supplements
Correct answer: B
Rationale: Choice B is the correct answer because for individuals with celiac disease, a strict gluten-free diet is essential for managing the condition. Foods containing wheat, barley, and rye must be completely avoided to prevent adverse reactions and damage to the intestines. This dietary restriction is crucial to ensure the child's health and well-being in managing celiac disease effectively. Choices A, C, and D are incorrect because giving small amounts of gluten occasionally, limiting dairy products, or taking gluten-free supplements are not sufficient measures to manage celiac disease. Complete avoidance of gluten-containing foods is necessary to prevent complications.
2. When assessing the breath sounds of an 18-month-old child who is crying, what action should the healthcare professional take?
- A. Document that the assessment is not available because the child is crying.
- B. Ask the caregiver to quiet the child so breath sounds can be auscultated.
- C. Allow the child to play with a stethoscope to distract them during auscultation.
- D. Auscultate and document breath sounds, noting that the child was crying at the time.
Correct answer: C
Rationale: Allowing the child to play with a stethoscope can help distract them, making it easier to auscultate breath sounds. This approach can create a more cooperative and engaging environment for the child, facilitating a more accurate assessment of their breath sounds. Choice A is incorrect because it does not address the need for an assessment. Choice B is not ideal as it puts pressure on the caregiver and may not be effective in calming the child. Choice D is not the best option as it does not actively involve the child in the assessment process and may not provide an accurate representation of their breath sounds.
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. When developing a behavior modification program for an extremely aggressive 10-year-old boy, what should the nurse do first?
- A. Determine what activities, foods, and toys the child enjoys
- B. Evaluate the child’s previous reactions to punishment
- C. Provide the child with positive feedback
- D. Encourage other children on the unit to describe the token system
Correct answer: A
Rationale: The first step in developing a behavior modification program for an aggressive child is to determine what activities, foods, and toys the child enjoys. Understanding the child's preferences allows the nurse to personalize the program, making it more engaging and effective. This approach increases the chances of success in modifying the aggressive behavior. Evaluating previous reactions to punishment (Choice B) may be important but comes later in the process. Providing positive feedback (Choice C) is beneficial but should come after tailoring the program. Encouraging other children to describe the token system (Choice D) is not the initial step; the focus should be on individualizing the program for the specific child first.
5. A 7-year-old child with leukemia is receiving chemotherapy. The mother asks the practical nurse (PN) how to manage the child's nausea at home. What advice should the PN provide?
- A. Provide small, frequent meals.
- B. Encourage the child to eat spicy foods.
- C. Offer large meals less frequently.
- D. Allow the child to eat whatever they want.
Correct answer: A
Rationale: During chemotherapy, children may experience nausea. Providing small, frequent meals can help manage nausea as they are easier to tolerate, reducing the likelihood of vomiting. It is important to offer bland, non-spicy foods to avoid exacerbating nausea. Encouraging large meals less frequently or allowing the child to eat whatever they want may overwhelm the digestive system and worsen nausea. Therefore, the correct advice is to provide small, frequent meals to help the child manage nausea effectively.
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