HESI RN
Pediatric HESI
1. What intervention should the nurse implement first for a male toddler brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin)?
- A. Administer activated charcoal
- B. Prepare gastric lavage
- C. Obtain a 12-lead electrocardiogram
- D. Give IV digoxin immune fab (Digibind)
Correct answer: A
Rationale: Administering activated charcoal is the priority intervention as it binds with digoxin, preventing further absorption in the gastrointestinal tract. This helps reduce the amount of digoxin available for systemic circulation and minimizes its toxic effects. Gastric lavage is no longer recommended due to potential complications and lack of evidence of efficacy. Obtaining an electrocardiogram may help assess the effects of digoxin toxicity, but it is not the initial priority. IV digoxin immune fab (Digibind) is used in severe cases of digoxin toxicity but is not the first-line intervention.
2. During a routine physical exam, a male adolescent client tells the nurse, 'sometimes, my mother gets angry because I want to be with my own friends.' What is the best initial response by the nurse?
- A. Offer reassurance that his mother's concern is normal
- B. Determine if his friends are engaged in unsafe behaviors
- C. Ask about the client's response to his mother's anger
- D. Offer to discuss his concerns with his mother
Correct answer: C
Rationale: When a client expresses concerns about family dynamics, it is important to explore their feelings and reactions to the situation. By asking about the client's response to his mother's anger, the nurse can gain insight into the client's emotions, thoughts, and coping mechanisms. Understanding these aspects is crucial in providing appropriate support and guidance. Option A is incorrect because it focuses solely on reassuring the client about his mother's concern without addressing the client's feelings. Option B assumes negative behaviors without evidence. Option D jumps to discussing concerns with the mother without understanding the client's perspective first.
3. According to Erikson's theory, what behavioral pattern should be displayed by a child who has not developed a sense of competence?
- A. Guilt.
- B. Shame.
- C. Alienation.
- D. Inferiority.
Correct answer: D
Rationale: Erikson's theory of psychosocial development outlines that the failure to establish a sense of competence during the industry vs. inferiority stage results in feelings of inferiority. This stage occurs during middle childhood where children strive to master skills and tasks. If they are unable to meet challenges successfully, they may start feeling inferior to their peers and may lack confidence in their abilities. Choices A, B, and C are incorrect as guilt, shame, and alienation are not the specific behavioral patterns associated with the lack of developing a sense of competence according to Erikson's theory.
4. 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.
5. What is the most important information for the PN to reinforce with the parents when caring for a child diagnosed with acute rheumatic fever?
- A. Complete the full course of prescribed antibiotics.
- B. Ensure the child gets plenty of physical exercise.
- C. Keep the child on a low-sodium diet.
- D. Administer prescribed pain medications as needed.
Correct answer: A
Rationale: Completing the full course of antibiotics is crucial in the management of acute rheumatic fever as it helps prevent recurrence and complications. Antibiotics are essential in eradicating the underlying infection that triggers the autoimmune response leading to rheumatic fever. Reinforcing the importance of completing the prescribed antibiotic regimen is vital to ensure the child's recovery and prevent further health issues. Choices B, C, and D are not as critical as completing the antibiotic treatment. While physical exercise, a low-sodium diet, and pain management are important aspects of overall health, they are not the primary focus when managing acute rheumatic fever.
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