HESI RN
Pediatric HESI
1. A 6-month-old female is scheduled to receive diphtheria, tetanus toxoid, and acellular pertussis vaccine (DTaP) and IPV (inactivated poliovirus vaccine) immunizations. She is recovering from a cold but is otherwise healthy and afebrile. Her 5-year-old sister is receiving chemotherapy. Which considerations should the nurse make for this situation?
- A. DTaP and IPV can be safely given to the infant at the scheduled time.
- B. DTaP and IPV are contraindicated because the infant has a cold.
- C. IPV is contraindicated because her sister is immunocompromised.
- D. DTaP is contraindicated because her sister is immunocompromised.
Correct answer: A
Rationale: DTaP and IPV can be safely administered to a child with a mild illness like a cold, even if there is an immunocompromised family member, as these vaccines do not contain live viruses. It is important to ensure that the child is otherwise healthy and afebrile before administering the vaccines. The presence of a cold is not a contraindication for receiving DTaP and IPV vaccines. Choice A is correct because the infant can receive both vaccines as scheduled. Choice B is incorrect as having a cold does not contraindicate DTaP and IPV administration. Choice C is incorrect because IPV is not contraindicated due to the sister's immunocompromised status. Choice D is incorrect as both DTaP and IPV can be given in this scenario.
2. 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.
3. A 4-year-old child with a history of frequent ear infections is brought to the clinic by the parents who are concerned about the child’s hearing. What is the nurse’s priority action?
- A. Perform a hearing test
- B. Inspect the child’s ears for drainage
- C. Refer the child to an audiologist
- D. Ask the parents about the child’s speech development
Correct answer: B
Rationale: The nurse's priority action should be to inspect the child's ears for drainage. This immediate assessment can provide valuable information about the presence of infection or fluid accumulation, which can directly impact the child's hearing. By identifying any signs of drainage, the nurse can promptly address any current issues affecting the child's ear health and hearing abilities. Performing a hearing test (Choice A) may be necessary but should follow the initial assessment of the ears. Referring the child to an audiologist (Choice C) can be considered later based on the findings. Asking about speech development (Choice D) is important but not the immediate priority compared to assessing for current ear issues.
4. The nurse is assessing a 4-month-old infant who has just received routine immunizations. The mother reports that the baby has been fussy and has a low-grade fever since the immunizations. What is the best response by the nurse?
- A. These are common side effects and should resolve within a few days
- B. Your baby may be having an allergic reaction to the immunizations
- C. You should bring your baby to the clinic immediately for evaluation
- D. You should give your baby aspirin to help with the fever
Correct answer: A
Rationale: The correct response by the nurse is to reassure the mother that fussiness and low-grade fever are common side effects of immunizations in infants and should resolve within a few days. It is essential to educate the mother about these expected reactions to alleviate her concerns. Choice B is incorrect because allergic reactions to immunizations usually present with more severe symptoms such as difficulty breathing or swelling. Choice C is not warranted unless there are concerning symptoms present. Choice D is inappropriate as aspirin is contraindicated in infants due to the risk of Reye's syndrome.
5. Following a motor vehicle collision, a 3-year-old girl has a spica cast applied. Which toy is best for the nurse to offer this child?
- A. Duck that squeaks.
- B. Fashion doll and clothes.
- C. Set of cloth and hand puppets.
- D. Handheld video game.
Correct answer: C
Rationale: In this scenario, a set of cloth and hand puppets is the best choice for a 3-year-old with a spica cast. Hand puppets encourage imaginative play, creativity, and interaction, which are developmentally appropriate for a child of this age. The soft materials are safe for the child and can provide entertainment and engagement without posing a risk of injury. The other options, such as a duck that squeaks, a fashion doll and clothes, and a handheld video game, may not be as suitable for a child in a spica cast due to safety concerns, lack of interactive play, or developmental appropriateness.
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