HESI RN
HESI Pediatric Practice Exam
1. A mother brings her school-aged daughter to the pediatric clinic for evaluation of her anti-epileptic medication regimen. What information should the nurse provide to the mother?
- A. The medication dose will be tapered over a period of 2 weeks when being discontinued
- B. If seizures return, multiple medications will be prescribed for another 2 years
- C. A dose of valproic acid (Depakote) should be available in the event of status epilepticus
- D. Phenytoin (Dilantin) and phenobarbital (Luminal) should be taken for life
Correct answer: A
Rationale: Antiepileptic drugs should not be abruptly stopped as it may lead to seizure recurrence. Tapering the medication over a period of 2 weeks helps to prevent withdrawal effects and minimize the risk of seizures. Choice B is incorrect because starting multiple medications for seizure recurrence is not the first-line approach. Choice C is incorrect because valproic acid is not the first-line medication given in the event of status epilepticus. Choice D is incorrect because antiepileptic medications are usually evaluated over time and adjusted based on the individual's response; it is not always necessary to take them for life.
2. A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment of the girl is most important for the nurse to obtain?
- A. Understanding of the quality control process used to troubleshoot the pump
- B. Interpretation of fingerstick glucose levels that influence diet selections
- C. Knowledge of her glycosylated hemoglobin A1c levels for the past year
- D. Ability to perform the pump for basal insulin with mealtime boluses
Correct answer: A
Rationale: In a patient transitioning to an insulin pump, understanding the quality control process to troubleshoot the pump is crucial for ensuring proper and safe management of diabetes. This knowledge enables the individual to identify and address any issues that may arise with the pump, helping maintain optimal glycemic control and prevent complications. Choices B, C, and D, although important in diabetes management, are not as critical as ensuring the correct understanding of troubleshooting the pump, which directly impacts the girl's ability to effectively use the pump for insulin delivery.
3. The mother calls the clinic and tells the practical nurse (PN) that her child cannot swallow a prescribed tablet that was dispensed by the local pharmacy as a whole tablet. How should the PN respond?
- A. You can crush the tablet and mix it with food.
- B. You should not force the child to swallow the tablets by holding her nose closed.
- C. If a liquid form is available, the pharmacist can be contacted for a prescription change.
- D. Do not advise the child to chew the tablet if she cannot swallow it.
Correct answer: C
Rationale: When a child is unable to swallow a tablet, the appropriate response is to consider if a liquid form of the medication is available. This is a safer and more effective alternative than forcing the child to swallow or chew the tablet. Contacting the pharmacist for a prescription change can provide a suitable solution that ensures the child receives the medication in a more manageable form. Choices A, B, and D are incorrect because crushing the tablet and mixing it with food may alter the medication's effectiveness or taste, forcing the child to swallow or holding her nose closed can be distressing and ineffective, and advising the child to chew the tablet is not recommended as an alternative to swallowing it.
4. What action should be taken by the healthcare provider for a child who has ingested a corrosive product?
- A. Induce vomiting using Ipecac to remove the corrosive agent.
- B. Administer vinegar or lemon juice to neutralize the caustic agent.
- C. Give activated charcoal to decontaminate the stomach.
- D. Telephone the poison control center and follow their advice.
Correct answer: D
Rationale: In cases of corrosive product ingestion, it is crucial to contact the poison control center for guidance. Inducing vomiting or attempting to neutralize the agent can lead to further harm. The poison control center professionals are trained to provide specific instructions tailored to the situation, ensuring the best possible outcome for the child. Therefore, the correct action is to call the poison control center for appropriate advice. Inducing vomiting can cause additional damage by re-exposing the esophagus and mouth to the corrosive substance. Administering vinegar or lemon juice is not recommended as it may worsen the situation by causing a chemical reaction. While activated charcoal can be useful in some cases of poisoning, it is not recommended for corrosive substances as it is ineffective in binding to them.
5. When should oral hygiene practices start for an infant according to the American Dental Association guidelines?
- A. There is no need to begin until after all of the child's baby teeth are in.
- B. You don't have to worry about that until your child can handle a toothbrush.
- C. You can begin now using toothpaste on a gauze pad and wiping the gums.
- D. Begin wiping the teeth with a washcloth and water when the first tooth appears.
Correct answer: D
Rationale: According to the American Dental Association guidelines, oral hygiene practices should start as soon as the first tooth appears. At this stage, using a soft cloth and water to clean the infant's gums and teeth is recommended to establish good oral hygiene habits early on and prevent dental issues. Choice A is incorrect as waiting until all baby teeth are in is too late for starting oral hygiene practices. Choice B is incorrect as it is essential to start oral hygiene before the child can handle a toothbrush. Choice C is incorrect as using toothpaste on a gauze pad is not recommended for infants with emerging teeth.
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