a 16 year old female student with a history of asthma controlled with both an oral antihistamine and an albuterol provenfil metered dose inhaler mdi c

HESI RN

Pediatric HESI

1. A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?

A. When she last took the antihistamine.
B. When her last asthma attack occurred.
C. Duration of most asthma attacks.
D. How often the MDI is used daily.

Correct answer: D

Rationale: The most important information for the nurse to obtain in this scenario is how often the MDI is used daily. This is crucial to assess if the symptoms the student is experiencing, such as insomnia, shakiness, and tachycardia, could be related to overuse of the inhaler. Overuse of albuterol can lead to side effects like tremors, palpitations, and difficulty sleeping, so understanding the frequency of MDI use is key in determining a potential cause for the student's symptoms. Options A, B, and C are not as pertinent in this situation as they do not directly address the possible link between the student's symptoms and the use of the albuterol MDI.

2. The nurse is caring for a 10-year-old child who is scheduled for surgery to repair a fractured femur. The child’s parent expresses concern about the child being afraid of the surgery. What is the nurse’s best response?

A. Children at this age are usually not afraid of surgery
B. It’s normal for your child to feel scared. Let’s talk about what to expect
C. You should talk to the surgeon about your child’s fear
D. Don’t worry, your child will be fine

Correct answer: B

Rationale: Acknowledging the child’s fear and providing information about what to expect can help alleviate anxiety.

3. 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.

4. What information should a nurse discuss with the mother of a 2-year-old girl who is drinking sweetened soda from her bottle?

A. Encouraging 2-word phrases in speech development for a 2-year-old
B. Explaining the association between drinking soda and dental caries
C. Discussing the link between drinking soda and childhood obesity
D. Emphasizing the importance of toddlers sleeping 10 hours a night

Correct answer: B

Rationale: The correct answer is explaining the association between drinking soda and dental caries. Soda consumption can lead to tooth decay and cavities, so it is crucial to educate the mother about this to prevent dental issues in the child.

5. After reinforcing information on treating a sprained ankle, what statement by the adolescent indicates to the practical nurse that further instruction is needed?

A. Keep the leg elevated when sitting.
B. Wrap the ankle in an elastic bandage for support.
C. Apply warm compresses to the ankle for the first 24 hours.
D. Put an ice pack on the ankle, alternating 30 minutes on and 30 minutes off.

Correct answer: C

Rationale: The correct answer is C. Applying warm compresses to a sprained ankle within the first 24 hours is incorrect as it can increase swelling and inflammation. Instead, cold compresses are recommended to help reduce swelling and pain. Option A, keeping the leg elevated, helps in reducing swelling. Option B, wrapping the ankle in an elastic bandage, provides support. Option D, using an ice pack in intervals, is effective in reducing swelling and pain. Therefore, the statement about applying warm compresses indicates the need for further instruction.