HESI RN
Pediatric HESI
1. What action should the nurse implement when the infusion of chemotherapy via an implanted medication port is complete for a 16-year-old with acute myelocytic leukemia at the outpatient oncology clinic?
- A. Administer Zofran
- B. Obtain blood samples for RBCs, WBCs, and platelets
- C. Flush mediport with saline and heparin solution
- D. Initiate an infusion of normal saline
Correct answer: C
Rationale: The correct action for the nurse to implement when the chemotherapy infusion is complete is to flush the mediport with saline and heparin solution. This process helps prevent clotting and ensures the patency of the port, which is essential for future medication administrations and blood draws. Administering Zofran (Choice A) is not necessary after completing the chemotherapy infusion. Obtaining blood samples (Choice B) for RBCs, WBCs, and platelets is important but not the immediate action after completing the infusion. Initiating an infusion of normal saline (Choice D) is not required unless there is a specific indication for it.
2. A school-age child with a history of type 1 diabetes mellitus is brought to the emergency department with confusion and rapid breathing. The practical nurse (PN) suspects diabetic ketoacidosis (DKA). Which initial intervention should the PN anticipate?
- A. Administer subcutaneous insulin.
- B. Give oral glucose tablets.
- C. Start intravenous fluids.
- D. Administer oxygen therapy.
Correct answer: C
Rationale: Intravenous fluids are typically the initial intervention in diabetic ketoacidosis (DKA) to treat dehydration and stabilize the patient's condition. The fluid replacement helps correct electrolyte imbalances and improve perfusion, which are crucial in managing DKA. Insulin therapy follows after fluid resuscitation to address the underlying cause of DKA, which is the lack of insulin leading to increased ketone production. Administering subcutaneous insulin (Choice A) would be premature without first addressing the dehydration and electrolyte imbalances. Giving oral glucose tablets (Choice B) is contraindicated in DKA as the patient already has high blood glucose levels. Administering oxygen therapy (Choice D) may be necessary based on the patient's condition, but addressing dehydration with intravenous fluids is the priority intervention in DKA.
3. When caring for a 4-year-old child diagnosed with celiac disease, the parent asks about foods to avoid. Which response by the nurse is correct?
- A. Avoid all dairy products
- B. Avoid foods containing wheat, barley, and rye
- C. Avoid all foods high in sugar
- D. Avoid foods with artificial coloring
Correct answer: B
Rationale: Celiac disease is managed with a strict gluten-free diet, necessitating the avoidance of foods containing wheat, barley, and rye. Gluten is found in these grains and can trigger an immune response in individuals with celiac disease, leading to damage to the small intestine. Therefore, it is essential for individuals with celiac disease, including children, to carefully avoid gluten-containing foods to maintain their health and well-being.
4. The mother of a 4-month-old asks the nurse for advice in preventing diaper rash. What suggestion should the nurse provide?
- A. At diaper change generously powder the baby's diaper area with talcum powder to promote dryness.
- B. Wash the diaper area every 2 hours with soap and water to help prevent skin breakdown.
- C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change.
- D. Place a cloth diaper inside the disposable diaper for overnight periods when increased wearing time is likely.
Correct answer: C
Rationale: Using a barrier cream like zinc oxide protects the skin and helps prevent diaper rash.
5. 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.
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