HESI RN
Pediatric HESI
1. What is the priority action for a 2-year-old child with croup presenting with a barking cough and stridor?
- A. Administer a corticosteroid
- B. Obtain a throat culture
- C. Administer nebulized epinephrine
- D. Place the child in an upright position
Correct answer: C
Rationale: The priority action for a 2-year-old child with croup and stridor is to administer nebulized epinephrine. Nebulized epinephrine helps reduce airway swelling, alleviate symptoms, and improve breathing by causing vasoconstriction and reducing upper airway edema. Administering a corticosteroid may be done but is not the priority in this scenario. Obtaining a throat culture is not necessary for the immediate management of croup. Placing the child in an upright position can aid in breathing but is not the priority action when the child is presenting with stridor.
2. The healthcare provider is preparing to give an enema to a laboring client. Which client requires the most caution when carrying out this procedure?
- A. A gravida 6, para 5 who is 38 years of age and in early labor.
- B. A 37-week primigravida who presents at 100% effacement, 3 cm cervical dilation, and a -1 station.
- C. A gravida 2, para 1 who is at 1 cm cervical dilation and a 0 station admitted for induction of labor due to postdates.
- D. A 40-week primigravida who is at 6 cm cervical dilation and the presenting part is not engaged.
Correct answer: D
Rationale: The client at 40 weeks of gestation with a 6 cm cervical dilation and a presenting part that is not engaged requires the most caution during an enema procedure. An unengaged presenting part increases the risk of cord prolapse, which can be a serious complication during the procedure. This situation demands careful attention to prevent potential complications and ensure the safety of the client and fetus. Choice A is incorrect as being in early labor does not pose the same level of risk as an unengaged presenting part. Choice B describes a client at 37 weeks with signs of early labor but does not indicate the same level of risk as an unengaged presenting part. Choice C involves a client at 1 cm cervical dilation and a 0 station with no mention of an unengaged presenting part, making it a less critical situation compared to an unengaged presentation, as in Choice D.
3. In Reproductive Health services, decision-making about RH matters is mostly done by:
- A. The Woman's parents
- B. The Man's parents
- C. The Husband
- D. The Wife
Correct answer: C
Rationale: In many societies, the husband often plays a significant role in decision-making about reproductive health matters, making choice C the correct answer. While the woman's parents might have some influence in certain cultures, the husband typically has a more direct role in such decisions. Choices A and B are less likely as the focus is on the immediate family unit rather than extended family members. Choice D, the wife, is less common in patriarchal societies where men usually have more authority in decision-making regarding reproductive health matters.
4. A client with type 1 diabetes mellitus is admitted to the emergency department with confusion, sweating, and a blood sugar level of 45 mg/dL. What is the nurse's priority action?
- A. Administer 50% dextrose IV push
- B. Provide a carbohydrate snack
- C. Check the client's urine for ketones
- D. Start an insulin drip
Correct answer: A
Rationale: A blood sugar level of 45 mg/dL indicates severe hypoglycemia, which can lead to life-threatening complications if not treated immediately. The priority is to administer IV dextrose to rapidly increase the blood sugar level. Administering 50% dextrose IV push will provide a quick source of glucose to raise the blood sugar. Providing a carbohydrate snack is not the immediate priority in this critical situation. Checking the client's urine for ketones is important in diabetic ketoacidosis, not for hypoglycemia. Starting an insulin drip would further lower the blood sugar and worsen the client's condition.
5. A client with cirrhosis is admitted with jaundice and ascites. Which laboratory value requires immediate intervention?
- A. Serum albumin of 3.0 g/dL
- B. Serum bilirubin of 3.0 mg/dL
- C. Serum ammonia level of 80 mcg/dL
- D. Serum sodium level of 135 mEq/L
Correct answer: C
Rationale: A serum ammonia level of 80 mcg/dL is most concerning in a client with cirrhosis as it may indicate hepatic encephalopathy, requiring immediate intervention. High serum ammonia levels can lead to altered mental status, confusion, and even coma. Serum albumin (choice A) is often decreased in cirrhosis but does not require immediate intervention. Serum bilirubin (choice B) elevation is expected in cirrhosis and may not require immediate intervention unless very high. Serum sodium (choice D) within the given range is generally acceptable and does not require immediate intervention.