HESI RN
HESI Pediatric Practice Exam
1. A 9-year-old child is brought to the clinic with complaints of fatigue, pallor, and shortness of breath. The nurse notes that the child has a history of iron-deficiency anemia. What is the nurse’s priority action?
- A. Administer iron supplements as prescribed
- B. Monitor the child’s hemoglobin levels
- C. Educate the parents about dietary sources of iron
- D. Notify the healthcare provider
Correct answer: A
Rationale: In a child with a history of iron-deficiency anemia presenting with symptoms of fatigue, pallor, and shortness of breath, the priority action for the nurse is to administer iron supplements as prescribed. Iron supplementation is essential to treat iron-deficiency anemia and improve the child's symptoms promptly. Monitoring hemoglobin levels is important but administering iron supplements takes precedence to address the underlying cause. Educating parents about dietary iron sources is valuable for prevention but not the immediate priority. Notifying the healthcare provider may be necessary but should not delay the initiation of treatment with iron supplements.
2. The healthcare provider is preparing a teaching plan for the parents of a 6-month-old infant with GERD. What instruction should the healthcare provider include when teaching the parents measures to promote adequate nutrition?
- A. Alternate glucose water with formula
- B. Mix the formula with rice cereal
- C. Add multivitamins with iron to the formula
- D. Use water to dilute the formula
Correct answer: B
Rationale: The correct instruction for promoting adequate nutrition in a 6-month-old infant with GERD is to mix the formula with rice cereal. This thickens the feed, reducing the risk of reflux, aiding in proper nutrition, and minimizing GERD symptoms. Choices A, C, and D are incorrect. Alternating glucose water with formula, adding multivitamins with iron to the formula, or diluting the formula with water are not recommended measures for promoting adequate nutrition in infants with GERD.
3. The parents of a 5-year-old child, recently diagnosed with celiac disease, are being educated by the healthcare provider. Which statement by the parents indicates a need for further teaching?
- A. We need to avoid giving our child any foods that contain wheat, barley, or rye
- B. Our child can still eat oats as long as they are labeled gluten-free
- C. We should read food labels carefully to check for hidden sources of gluten
- D. It’s okay for our child to have small amounts of gluten occasionally
Correct answer: D
Rationale: The correct answer is D. Children with celiac disease must strictly adhere to a gluten-free diet. Even small amounts of gluten can cause harm by triggering an immune response that damages the intestines. It is crucial for parents to understand that allowing their child to have small amounts of gluten occasionally is not safe and can lead to complications. Therefore, further teaching is needed to emphasize the importance of complete avoidance of gluten-containing foods for a child with celiac disease. Choices A, B, and C demonstrate understanding of the need to avoid gluten-containing foods and hidden sources of gluten, which are essential in managing celiac disease. Choice D is incorrect as it suggests a lax approach to the child's diet, which can be harmful in the case of celiac disease.
4. The parents of a 4-year-old child who has just been diagnosed with celiac disease are being educated by a healthcare provider. Which statement by the parents indicates a correct understanding of the condition?
- A. We can give our child small amounts of gluten occasionally
- B. We need to avoid giving our child foods containing wheat, barley, and rye
- C. We should limit our child’s intake of dairy products
- D. Our child will need to take gluten-free supplements
Correct answer: B
Rationale: Choice B is the correct answer because for individuals with celiac disease, a strict gluten-free diet is essential for managing the condition. Foods containing wheat, barley, and rye must be completely avoided to prevent adverse reactions and damage to the intestines. This dietary restriction is crucial to ensure the child's health and well-being in managing celiac disease effectively. Choices A, C, and D are incorrect because giving small amounts of gluten occasionally, limiting dairy products, or taking gluten-free supplements are not sufficient measures to manage celiac disease. Complete avoidance of gluten-containing foods is necessary to prevent complications.
5. An adolescent female who is leaning forward with her hands on her knees to breathe tells the practical nurse that she has been using triamcinolone (Azmacort) inhalation aerosol before coming to the clinic. Which action should the PN implement?
- A. Obtain vital signs and assess breath sounds for wheezing.
- B. Collect a blood sample for white blood cell count.
- C. Give the client a nebulizer breathing treatment.
- D. Administer another dose of Azmacort.
Correct answer: A
Rationale: When a patient presents with breathing difficulties, the first action should be to assess vital signs and breath sounds to evaluate the severity of the condition. This assessment will provide crucial information to determine the appropriate course of action and treatment. Collecting a blood sample for a white blood cell count, giving a nebulizer treatment, or administering another dose of Azmacort would not be the initial priority in this situation. Therefore, option A is the correct choice as it focuses on assessing the patient's respiratory status to guide further interventions.
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