HESI RN
Pediatric HESI
1. A mother brings her 3-month-old infant to the clinic, concerned about frequent vomiting after feeding. The practical nurse (PN) suspects gastroesophageal reflux (GER). Which recommendation should the PN provide to the mother?
- A. Feed the infant in a prone position.
- B. Provide larger, less frequent feedings.
- C. Keep the infant upright for 30 minutes after feeding.
- D. Offer only formula thickened with rice cereal.
Correct answer: C
Rationale: The correct recommendation for reducing symptoms of gastroesophageal reflux (GER) in infants is to keep the infant upright for 30 minutes after feeding. This position helps prevent the backflow of stomach contents, alleviating symptoms of reflux. Placing the infant in a prone position or providing larger, less frequent feedings may worsen symptoms by increasing the likelihood of regurgitation. Offering only formula thickened with rice cereal is not the first-line intervention for GER and should not be recommended initially.
2. The caregiver is providing discharge instructions to the parents of a 6-month-old infant who was hospitalized for bronchiolitis. Which statement by the parents indicates a correct understanding of the instructions?
- A. We should keep our baby away from people with colds
- B. We should continue giving the prescribed medication even if our baby seems better
- C. We should avoid giving solid foods to help with recovery
- D. We can place our baby to sleep on their back to help with breathing
Correct answer: A
Rationale: Keeping the infant away from people with colds is crucial to prevent the spread of respiratory infections, especially for infants recently hospitalized with bronchiolitis. This precaution helps protect the baby from further illnesses and promotes recovery. The other choices are incorrect because it is important to complete the prescribed medication course even if the baby seems better to ensure the infection is fully treated (Choice B). Solid foods are usually introduced around six months of age, so avoiding them entirely may not be necessary (Choice C). Placing the baby to sleep on their back is a safe sleep practice to prevent sudden infant death syndrome (SIDS) but may not directly help with breathing in the context of bronchiolitis (Choice D).
3. A parent of a 2-month-old infant, who was treated for pyloric stenosis, is receiving discharge instructions from a healthcare provider. Which statement by the parent indicates a need for further teaching?
- A. We will burp our baby more frequently during feedings
- B. We should feed our baby in an upright position
- C. We will lay our baby on their stomach after feeding
- D. We will start feeding our baby with small, frequent feedings
Correct answer: C
Rationale: Placing infants on their stomach after feeding increases the risk of sudden infant death syndrome (SIDS). It is important to educate parents to always place infants on their back to sleep to reduce this risk.
4. When assessing a 10-year-old newly diagnosed with osteomyelitis, which information is most important for the nurse to obtain?
- A. Recent history of infection recurrences.
- B. Cultural heritage and beliefs.
- C. Family history of bone disorders.
- D. Increased fluid intake occurrences.
Correct answer: A
Rationale: In a 10-year-old with newly diagnosed osteomyelitis, the most important information for the nurse to obtain is the recent history of infection recurrences. This is crucial because osteomyelitis is an infection of the bone, and assessing for any recent recurrence of infections can help in determining the possible source of the osteomyelitis and guide the treatment plan accordingly. Choices B, C, and D are less relevant in the immediate assessment of a newly diagnosed case of osteomyelitis as they do not directly impact the current infection or treatment plan.
5. The healthcare provider is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective?
- A. Laughs readily, turns from back to side.
- B. Has strong Moro and tonic neck reflexes.
- C. Keeps fists clenched, opens hands when grasping an object.
- D. Can lift head, but not chest when lying on abdomen.
Correct answer: A
Rationale: The ability to laugh readily and turn from back to side indicates the effectiveness of thyroid therapy and normal development in a 5-month-old. These behaviors suggest improved muscle tone and motor skills, which are positive outcomes of thyroid hormone replacement therapy for hypothyroidism. Choices B, C, and D describe developmental milestones that are not specific indicators of the effectiveness of thyroid therapy in treating hypothyroidism in a 5-month-old.
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