HESI RN
Pediatric HESI
1. Following a motor vehicle collision, a 3-year-old girl has a spica cast applied. Which toy is best for the nurse to offer this child?
- A. Duck that squeaks.
- B. Fashion doll and clothes.
- C. Set of cloth and hand puppets.
- D. Handheld video game.
Correct answer: C
Rationale: In this scenario, a set of cloth and hand puppets is the best choice for a 3-year-old with a spica cast. Hand puppets encourage imaginative play, creativity, and interaction, which are developmentally appropriate for a child of this age. The soft materials are safe for the child and can provide entertainment and engagement without posing a risk of injury. The other options, such as a duck that squeaks, a fashion doll and clothes, and a handheld video game, may not be as suitable for a child in a spica cast due to safety concerns, lack of interactive play, or developmental appropriateness.
2. The nurse is providing care for a client with a new tracheostomy. Which of these assessments is a priority?
- A. Checking the client's oxygen saturation level
- B. Monitoring the client's pain level
- C. Checking the tracheostomy site for signs of infection
- D. Monitoring the client's level of consciousness
Correct answer: C
Rationale: When caring for a client with a new tracheostomy, the priority assessment is checking the tracheostomy site for signs of infection. This is essential to detect early signs of complications such as infection, which can lead to serious issues. Monitoring oxygen saturation is important but not as critical as ensuring the tracheostomy site is free from infection. Pain assessment and level of consciousness are also important but secondary to assessing for signs of infection in this scenario.
3. When administering ceftriaxone sodium (Rocephin) intravenously to a client, what finding requires the most immediate intervention by the nurse?
- A. Stridor
- B. Nausea
- C. Headache
- D. Pruritus
Correct answer: A
Rationale: The correct answer is A: Stridor. Stridor is a high-pitched sound that indicates airway obstruction. When administering ceftriaxone sodium (Rocephin) intravenously, if the client develops stridor, it is a medical emergency requiring immediate intervention to maintain a patent airway. Nausea, headache, and pruritus are important to assess, but they do not pose an immediate threat to the client's airway and would not require the same level of urgent intervention as stridor.
4. What is Carboprost used for?
- A. Affects milk production.
- B. Relieve constriction ring.
- C. Management of post-partum haemorrhage.
- D. Induce labor.
Correct answer: C
Rationale: Carboprost is used in the management of post-partum haemorrhage. This medication helps to reduce excessive bleeding after childbirth. Choices A, B, and D are incorrect. Carboprost does not affect milk production, relieve constriction ring, or induce labor.
5. A nurse cares for clients with urinary incontinence. Which types of incontinence are correctly paired with their clinical manifestations? (Select all that apply.)
- A. Stress incontinence – Urine loss with physical exertion
- B. Urge incontinence – Large amount of urine with each occurrence
- C. Overflow incontinence – Constant dribbling of urine
- D. All of the above
Correct answer: D
Rationale: The correct answer is D, as all the choices are correctly paired with their clinical manifestations. Stress incontinence is characterized by urine loss with physical exertion, coughing, sneezing, or exercising. Urge incontinence presents with a sudden and strong urge to void, often accompanied by a large amount of urine released during each occurrence. Overflow incontinence occurs when the bladder is distended, leading to a constant dribbling of urine. Functional incontinence, not mentioned in the options, is the leakage of urine due to factors unrelated to a lower urinary tract disorder. Reflex incontinence, also not mentioned, is a condition resulting from abnormal detrusor contractions.