HESI RN
HESI Pediatrics Practice Exam
1. When should a mother introduce solid foods to her 4-month-old baby girl? The mother states, 'My mother says I should put rice cereal in the baby's bottle now.' The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?
- A. Stops rooting when hungry
- B. Opens mouth when food comes her way
- C. Awakens once for nighttime feedings
- D. Gives up a bottle for a cup
Correct answer: B
Rationale: The correct answer is B: 'Opens mouth when food comes her way.' This behavior indicates readiness to start trying solid foods. Infants should be introduced to solid foods based on developmental cues, such as showing an interest in food and the ability to accept it. Choices A, C, and D are not indicative of readiness for solid foods. Stopping rooting when hungry is a reflex that may persist beyond the readiness for solids. Awakening for nighttime feedings is a normal behavior for a 4-month-old, and transitioning from a bottle to a cup is a later developmental milestone.
2. A 7-year-old child with type 1 diabetes is brought to the emergency department with abdominal pain, nausea, and vomiting. The nurse notes that the child's blood glucose level is 350 mg/dL. What should the nurse do first?
- A. Administer IV fluids as prescribed
- B. Administer insulin as prescribed
- C. Monitor the child's urine output
- D. Check the child's urine for ketones
Correct answer: A
Rationale: In a child with type 1 diabetes presenting with abdominal pain, nausea, vomiting, and a high blood glucose level, the priority is to administer IV fluids to correct dehydration and electrolyte imbalances, which are crucial in managing diabetic ketoacidosis. Administering insulin without addressing fluid deficits can lead to further complications. While monitoring urine output and checking for ketones are important steps in the care of a child with diabetes, the immediate focus should be on correcting dehydration and electrolyte imbalances through IV fluid administration to stabilize the child's condition.
3. When reinforcing information about the use of corticosteroids in treating asthma in children, which statement indicates that the parent understands the teaching?
- A. My child should take the medication only when experiencing symptoms.
- B. I will rinse my child's mouth after each use of the inhaler.
- C. I should discontinue the medication if my child seems better.
- D. Corticosteroids are used for quick relief during an asthma attack.
Correct answer: B
Rationale: Rinsing the mouth after using corticosteroid inhalers is crucial as it helps prevent oral thrush, a common side effect associated with these medications. This practice reduces the risk of developing fungal infections in the mouth and throat, maintaining optimal oral health during asthma treatment.
4. A 12-year-old child with type 1 diabetes is under the nurse's care. The child’s parent asks how to prevent hypoglycemia during physical activity. What is the nurse’s best response?
- A. Give your child extra insulin before exercise
- B. Make sure your child eats a snack before exercise
- C. Limit your child’s physical activity to avoid hypoglycemia
- D. Monitor your child’s blood glucose levels after exercise
Correct answer: B
Rationale: The most effective way to prevent hypoglycemia during physical activity in a child with type 1 diabetes is to ensure they eat a snack before exercising. Eating a snack before exercise helps maintain blood glucose levels by providing additional glucose for energy during physical activity, reducing the risk of hypoglycemia. Giving extra insulin before exercise (Choice A) can increase the risk of hypoglycemia as it lowers blood glucose levels further. Limiting physical activity (Choice C) is not recommended as exercise is important for overall health. Monitoring blood glucose levels after exercise (Choice D) is essential but does not directly prevent hypoglycemia during physical activity.
5. What action should the nurse implement after the infusion is complete for a 16-year-old with acute myelocytic leukemia receiving chemotherapy via an implanted medication port at the outpatient oncology clinic?
- A. Administer Zofran
- B. Obtain blood samples for RBCs, WBCs, and platelets
- C. Flush the mediport with saline and heparin solution
- D. Initiate an infusion of normal saline
Correct answer: C
Rationale: After completing the chemotherapy infusion via the implanted medication port, the nurse should flush the mediport with saline and heparin solution. This action helps prevent clot formation in the port, ensuring its patency for future use and reducing the risk of complications associated with catheter occlusion. Administering Zofran (Choice A) is used for managing chemotherapy-induced nausea and vomiting, not for post-infusion care. Obtaining blood samples for RBCs, WBCs, and platelets (Choice B) is important for monitoring the patient's blood count but is not the immediate post-infusion priority. Initiating an infusion of normal saline (Choice D) is not necessary after completing the chemotherapy infusion.
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