HESI RN
Pediatric HESI
1. The healthcare provider is preparing to administer a scheduled dose of digoxin to a 4-year-old child with heart failure. The healthcare provider notes that the child’s heart rate is 70 beats per minute. What should the healthcare provider do next?
- A. Administer the medication as prescribed
- B. Hold the medication and notify the healthcare provider
- C. Recheck the heart rate in 30 minutes
- D. Administer half of the prescribed dose
Correct answer: B
Rationale: In pediatric patients, digoxin administration is guided by the heart rate. If the child's heart rate is below the established threshold, which is typically 90-100 beats per minute in a 4-year-old, the medication should be withheld, and the healthcare provider should be notified for further evaluation and instructions. Choice A is incorrect because administering the medication when the heart rate is low can lead to adverse effects. Rechecking the heart rate in 30 minutes (Choice C) may delay necessary intervention if the heart rate remains low. Administering half of the prescribed dose (Choice D) is not recommended without healthcare provider guidance.
2. The nurse is assessing a client with left-sided heart failure. Which assessment finding is most concerning?
- A. Jugular venous distention
- B. Peripheral edema
- C. Shortness of breath
- D. Crackles in the lungs
Correct answer: C
Rationale: Shortness of breath is the most concerning finding in a client with left-sided heart failure as it indicates worsening pulmonary congestion and impaired gas exchange. This symptom suggests that the client is experiencing significant difficulty in breathing and inadequate oxygenation, requiring immediate intervention. Jugular venous distention (Choice A) is often seen in right-sided heart failure, while peripheral edema (Choice B) and crackles in the lungs (Choice D) are common manifestations of left-sided heart failure but are not as acutely concerning as severe shortness of breath, which can rapidly progress to respiratory distress if not addressed promptly.
3. A client with chronic obstructive pulmonary disease (COPD) is admitted with pneumonia. Which intervention should the nurse implement first?
- A. Administer oxygen therapy as prescribed.
- B. Elevate the head of the bed.
- C. Obtain a sputum culture.
- D. Administer antibiotics as prescribed.
Correct answer: A
Rationale: In a client with COPD admitted with pneumonia, the priority intervention should be to administer oxygen therapy as prescribed. This is crucial to improve oxygenation, especially in a client with compromised respiratory function. Elevating the head of the bed can help with breathing but is secondary to ensuring adequate oxygenation. Obtaining a sputum culture and administering antibiotics are important steps in the treatment of pneumonia but come after ensuring adequate oxygen supply.
4. A client with chronic heart failure is admitted with worsening dyspnea. What is the nurse's priority action?
- A. Administer oxygen at 2 liters per nasal cannula.
- B. Administer a diuretic as prescribed.
- C. Assess the client's lung sounds.
- D. Reposition the client to relieve dyspnea.
Correct answer: A
Rationale: In a client with chronic heart failure experiencing worsening dyspnea, the priority action for the nurse is to administer oxygen at 2 liters per nasal cannula. This helps improve oxygenation and alleviate respiratory distress. Administering a diuretic (Choice B) may be necessary but addressing oxygenation comes first. While assessing lung sounds (Choice C) is important, it is not the immediate priority when the client is in respiratory distress. Repositioning the client (Choice D) may help with comfort but does not address the underlying issue of inadequate oxygenation.
5. What is the purpose of Hysterosalpingo-contrast Sonography?
- A. Check a woman's tubes and is done with an X-ray and dye test called a hysterosalpingogram
- B. Detect Human Chorionic Gonadotrophic hormone (HCG) in urine or whole blood.
- C. Diagnose ovarian cancer using MRI technology.
- D. Detect cancer cells in the cervix.
Correct answer: A
Rationale: Hysterosalpingo-contrast Sonography is a test used to check a woman's fallopian tubes with an X-ray and dye test called a hysterosalpingogram. This test is specifically designed to evaluate the patency of the fallopian tubes and the uterine cavity. Choices B, C, and D are incorrect as they do not align with the purpose of Hysterosalpingo-contrast Sonography.