HESI RN
Pediatric HESI
1. 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.
2. A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?
- A. Increased weight gain
- B. Decreased heart rate
- C. Reduced headaches
- D. Diminished fatigue
Correct answer: B
Rationale: When a child with Graves' disease is prescribed propranolol (Inderal), the nurse should monitor for a decreased heart rate as a therapeutic response. Propranolol is a beta-blocker that acts to slow down the heart rate, which is beneficial in managing the symptoms of Graves' disease, such as tachycardia and other cardiovascular manifestations. Choices A, C, and D are incorrect because propranolol is not typically associated with increased weight gain, reduced headaches, or diminished fatigue as its primary therapeutic effect in this context.
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. 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: In infants, laughing readily and turning from back to side are indicative of normal development. These behaviors indicate that the thyroid therapy is effective, as they suggest the baby is achieving age-appropriate milestones. A 5-month-old infant should be able to laugh readily and turn from back to side, showing progress in motor and social development. Choices B, C, and D describe behaviors that are not specific to the expected developmental milestones of a 5-month-old. Strong Moro and tonic neck reflexes, clenched fists, and limited ability to lift the chest when lying on the abdomen are not necessarily indicative of the effectiveness of thyroid therapy for hypothyroidism.
5. A 2-year-old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure?
- A. Describe the side-lying, knees to chest position that must be assumed during the procedure.
- B. Tell the child to expect loud clicking noises during the procedure that may be slightly annoying.
- C. Reassure the child that there will be no restrictions on activity after the procedure is completed.
- D. Explain that fluids cannot be taken for 8 hours before the procedure and for 4 hours after the procedure.
Correct answer: A
Rationale: The correct answer is A. Describing the side-lying, knees to chest position that must be assumed during the lumbar puncture procedure is essential as it helps the child understand what to expect, promotes cooperation, and reduces anxiety. This position is necessary for the procedure to be performed safely and effectively. Choice B is incorrect because mentioning loud clicking noises may increase the child's anxiety. Choice C is incorrect because there may be restrictions on activity after the procedure, depending on individual cases. Choice D is also incorrect as it provides information about fluid intake restrictions that are not directly related to the procedure itself.
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