HESI RN
HESI Pediatrics Practice Exam
1. The caregiver is teaching a group of parents about injury prevention for toddlers. Which statement by a parent indicates a need for further teaching?
- A. I will keep all cleaning supplies locked away.
- B. I will teach my child how to swim this summer.
- C. I will make sure my child wears a helmet while riding a tricycle.
- D. I will place my child in a car seat for every car ride.
Correct answer: B
Rationale: Teaching children how to swim is valuable, but parental supervision around water is essential to prevent drowning. It's crucial to emphasize constant supervision when young children are near water, regardless of their swimming abilities. The other choices (A, C, and D) demonstrate appropriate safety measures for injury prevention in toddlers, such as securing cleaning supplies, ensuring helmet use during tricycle rides, and using a car seat for every car ride.
2. A client scheduled for the surgical creation of an ileal conduit expresses anxiety and asks about having a drainage tube. How should the nurse respond?
- A. I will ask the provider to prescribe you an antianxiety medication.
- B. Would you like to discuss the procedure with your doctor once more?
- C. I think it would be nice to not have to worry about finding a bathroom.
- D. Would you like to speak with someone who has an ileal conduit?
Correct answer: D
Rationale: The most appropriate response for the nurse is to offer the client the opportunity to speak with someone who has undergone the same procedure. This allows the client to gain insight, ask questions, and share concerns with someone who has firsthand experience, which can help alleviate anxiety and promote a positive self-image. Seeking an antianxiety medication does not address the client's emotional concerns or promote a positive attitude towards the procedure. Discussing the procedure with the doctor again may provide more information but may not offer the same level of emotional support and understanding as speaking with someone who has lived through the experience. Commenting on the convenience of not having to search for a bathroom minimizes the client's anxiety and overlooks the emotional aspect of the client's concerns.
3. When teaching a gravid client how to perform kick (fetal movement) counts, which instruction should the nurse include?
- A. If 10 kicks are not felt within one hour, drink orange juice and count for another hour.
- B. Count the movements once daily, for one hour, before breakfast.
- C. Avoid caffeinated drinks for 24 hours before conducting the kick test.
- D. Exercise for 15 minutes before starting the counting to help increase fetal movement.
Correct answer: A
Rationale: When teaching a gravid client about kick (fetal movement) counts, the nurse should instruct them that if 10 kicks are not felt within one hour, they should drink orange juice and continue counting for another hour. This instruction is crucial as a drop in fetal movements could indicate potential issues with fetal well-being, and taking action such as rechecking after food intake is recommended to monitor the situation closely.
4. A 5-year-old child is admitted to the pediatric unit with fever and pain secondary to a sickle cell crisis. Which intervention should the nurse implement first?
- A. Obtain a culture of any sputum or wound drainage
- B. Initiate normal saline IV at 50 ml/hr
- C. Administer a loading dose of penicillin IM
- D. Administer the initial dose of folic acid PO
Correct answer: B
Rationale: In a child with a sickle cell crisis, the priority intervention is to initiate normal saline IV at 50 ml/hr to manage dehydration and help alleviate pain. This intervention helps improve hydration status and supports the circulation of sickled red blood cells, reducing the risk of vaso-occlusive episodes and associated pain. Obtaining a culture of any sputum or wound drainage (Choice A) may be necessary but is not the initial priority. Administering a loading dose of penicillin IM (Choice C) is important but not the first intervention. Administering the initial dose of folic acid PO (Choice D) is beneficial but does not address the immediate need for hydration in a sickle cell crisis.
5. A client with cirrhosis develops ascites. What is the nurse’s priority intervention?
- A. Administer diuretics as prescribed.
- B. Restrict fluid intake to manage fluid overload.
- C. Position the client in Fowler’s position and assess for respiratory distress.
- D. Measure the client's abdominal girth daily.
Correct answer: B
Rationale: The correct answer is B: Restrict fluid intake to manage fluid overload. In a client with cirrhosis developing ascites, the priority intervention is to restrict fluid intake. This helps manage fluid overload, prevent further complications, such as respiratory distress or kidney impairment, and reduce the accumulation of ascitic fluid. Administering diuretics may be a part of the treatment plan, but the primary focus should be on fluid restriction. Positioning the client in Fowler’s position and measuring the abdominal girth are important interventions but not the priority when managing ascites in cirrhosis.