HESI RN
Pediatric HESI
1. When should the surgical correction of hypospadias in a newborn infant typically be done?
- A. Repair should be done by one month to prevent bladder infection.
- B. To form a proper urethra repair, it should be done after sexual maturity.
- C. Repairs typically should be done before the child is potty trained.
- D. Delaying the repair until school age reduces castration fears.
Correct answer: C
Rationale: Surgical repairs for hypospadias are typically recommended to be performed before the child is potty trained. This timing helps in avoiding complications, ensures better outcomes, and makes the surgical process smoother. Early correction also minimizes the psychological impact on the child regarding genital differences and can improve long-term psychological well-being. Choices A, B, and D are incorrect because repairing hypospadias at one month to prevent bladder infection, after sexual maturity to form a proper urethra, or delaying the repair until school age to reduce castration fears are not the standard recommendations. The optimal timing for surgical correction is before the child is potty trained to achieve the best results and psychological outcomes.
2. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child’s plan of care?
- A. Obtain vital signs to monitor for fluid overload
- B. Change IV site dressing every 3 days and as needed
- C. Monitor for signs of facial swelling or urticaria
- D. Assess for abdominal pain and vomiting
Correct answer: C
Rationale: Monitoring for signs of an allergic reaction, such as facial swelling or urticaria, is crucial when administering antibiotics like azithromycin. It is important to watch for these signs to promptly identify and manage any potential adverse reactions during the course of treatment.
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. The healthcare provider is preparing to suture a 10-year-old child with a lacerated forehead. Both parents and a 12-year-old sibling are present at the child's bedside. Which instruction best supports family involvement?
- A. While waiting for the healthcare provider, only one visitor may stay with the child.
- B. All of you should leave while the healthcare provider sutures the child's forehead.
- C. It is best if the sibling goes to the waiting room until the suturing is completed.
- D. Please decide who will stay when the healthcare provider begins suturing.
Correct answer: D
Rationale: Involving the family members in deciding who will stay when the healthcare provider begins suturing supports family involvement and helps reduce anxiety for the child. This approach respects the family's dynamics and preferences, promoting a supportive environment during the procedure.
5. The child is 3 years old and is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding indicates arterial obstruction?
- A. Blood pressure is decreasing, and the pulse is rapid and irregular.
- B. The right foot feels cool to the touch and appears pale and blanched.
- C. The pulse distal to the femoral artery is weaker in the left foot than the right foot.
- D. The pressure dressing at the right femoral area is damp and oozing blood.
Correct answer: B
Rationale: A cool, pale, and blanched foot is indicative of arterial obstruction, leading to poor blood flow. This finding requires immediate intervention to prevent further complications such as tissue damage or necrosis. Monitoring for signs of arterial compromise, such as color changes, temperature, and capillary refill, is crucial in detecting and managing vascular complications post-cardiac catheterization. Choices A, C, and D do not directly indicate arterial obstruction. While a decreasing blood pressure and rapid, irregular pulse may suggest compromise, these findings are more nonspecific. A weaker pulse distal to the femoral artery indicates reduced perfusion but not necessarily arterial obstruction. Finally, a damp, oozing pressure dressing suggests a dressing issue rather than arterial obstruction.
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