HESI RN
HESI Pediatrics Practice Exam
1. When caring for a child experiencing severe asthma symptoms, which medication should the practical nurse anticipate being administered first?
- A. Inhaled corticosteroids.
- B. Oral corticosteroids.
- C. Short-acting beta agonists.
- D. Leukotriene receptor antagonists.
Correct answer: C
Rationale: In the management of acute asthma exacerbations, the first-line medication for quick relief of bronchoconstriction is a short-acting beta agonist, such as albuterol. These medications help to rapidly open up the airways, providing immediate relief to the patient. Inhaled corticosteroids are more commonly used for long-term control of asthma symptoms, while oral corticosteroids and leukotriene receptor antagonists are often reserved for more severe or chronic cases. Therefore, in a child experiencing severe asthma symptoms, the practical nurse should anticipate the administration of short-acting beta agonists as the initial intervention to provide quick relief and improve breathing.
2. A mother brings her 3-week-old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicates that the infant's vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life-threatening complication?
- A. Irregular palpable pulse
- B. Hyperactive bowel sounds
- C. Underweight for age
- D. Crying without tears
Correct answer: D
Rationale: Crying without tears is a sign of severe dehydration, which is a potentially life-threatening complication in infants with projectile vomiting. Dehydration can rapidly progress in infants, leading to serious consequences if not promptly addressed. The combination of projectile vomiting, listlessness, and absence of tears when crying should raise concerns about severe dehydration and the need for urgent intervention to prevent further complications.
3. When reviewing the dietary guidelines for a child with nephrotic syndrome, which diet should the practical nurse reinforce with the parents?
- A. High protein.
- B. Low sodium.
- C. Low fat.
- D. High carbohydrate.
Correct answer: B
Rationale: The correct diet that the practical nurse should reinforce with the parents of a child with nephrotic syndrome is a low-sodium diet. This diet is crucial for managing fluid retention and reducing the risk of edema, which are common concerns in children with nephrotic syndrome.
4. 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.
5. A 3-year-old child is brought to the clinic by the parents who are concerned that the child is not yet potty trained. What is the nurse’s best response?
- A. Most children are potty trained by this age, so you should not be concerned
- B. Every child develops at their own pace. Let’s discuss some strategies to help
- C. Your child may need to be evaluated for developmental delays
- D. It’s best to force your child to use the potty to encourage training
Correct answer: B
Rationale: The correct answer is B because it is important to acknowledge that children develop at different rates. By offering support and discussing strategies for potty training, the nurse can provide the necessary guidance without causing unnecessary concern or pressure on the parents. Choice A is incorrect because it dismisses the parents' concerns. Choice C is incorrect because jumping to the conclusion of developmental delays without further assessment or discussion can cause undue anxiety. Choice D is incorrect because forcing a child to use the potty can lead to resistance and negative associations with potty training.
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