HESI RN
Pediatric HESI
1. What is the most important information for the PN to reinforce with the parents when caring for a child diagnosed with acute rheumatic fever?
- A. Complete the full course of prescribed antibiotics.
- B. Ensure the child gets plenty of physical exercise.
- C. Keep the child on a low-sodium diet.
- D. Administer prescribed pain medications as needed.
Correct answer: A
Rationale: Completing the full course of antibiotics is crucial in the management of acute rheumatic fever as it helps prevent recurrence and complications. Antibiotics are essential in eradicating the underlying infection that triggers the autoimmune response leading to rheumatic fever. Reinforcing the importance of completing the prescribed antibiotic regimen is vital to ensure the child's recovery and prevent further health issues. Choices B, C, and D are not as critical as completing the antibiotic treatment. While physical exercise, a low-sodium diet, and pain management are important aspects of overall health, they are not the primary focus when managing acute rheumatic fever.
2. A mother brings her 3-month-old infant to the clinic, concerned about frequent vomiting after feeding. The practical nurse (PN) suspects gastroesophageal reflux (GER). Which recommendation should the PN provide to the mother?
- A. Feed the infant in a prone position.
- B. Provide larger, less frequent feedings.
- C. Keep the infant upright for 30 minutes after feeding.
- D. Offer only formula thickened with rice cereal.
Correct answer: C
Rationale: The correct recommendation for reducing symptoms of gastroesophageal reflux (GER) in infants is to keep the infant upright for 30 minutes after feeding. This position helps prevent the backflow of stomach contents, alleviating symptoms of reflux. Placing the infant in a prone position or providing larger, less frequent feedings may worsen symptoms by increasing the likelihood of regurgitation. Offering only formula thickened with rice cereal is not the first-line intervention for GER and should not be recommended initially.
3. A 6-year-old child with a history of asthma is brought to the clinic with complaints of wheezing and shortness of breath. The nurse notes that the child is using accessory muscles to breathe. What should the nurse do first?
- A. Administer a bronchodilator
- B. Obtain a peak flow reading
- C. Apply oxygen
- D. Perform a complete respiratory assessment
Correct answer: A
Rationale: Administering a bronchodilator is the initial priority as it helps open the child's airways, reducing the wheezing and shortness of breath. This intervention aims to provide immediate relief and improve the child's respiratory distress. Obtaining a peak flow reading or applying oxygen may be necessary after administering the bronchodilator, but the priority is to address the acute symptoms of wheezing and shortness of breath first. Performing a complete respiratory assessment can be done after the immediate intervention of administering the bronchodilator to further evaluate the child's respiratory status.
4. The healthcare provider is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective?
- A. Creamed corn.
- B. Pancakes.
- C. Rye crackers.
- D. Cooked oatmeal.
Correct answer: A
Rationale: Creamed corn is a gluten-free food, making it a suitable option for clients with celiac disease. This choice indicates effective diet teaching as it aligns with the dietary restrictions necessary for managing the condition. Pancakes, rye crackers, and cooked oatmeal contain gluten, which is harmful to individuals with celiac disease. Therefore, they are not suitable choices and would not indicate effective teaching for a client with this condition.
5. A 7-year-old child with a history of asthma presents to the clinic with shortness of breath and wheezing. The nurse notes that the child’s peak flow reading is in the red zone. What should the nurse do first?
- A. Administer a bronchodilator
- B. Reassess the peak flow reading
- C. Notify the healthcare provider
- D. Provide oxygen therapy
Correct answer: A
Rationale: When a child with asthma presents with shortness of breath and wheezing, and the peak flow reading is in the red zone, indicating severe airflow limitation, the priority intervention is to administer a bronchodilator. Bronchodilators help dilate the airways quickly, improving airflow and assisting with breathing. Reassessing the peak flow reading is important but not the first action to take in a severe asthma exacerbation. Notifying the healthcare provider can be done after initiating immediate treatment with a bronchodilator. Providing oxygen therapy may be needed in some cases, but addressing the airway constriction with a bronchodilator should come first to improve ventilation.
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