HESI RN
HESI Pediatric Practice Exam
1. When teaching parents of a 5-year-old child with sickle cell anemia about pain management, what information should be included?
- A. Apply cold compresses to painful areas.
- B. Encourage the child to rest as much as possible.
- C. Administer prescribed pain medication at the first sign of pain.
- D. Offer a high-protein diet to help with pain management.
Correct answer: C
Rationale: Administering prescribed pain medication at the first sign of pain is crucial in managing sickle cell anemia-related pain effectively. Prompt administration helps prevent the pain from escalating and becoming severe, enhancing the child's comfort and quality of life. Cold compresses, rest, and diet modifications may play supportive roles but are not as directly impactful in addressing acute pain episodes associated with sickle cell anemia. Therefore, while comforting measures like cold compresses and rest are helpful, they should not replace the importance of timely administration of prescribed pain medication. Additionally, offering a high-protein diet, although important for overall health, is not directly linked to managing acute pain in sickle cell anemia.
2. A male client with bipolar disorder tells the nurse that he needs to 'make some deals so that he can improve his retirement savings.' Based on this information, which client outcome should the nurse include in the plan of care?
- A. Delay business decisions until his mania subsides.
- B. Identify the feelings associated with his behaviors.
- C. Seek legal counsel when making business decisions.
- D. Describe why he is feeling fearful about his finances.
Correct answer: A
Rationale: In individuals with bipolar disorder experiencing mania, impulsivity and poor judgment are common. Delaying business decisions until the mania subsides is crucial to prevent impulsive and potentially harmful financial choices. Choice B, identifying feelings associated with behaviors, may be important but does not directly address the immediate need to prevent risky financial decisions. Seeking legal counsel (Choice C) may be appropriate in some situations but is not the priority in managing acute mania. Describing why he feels fearful about finances (Choice D) is relevant for understanding emotions but does not address the immediate risk of impulsive financial actions during mania.
3. The nurse is caring for a postpartum client who is exhibiting symptoms of a spinal headache 24 hours following the delivery of a normal newborn. Prior to the anesthesiologist's arrival on the unit, which action should the nurse perform?
- A. Apply an abdominal binder.
- B. Cleanse the spinal injection site.
- C. Insert an indwelling Foley catheter.
- D. Place procedure equipment at the bedside.
Correct answer: A
Rationale: In a postpartum client exhibiting symptoms of a spinal headache, applying an abdominal binder is a priority action. The abdominal binder can help reduce the severity of a spinal headache by increasing intra-abdominal pressure, which may relieve pressure on the dural sac and alleviate symptoms. This intervention can be performed promptly by the nurse to provide immediate relief while waiting for further evaluation and management by the anesthesiologist. Cleansing the spinal injection site (Choice B) is not the priority in this situation as the headache is likely due to a dural puncture during epidural anesthesia rather than infection. Inserting an indwelling Foley catheter (Choice C) and placing procedure equipment at the bedside (Choice D) are not the appropriate actions to address a spinal headache and should not take precedence over applying an abdominal binder.
4. In a client with congestive heart failure, the nurse would be correct in withholding a dose of digoxin without specific instruction from the healthcare provider if the client's
- A. serum digoxin level is 1.5 ng/mL.
- B. blood pressure is 104/68 mmHg.
- C. serum potassium level is 3 mEq/L.
- D. apical pulse is 68/min.
Correct answer: C
Rationale: The correct answer is C. Hypokalemia can precipitate digitalis toxicity in individuals on digoxin, increasing the risk of dangerous dysrhythmias. A serum potassium level of 3 mEq/L is below the normal range (3.5 to 5.5 mEq/L) and indicates hypokalemia, which can potentiate the effects of digoxin. Choices A, B, and D are not directly related to the potential for digitalis toxicity. Serum digoxin level of 1.5 ng/mL is within the therapeutic range, blood pressure of 104/68 mmHg is not a contraindication for administering digoxin, and an apical pulse of 68/min is within the normal range and not a reason to withhold digoxin.
5. The nurse is caring for a client with DM who is experiencing ketoacidosis. The nurse should prioritize which action?
- A. Administering insulin intravenously.
- B. Giving the client sips of water.
- C. Monitoring the client's urine output.
- D. Applying a heating pad to the client's abdomen.
Correct answer: A
Rationale: Administering insulin intravenously is the priority action for managing diabetic ketoacidosis. Insulin helps lower blood glucose levels and halts the production of ketones, addressing the underlying cause of ketoacidosis. Giving sips of water (Choice B) may be necessary for hydration, but it does not address the immediate life-threatening issue of ketoacidosis. Monitoring urine output (Choice C) is important for assessing renal function but is not the priority over administering insulin. Applying a heating pad (Choice D) is not indicated and can potentially worsen the condition in ketoacidosis.