HESI RN
HESI Pediatrics Practice Exam
1. What information should be reinforced with the mother of a child with ringworm (Tinea)?
- A. Ringworm is not contagious.
- B. Tinea infections are indicative of poor hygiene and uncleanliness.
- C. Tinea infections are spread by direct and indirect contact.
- D. Ringworm often subsides spontaneously.
Correct answer: C
Rationale: The correct answer is C. Ringworm, a fungal infection, is highly contagious and can be spread by direct contact with infected individuals or animals and indirectly through contaminated objects. It is important for the mother to understand the modes of transmission to prevent the spread of the infection to others and to take necessary precautions to ensure proper treatment and containment of the condition. Choices A and D are incorrect because ringworm is indeed contagious, and it may not always subside spontaneously. Choice B is misleading as tinea infections are not solely indicative of poor hygiene; they can affect anyone, regardless of personal cleanliness.
2. A 4-month-old girl is brought to the clinic by her mother because she has had a cold for 2 to 3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress?
- A. Bilateral bronchial breath sounds.
- B. Diaphragmatic respiration.
- C. A resting respiratory rate of 35 breaths per minute.
- D. Flaring of the nares.
Correct answer: D
Rationale: Flaring of the nares is a clinical sign of acute respiratory distress in infants. It indicates an increased effort to breathe and is a crucial finding that requires immediate attention, as it signifies the child is having difficulty breathing and may be in respiratory distress. Choices A, B, and C are incorrect. Bilateral bronchial breath sounds may be present in conditions like pneumonia but do not specifically indicate acute respiratory distress. Diaphragmatic respiration is a normal breathing pattern and not a sign of distress. A resting respiratory rate of 35 breaths per minute in a 4-month-old infant is within the expected range, so it does not necessarily indicate acute respiratory distress.
3. While auscultating the lung sounds of a 5-year-old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. What action is best for the nurse to take?
- A. Identify the antibiotics used for treating the pneumonia.
- B. Inquire about the use of alternative treatment methods.
- C. Ask the parents if the child has been in a recent accident.
- D. Report suspected child abuse to the authorities.
Correct answer: B
Rationale: Inquiring about the use of alternative treatment methods is essential to understand cultural practices and provide holistic care. It allows the nurse to gather more information about the blemishes and potentially uncover traditional or alternative healing approaches that the family may have used. This approach demonstrates cultural sensitivity and a comprehensive assessment before making assumptions or taking further actions. Identifying the antibiotics used for treating pneumonia (Choice A) is not immediately necessary in this context as the focus is on the blemishes. Asking about a recent accident (Choice C) assumes a traumatic cause without evidence. Reporting suspected child abuse (Choice D) is premature without further assessment or evidence of abuse.
4. What instructions should the nurse provide to the parents about the treatment of head lice in a 3-year-old boy who has been confirmed to have head lice?
- A. Wash the child's bed linens and clothing in hot soapy water.
- B. Dispose of the child's brushes, combs, and other hair accessories.
- C. Rewash the child's hair following a 24-hour isolation period.
- D. Take the child to a hair salon for a shampoo and shorter haircut.
Correct answer: A
Rationale: The correct instruction for the nurse to provide to the parents is to wash the child's bed linens and clothing in hot soapy water. This is essential to eliminate head lice as they can survive on bedding and clothing. It is also important to wash any other items that the child may have used or come into contact with, such as brushes and combs, to prevent reinfestation. Rewashing the child's hair following an isolation period is not necessary, and taking the child to a hair salon for a shampoo and shorter haircut is not a recommended treatment for head lice.
5. A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment of the girl is most important for the nurse to obtain?
- A. Understanding of the quality control process used to troubleshoot the pump
- B. Interpretation of fingerstick glucose levels that influence diet selections
- C. Knowledge of her glycosylated hemoglobin A1c levels for the past year
- D. Ability to perform the pump for basal insulin with mealtime boluses
Correct answer: A
Rationale: In a patient transitioning to an insulin pump, understanding the quality control process to troubleshoot the pump is crucial for ensuring proper and safe management of diabetes. This knowledge enables the individual to identify and address any issues that may arise with the pump, helping maintain optimal glycemic control and prevent complications. Choices B, C, and D, although important in diabetes management, are not as critical as ensuring the correct understanding of troubleshooting the pump, which directly impacts the girl's ability to effectively use the pump for insulin delivery.
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