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Pediatrics HESI 2023
1. What should an adolescent with type 1 diabetes do if an insulin reaction is experienced while at a basketball game?
- A. Call your parents immediately.
- B. Buy a soda and hamburger to eat.
- C. Administer insulin as soon as possible.
- D. Leave the arena and rest until the symptoms subside.
Correct answer: B
Rationale: Choosing option B, 'Buy a soda and hamburger to eat,' is the most appropriate action for an adolescent with type 1 diabetes experiencing an insulin reaction during a basketball game. In this situation, the individual is likely experiencing hypoglycemia, and consuming a soda provides a quick source of sugar to raise blood glucose levels rapidly. The hamburger can offer a more sustained release of energy due to its protein and fat content. Option A is incorrect because while contacting parents for help may be necessary in some situations, immediate action to address hypoglycemia is crucial. Option C is incorrect because administering insulin would further lower blood sugar levels, worsening the condition. Option D is incorrect as leaving the arena without addressing the hypoglycemia can lead to a worsening of symptoms and potentially dangerous outcomes.
2. A child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?
- A. Avoid spicy foods
- B. Avoid gluten
- C. Avoid high-fat foods
- D. Avoid dairy products
Correct answer: B
Rationale: The correct dietary instruction for a child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye, and it can exacerbate GERD symptoms in some individuals. Avoiding gluten can help reduce inflammation and irritation in the gastrointestinal tract, thereby alleviating symptoms of GERD. Choices A, C, and D are incorrect because while spicy foods, high-fat foods, and dairy products can trigger GERD symptoms in some individuals, avoiding gluten specifically is more relevant for managing GERD.
3. At 2 years of age, a child is readmitted to the hospital for additional surgery. What is the most important factor in preparing the toddler for this experience?
- A. Meeting the child’s wishes
- B. Previous hospitalization experience
- C. Preventing the child from staying with strangers
- D. Ensuring ongoing parental affection
Correct answer: B
Rationale: The most important factor in preparing a toddler for additional surgery is their previous hospitalization experience. This familiarity with the hospital setting and procedures can help reduce anxiety and fear in the child. Choice A, meeting the child's wishes, may not always align with what is medically necessary or safe for the child. Choice C, preventing the child from staying with strangers, is important for general comfort but may not directly address the child's preparation for surgery. Choice D, ensuring ongoing parental affection, is crucial for emotional support but may not have the same impact as the child's previous hospitalization experience in preparing them for the surgery.
4. The nurse is counseling a young couple who in 2 months are having their third baby. The nurse uses Von Bertalanffy's general system theory applied to families to analyze the family structure. Which best describes the main emphasis of this theory and its application to family dynamics?
- A. It emphasizes the family as a system with interdependent, interacting parts that endure over time to ensure the survival, continuity, and growth of its components.
- B. It emphasizes the social system of the family, such as the organization or structure of the family and how the structure relates to its function.
- C. It emphasizes the developmental stages that all families go through, beginning with marriage; the longitudinal career of the family is also known as the family life cycle.
- D. It addresses how families respond to stress and how the family copes with stress as a group and how each individual member copes.
Correct answer: A
Rationale: Von Bertalanffy's general system theory applied to families emphasizes the family as a system with interdependent, interacting parts that endure over time to ensure the survival, continuity, and growth of its components. This theory focuses on viewing the family as a dynamic system where each member's actions and behaviors impact the whole family unit. Choice B is incorrect as it focuses solely on the social system of the family, while Von Bertalanffy's theory looks at the family as a whole system. Choice C is incorrect as it discusses family developmental stages, which is not the main emphasis of Von Bertalanffy's theory. Choice D is also incorrect as it only addresses how families respond to stress, which is a narrower focus compared to the broader system view of Von Bertalanffy's theory.
5. A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?
- A. Child is in the concrete operational stage of cognition.
- B. Child’s dependence on peer influence is increasing.
- C. Child will welcome opportunities for participation in self-care.
- D. Child is exploring their sense of self-identity.
Correct answer: C
Rationale: The correct answer is C. At the age of 8, children are typically eager to take on responsibilities and participate in self-care activities. This is a crucial developmental characteristic to consider when educating a child about managing a chronic condition like type 1 diabetes. Choice A is incorrect as children at this age are usually in the concrete operational stage, not abstract level, of cognition. Choice B is incorrect because while peer influence is important, it does not reach its peak at this age. Choice D is incorrect as exploring self-identity is more characteristic of adolescence, not 8-year-old children.
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