HESI RN
Pediatric HESI
1. When assessing the breath sounds of an 18-month-old child who is crying, what action should the healthcare professional take?
- A. Document that the assessment is not available because the child is crying.
- B. Ask the caregiver to quiet the child so breath sounds can be auscultated.
- C. Allow the child to play with a stethoscope to distract them during auscultation.
- D. Auscultate and document breath sounds, noting that the child was crying at the time.
Correct answer: C
Rationale: Allowing the child to play with a stethoscope can help distract them, making it easier to auscultate breath sounds. This approach can create a more cooperative and engaging environment for the child, facilitating a more accurate assessment of their breath sounds. Choice A is incorrect because it does not address the need for an assessment. Choice B is not ideal as it puts pressure on the caregiver and may not be effective in calming the child. Choice D is not the best option as it does not actively involve the child in the assessment process and may not provide an accurate representation of their breath sounds.
2. A 7-year-old child with cystic fibrosis is admitted to the hospital with a respiratory infection. The nurse is teaching the child’s parents about the importance of chest physiotherapy (CPT). Which statement by the parents indicates they need further teaching?
- A. We should perform CPT before meals.
- B. CPT will help loosen mucus in the lungs.
- C. We should perform CPT right after the child eats.
- D. CPT is an important part of our child’s treatment.
Correct answer: C
Rationale: The correct answer is C. Chest physiotherapy should not be performed right after meals to avoid inducing vomiting. It should be done before meals or at least 1 hour after for effective mucus clearance and to prevent any potential complications like vomiting. Choice A is correct as performing CPT before meals helps in loosening mucus. Choice B is also correct as CPT is indeed helpful in loosening mucus in the lungs. Choice D is correct as CPT plays a crucial role in the treatment of cystic fibrosis.
3. A child with sickle cell anemia is being treated for a vaso-occlusive crisis. Which intervention should the practical nurse (PN) implement?
- A. Apply cold packs to painful areas.
- B. Encourage increased fluid intake.
- C. Administer high doses of vitamin C.
- D. Provide low-calorie meals.
Correct answer: B
Rationale: Encouraging increased fluid intake is crucial in managing vaso-occlusive crises in patients with sickle cell anemia. Dehydration can worsen these crises, so adequate hydration is essential to prevent complications and improve outcomes. Applying cold packs to painful areas may exacerbate vaso-occlusive crises by causing vasoconstriction. Administering high doses of vitamin C is not directly indicated for vaso-occlusive crises in sickle cell anemia. Providing low-calorie meals is not the priority during a vaso-occlusive crisis; maintaining adequate nutrition is important, but hydration takes precedence in this situation.
4. After observing a mother giving her 11-month-old ferrous sulfate followed by two ounces of orange juice, what should the nurse do next?
- A. Suggest placing the iron drops in the orange juice and feed the infant.
- B. Tell the mother to follow the iron drops with formula instead of orange juice.
- C. Instruct the mother to feed the infant nothing in the next 30 minutes after the iron.
- D. Give positive feedback about the way she administered the sulfate.
Correct answer: D
Rationale: Providing positive feedback to the mother for correctly administering the iron supplements is essential as it reinforces proper medication administration practices. This encouragement can help build the mother's confidence and ensure that she continues to administer the supplements correctly in the future, promoting the infant's health and well-being. Choices A, B, and C are incorrect because there is no need to suggest altering the administration method, changing the liquid used, or restricting feeding immediately after administering the iron supplement. Giving positive feedback is the most appropriate action in this scenario to acknowledge the mother's correct administration technique.
5. The mother of an 11-year-old boy with juvenile arthritis tells the nurse, 'I really don't want my son to become dependent on pain medication, so I only allow him to take it when he is really hurting.' Which information is most important for the nurse to provide this mother?
- A. The child should be encouraged to rest when experiencing pain
- B. Encourage quiet activities such as reading as a pain distracter
- C. The use of hot baths can be used as an alternative to pain medication
- D. Giving pain medication around the clock helps control the pain
Correct answer: D
Rationale: It is crucial for the nurse to educate the mother that giving pain medication around the clock helps manage pain effectively and improves the child's quality of life. This approach ensures a more consistent level of pain relief and prevents the pain from becoming severe, which can be more challenging to manage. Choices A, B, and C do not address the importance of consistent pain management and may not provide adequate relief for the child's condition.
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