HESI RN
Pediatric HESI
1. Which nursing diagnosis is a priority for a 4-year-old child diagnosed with nephrotic syndrome?
- A. Impaired urinary elimination.
- B. Risk for infection.
- C. Fluid volume excess.
- D. Risk for impaired skin integrity.
Correct answer: C
Rationale: In a child with nephrotic syndrome, fluid volume excess is a priority nursing diagnosis due to the risk of edema and related complications. This patient may experience significant fluid retention, leading to edema, hypertension, and potential respiratory distress. Monitoring and managing fluid volume excess are crucial in preventing further complications and supporting the child's health during nephrotic syndrome. The other options are not the priority in this case. Impaired urinary elimination is not typically a primary concern in nephrotic syndrome. While infection is a risk due to compromised immunity, fluid volume excess poses a more immediate threat to the child's health. Risk for impaired skin integrity may be a concern secondary to edema, but addressing fluid volume excess takes precedence.
2. Which of the following is NOT a strategy for family planning?
- A. Integrating family planning services with other Reproductive Health programs
- B. Expanding access to family planning through non-public delivery systems
- C. Targeting family planning services to priority groups
- D. Expanding programs of immunization
Correct answer: D
Rationale: The correct answer is D. Expanded programs of immunization are not considered a strategy for family planning. Immunization programs focus on preventing diseases through vaccines and are distinct from family planning strategies, which aim to help individuals and couples plan their desired family size and spacing of children. Choices A, B, and C are all valid strategies for family planning. Integrating family planning services with other reproductive health programs, expanding access to family planning through non-public delivery systems, and targeting family planning services to priority groups are common approaches to improve the availability and effectiveness of family planning services.
3. A mother brings her 3-week-old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicates that the infant's vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life-threatening complication?
- A. Irregular palpable pulse
- B. Hyperactive bowel sounds
- C. Underweight for age
- D. Crying without tears
Correct answer: D
Rationale: Crying without tears is a sign of severe dehydration, which is a potentially life-threatening complication in infants with projectile vomiting. Dehydration can rapidly progress in infants, leading to serious consequences if not promptly addressed. The combination of projectile vomiting, listlessness, and absence of tears when crying should raise concerns about severe dehydration and the need for urgent intervention to prevent further complications.
4. The healthcare provider is assessing a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory findings is most consistent with this condition?
- A. Increased serum sodium
- B. Decreased urine specific gravity
- C. Decreased serum osmolality
- D. Increased serum potassium
Correct answer: C
Rationale: The correct answer is C: Decreased serum osmolality. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. The dilution of sodium results in decreased serum osmolality. Option A is incorrect because SIADH causes hyponatremia, resulting in decreased serum sodium levels. Option B is incorrect because SIADH leads to concentrated urine with increased urine specific gravity. Option D is incorrect as SIADH does not typically affect serum potassium levels.
5. A client with a history of alcoholism is admitted with confusion, ataxia, and nystagmus. Which nursing intervention is a priority for this client?
- A. Monitor for signs of alcohol withdrawal.
- B. Administer thiamine as prescribed.
- C. Provide a quiet environment to reduce confusion.
- D. Initiate fall precautions.
Correct answer: B
Rationale: The correct answer is B: Administer thiamine as prescribed. Administering thiamine is crucial in clients with a history of alcoholism to prevent Wernicke's encephalopathy, which is characterized by confusion, ataxia, and nystagmus. Monitoring for signs of alcohol withdrawal (choice A) is important but not the priority. Providing a quiet environment (choice C) and initiating fall precautions (choice D) are important interventions, but administering thiamine takes precedence due to the risk of Wernicke's encephalopathy.