HESI RN
HESI Pediatric Practice Exam
1. A 4-year-old child is brought to the clinic with complaints of ear pain and fever. The practical nurse suspects otitis media. Which symptom supports this suspicion?
- A. Clear nasal discharge.
- B. Dry, hacking cough.
- C. Tugging at the ear.
- D. Sore throat.
Correct answer: C
Rationale: Tugging at the ear is a common symptom in children with otitis media. It often indicates discomfort or pain in the ear, suggesting inflammation or infection in the middle ear. This behavior is frequently observed in young children who are unable to express their discomfort verbally, making it a significant clinical indicator for otitis media in this age group. Clear nasal discharge (Choice A) is more indicative of a cold or allergies, while a dry, hacking cough (Choice B) is not typically associated with otitis media. Although a sore throat (Choice D) can sometimes accompany ear infections, tugging at the ear is a more specific and reliable symptom in this case.
2. During a well baby visit, the parents explain that a soft bulge appears in the groin of their 4-month-old son when he cries or strains during stooling. The infant is scheduled for surgical repair of the inguinal hernia in two weeks. What should the parent be instructed to do if the hernia becomes incarcerated prior to the surgery?
- A. Use a rectal thermometer to strain during stooling.
- B. Gently manipulate the hernia for reduction.
- C. Offer oral electrolyte fluids for comfort.
- D. Give acetaminophen or aspirin for crying.
Correct answer: B
Rationale: In the case of an incarcerated inguinal hernia, gentle manipulation can sometimes help in reducing it before surgery. This action should be taken cautiously and immediately followed by seeking medical attention. It is important to note that attempting reduction should be done by a healthcare professional, and parents should be advised to seek urgent medical care if the hernia becomes incarcerated. Using a rectal thermometer to strain during stooling (Choice A) is not the correct approach for an incarcerated hernia and can worsen the condition. Offering oral electrolyte fluids for comfort (Choice C) or giving acetaminophen or aspirin for crying (Choice D) are not appropriate interventions for an incarcerated hernia and may delay necessary medical treatment.
3. The mother calls the clinic and tells the practical nurse (PN) that her child cannot swallow a prescribed tablet that was dispensed by the local pharmacy as a whole tablet. How should the PN respond?
- A. You can crush the tablet and mix it with food.
- B. You should not force the child to swallow the tablets by holding her nose closed.
- C. If a liquid form is available, the pharmacist can be contacted for a prescription change.
- D. Do not advise the child to chew the tablet if she cannot swallow it.
Correct answer: C
Rationale: When a child is unable to swallow a tablet, the appropriate response is to consider if a liquid form of the medication is available. This is a safer and more effective alternative than forcing the child to swallow or chew the tablet. Contacting the pharmacist for a prescription change can provide a suitable solution that ensures the child receives the medication in a more manageable form. Choices A, B, and D are incorrect because crushing the tablet and mixing it with food may alter the medication's effectiveness or taste, forcing the child to swallow or holding her nose closed can be distressing and ineffective, and advising the child to chew the tablet is not recommended as an alternative to swallowing it.
4. A 9-year-old child is brought to the clinic with complaints of fatigue, pallor, and shortness of breath. The nurse notes that the child has a history of iron-deficiency anemia. What is the nurse’s priority action?
- A. Administer iron supplements as prescribed
- B. Monitor the child’s hemoglobin levels
- C. Educate the parents about dietary sources of iron
- D. Notify the healthcare provider
Correct answer: A
Rationale: In a child with a history of iron-deficiency anemia presenting with symptoms of fatigue, pallor, and shortness of breath, the priority action for the nurse is to administer iron supplements as prescribed. Iron supplementation is essential to treat iron-deficiency anemia and improve the child's symptoms promptly. Monitoring hemoglobin levels is important but administering iron supplements takes precedence to address the underlying cause. Educating parents about dietary iron sources is valuable for prevention but not the immediate priority. Notifying the healthcare provider may be necessary but should not delay the initiation of treatment with iron supplements.
5. The healthcare provider is preparing a teaching plan for the parents of a 6-month-old infant with GERD. What instruction should the healthcare provider include when teaching the parents measures to promote adequate nutrition?
- A. Alternate glucose water with formula
- B. Mix the formula with rice cereal
- C. Add multivitamins with iron to the formula
- D. Use water to dilute the formula
Correct answer: B
Rationale: The correct instruction for promoting adequate nutrition in a 6-month-old infant with GERD is to mix the formula with rice cereal. This thickens the feed, reducing the risk of reflux, aiding in proper nutrition, and minimizing GERD symptoms. Choices A, C, and D are incorrect. Alternating glucose water with formula, adding multivitamins with iron to the formula, or diluting the formula with water are not recommended measures for promoting adequate nutrition in infants with GERD.
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