a 16 yo female student with a history of asthma controlled with both an oral antihistamine and an albuterol provenfil metere dose inhaler mdi comes to
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Nursing Elites

HESI RN

HESI Practice Test Pediatrics

1. A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (ProAir) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky, and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?

Correct answer: D

Rationale: The most crucial information for the nurse to obtain in this scenario is how often the metered-dose inhaler (MDI) is used daily. This information will help assess if the symptoms of insomnia, shakiness, and palpitations are potentially related to overuse of the inhaler, which can cause side effects such as tremors and palpitations. Monitoring the frequency of MDI usage is essential in managing asthma and ensuring appropriate medication administration.

2. A child with sickle cell anemia is being treated for a vaso-occlusive crisis. Which intervention should the practical nurse (PN) implement?

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.

3. The mother of a 9-month-old, diagnosed with respiratory syncytial virus (RSV) yesterday, calls the clinic to inquire if it will be all right to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide this mother?

Correct answer: D

Rationale: The correct answer is D. RSV is highly contagious, even without direct contact. It is important to prevent the spread of the virus to other children, so the infected child should not attend the birthday party to avoid exposing other children to RSV. This is crucial to protect the health of other children who may be more vulnerable to the virus. Choices A, B, and C are incorrect. Choice A is incorrect as RSV remains contagious for a period of time, and precautions should be taken to prevent its spread. Choice B is incorrect because the age limit specified is not a reliable measure to prevent transmission. Choice C is incorrect as wearing a mask may not be sufficient to prevent the spread of RSV in a social setting like a birthday party.

4. A 10-year-old child is admitted with diabetic ketoacidosis (DKA). Which laboratory value should the practical nurse (PN) anticipate?

Correct answer: A

Rationale: In a case of diabetic ketoacidosis (DKA), the primary feature is elevated blood glucose levels due to insulin deficiency. Additionally, ketones are increased in the blood and urine. Bicarbonate levels are usually low because of the metabolic acidosis that accompanies DKA. Therefore, the practical nurse should anticipate elevated blood glucose levels as a characteristic laboratory finding in a child admitted with DKA. Choice B is incorrect because serum ketones are increased in DKA. Choice C is incorrect because in DKA, urine glucose is typically high due to spillage of glucose into the urine. Choice D is incorrect because bicarbonate levels are usually low in DKA, not high.

5. The parents of a 2-year-old child with a history of febrile seizures are being taught by the healthcare provider. Which statement by the parents indicates a need for further teaching?

Correct answer: B

Rationale: Placing a child in a cool bath during a seizure is not recommended as it can be dangerous and may lead to accidental drowning or injuries. The priority during a febrile seizure is to ensure the safety of the child by placing them on a soft surface, removing any nearby objects that may cause harm, and gently turning their head to the side to prevent aspiration. Cooling measures like removing excess clothing can be employed, but immersing the child in a cool bath is not advised. Calling 911 if the seizure lasts longer than 5 minutes is important to seek immediate medical assistance. Administering acetaminophen to reduce fever and trying to keep the child's fever under control are appropriate interventions which should be continued.

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