a 4 year old child is brought to the clinic with complaints of ear pain and fever the practical nurse pn suspects otitis media which symptom supports
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Nursing Elites

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?

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. What intervention should the nurse implement first for a male toddler brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin)?

Correct answer: A

Rationale: Administering activated charcoal is the priority intervention as it binds with digoxin, preventing further absorption in the gastrointestinal tract. This helps reduce the amount of digoxin available for systemic circulation and minimizes its toxic effects. Gastric lavage is no longer recommended due to potential complications and lack of evidence of efficacy. Obtaining an electrocardiogram may help assess the effects of digoxin toxicity, but it is not the initial priority. IV digoxin immune fab (Digibind) is used in severe cases of digoxin toxicity but is not the first-line intervention.

3. The nurse is preparing to administer an immunization to a 5-year-old child. The parent asks if the vaccine can be given in a different way because the child is afraid of needles. What is the nurse’s best response?

Correct answer: C

Rationale: Administering the vaccine as a nasal spray provides an alternative method of delivery that avoids the use of needles, addressing the child's fear while ensuring immunization. Nasal sprays are effective for certain vaccines and can be a suitable option in this scenario. Choice A is not the best response as it only addresses pain management but does not eliminate the use of needles. Choice B is incorrect as there are alternative delivery methods like nasal sprays. Choice D is incorrect as skipping the vaccine would leave the child unprotected and is not a recommended course of action.

4. The parents of a 10-year-old child with newly diagnosed type 1 diabetes are being taught by the nurse about managing their child’s condition. Which statement by the parents indicates they need further teaching?

Correct answer: B

Rationale: It is important for individuals with diabetes to manage their carbohydrate intake, including sugary foods and drinks, rather than completely avoiding them. Sugary foods should be consumed in moderation as part of a balanced diet to help maintain stable blood glucose levels.

5. While auscultating the lung sounds of a 5-year-old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. What action is best for the nurse to take?

Correct answer: B

Rationale: Inquiring about the use of alternative treatment methods is essential to understand cultural practices and provide holistic care. It allows the nurse to gather more information about the blemishes and potentially uncover traditional or alternative healing approaches that the family may have used. This approach demonstrates cultural sensitivity and a comprehensive assessment before making assumptions or taking further actions. Identifying the antibiotics used for treating pneumonia (Choice A) is not immediately necessary in this context as the focus is on the blemishes. Asking about a recent accident (Choice C) assumes a traumatic cause without evidence. Reporting suspected child abuse (Choice D) is premature without further assessment or evidence of abuse.

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