HESI RN
Pediatric HESI
1. A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist agent albuterol (Proventil). The child's mother tells the nurse that she uses this medication to open her son's airway when he is having trouble breathing. What is the nurse's best response?
- A. Recommend that the mother bring the child in for immediate evaluation
- B. Advise the mother that overuse of the drug may cause chronic bronchitis
- C. Assure the mother that she is using the medication correctly
- D. Confirm that the medication helps to reduce airway inflammation
Correct answer: C
Rationale: The nurse's priority is to reassure the mother that she is using albuterol correctly to open her son's airways during episodes of difficulty breathing. This reassurance helps build trust and ensures that the child receives the intended benefit of the medication. The answer choice recommending immediate evaluation (A) is not appropriate at this point as the mother is using the medication as prescribed. Advising about overuse causing chronic bronchitis (B) is incorrect and may cause unnecessary alarm. Confirming that the medication helps reduce airway inflammation (D) is not the best response because albuterol is a beta-adrenergic agonist used primarily for bronchodilation in acute asthma exacerbations, rather than for reducing inflammation.
2. A 3-year-old child is brought to the clinic by the parents who are concerned that the child is not yet potty trained. What is the nurse’s best response?
- A. Most children are potty trained by this age, so you should not be concerned
- B. Every child develops at their own pace. Let’s discuss some strategies to help
- C. Your child may need to be evaluated for developmental delays
- D. It’s best to force your child to use the potty to encourage training
Correct answer: B
Rationale: The correct answer is B because it is important to acknowledge that children develop at different rates. By offering support and discussing strategies for potty training, the nurse can provide the necessary guidance without causing unnecessary concern or pressure on the parents. Choice A is incorrect because it dismisses the parents' concerns. Choice C is incorrect because jumping to the conclusion of developmental delays without further assessment or discussion can cause undue anxiety. Choice D is incorrect because forcing a child to use the potty can lead to resistance and negative associations with potty training.
3. The nurse is assessing a 3-month-old infant who was brought to the clinic by the parents due to concerns about the infant’s feeding. The parents report that the infant has been vomiting after every feeding and has not gained any weight. What should the nurse assess first?
- A. Evaluate the infant’s feeding technique
- B. Check the infant’s hydration status
- C. Measure the infant’s abdominal circumference
- D. Review the infant’s growth chart
Correct answer: B
Rationale: Assessing hydration status is crucial in an infant who is vomiting frequently, as dehydration can quickly become a serious issue. In this scenario, the infant's inability to retain feeds and lack of weight gain may indicate a potential risk of dehydration, making it essential to prioritize checking the infant's hydration status to prevent complications. Evaluating the feeding technique (Choice A) could be important but is secondary to addressing potential dehydration. Measuring the abdominal circumference (Choice C) and reviewing the growth chart (Choice D) are not the priority in this situation where dehydration is a primary concern.
4. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child’s plan of care?
- A. Obtain vital signs to monitor for fluid overload
- B. Change IV site dressing every 3 days and as needed
- C. Monitor for signs of facial swelling or urticaria
- D. Assess for abdominal pain and vomiting
Correct answer: C
Rationale: Monitoring for signs of an allergic reaction, such as facial swelling or urticaria, is crucial when administering antibiotics like azithromycin. It is important to watch for these signs to promptly identify and manage any potential adverse reactions during the course of treatment.
5. The infant scheduled for reduction of intussusception passes a soft-formed brown stool the day before the scheduled procedure. Which intervention should the nurse implement?
- A. Instruct the parents that the infant needs to be NPO.
- B. Notify the healthcare provider of the passage of brown stool.
- C. Obtain a stool specimen for laboratory analysis.
- D. Ask the parents about recent changes in the infant's diet.
Correct answer: B
Rationale: Notifying the healthcare provider is crucial in this situation because the passage of a brown stool may indicate the resolution of intussusception. It is important to keep the healthcare provider informed about any changes in the infant's condition to ensure appropriate care and management. Instructing the parents that the infant needs to be NPO (nothing by mouth) is not necessary based on the passage of brown stool. Obtaining a stool specimen for laboratory analysis is not indicated in this scenario since the brown stool is likely a positive sign. Asking about recent changes in the infant's diet is not the priority at this moment as notifying the healthcare provider takes precedence.
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