a 6 year old child with sickle cell anemia presents to the emergency department with severe pain in the legs and abdomen the child is crying and state
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Nursing Elites

HESI RN

HESI Pediatric Practice Exam

1. A 6-year-old child with sickle cell anemia presents to the emergency department with severe pain in the legs and abdomen. The child is crying and states that the pain is unbearable. What is the nurse’s priority action?

Correct answer: B

Rationale: In a sickle cell crisis, pain management is a priority to alleviate the child's suffering. Administering the prescribed pain medication is crucial to address the severe pain experienced by the child. Warm compresses, encouraging fluid intake, and monitoring oxygen saturation are important interventions but should follow the priority of pain management in this situation.

2. When reviewing developmental changes with the parents of a 6-month-old infant, what information should the practical nurse reinforce?

Correct answer: C

Rationale: The correct answer is C because providing a developmentally safe environment for a 6-month-old infant is crucial as they begin to explore their surroundings more actively. This includes ensuring that the environment is free of hazards and that the infant is supervised to prevent accidents. Choice A is incorrect because self-feeding finger foods may not be developmentally appropriate for a 6-month-old infant. Choice B is incorrect as most infants are able to sit up with support around 6 months of age without the need for specific teaching strategies. Choice D is also incorrect as while appetite changes can occur, explaining a specific increase in appetite over the next 6 months is not a primary focus when discussing developmental changes with parents of a 6-month-old.

3. Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children?

Correct answer: A

Rationale: Recording the height and weight of children is crucial in detecting growth abnormalities like hypopituitarism and hyperpituitarism. Inappropriate growth patterns, such as disproportionate weight gain or stunted height, can be indicative of these conditions. Regular monitoring of height and weight is a fundamental nursing intervention that can aid in the early identification and management of pituitary-related disorders in children.

4. A 2-year-old child is admitted with severe dehydration due to gastroenteritis. Which assessment finding indicates that the child's condition is improving?

Correct answer: C

Rationale: Increased urine output is a positive sign indicating that the child's hydration status is improving. It suggests that the kidneys are functioning more effectively and able to excrete urine, which is a crucial indicator of improved hydration levels in a dehydrated patient. Decreased heart rate (Choice A) can be a sign of possible shock. A sunken fontanelle (Choice B) is a sign of dehydration. Dry mucous membranes (Choice D) are also indicative of dehydration.

5. When screening a 5-year-old for strabismus, what action should the nurse take?

Correct answer: B

Rationale: When screening a 5-year-old for strabismus, directing the child through the six cardinal positions of gaze is the most appropriate action. This method helps the nurse to assess eye alignment, which is crucial in identifying any misalignment that may indicate strabismus. Choices A, C, and D are incorrect. Having the child identify colored patterns on polychromatic cards is more related to visual acuity testing rather than strabismus screening. Inspecting the child for the setting sun sign is not a standard method for strabismus screening. Observing the child for blank, sunken eyes is not specific to strabismus assessment.

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