a 7 year old child has an altered mental status high fever and a generalized rash you perform your assessment and initiate oxygen therapy en route to
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Nursing Elites

HESI LPN

Pediatrics HESI 2023

1. A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and initiate oxygen therapy. En route to the hospital, you should be most alert for

Correct answer: B

Rationale: Seizures are a common complication in children with high fever and altered mental status, indicating a risk of febrile seizures. While vomiting can occur with altered mental status, seizures are of higher concern due to the association with febrile illnesses in children. Combativeness may be a concern in some altered mental status cases but is not as common as seizures. Respiratory distress, although important, is not the primary concern in this scenario given the symptoms presented.

2. When you attempt to assess a 22-year-old woman who has been sexually assaulted, and she orders you not to touch her, your most appropriate initial action should be to

Correct answer: B

Rationale: In this scenario, the patient has requested not to be touched, indicating a need for sensitivity and understanding. Asking a female EMT-B to attempt to assess the patient is the most appropriate initial action as it respects the patient's need for privacy, comfort, and potentially reduces re-traumatization. Asking the patient to sign a release form (Choice A) is not suitable as it disregards the patient's immediate concerns. Explaining to the patient that she must be examined (Choice C) may further distress her and violate her autonomy. Transporting the patient without performing an assessment (Choice D) ignores the patient's expressed wishes and may lead to inadequate care.

3. When teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'

Correct answer: C

Rationale: Moving a child to a regular bed by the appropriate age is not recommended as it can increase the risk of falls. Toddlers should transition to a regular bed only when developmentally ready to prevent accidents. Keeping medications in a medicine cabinet (Choice A) promotes safety by preventing accidental ingestion. Securing gates at entrances to staircases (Choice B) helps prevent falls down stairs. Buying shoes that close with Velcro rather than laces (Choice D) is a good practice to prevent tripping and falling.

4. Which of the following signs or symptoms is more common in children than adults following head trauma?

Correct answer: A

Rationale: Nausea and vomiting are more common in children following head trauma due to their higher risk of increased intracranial pressure. Children have less skull compliance and higher brain water content, making them more susceptible to developing symptoms like nausea and vomiting. Altered mental status (choice B) can occur in both children and adults but is not more common in children. Tachycardia and diaphoresis (choice C) are nonspecific and can occur in both age groups. Changes in pupillary reaction (choice D) are not typically more common in children following head trauma compared to adults.

5. The caregiver is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching?

Correct answer: B

Rationale: The correct answer is B. Setting the water heater at 130 degrees is incorrect because water heaters should be set to no higher than 120 degrees to prevent scald burns. Choice A is correct as leaving fireworks displays to professionals reduces the risk of burns. Choice C is also correct as flame-retardant sleepwear reduces the risk of burn injuries. Choice D is correct as keeping pot handles facing inward prevents accidental spills and burns.

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