a child with sickle cell anemia develops severe chest pain fever a cough and dyspnea the nurses first action is to
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Nursing Elites

HESI LPN

Pediatric HESI 2023

1. A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. The nurse's first action is to

Correct answer: C

Rationale: In a child with sickle cell anemia experiencing severe chest pain, fever, cough, and dyspnea, the priority action is to suspect acute chest syndrome, a life-threatening complication. The nurse's first action should be to notify the practitioner for immediate evaluation and intervention. Administering 100% oxygen (Choice A) may be necessary later but is not the initial priority. Administering pain medication (Choice B) should not precede notifying the practitioner, as addressing the underlying cause is crucial. The symptoms described are more indicative of acute chest syndrome than a stroke, so notifying the practitioner for chest syndrome (Choice C) takes precedence over suspecting a stroke (Choice D).

2. A child with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) is being evaluated for medication management. What is an important assessment for the nurse to perform?

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing symptoms and ensuring proper nutrition in children with ADHD. Dietary factors can influence ADHD symptoms. While sleep patterns, academic performance, and behavior at home are important aspects to consider, dietary assessment plays a significant role in the management of ADHD.

3. The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). What would the nurse interpret as indicative of this disorder?

Correct answer: C

Rationale: Positive fibrin split products indicate disseminated intravascular coagulation (DIC), a condition characterized by the widespread formation of blood clots throughout the body. In DIC, clotting factors are consumed, leading to increased fibrin split products. A shortened prothrombin time (Choice A) is not typically seen in DIC as it indicates faster blood clotting, which is not consistent with the pathophysiology of DIC. An increased fibrinogen level (Choice B) is also not a characteristic finding in DIC, as fibrinogen levels may be decreased due to consumption in the formation of clots. Increased platelets (Choice D) are not typically observed in DIC; instead, thrombocytopenia (decreased platelet count) is more common due to their consumption in clot formation.

4. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 90 beats/min. What is the most appropriate initial management for this newborn?

Correct answer: A

Rationale: In a newborn, a heart rate below 100 beats/min indicates the need for positive pressure ventilation to improve oxygenation. Providing blow-by oxygen or assessing skin condition/color may not address the primary issue of inadequate oxygenation due to the low heart rate. Starting chest compressions and contacting medical control is not warranted as the newborn is breathing spontaneously and only has a slightly low heart rate, which can be managed initially with positive pressure ventilations.

5. What should the nurse include when teaching an adolescent about tinea pedis?

Correct answer: B

Rationale: The correct way to prevent tinea pedis is by keeping the feet dry, especially between the toes, to decrease the risk of fungal infection. Choice A is incorrect as keeping the feet moist can promote fungal growth. Choice C is incorrect because nylon or synthetic socks can trap moisture, contributing to the growth of fungi. Choice D is incorrect as going barefoot in public, especially in areas like locker rooms, increases the risk of contracting tinea pedis.

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