HESI RN
Pediatric HESI
1. According to Erikson's theory, what behavioral pattern should be displayed by a child who has not developed a sense of competence?
- A. Guilt.
- B. Shame.
- C. Alienation.
- D. Inferiority.
Correct answer: D
Rationale: Erikson's theory of psychosocial development outlines that the failure to establish a sense of competence during the industry vs. inferiority stage results in feelings of inferiority. This stage occurs during middle childhood where children strive to master skills and tasks. If they are unable to meet challenges successfully, they may start feeling inferior to their peers and may lack confidence in their abilities. Choices A, B, and C are incorrect as guilt, shame, and alienation are not the specific behavioral patterns associated with the lack of developing a sense of competence according to Erikson's theory.
2. After reinforcing information on treating a sprained ankle, what statement by the adolescent indicates to the practical nurse that further instruction is needed?
- A. Keep the leg elevated when sitting.
- B. Wrap the ankle in an elastic bandage for support.
- C. Apply warm compresses to the ankle for the first 24 hours.
- D. Put an ice pack on the ankle, alternating 30 minutes on and 30 minutes off.
Correct answer: C
Rationale: The correct answer is C. Applying warm compresses to a sprained ankle within the first 24 hours is incorrect as it can increase swelling and inflammation. Instead, cold compresses are recommended to help reduce swelling and pain. Option A, keeping the leg elevated, helps in reducing swelling. Option B, wrapping the ankle in an elastic bandage, provides support. Option D, using an ice pack in intervals, is effective in reducing swelling and pain. Therefore, the statement about applying warm compresses indicates the need for further instruction.
3. When should a mother introduce solid foods to her infant? The mother of a 4-month-old baby girl asks the nurse when she should introduce solid foods to her infant. The mother states, 'My mother says I should put rice cereal in the baby’s bottle now.' The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?
- A. Stops rooting when hungry
- B. Opens mouth when food comes her way
- C. Awakens once for nighttime feedings
- D. Gives up a bottle for a cup
Correct answer: B
Rationale: The correct answer is 'B: Opens mouth when food comes her way.' Readiness for solid foods is indicated by the infant showing interest in food and being able to sit up with support. This behavior demonstrates the infant's readiness to start introducing solid foods in their diet. Choices A, C, and D are incorrect because stopping rooting when hungry, awakening once for nighttime feedings, and giving up a bottle for a cup are not indicators of readiness for solid foods in infants.
4. The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours; it is now 76 bpm, whereas the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider?
- A. Oxygen saturation of 94%.
- B. Respiratory rate of 25 breaths/minute.
- C. Urine output of 20 mL/hr.
- D. Blood pressure of 70/40.
Correct answer: D
Rationale: A significant drop in heart rate and blood pressure should be reported immediately as it may indicate worsening of the congenital heart defect. A decrease in blood pressure to 70/40 is a critical finding that suggests potential cardiovascular compromise and requires urgent attention to prevent further deterioration. Oxygen saturation, respiratory rate, and urine output are important parameters, but in this scenario, the alarming decrease in blood pressure is a more critical finding that necessitates immediate reporting to the healthcare provider.
5. A 10-year-old child is brought to the emergency department after falling from a bicycle and hitting their head. The nurse notes that the child is drowsy and has a headache. What is the nurse’s priority action?
- A. Perform a full neurological assessment
- B. Administer pain medication
- C. Allow the child to rest quietly
- D. Check the child's immunization status
Correct answer: A
Rationale: In a child who has fallen and hit their head, presenting with drowsiness and headache, the priority action for the nurse is to perform a full neurological assessment. This is crucial to evaluate the extent of the head injury and monitor for signs of increased intracranial pressure, which could indicate a more severe traumatic brain injury. Administering pain medication or allowing the child to rest quietly are not appropriate initial actions without first assessing the neurological status. Checking the child's immunization status is important for overall health but is not the priority in this acute situation.
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