HESI RN
HESI Practice Test Pediatrics
1. A 10-year-old child is being discharged after being admitted for status asthmaticus. Which instruction is most important for the nurse to include in the discharge teaching?
- A. Use a peak flow meter daily to monitor asthma control
- B. Avoid exposure to known allergens
- C. Continue taking asthma medications as prescribed
- D. Seek emergency care if symptoms worsen
Correct answer: A
Rationale: Using a peak flow meter daily is crucial as it helps monitor asthma control by measuring how well the child's lungs are functioning. This monitoring can indicate when intervention is needed before symptoms worsen or become severe, allowing for timely management of asthma exacerbations.
2. The mother of a 4-month-old asks the nurse for advice in preventing diaper rash. What suggestion should the nurse provide?
- A. At diaper change generously powder the baby's diaper area with talcum powder to promote dryness.
- B. Wash the diaper area every 2 hours with soap and water to help prevent skin breakdown.
- C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change.
- D. Place a cloth diaper inside the disposable diaper for overnight periods when increased wearing time is likely.
Correct answer: C
Rationale: Using a barrier cream like zinc oxide protects the skin and helps prevent diaper rash.
3. Why is honest information important in building a trusting relationship with adolescent patients?
- A. Encourage the adolescent to seek help outside of the school clinic.
- B. Keep disclosures from the adolescent confidential.
- C. Honest information ensures establishing a trusting relationship.
- D. Discourage minor adolescents from disclosing private concerns.
Correct answer: C
Rationale: Honesty is fundamental in building trust with adolescent patients as it helps create an environment where they feel safe to share their concerns openly. By being honest and maintaining confidentiality, healthcare providers can establish a strong and trusting relationship with adolescents, ultimately leading to better healthcare outcomes.
4. What information should the nurse provide to parents of a 3-year-old boy with Duchenne muscular dystrophy who inquire about the disease and future children?
- A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family
- B. The striated muscle groups of males can be impacted by a lack of the protein dystrophin in their mothers
- C. The male infant had a viral infection that went unnoticed and untreated so muscle damage was incurred
- D. Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles
Correct answer: A
Rationale: Duchenne muscular dystrophy is an X-linked recessive disorder caused by mutations in the DMD gene on the X chromosome. This disorder primarily affects males because they have one X chromosome, inherited from their mothers, who may be carriers of the mutated gene. Females have two X chromosomes, providing a protective effect as the normal gene on one X chromosome can compensate for the mutated gene on the other. Therefore, the nurse should explain to the parents that Duchenne muscular dystrophy is an inherited X-linked recessive disorder, which is why their son has the disease and why there is a risk of passing it on to future sons. Choice B is incorrect as it inaccurately implies that the lack of dystrophin in mothers impacts their sons' muscle groups. Choice C is incorrect as it suggests a viral infection caused the muscle damage, which is not the case with Duchenne muscular dystrophy. Choice D is incorrect as it attributes the muscle weakness to birth trauma instead of the genetic nature of the disorder.
5. In a 6-year-old child with asthma experiencing difficulty breathing and using accessory muscles to breathe with a peak flow reading in the red zone, what should the nurse do first?
- A. Administer a nebulized bronchodilator
- B. Obtain an arterial blood gas
- C. Start the child on oxygen therapy
- D. Contact the healthcare provider
Correct answer: A
Rationale: The correct action for a 6-year-old child with asthma who is experiencing difficulty breathing, using accessory muscles to breathe, and has a peak flow reading in the red zone is to administer a nebulized bronchodilator first. Nebulized bronchodilators work rapidly to open up the airways, providing immediate relief and improving breathing. This intervention is crucial in addressing the acute respiratory distress the child is facing. Obtaining an arterial blood gas, starting oxygen therapy, or contacting the healthcare provider can be considered after the initial administration of the bronchodilator, as they are not the primary interventions needed to manage the child's acute respiratory distress.
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