HESI RN
HESI Pediatric Practice Exam
1. What action should be taken by the healthcare provider for a child who has ingested a corrosive product?
- A. Induce vomiting using Ipecac to remove the corrosive agent.
- B. Administer vinegar or lemon juice to neutralize the caustic agent.
- C. Give activated charcoal to decontaminate the stomach.
- D. Telephone the poison control center and follow their advice.
Correct answer: D
Rationale: In cases of corrosive product ingestion, it is crucial to contact the poison control center for guidance. Inducing vomiting or attempting to neutralize the agent can lead to further harm. The poison control center professionals are trained to provide specific instructions tailored to the situation, ensuring the best possible outcome for the child. Therefore, the correct action is to call the poison control center for appropriate advice. Inducing vomiting can cause additional damage by re-exposing the esophagus and mouth to the corrosive substance. Administering vinegar or lemon juice is not recommended as it may worsen the situation by causing a chemical reaction. While activated charcoal can be useful in some cases of poisoning, it is not recommended for corrosive substances as it is ineffective in binding to them.
2. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child's plan of care?
- A. Obtain vital signs to monitor for fluid overload
- B. Change IV site dressing every 3 days and as needed
- C. Monitor for signs of facial swelling or urticaria
- D. Assess for abdominal pain and vomiting
Correct answer: C
Rationale: When administering azithromycin IV, monitoring for signs of an allergic reaction, such as facial swelling or urticaria, is crucial. This helps in early detection of potential adverse reactions and ensures prompt intervention to prevent complications associated with the medication. The other options are not directly related to the administration of azithromycin IV in this scenario. Monitoring for fluid overload would be more relevant for fluid administration, changing IV site dressing is important but not the priority in this case, and assessing for abdominal pain and vomiting may be important but not as critical as monitoring for signs of an allergic reaction.
3. The practical nurse is reinforcing education with the parents of a child prescribed iron supplements for iron-deficiency anemia. Which statement by the parents indicates they need further instruction?
- A. We will give the iron supplement with milk to reduce stomach upset.
- B. We should give the iron supplement with orange juice to improve absorption.
- C. The supplement may cause the stools to appear dark or black.
- D. We should store the iron supplements out of reach of children.
Correct answer: A
Rationale: Iron supplements should not be given with milk as calcium can interfere with iron absorption. Instead, it is recommended to give it with a source of vitamin C, such as orange juice, to enhance iron absorption. Giving iron supplements with milk may decrease the absorption of iron and should be avoided. Choice B is the correct method to improve iron absorption. Choice C is correct as iron supplements can cause dark or black stools due to unabsorbed iron. Choice D is also correct as iron supplements should always be stored out of reach of children to prevent accidental ingestion.
4. The parents of a 3-month-old infant are being educated by the healthcare provider about safe sleep practices. Which statement by the parents indicates a need for further teaching?
- A. We will place our baby on their back to sleep
- B. We will use a firm mattress and avoid soft bedding
- C. We will keep our baby in our bed so we can monitor them closely
- D. We will avoid putting toys or pillows in the crib
Correct answer: C
Rationale: The correct answer is C. Co-sleeping, or keeping the baby in the parents' bed, increases the risk of sudden infant death syndrome (SIDS). It is crucial for parents to place the baby in a separate crib or bassinet to ensure a safe sleep environment and reduce the risk of SIDS. Choices A, B, and D demonstrate understanding of safe sleep practices by mentioning placing the baby on their back, using a firm mattress and avoiding soft bedding, and not putting toys or pillows in the crib, which are all measures to promote safe sleep and reduce the risk of SIDS.
5. A mother brings her 3-week-old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicates that the infant's vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life-threatening complication?
- A. Irregular palpable pulse
- B. Hyperactive bowel sounds
- C. Underweight for age
- D. Crying without tears
Correct answer: D
Rationale: Crying without tears is a sign of severe dehydration, which is a potentially life-threatening complication in infants with projectile vomiting. Dehydration can rapidly progress in infants, leading to serious consequences if not promptly addressed. The combination of projectile vomiting, listlessness, and absence of tears when crying should raise concerns about severe dehydration and the need for urgent intervention to prevent further complications.
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