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Pediatric HESI 2023
1. What is the primary treatment for minimal change nephrotic syndrome?
- A. corticosteroids
- B. antihypertensive agents
- C. long-term diuretics
- D. increased fluids to promote diuresis
Correct answer: A
Rationale: Corticosteroids are the mainstay of treatment for minimal change nephrotic syndrome due to their immunosuppressive effects, which help reduce proteinuria and control the disease progression. Antihypertensive agents are not the primary treatment for this condition and are typically used to manage hypertension that may result from nephrotic syndrome. Long-term diuretics are not indicated in the treatment of minimal change nephrotic syndrome as they do not address the underlying cause. Increasing fluids to promote diuresis is not a recommended treatment for minimal change nephrotic syndrome, as it can exacerbate edema and fluid overload in these patients.
2. A 5-year-old child is admitted to the hospital with a diagnosis of bacterial meningitis. What is the priority nursing intervention?
- A. Administering antibiotics
- B. Isolating the child
- C. Monitoring vital signs
- D. Administering fluids
Correct answer: B
Rationale: The priority nursing intervention for a 5-year-old child admitted to the hospital with bacterial meningitis is to isolate the child. Isolating the child is crucial to prevent the spread of infection to others, as bacterial meningitis is highly contagious. Administering antibiotics (Choice A) is important in the treatment of bacterial meningitis, but isolating the child takes precedence to protect others. Monitoring vital signs (Choice C) and administering fluids (Choice D) are essential aspects of care for a child with meningitis but are not the priority intervention to prevent the spread of the infection.
3. A child is being assessed by a nurse for suspected nephrotic syndrome. What clinical manifestation is the nurse likely to observe?
- A. Jaundice
- B. Edema
- C. Hypertension
- D. Polyuria
Correct answer: B
Rationale: Edema is a hallmark clinical manifestation of nephrotic syndrome. In nephrotic syndrome, there is increased permeability of the glomerular filtration barrier, leading to protein loss in the urine (proteinuria). The decrease in serum protein levels results in a reduced oncotic pressure, leading to fluid shifting from the intravascular space into the interstitial spaces, causing edema. Jaundice (choice A) is not typically associated with nephrotic syndrome. Hypertension (choice C) is more commonly seen in conditions like nephritic syndrome. Polyuria (choice D) is excessive urination and is not a prominent feature of nephrotic syndrome.
4. A 2-year-old child with a diagnosis of hemophilia is admitted to the hospital. What should the nurse include in the care plan?
- A. Encourage participation in contact sports
- B. Use a soft toothbrush for oral care
- C. Administer nonsteroidal anti-inflammatory drugs
- D. Administer aspirin for pain
Correct answer: B
Rationale: Using a soft toothbrush helps to prevent bleeding in a child with hemophilia.
5. The nurse volunteering at a homeless shelter to assist families with children identifies homelessness as a risk preventing families from achieving positive outcomes in life. What family theory encompasses this approach to assessing family dynamics?
- A. Duvall's developmental theory
- B. Friedman's structural functional theory
- C. Von Bertalanffy's general system theory applied to families
- D. Resiliency model of family stress, adjustment, and adaptation
Correct answer: D
Rationale: The Resiliency model of family stress, adjustment, and adaptation focuses on identifying the elements of risks and protective factors that help families achieve positive outcomes. In this scenario, the nurse recognizing homelessness as a risk aligns with the resiliency model, which emphasizes how families cope and adapt in the face of stressors. Duvall's theory primarily focuses on family life cycle stages, Friedman's theory emphasizes the roles and functions within a family structure, and Von Bertalanffy's theory looks at families as complex systems rather than specifically addressing resilience in the face of stressors.
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