HESI Pediatrics Practice Exam

HESI Pediatrics Practice Exam Related

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A 12-year-old male is brought to the clinic after falling during a skateboarding trick. The child's vital signs are heart rate 135 beats/minute, respirations 20 breaths/minute, and blood pressure 90/60. Which finding should the practical nurse report to the healthcare provider immediately?

  • A. The client complains of his back being sore.
  • B. Capillary refill is less than 2 seconds.
  • C. Blood pressure is 94/68.
  • D. Peripheral pulses are weak and rapid.
Correct Answer: D

Rationale: In this scenario, the 12-year-old male with a heart rate of 135 beats/minute, respirations of 20 breaths/minute, and blood pressure of 90/60 after falling during a skateboarding trick exhibits signs of shock. Weak and rapid peripheral pulses are concerning as they may indicate decreased cardiac output and tissue perfusion, which are signs of shock. This finding should be reported to the healthcare provider immediately for further evaluation and intervention to prevent potential complications. The other choices are less urgent. Complaints of back soreness (choice A) could be related to musculoskeletal injury. Capillary refill less than 2 seconds (choice B) is within the normal range, indicating adequate peripheral perfusion. A blood pressure of 94/68 (choice C) is slightly higher than the initial reading and may be compensatory in response to the fall and shock state.

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When should a mother introduce solid foods to her 4-month-old infant? The mother states that her mother suggests putting rice cereal in the baby's bottle. 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 is offered
  • C. Awakens once for nighttime feedings
  • D. Gives up a bottle for a cup
Correct Answer: B

Rationale: Introducing solid foods when the child opens their mouth for food is important to ensure readiness for solids. This behavior indicates the infant's interest and readiness for new textures and flavors, promoting safe and successful introduction to solid foods. The other choices are not indicative of the infant's readiness for solid foods: A - stopping rooting is a reflex action, C - awakening for nighttime feedings is a normal behavior, and D - transitioning from a bottle to a cup is a developmental milestone unrelated to solid food introduction.

A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?

  • A. Increased weight gain
  • B. Decreased heart rate
  • C. Reduced headaches
  • D. Diminished fatigue
Correct Answer: B

Rationale: The correct answer is B: 'Decreased heart rate.' Propranolol is a beta-blocker commonly used to manage symptoms of hyperthyroidism, including tachycardia. Monitoring for a decreased heart rate is important as it indicates the drug's therapeutic response in controlling the elevated heart rate associated with Graves' disease. Choices A, C, and D are incorrect because weight gain, reduced headaches, and diminished fatigue are not typical therapeutic responses to propranolol in the context of managing Graves' disease.

A child with acute lymphocytic leukemia (ALL) who is receiving chemotherapy via a subclavian IV infusion has an oral temperature of 103 degrees. In assessing the IV site, the nurse determines that there are no signs of infection at the site. Which intervention is the most important for the nurse to implement?

  • A. Obtain a specimen for blood cultures.
  • B. Assess the CBC.
  • C. Monitor the oral temperature every hour.
  • D. Administer acetaminophen as prescribed.
Correct Answer: A

Rationale: Obtaining a specimen for blood cultures is crucial in this situation as it helps identify the source of infection, if present, and guide appropriate treatment. This is important in a child with leukemia receiving chemotherapy to prevent potential complications and ensure timely intervention. Assessing the CBC may provide overall information on the child's condition but may not specifically identify a potential infection. Monitoring the oral temperature is important but obtaining blood cultures takes precedence in this scenario. Administering acetaminophen can help reduce fever but does not address the need to identify a possible infection source.

The caregiver is teaching a group of parents about injury prevention for toddlers. Which statement by a parent indicates a need for further teaching?

  • A. I will keep all cleaning supplies locked away.
  • B. I will teach my child how to swim this summer.
  • C. I will make sure my child wears a helmet while riding a tricycle.
  • D. I will place my child in a car seat for every car ride.
Correct Answer: B

Rationale: Teaching children how to swim is valuable, but parental supervision around water is essential to prevent drowning. It's crucial to emphasize constant supervision when young children are near water, regardless of their swimming abilities. The other choices (A, C, and D) demonstrate appropriate safety measures for injury prevention in toddlers, such as securing cleaning supplies, ensuring helmet use during tricycle rides, and using a car seat for every car ride.

A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?

  • A. The mother is a single parent and lives with her parents
  • B. The mother states the baby is irritable during feedings
  • C. The infant's formula has been changed twice
  • D. The diaper area shows severe skin breakdown
Correct Answer: D

Rationale: Severe skin breakdown in the diaper area is significant as it indicates a potential severe issue that needs immediate attention to prevent further complications. Skin breakdown can lead to infections and discomfort for the infant, making it a priority in planning care for this family. The other findings, such as the mother's living situation, baby's irritability during feedings, or formula changes, are important but do not pose immediate risks to the infant's health compared to severe skin breakdown.

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