Pediatric HESI 2023

Pediatric HESI 2023 Related

Review Pediatric HESI 2023 related questions and content

A 6-year-old child comes to the school nurse reporting a sore throat, and the nurse verifies that the child has a fever and a red, inflamed throat. When a parent of the child arrives at school to take the child home, the nurse urges the parent to seek treatment. The nurse is aware that the causative agent may be beta-hemolytic streptococcus, and the illness may progress to inflamed joints and an infection in the heart. What illness is of most concern to the nurse?

  • A. Tetanus
  • B. Influenza
  • C. Scarlet fever
  • D. Rheumatic fever
Correct Answer: D

Rationale: The correct answer is D, Rheumatic fever. Rheumatic fever can develop as a complication of untreated strep throat caused by beta-hemolytic streptococcus. It is characterized by inflamed joints and can lead to serious complications such as heart infections. Tetanus (choice A) is caused by a bacterial toxin affecting the nervous system, Influenza (choice B) is a viral respiratory illness, and Scarlet fever (choice C) is also caused by streptococcus but is characterized by a sandpaper-like rash and strawberry tongue. However, in the scenario described, the nurse is most concerned about the child developing rheumatic fever due to the potential serious consequences associated with it.

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Which observation of the exposed abdomen is most indicative of pyloric stenosis?

  • A. abdominal rigidity
  • B. substernal retraction
  • C. palpable olive-like mass
  • D. marked distention of the lower abdomen
Correct Answer: C

Rationale: In pyloric stenosis, a palpable olive-like mass in the abdomen is a classic finding. This mass is due to the hypertrophied pyloric muscle. Abdominal rigidity (choice A) is associated with conditions like peritonitis, substernal retraction (choice B) is typically seen in respiratory distress, and marked distention of the lower abdomen (choice D) is more characteristic of conditions like intestinal obstruction rather than pyloric stenosis.

A parent brings an 18-month-old toddler to the clinic. The parent states, 'My child is so difficult to please, has temper tantrums, and annoys me by throwing food from the table.' What is the nurse's best response?

  • A. "Toddlers need discipline to prevent the development of antisocial behaviors."
  • B. "Toddlers are learning to assert independence, and this behavior is expected at this age."
  • C. "It is best to leave the toddler alone in the crib after calmly explaining why the behavior is unacceptable."
  • D. "This is the way a toddler expresses needs, and this behavior is acceptable during the initiative stage of development."
Correct Answer: B

Rationale: The correct answer is B: "Toddlers are learning to assert independence, and this behavior is expected at this age." At 18 months, toddlers are in the stage of developing autonomy and independence. They may exhibit behaviors like temper tantrums and defiance as they assert their independence and test limits. It is crucial for parents and caregivers to understand that these behaviors are typical for toddlers at this age. Choice A is incorrect because discipline should be age-appropriate and focus on positive reinforcement rather than preventing antisocial behaviors. Choice C is inappropriate as leaving a toddler alone in a crib after explaining unacceptable behavior is not a recommended approach and can lead to feelings of abandonment. Choice D is inaccurate as the described behavior is more related to asserting independence rather than the initiative stage of development.

After undergoing surgery using steel bar placement to correct pectus excavatum, what position should the nurse instruct the parents to avoid for the child?

  • A. Semi-Fowler position.
  • B. Supine position.
  • C. High Fowler position.
  • D. Side-lying position.
Correct Answer: D

Rationale: After undergoing surgery for pectus excavatum correction with steel bar placement, the nurse should instruct the parents to avoid placing the child in a side-lying position. This position should be avoided to prevent displacement of the steel bar, which could compromise the surgical outcome. Semi-Fowler, supine, and high Fowler positions do not pose the same risk of displacing the steel bar and are generally safe and comfortable for the child in this postoperative period.

An order is written for an isotonic enema for a 2-year-old child. What is the maximum amount of fluid the nurse should administer without a specific order from the health care provider?

  • A. 100 to 150 mL
  • B. 155 to 250 mL
  • C. 255 to 360 mL
  • D. 365 to 500 mL
Correct Answer: B

Rationale: For a 2-year-old child, the maximum recommended amount of fluid for an isotonic enema is between 155 to 250 mL to prevent overdistension and potential harm. Choice A (100 to 150 mL) is too low and may not be effective in achieving the desired outcome. Choices C (255 to 360 mL) and D (365 to 500 mL) exceed the safe range for a 2-year-old child and can lead to overdistension, electrolyte imbalance, or other complications. Therefore, the correct answer is B.

A child is admitted to the hospital with pneumonia. What is the priority need that must be included in the nursing plan of care for this child?

  • A. Rest
  • B. Exercise
  • C. Nutrition
  • D. Elimination
Correct Answer: A

Rationale: The correct answer is Rest. When a child is admitted to the hospital with pneumonia, the priority need in the nursing plan of care is to ensure adequate rest for the child. Rest is crucial as it allows the child's body to fight the infection and recover. Choice B, Exercise, is incorrect as strenuous physical activity may further strain the child's respiratory system. Choice C, Nutrition, is important but providing rest takes precedence initially. Choice D, Elimination, is not the priority concern in this scenario compared to ensuring rest for recovery from pneumonia.

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