Pediatric HESI Test Bank

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At 0345, you receive a call for a woman in labor. Upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby 'now.' This man escorts you into the living room where a 25-year-old woman is lying on the couch in obvious pain. After determining that delivery is not imminent, you begin transport. While en route, the mother tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. What is your most appropriate first action?

  • A. Allow the head to deliver and check for the location of the cord.
  • B. Advise your partner to stop the ambulance and assist with the delivery.
  • C. Tell the mother to take short, quick breaths until you arrive at the hospital.
  • D. Prepare the mother for an emergency delivery and open the obstetrics kit.
Correct Answer: B

Rationale: In this scenario, the most appropriate first action is to advise your partner to stop the ambulance and assist with the delivery. When the baby's head is visible and delivery is imminent, it is crucial to provide immediate assistance to ensure the safety of both the mother and the baby. Allowing the head to deliver and checking for the location of the cord (Choice A) may delay necessary actions during an imminent delivery. Instructing the mother to take short, quick breaths (Choice C) is not suitable as active delivery is already in progress. Preparing the mother for an emergency delivery and opening the obstetrics kit (Choice D) is not the most immediate action needed when the baby's head is already visible and delivery is imminent.

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A major developmental milestone of a toddler is the achievement of autonomy. What should the parents do to enhance their toddler's need for autonomy?

  • A. Teach the child to share with others.
  • B. Help the child learn society's roles.
  • C. Teach the child to accept external limits.
  • D. Help the child develop internal controls.
Correct Answer: D

Rationale: Toddlers striving for autonomy need to develop internal controls to foster their independence. Teaching the child to share (Choice A) focuses more on social skills rather than autonomy. Helping the child learn society's roles (Choice B) is important but not directly related to enhancing autonomy. Teaching the child to accept external limits (Choice C) is contrary to promoting autonomy as it emphasizes conformity to external rules rather than internal self-regulation.

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 child admitted with bacterial meningitis is isolating the child. Isolation is crucial to prevent the spread of the highly contagious infection to other patients and healthcare workers. Administering antibiotics (Choice A) is important but isolating the child takes precedence to contain the spread of the infection. Monitoring vital signs (Choice C) and administering fluids (Choice D) are essential aspects of care but do not address the immediate need to prevent transmission of the infection.

A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect

  • A. croup
  • B. epiglottitis
  • C. lower respiratory infection
  • D. foreign body airway obstruction
Correct Answer: D

Rationale: In a 3-year-old child presenting with sudden respiratory distress without fever or recent illness, the most likely cause is a foreign body airway obstruction. Foreign body airway obstruction can lead to a sudden onset of respiratory distress as it blocks the air passage. Croup typically presents with a barking cough and stridor, often preceded by a viral illness. Epiglottitis is characterized by high fever, drooling, and a muffled voice. Lower respiratory infections usually present with symptoms such as cough, fever, and chest congestion. Therefore, in this case, the absence of recent illness or fever makes foreign body airway obstruction the most likely cause of the respiratory distress.

At 7 AM, a nurse receives the information that an adolescent with diabetes has a 6:30 AM fasting blood glucose level of 180 mg/dL. What is the priority nursing action at this time?

  • A. Encourage the adolescent to start exercising.
  • B. Ask the adolescent to obtain an immediate glucometer reading.
  • C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
  • D. Tell the adolescent that the prescribed dose of rapid acting insulin should be administered.
Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Which cardiac defects are associated with tetralogy of Fallot?

  • A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
  • B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
  • C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
  • D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect
Correct Answer: C

Rationale: The correct answer is C: Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta are the cardiac defects associated with Tetralogy of Fallot. In Tetralogy of Fallot, these specific abnormalities contribute to the classic features of the condition. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of Tetralogy of Fallot. Choice B describes transposition of the great arteries, not Tetralogy of Fallot. Choice D mentions an altered connection between the pulmonary artery and the aorta, which is not a defining characteristic of Tetralogy of Fallot.

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