Pediatric HESI 2023

Pediatric HESI 2023 Related

Review Pediatric HESI 2023 related questions and content

You are called to a residence for a "sick" 5-year-old child. When you arrive and begin your assessment, you note that the child is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of

  • A. 100% oxygen via a non-rebreathing mask and rapid transport
  • B. positive pressure ventilations with a BVM device and rapid transport
  • C. chest compressions, artificial ventilations, and rapid transport
  • D. back blows and chest thrusts while attempting artificial ventilations
Correct Answer: C

Rationale: In a pediatric patient with an unconscious state, a respiratory rate of 8 breaths/min, and a heart rate of 50 beats/min, the appropriate management involves chest compressions, artificial ventilations, and rapid transport. These signs indicate severe respiratory and circulatory compromise, requiring immediate intervention to support breathing and circulation. Choice A (100% oxygen via a non-rebreathing mask) is not sufficient in this critical situation as the child requires more than just oxygen supplementation. Choice B (positive pressure ventilations with a BVM device) may be needed, but chest compressions are crucial in this scenario due to the presence of bradycardia. Choice D (back blows and chest thrusts) are not indicated for an unconscious child with respiratory and circulatory compromise; instead, immediate chest compressions are necessary to provide circulatory support.

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A 12-month-old infant has become immunosuppressed during a course of chemotherapy. When preparing the parents for the infant's discharge, what information should the nurse give concerning the measles, mumps, and rubella (MMR) immunization?

  • A. It should not be given until the infant reaches 2 years of age.
  • B. Infants who are receiving chemotherapy should not be given these vaccines.
  • C. It should be given to protect the infant from contracting any of these diseases.
  • D. The parents should discuss this with their healthcare provider at the next visit.
Correct Answer: B

Rationale: Live vaccines, like the measles, mumps, and rubella (MMR) vaccine, should not be administered to immunosuppressed infants, such as those undergoing chemotherapy. The weakened immune system of these infants may not be able to handle live vaccines safely, potentially leading to severe complications. Therefore, it is crucial to avoid giving live vaccines like MMR to infants receiving chemotherapy. Choice A is incorrect as delaying the MMR vaccine until the infant reaches 2 years of age is not the main concern in this scenario. Choice C is incorrect because although MMR vaccination is important for disease prevention, it should not be given to immunosuppressed infants. Choice D is incorrect as immediate action is needed to prevent potential harm from live vaccines in immunosuppressed infants.

An infant who had cardiac surgery for a congenital defect is to be discharged. What should the nurse emphasize to the parents regarding administering the prescribed antibiotic?

  • A. Give the antibiotic between feedings.
  • B. Ensure that the antibiotic is administered as prescribed.
  • C. Shake the bottle thoroughly before giving the antibiotic.
  • D. Keep the antibiotic in the refrigerator after the bottle has been opened.
Correct Answer: B

Rationale: The correct answer is B: 'Ensure that the antibiotic is administered as prescribed.' It is crucial for the parents to follow the prescribed antibiotic regimen to prevent infections and promote proper healing following cardiac surgery. Option A is incorrect because the timing of antibiotic administration may vary depending on the specific medication and instructions. Option C is not necessary and could potentially affect the antibiotic's effectiveness. Option D is not relevant to the administration of the antibiotic and does not ensure proper usage.

A child has undergone surgery using steel bar placement to correct pectus excavatum. What position would the nurse instruct the parents to avoid?

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

Rationale: The correct answer is D: Side-lying. After surgery using steel bar placement to correct pectus excavatum, 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. Choices A, B, and C are incorrect. Semi-Fowler, Supine, and High Fowler positions are generally safe and commonly used in postoperative care, but in this specific case, side-lying should be avoided to ensure the effectiveness of the surgical correction.

What should the nurse suggest to a parent asking for advice on managing their child's earache and fever?

  • A. Applying a warm compress to the affected ear
  • B. Giving the child a cold drink
  • C. Administering acetaminophen
  • D. Taking the child to the emergency department
Correct Answer: A

Rationale: The correct answer is to suggest applying a warm compress to the affected ear. This can help alleviate pain and discomfort associated with the earache. Giving a cold drink (Choice B) may not address the underlying issue and is not a recommended treatment for earaches. Administering acetaminophen (Choice C) can help reduce fever but may not directly target the earache. Taking the child to the emergency department (Choice D) is usually not necessary for a common earache unless there are severe symptoms or complications present.

You are caring for a 6-year-old child with a possible fractured left arm and have reason to believe that the child was abused. How should you manage this situation?

  • A. inform the parents of your suspicions
  • B. call the police so the parents can be arrested
  • C. advise the parents that the child needs to be transported
  • D. transport the child to the hospital regardless of the parents' wishes
Correct Answer: C

Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported allows for the child to receive necessary medical care without immediate confrontation or escalating the situation. Calling the police to have the parents arrested without concrete evidence may not be appropriate and could further endanger the child. Informing the parents of suspicions may lead to interference or denial of necessary care. Transporting the child to the hospital is crucial, but involving and engaging with the parents in a non-confrontational manner is the initial step to ensure the child's safety and well-being.

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