Pediatric HESI Test Bank

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You are managing a 10-month-old infant who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. You have initiated supplemental oxygen therapy and elevated the lower extremities. En route to the hospital, you note that the child's work of breathing has increased. What must you do first?

  • A. Lower the extremities and reassess the child
  • B. Begin positive pressure ventilations and reassess the child
  • C. Place a nasopharyngeal airway and increase the oxygen flow
  • D. Listen to the lungs with a stethoscope for abnormal breath sounds
Correct Answer: A

Rationale: In this scenario, the infant is presenting with signs of respiratory distress, as evidenced by the increased work of breathing. Lowering the extremities can help reduce the workload on the diaphragm and improve respiratory mechanics. This action can be beneficial in optimizing the infant's breathing before considering more invasive interventions. Option B, initiating positive pressure ventilations, should be considered if the infant's condition deteriorates further and not as the first step. Option C, placing a nasopharyngeal airway and increasing oxygen flow, is not indicated as the primary intervention for increased work of breathing. Option D, listening to the lungs with a stethoscope, may provide additional information but is not the most urgent action needed in this situation.

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While assessing a child admitted for an asthma attack, a nurse in the emergency department observes large welts and scars on the child's back. What additional information must be included in the nurse's assessment?

  • A. History of an injury
  • B. Signs of child abuse
  • C. Presence of food allergies
  • D. Recent recovery from chickenpox
Correct Answer: B

Rationale: The correct answer is B: Signs of child abuse. When a nurse observes large welts and scars on a child, it raises concern for possible child abuse. It is crucial for the nurse to assess further for signs of abuse, document findings, and report appropriately to protect the child. Choice A, history of an injury, is not specific to potential abuse and may not provide insight into the current situation. Choice C, presence of food allergies, is not directly related to the observed welts and scars. Choice D, recent recovery from chickenpox, is also unrelated to the signs of abuse and does not impact the immediate assessment of the child's safety.

What should the nurse include in the preoperative teaching for a 4-year-old child scheduled for a myringotomy?

  • A. Explain the procedure in simple terms
  • B. Encourage fluid intake
  • C. Allow the child to play with medical equipment
  • D. Use play therapy to prepare the child
Correct Answer: A

Rationale: For a 4-year-old child scheduled for a myringotomy, explaining the procedure in simple terms is essential in helping the child understand what will happen during the surgery and reducing anxiety. Encouraging fluid intake, allowing the child to play with medical equipment, and using play therapy are not directly related to preparing the child for the myringotomy procedure. Therefore, these options are incorrect and not as beneficial as explaining the procedure in simple terms.

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: The correct action in this scenario is to advise your partner to stop the ambulance and assist with the delivery. When the mother feels the urge to push and you see the baby's head bulging from the vagina, it indicates an imminent delivery. Stopping the ambulance allows for a safer environment for the delivery of the baby and ensures that immediate assistance can be provided to both the mother and the newborn. Allowing the head to deliver before checking for the cord (Choice A) may delay necessary interventions in case of complications. Instructing the mother to take short, quick breaths (Choice C) is not appropriate when the baby's head is already visible. Preparing for an emergency delivery and opening the obstetrics kit (Choice D) is important but should come after stopping the ambulance and assisting with the imminent birth.

When teaching a class of new parents about positioning their infants during the first few weeks of life, which position is safest?

  • A. On the back, lying flat
  • B. On either side, lying flat
  • C. Head slightly elevated on the left side
  • D. Head slightly elevated on the right side
Correct Answer: A

Rationale: The correct answer is A: 'On the back, lying flat'. Placing infants on their back to sleep is recommended to reduce the risk of sudden infant death syndrome (SIDS). This position helps ensure the baby's airway remains clear and reduces the likelihood of suffocation. Choices B, C, and D are not as safe as placing the infant on their back, as they may increase the risk of accidental suffocation or SIDS.

A 2-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the primary goal of therapy during the acute phase?

  • A. Preventing coronary artery aneurysms
  • B. Reducing fever
  • C. Improving cardiac function
  • D. Preventing dehydration
Correct Answer: A

Rationale: The primary goal of therapy during the acute phase of Kawasaki disease is to prevent coronary artery aneurysms. Kawasaki disease is characterized by systemic vasculitis and the most serious complication is the development of coronary artery aneurysms. While reducing fever and improving cardiac function are important aspects of managing Kawasaki disease, the primary focus in the acute phase is to prevent the development of coronary artery aneurysms. Preventing dehydration is also essential but not the primary goal in managing Kawasaki disease.

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