Pediatrics HESI PN Review (Q & A With
Rationales)
The practical nurse (PN) is monitoring a child who is manifesting signs of
shock after a motor vehicle collision. Which finding is most important for the
PN to report to the charge nurse?
a) narrowing pulse pressure
b) apprehension
c) irritability
d) thirst Correct Ans - Answer: A
Rationale:
As shock progresses, perfusion in the microcirculation becomes marginal
despite compensatory adjustments, and the signs of decompensated shock
become pronounced, such as tachycardia and narrowing pulse pressure (A).
(The difference between systolic and diastolic blood pressure), which should
be reported immediately. (B,C, and D) are not as significant as (A).
The mother of a 9 month old male infant is concerned because he cries
whenever she leaves him with a sitter. What is the best response for the
practical nurse (PN) to provide?
a) "Have you noticed whether your baby is teething?"
b) "Crying when you leave him in a healthy sign of attachment."
c) "Consider taking the baby to the doctor because he may be ill."
d) "You could consider leaving the infant more often so he can adjust."
Correct Ans - Answer: B
Rationale:
Healthy attachment is manifested by stranger anxiety in late infancy (B).
Pain from teething expressed by the infant's cries does not occur only when
the mother leaves the infant with another person (A). The PN should evaluate
the infant's developmental needs (C) before suggesting the infant may be ill.
An infant who manifests stranger anxiety is best supported by the mother if
the infant is left for shorter periods of time, not (D).
Which preoperative action is most important for the practical nurse (PN) to
implement for a newborn with meningomyelocele?
a) document vital signs
b) prevent skin breakdown
c) minimize the risk for infection
d) monitor neurologic functioning Correct Ans - Answer: C
,Rationale:
A meningomyelocele provides a direct entry for bacteria into the central
nervous system, leading to meningitis. Measures that protect the integrity of
the meningomyelocele sac and infection control measures should be
implemented to minimize the risk of infection (C). (A,B, and D) should be
implemented but do not have the priority of (C).
The practical nurse is caring for a 6 year old girl who had surgery 12 hours
ago. The child tells the PN that she does not have pain but a few minutes
later, tells her parents that she does. What child development concept is
relevant to this situation?
a) inconsistency in pain reporting suggests that pain not present
b) a child may have pain yet deny its presence to the nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their parents Correct Ans -
Answer: B
Rationale:
A child may fear receiving an injection for pain or may believe that pain is a
deserved punishment for some misdeed, so the pain is denied (D) when the
nurse asks the child, who then readily admits having pain to a parent. This
behavior should not be interpreted as (C) but as a valid indication of pain. (A
and C) are incorrect interpretations of this behavior.
A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst.
What should the practical nurse (PN) offer?
a) popsicle
b) lemonade
c) orange juice
d) chocolate milk Correct Ans - Answer: A
Rationale:
Small amounts of clear liquids without red dyes should be offered to the
child. Popsicles (A) are cold and help soothe a dry throat. Citrus drinks (B and
C) are acidic and irritate the operative site in the posterior oropharynx. Milk
(D) thickens oral mucus which makes swallowing more difficult and causes
coughing.
The mother of a male newborn calls the clinic to inquire about the formation
of a yellow crust over her son's circumcision area. What information should
the practical nurse (PN) provide?
a) do not remove the yellow crust from the site
, b) stop using petroleum around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper Correct Ans - Answer: A
Rationale:
Crust formation is part of the healing process and should be removed (A). (C)
is not indicated at this time. The diaper should be fastened loosely, not
tightly (D) which can place pressure on the incision site. (B) assists in the
healing process and should not be discontinued.
The mother of a child with croup is having barking, coughing episodes calls
the clinic for assistance. What action should the practical nurse (PN)
recommend that the mother implement first?
a) take the child outside in the cool air
b) bring the child directly to the emergency room
c) sit with the child in bathroom with a hot shower running
d) have the child drink plenty of fluids Correct Ans - Answer: C
Rationale:
Croup (laryngotracheobronchitis) is a viral infection that causes a "barking"
cough and varying degrees of inspiratory stridor, which often responds to a
high humidity environment. Most children can be managed at home using
the stream from a hot shower in a closed bathroom (C) which often stops
laryngeal spasm. Increasing the child's fluid intake is important (D), but not a
priority at this time.Although exposure to cold air (A) also relieves stridor,
parents should be encouraged to use mist humidifier in the child's room. (B)
is not necessary unless the child is having increasingly difficulty breathing
that may lead to a compromised airway.
Which finding should the practical nurse confirm with the parents of an infant
who is admitted with possible intussusception?
a) red currant jelly stools
b) clay colored stools
c) constant abdominal pain
d) projectile vomiting after meals Correct Ans - Answer: A
Rationale:
Red currant jelly stools (A) is a sign of intussusception, which causes a
mixture of stool, mucous, and blood as the intestines telescopes inside itself.
(D) is associated with pyloric stenosis. (B) is consistent with biliary
obstruction. Infants with intussusception usually have periods of severe pain
followed by intervals in which they appear comfortable, not (C).
Rationales)
The practical nurse (PN) is monitoring a child who is manifesting signs of
shock after a motor vehicle collision. Which finding is most important for the
PN to report to the charge nurse?
a) narrowing pulse pressure
b) apprehension
c) irritability
d) thirst Correct Ans - Answer: A
Rationale:
As shock progresses, perfusion in the microcirculation becomes marginal
despite compensatory adjustments, and the signs of decompensated shock
become pronounced, such as tachycardia and narrowing pulse pressure (A).
(The difference between systolic and diastolic blood pressure), which should
be reported immediately. (B,C, and D) are not as significant as (A).
The mother of a 9 month old male infant is concerned because he cries
whenever she leaves him with a sitter. What is the best response for the
practical nurse (PN) to provide?
a) "Have you noticed whether your baby is teething?"
b) "Crying when you leave him in a healthy sign of attachment."
c) "Consider taking the baby to the doctor because he may be ill."
d) "You could consider leaving the infant more often so he can adjust."
Correct Ans - Answer: B
Rationale:
Healthy attachment is manifested by stranger anxiety in late infancy (B).
Pain from teething expressed by the infant's cries does not occur only when
the mother leaves the infant with another person (A). The PN should evaluate
the infant's developmental needs (C) before suggesting the infant may be ill.
An infant who manifests stranger anxiety is best supported by the mother if
the infant is left for shorter periods of time, not (D).
Which preoperative action is most important for the practical nurse (PN) to
implement for a newborn with meningomyelocele?
a) document vital signs
b) prevent skin breakdown
c) minimize the risk for infection
d) monitor neurologic functioning Correct Ans - Answer: C
,Rationale:
A meningomyelocele provides a direct entry for bacteria into the central
nervous system, leading to meningitis. Measures that protect the integrity of
the meningomyelocele sac and infection control measures should be
implemented to minimize the risk of infection (C). (A,B, and D) should be
implemented but do not have the priority of (C).
The practical nurse is caring for a 6 year old girl who had surgery 12 hours
ago. The child tells the PN that she does not have pain but a few minutes
later, tells her parents that she does. What child development concept is
relevant to this situation?
a) inconsistency in pain reporting suggests that pain not present
b) a child may have pain yet deny its presence to the nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their parents Correct Ans -
Answer: B
Rationale:
A child may fear receiving an injection for pain or may believe that pain is a
deserved punishment for some misdeed, so the pain is denied (D) when the
nurse asks the child, who then readily admits having pain to a parent. This
behavior should not be interpreted as (C) but as a valid indication of pain. (A
and C) are incorrect interpretations of this behavior.
A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst.
What should the practical nurse (PN) offer?
a) popsicle
b) lemonade
c) orange juice
d) chocolate milk Correct Ans - Answer: A
Rationale:
Small amounts of clear liquids without red dyes should be offered to the
child. Popsicles (A) are cold and help soothe a dry throat. Citrus drinks (B and
C) are acidic and irritate the operative site in the posterior oropharynx. Milk
(D) thickens oral mucus which makes swallowing more difficult and causes
coughing.
The mother of a male newborn calls the clinic to inquire about the formation
of a yellow crust over her son's circumcision area. What information should
the practical nurse (PN) provide?
a) do not remove the yellow crust from the site
, b) stop using petroleum around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper Correct Ans - Answer: A
Rationale:
Crust formation is part of the healing process and should be removed (A). (C)
is not indicated at this time. The diaper should be fastened loosely, not
tightly (D) which can place pressure on the incision site. (B) assists in the
healing process and should not be discontinued.
The mother of a child with croup is having barking, coughing episodes calls
the clinic for assistance. What action should the practical nurse (PN)
recommend that the mother implement first?
a) take the child outside in the cool air
b) bring the child directly to the emergency room
c) sit with the child in bathroom with a hot shower running
d) have the child drink plenty of fluids Correct Ans - Answer: C
Rationale:
Croup (laryngotracheobronchitis) is a viral infection that causes a "barking"
cough and varying degrees of inspiratory stridor, which often responds to a
high humidity environment. Most children can be managed at home using
the stream from a hot shower in a closed bathroom (C) which often stops
laryngeal spasm. Increasing the child's fluid intake is important (D), but not a
priority at this time.Although exposure to cold air (A) also relieves stridor,
parents should be encouraged to use mist humidifier in the child's room. (B)
is not necessary unless the child is having increasingly difficulty breathing
that may lead to a compromised airway.
Which finding should the practical nurse confirm with the parents of an infant
who is admitted with possible intussusception?
a) red currant jelly stools
b) clay colored stools
c) constant abdominal pain
d) projectile vomiting after meals Correct Ans - Answer: A
Rationale:
Red currant jelly stools (A) is a sign of intussusception, which causes a
mixture of stool, mucous, and blood as the intestines telescopes inside itself.
(D) is associated with pyloric stenosis. (B) is consistent with biliary
obstruction. Infants with intussusception usually have periods of severe pain
followed by intervals in which they appear comfortable, not (C).
