HESI Case Studies--Pediatrics-Burns Test with
Questions & Answers
1. Which nursing diagnosis has the highest priority in the emergent phase? - ✔✔Fluid
volume deficit related to increased capillary permeability
2. Which intervention will the RN implement to assess for Curling's ulcer? - ✔✔Assess the
gastric aspirate for pH and blood the color of coffee grounds
3. Which action should the nurse implement? - ✔✔Notify the HCP immediately
unrelenting pain and neurovascular compromise are the hallmark clinical manifestations of
compartment syndrome
4. How should the RN respond? - ✔✔"The HCP will make an incision in David's leg to relieve
the pressure."
5. Which action should the RN implement? (Select all) - ✔✔-Inform David's family members
that plants and flowers are not allowed in David's room
**not allowed because stagnant water is a potential source of bacterial growth**
-Provide visitors with isolation gowns and
instruction in hand hygiene
**
6. Which intervention should the nurse implement during David's hydrotherapy? (Select all) -
✔✔-Active range of motion exercises of his extremities
-Wash burn areas thoroughly and gently with mild soap and water
, 7. Which intervention should the RN implement? - ✔✔Premedicate with an opioid analgesic
20 minutes prior to applying this medication
8. Which snack is best for the RN to provide to David? - ✔✔A peanut butter sandwich
9. Which action should the RN take before completing the assessment? - ✔✔Ask the parents
to leave the room before obtaining information from David
10. According to Erikson, which statement by the client indicates that he is achieving the tasks
of his stage of growth and development? - ✔✔"I really hate it when my mom kisses me in
front of my friends."
11. Which action is included when a level 1 disaster is declared? - ✔✔All local hospitals
prepare to receive casualties
Classification as a Level I disaster indicates that local emergency response personnel and
organizations can contain and effectively manage the disaster and its aftermath.
12. Some parents call the local emergency rooms in an attempt to learn where their children
will be transferred. Which action should be implemented to help these family members? -
✔✔Designate specific family areas that are staffed with counselors
13. Paramedics are triaging clients at the accident site. Which action is implemented by the
triage personnel. - ✔✔Place a disaster tag securely on each victim
Victim tracking is a critical component in casualty management. Disaster tags are color-coded
and numbered to indicate triage priority. They include the client's name, address, and age, as
well as a description and location of the client's injuries
Questions & Answers
1. Which nursing diagnosis has the highest priority in the emergent phase? - ✔✔Fluid
volume deficit related to increased capillary permeability
2. Which intervention will the RN implement to assess for Curling's ulcer? - ✔✔Assess the
gastric aspirate for pH and blood the color of coffee grounds
3. Which action should the nurse implement? - ✔✔Notify the HCP immediately
unrelenting pain and neurovascular compromise are the hallmark clinical manifestations of
compartment syndrome
4. How should the RN respond? - ✔✔"The HCP will make an incision in David's leg to relieve
the pressure."
5. Which action should the RN implement? (Select all) - ✔✔-Inform David's family members
that plants and flowers are not allowed in David's room
**not allowed because stagnant water is a potential source of bacterial growth**
-Provide visitors with isolation gowns and
instruction in hand hygiene
**
6. Which intervention should the nurse implement during David's hydrotherapy? (Select all) -
✔✔-Active range of motion exercises of his extremities
-Wash burn areas thoroughly and gently with mild soap and water
, 7. Which intervention should the RN implement? - ✔✔Premedicate with an opioid analgesic
20 minutes prior to applying this medication
8. Which snack is best for the RN to provide to David? - ✔✔A peanut butter sandwich
9. Which action should the RN take before completing the assessment? - ✔✔Ask the parents
to leave the room before obtaining information from David
10. According to Erikson, which statement by the client indicates that he is achieving the tasks
of his stage of growth and development? - ✔✔"I really hate it when my mom kisses me in
front of my friends."
11. Which action is included when a level 1 disaster is declared? - ✔✔All local hospitals
prepare to receive casualties
Classification as a Level I disaster indicates that local emergency response personnel and
organizations can contain and effectively manage the disaster and its aftermath.
12. Some parents call the local emergency rooms in an attempt to learn where their children
will be transferred. Which action should be implemented to help these family members? -
✔✔Designate specific family areas that are staffed with counselors
13. Paramedics are triaging clients at the accident site. Which action is implemented by the
triage personnel. - ✔✔Place a disaster tag securely on each victim
Victim tracking is a critical component in casualty management. Disaster tags are color-coded
and numbered to indicate triage priority. They include the client's name, address, and age, as
well as a description and location of the client's injuries
