Pediatrics HESI PN 2022-23 EXAM Questions and Answers (Guarantee Grade A+)

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 - ans

b) apprehension

c)   irritability

d)   thirst

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." -ans

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." -

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-ans

d)     monitor neurologic functioning

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).