HESI RN Pedriatics Proctored Exam 2

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Sample questions from HESI RN Pedriatics Proctored Exam 2

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 4-year-old with asthma is in the emergency department with audible wheezing, suprasternal retractions, and an oxygen saturation of 89% on room air. Which action should the nurse take first?

   • A.Apply supplemental oxygen and assess the child's response
   • B.Obtain a detailed history of the child's asthma triggers
   • C.Teach the caregiver how to use a peak-flow meter
   • D.Offer oral fluids to thin respiratory secretions

   Rationale: The low oxygen saturation and increased work of breathing indicate impaired oxygenation, so oxygen and prompt reassessment take priority. A history and teaching are important after the child is stabilized. Oral fluids do not correct acute hypoxemia and may be unsafe if respiratory distress worsens.

2. 2.A 10-year-old admitted with diabetic ketoacidosis has a glucose of 510 mg/dL, pH 7.18, and deep, rapid respirations. Which prescription should the nurse implement first?

   • A.Add potassium to the IV fluid
   • B.Begin isotonic IV fluid replacement
   • C.Administer IV regular insulin
   • D.Give sodium bicarbonate IV

   Rationale: Initial isotonic fluid replacement supports circulation and begins correction of dehydration in diabetic ketoacidosis. Insulin follows fluid resuscitation and assessment of potassium, since insulin can lower serum potassium rapidly. Potassium is added only after confirming adequate urine output and serum potassium status; bicarbonate is generally avoided unless severe acidosis meets specific criteria.

3. 3.A 7-year-old with sickle cell disease is admitted with severe leg pain, temperature 38.4 C (101.1 F), and oxygen saturation 95% on room air. Which actions should the nurse take? Select all that apply.

   • A.Notify the provider about the fever
   • B.Administer prescribed analgesia promptly
   • C.Encourage oral or prescribed IV hydration
   • D.Restrict fluids to reduce the risk of edema
   • E.Assess for chest pain, cough, and increased work of breathing
   • F.Apply cold packs to painful joints

   Rationale: Prompt analgesia and hydration help manage a vaso-occlusive episode, while respiratory assessment can identify acute chest syndrome early. Fever in a child with sickle cell disease requires prompt provider notification because of infection risk. Cold can cause vasoconstriction and worsen pain, and fluid restriction can aggravate dehydration and sickling.

4. 4.A 2-year-old on a pediatric unit has a new prescription for IV ceftriaxone. The child weighs 12 kg, and the medication dose is within the facility's dosing range. Which action should the nurse take before administration?

   • A.Mix the medication with the child's formula
   • B.Ask another nurse to calculate the dose after administration
   • C.Give the medication rapidly to reduce distress
   • D.Verify the child's allergy history with the caregiver and record

   Answer and rationale are in the full material.

5. 5.A 15-year-old with appendicitis has increasing abdominal pain, a rigid abdomen, heart rate 132/min, and blood pressure 92/54 mm Hg while awaiting surgery. What is the nurse's priority action?

   • A.Give the prescribed oral laxative
   • B.Apply a heating pad to the abdomen
   • C.Notify the surgeon immediately and prepare for urgent intervention
   • D.Encourage the adolescent to ambulate

   Answer and rationale are in the full material.