Pediatric Practice Exam HESI

Correct Answer: B

Rationale: The correct preoperative teaching for a 2-year-old child undergoing surgery involves using a doll to demonstrate the procedure. This method helps the child understand what to expect in a non-threatening and visual way, making the experience less intimidating. Explaining the procedure in simple terms (Choice A) may not effectively convey the details to a young child. Showing pictures of the hospital environment (Choice C) may not directly address the surgical procedure itself. Allowing the child to play with medical equipment (Choice D) can be unsafe and may not effectively prepare the child for the surgery.

Correct Answer: A

Rationale: The correct answer is A: Syndrome of inappropriate antidiuretic hormone (SIADH). Vasopressin is a medication used to treat diabetes insipidus by increasing water reabsorption in the kidneys. However, an excessive dose of vasopressin can lead to water retention, causing SIADH, which is characterized by dilutional hyponatremia. Choices B, C, and D are incorrect. Thyroid storm is a severe form of hyperthyroidism characterized by increased metabolism and can lead to life-threatening complications. Cushing syndrome results from excess cortisol production and is characterized by weight gain, hypertension, and other features. Vitamin D toxicity occurs due to an overdose of vitamin D, leading to hypercalcemia and symptoms such as nausea, vomiting, and weakness.

Correct Answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas are unlikely to lead to loss of necessary nutrients. Choice C is incorrect as it does not directly relate to the physiological risk of tap water enemas. Choice D is incorrect as shock from a sudden drop in temperature is not a common concern with tap water enemas.

Correct Answer: D

Rationale: A respiratory rate of 50 breaths per minute in a 5-month-old infant is higher than the expected range and may indicate respiratory distress. This finding is concerning and should prompt the nurse to notify the health care provider for further evaluation and intervention. A temperature of 99.5�F, blood pressure of 75/48 mm Hg, and heart rate of 100 beats per minute are within normal ranges for a 5-month-old infant. Elevated temperature may indicate a mild fever, which can be monitored. A blood pressure of 75/48 mm Hg is within the normal range for infants. A heart rate of 100 beats per minute is also within the expected range for a 5-month-old infant and does not typically require immediate notification of the health care provider.

Correct Answer: A

Rationale: When caring for a neonate with a suspected tracheoesophageal fistula, it is essential to elevate the head and avoid giving anything by mouth. Elevating the head helps prevent aspiration, and withholding oral intake reduces the risk of complications like aspiration pneumonia. Elevating the head at all times (choice B) is overly restrictive and unnecessary. Administering glucose water only during feedings (choice C) is not recommended as it can still lead to aspiration. Avoiding suctioning unless the infant is cyanotic (choice D) is incorrect because maintaining airway patency may require suctioning, irrespective of cyanosis, in a neonate with a suspected tracheoesophageal fistula.