HESI Case Study (PEDS) Exam.
1. Meet the Clients: Casey and John Martin
Six-month-old Casey Martin and her 4-year-old
brother, John Martin sustain head injuries when
the car driven by their mother is struck head
on at an intersection. Although Casey is in an
infant seat, her head is severely shaken. John
unbuckles his car seat and his head strikes
the dash board with force.
The Martins are transported to the emergency
de-
partment (ED) where Mrs. Martin is treated
and released. The children are triaged as
needing im- mediate intervention.
Rapid brain decompression
2. The nurse recognizes that epidural
hematomas have which characteristic?
A nurse from the ED will
3. To prepare Casey's parents for her CT scan, remain with Casey to
which explanation by the nurse is accurate?
monitor her con- stantly.
4. Which symptom is most characteristic of Separated cranial sutures
ICP in infants?
5. While conducting Casey's neurological assess-
ment, the nurse notes possible damage to Ptosis and dilated pupils
cranial nerve III as evidenced by which of the
following symptoms?
6. Which data should the nurse include in document- Lid lag for both eyes and
dilated
ing Casey's ocular findings? pupils
7. -Frequent neuro assessment
-Maintain the airway and
moni-
1/
5
, HESI Case Study (PEDS) Exam.
While providing care for a child with an tor O2 sat
epidural hematoma, which nursing
interventions are most essential? (Select all -Implement seizure precau-
that apply) tions
-Monitor fluid status and
osmo- lality
8. Which seizure precautions should the nurse
plan to implement? Padding the side rails
9. Laboratory studies are prescribed for Casey. Which 24 hours urine
collection
prescription should the nurse question?
10. The mother asks the nurse why her child is having It is important to assess
for other
x-rays. Which response is best for the nurse to injuries that may have been sus-
provide? tained in the car accident.
11. Which of the following strategies should the nurse Prioritize assessment of
level of
incorporated into the neurological assessment ofalertness
Casey?
12. Several diagnostic tests are prescribed for
Casey. Which tests should the nurse Lumbar puncture
question?
13. The nurse can allay anxiety by providing theCasey will have an IV placed for
par- ents with accurate preoperative
education. Which statement is accurate? fluids and medication and
she may initially have a
tube in her throat.
14. Which strategies are appropriate ways to
involve the family in Casey's care? (Select all
-Participating in multidiscipli-
that apply)
nary discharge planning
meet- ings.
-Bringing a familiar blanket from
2/
5
1. Meet the Clients: Casey and John Martin
Six-month-old Casey Martin and her 4-year-old
brother, John Martin sustain head injuries when
the car driven by their mother is struck head
on at an intersection. Although Casey is in an
infant seat, her head is severely shaken. John
unbuckles his car seat and his head strikes
the dash board with force.
The Martins are transported to the emergency
de-
partment (ED) where Mrs. Martin is treated
and released. The children are triaged as
needing im- mediate intervention.
Rapid brain decompression
2. The nurse recognizes that epidural
hematomas have which characteristic?
A nurse from the ED will
3. To prepare Casey's parents for her CT scan, remain with Casey to
which explanation by the nurse is accurate?
monitor her con- stantly.
4. Which symptom is most characteristic of Separated cranial sutures
ICP in infants?
5. While conducting Casey's neurological assess-
ment, the nurse notes possible damage to Ptosis and dilated pupils
cranial nerve III as evidenced by which of the
following symptoms?
6. Which data should the nurse include in document- Lid lag for both eyes and
dilated
ing Casey's ocular findings? pupils
7. -Frequent neuro assessment
-Maintain the airway and
moni-
1/
5
, HESI Case Study (PEDS) Exam.
While providing care for a child with an tor O2 sat
epidural hematoma, which nursing
interventions are most essential? (Select all -Implement seizure precau-
that apply) tions
-Monitor fluid status and
osmo- lality
8. Which seizure precautions should the nurse
plan to implement? Padding the side rails
9. Laboratory studies are prescribed for Casey. Which 24 hours urine
collection
prescription should the nurse question?
10. The mother asks the nurse why her child is having It is important to assess
for other
x-rays. Which response is best for the nurse to injuries that may have been sus-
provide? tained in the car accident.
11. Which of the following strategies should the nurse Prioritize assessment of
level of
incorporated into the neurological assessment ofalertness
Casey?
12. Several diagnostic tests are prescribed for
Casey. Which tests should the nurse Lumbar puncture
question?
13. The nurse can allay anxiety by providing theCasey will have an IV placed for
par- ents with accurate preoperative
education. Which statement is accurate? fluids and medication and
she may initially have a
tube in her throat.
14. Which strategies are appropriate ways to
involve the family in Casey's care? (Select all
-Participating in multidiscipli-
that apply)
nary discharge planning
meet- ings.
-Bringing a familiar blanket from
2/
5
