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HESI PEDIATRICS V1, V2 & V3>HESI PEDIATRICS V1, V2 & V3 QUESTIONS AND ANSWERS
HESI PEDIATRICS V1, V2 & V3 TOTAL OF 134 QUESTIONS/ANSWER(S) 2020 RN 1. The nurse is planning care for a 5 - month-old with gastroesophageal reflu... [Show More] x disease whose weight has decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instruction should the nurse provide this mother? •Dilute the child's formula with equal parts of water • Thicken formula with cereal for each feeding 2. characteristic of the disease is most important for the nurse to focus on during the initial teaching? •Muscular strength can be regained with physical exercise and therapy •Growth and development have been abnormal since birth •Respiratory dysfunction and aspiration are prime concerns at this stage of the disease • Lower legs become progressively weaker, causing a wedding, unsteady gait 3. In caring for an client with acute epiglottitis, which nursing action takes priority? •Obtain a STAT CBC • Prepare for endotracheal intubation •Auscultate breath sounds •Apply ice packs to the neck 4. Which client requires immediate intervention by the nurse? •A toddler with chickenpox who is scratching •An adolescent with a migraine and photophobia •A child with cystic fibrosis who is constipated •A Child with acute renal failure and hyperkalemia 5. A toddler with hemophilia is being discharged from the hospital. Which teaching should the nurse include in the discharge instructions to the mother? • Apply padding on the sharp corners of the furniture • Prevent the child from running inside the house • Give an 81 mg tablet of aspirin for pain relief • Use a soft toothbrush for frequent cleaning 6. The nurse is using the Stage Questionnaire (b) to assess a 24 - month-old child. What is the best intervention for the nurse to initiate after the assessment is completed? • Assess for changes in the vital signs • Review the child's birth history • Provide the parents with a list of stimulating activities • Meet with a social worker to review the results 7. When caring for a child sickle cell disease, the nurse knows that the child will most likely exhibit which sign when experiencing a sickle cell crisis? • Decreased hemoglobin • Pain • Infection • Dehydration 8. The nurse is administering an oral medication to a reluctant preschool-age boy. Which intervention should the nurse implement? • Advise the parents that they will need to give the medication • Use straightforward approach with the child • Mix the medication in with the child's favorite breakfast cereal • Offer to bring the medicine back later in the day 9. The nurse is planning care for a newborn infant scheduled for a cardiac catheterization. Which occurrence poses the greatest risk for this child? • Loss of pulse proximal to the entry side of the catheter • Allergic response to the plastics in the catheter used for catheterization • Acute hemorrhage from the entry site of the catheter after the procedure • Fever associated with nausea and vomiting after the procedure 10. The school nurse is presenting a seminar to parents about child safety that focuses on prevention of spinal cord injuries. What information is most important for the nurse include in the teaching plan? • Trampoline activities of school-aged children should be supervised by adults • Protective gear to prevent neck flexion should be worn during contact sports • Seat belt and car seat laws for use in motor vehicles should be reinforced • Monkey bars should be removed from school playgrounds to reduce falls 11. A mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2 F (38 C). Which intervention should the nurse implement? • Provide parent education to prevent recurrence • Clearance purulent exudate from the affected ear canal • Apply a topical antibiotic to the preauricular area • Ask the mother if the child has had a runny nose 12. A 4-month-old boy has an inguinal hernia that is visible when he cries, but it does not cause him discomfort. His parents ask if the hernia should be repaired now. The nurse's response should be based on what information? • An inguinal hernia is treated as a surgical emergency • Surgical repair is planned after successful toilet training • Surgical correction is indicated if the hernia is incarcerated 13. A 2-year-old child with heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 beast| minute. What action should the nurse implement? • Determined the pulse déficit • Calculate the safe dose range • Administer the scheduled dose • Review the serum digoxin level 14. The nurse is assisting the mother of child with phenylketonuria (PKU) to select foods that are in keeping with the child's dietary restrictions. Which foods are contraindicated for this child? • High fat foods • Foods sweetened with aspartame • Wheat products • High calorie foods 15. During a routine physical exam, a male adolescent client tell the nurse, " Sometimes, my mother gets angry because I want to be with my own friends". What is the best initial response by the nurse? • Offer to discuss his concerns together with his mother • Ask about client's response to his mother's age • Determine if his friends are engaged unsafe behaviors • Offer reassurance that his mother's concern is normal 16. Which response demonstrates that the mother of a young girl with a urinary tract infection (UTI) understands home care for the child? • I will give the antibiotics until she does not complain of burning anymore • I will bring her back to the doctor's office for another urine test • I will make sure she wipes from back to front after she uses the bathroom • I will refill the prescription for antibiotics if her symptoms are skill present after taking these 17. The nurse is caring for a one-year-old boy who has type 1 diabetes mellitus (DM). His mother asks how will she recognize hypoglycemia in her infant who cannot tell her how he feels. Which information should the nurse provide? • The baby's breath smell swells sweet when the sugar and blood ketone levels are high • Hypoglycemia in infants causes changes in behavior and cold clammy skin • Excess urination and dry skin are common indicators of hypoglycemia 18. An 8 year-old child is admitted to the Emergency Department because of lower right quadrant pain, nausea, and vomiting. Which assessment of the abdomen should the nurse conduct after all other assessments are complete? • Percussion • Palpation • Inspection • Auscultation 19. A female of child - bearing age receives a rubella vaccination. She has two children at home, ages 13 months and 3 years. Which instruction is most important for the nurse to provide to this client? • Tell the mother to isolate the children for 3 days • Inquire if anyone in the family is allergic to eggs • Encourage the client to immunize the children • Assess family history for incidence of rubella 20. The teacher notifies the school nurse that a child's nose is bleeding for no apparent reason. What action should the nurse implement first? • Tip the child's head back to avoid swallowing blood • Pinch the nose using thumb and finger for 10 minutes • Insert a sterile cotton ball in the nares that is bleeding • Apply an ice compress to the child's nose right away 21. A hospitalized child stiffens and stars to seize as the nurse enters the room. What actions should the nurse take? (Select all apply) • Turn client to the side if possible • Pad side rails with available pillows and blankets • Instruct the parents to leave the room • Notify the emergency response team • Monitor duration and progress of the seizure 22. An adolescent boy is hospitalized with full-thickness (third degreed) burns to both hands following a house fire. Three days after his admission to the burned unit, the nurse notes that teenager's hands are becoming more edematous. Which intervention is most important for the nurse to include in this client's plan care? • Record accurate intake and output • Ensure patient intravenous access • Assess radial pulses every 2 hours • Ensure that antibiotics are administered on time [Show Less]
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HESI PEDIATRICS V1, V2 & V3 TOTAL OF 134 QUESTIONS/ANSWER(S) 2020 RN
HESI PEDIATRICS V1, V2 & V3 TOTAL OF 134 QUESTIONS/ANSWER(S) 2020 RN 1. The nurse is planning care for a 5 - month-old with gastroesophageal reflu... [Show More] x disease whose weight has decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instruction should the nurse provide this mother? •Dilute the child's formula with equal parts of water • Thicken formula with cereal for each feeding 2. characteristic of the disease is most important for the nurse to focus on during the initial teaching? •Muscular strength can be regained with physical exercise and therapy •Growth and development have been abnormal since birth •Respiratory dysfunction and aspiration are prime concerns at this stage of the disease • Lower legs become progressively weaker, causing a wedding, unsteady gait 3. In caring for an client with acute epiglottitis, which nursing action takes priority? •Obtain a STAT CBC • Prepare for endotracheal intubation •Auscultate breath sounds •Apply ice packs to the neck 4. Which client requires immediate intervention by the nurse? •A toddler with chickenpox who is scratching •An adolescent with a migraine and photophobia •A child with cystic fibrosis who is constipated •A Child with acute renal failure and hyperkalemia 5. A toddler with hemophilia is being discharged from the hospital. Which teaching should the nurse include in the discharge instructions to the mother? • Apply padding on the sharp corners of the furniture • Prevent the child from running inside the house • Give an 81 mg tablet of aspirin for pain relief • Use a soft toothbrush for frequent cleaning 6. The nurse is using the Stage Questionnaire (b) to assess a 24 - month-old child. What is the best intervention for the nurse to initiate after the assessment is completed? • Assess for changes in the vital signs • Review the child's birth history • Provide the parents with a list of stimulating activities • Meet with a social worker to review the results 7. When caring for a child sickle cell disease, the nurse knows that the child will most likely exhibit which sign when experiencing a sickle cell crisis? • Decreased hemoglobin • Pain • Infection • Dehydration 8. The nurse is administering an oral medication to a reluctant preschool-age boy. Which intervention should the nurse implement? • Advise the parents that they will need to give the medication • Use straightforward approach with the child • Mix the medication in with the child's favorite breakfast cereal • Offer to bring the medicine back later in the day 9. The nurse is planning care for a newborn infant scheduled for a cardiac catheterization. Which occurrence poses the greatest risk for this child? • Loss of pulse proximal to the entry side of the catheter • Allergic response to the plastics in the catheter used for catheterization • Acute hemorrhage from the entry site of the catheter after the procedure • Fever associated with nausea and vomiting after the procedure 10. The school nurse is presenting a seminar to parents about child safety that focuses on prevention of spinal cord injuries. What information is most important for the nurse include in the teaching plan? • Trampoline activities of school-aged children should be supervised by adults • Protective gear to prevent neck flexion should be worn during contact sports • Seat belt and car seat laws for use in motor vehicles should be reinforced • Monkey bars should be removed from school playgrounds to reduce falls 11. A mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2 F (38 C). Which intervention should the nurse implement? • Provide parent education to prevent recurrence • Clearance purulent exudate from the affected ear canal • Apply a topical antibiotic to the preauricular area • Ask the mother if the child has had a runny nose 12. A 4-month-old boy has an inguinal hernia that is visible when he cries, but it does not cause him discomfort. His parents ask if the hernia should be repaired now. The nurse's response should be based on what information? • An inguinal hernia is treated as a surgical emergency • Surgical repair is planned after successful toilet training • Surgical correction is indicated if the hernia is incarcerated 13. A 2-year-old child with heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 beast| minute. What action should the nurse implement? • Determined the pulse déficit • Calculate the safe dose range • Administer the scheduled dose • Review the serum digoxin level 14. The nurse is assisting the mother of child with phenylketonuria (PKU) to select foods that are in keeping with the child's dietary restrictions. Which foods are contraindicated for this child? • High fat foods • Foods sweetened with aspartame • Wheat products • High calorie foods 15. During a routine physical exam, a male adolescent client tell the nurse, " Sometimes, my mother gets angry because I want to be with my own friends". What is the best initial response by the nurse? • Offer to discuss his concerns together with his mother • Ask about client's response to his mother's age • Determine if his friends are engaged unsafe behaviors • Offer reassurance that his mother's concern is normal 16. Which response demonstrates that the mother of a young girl with a urinary tract infection (UTI) understands home care for the child? • I will give the antibiotics until she does not complain of burning anymore • I will bring her back to the doctor's office for another urine test • I will make sure she wipes from back to front after she uses the bathroom • I will refill the prescription for antibiotics if her symptoms are skill present after taking these 17. The nurse is caring for a one-year-old boy who has type 1 diabetes mellitus (DM). His mother asks how will she recognize hypoglycemia in her infant who cannot tell her how he feels. Which information should the nurse provide? • The baby's breath smell swells sweet when the sugar and blood ketone levels are high • Hypoglycemia in infants causes changes in behavior and cold clammy skin • Excess urination and dry skin are common indicators of hypoglycemia 18. An 8 year-old child is admitted to the Emergency Department because of lower right quadrant pain, nausea, and vomiting. Which assessment of the abdomen should the nurse conduct after all other assessments are complete? • Percussion • Palpation • Inspection • Auscultation 19. A female of child - bearing age receives a rubella vaccination. She has two children at home, ages 13 months and 3 years. Which instruction is most important for the nurse to provide to this client? • Tell the mother to isolate the children for 3 days • Inquire if anyone in the family is allergic to eggs • Encourage the client to immunize the children • Assess family history for incidence of rubella 20. The teacher notifies the school nurse that a child's nose is bleeding for no apparent reason. What action should the nurse implement first? • Tip the child's head back to avoid swallowing blood • Pinch the nose using thumb and finger for 10 minutes • Insert a sterile cotton ball in the nares that is bleeding • Apply an ice compress to the child's nose right away 21. A hospitalized child stiffens and stars to seize as the nurse enters the room. What actions should the nurse take? (Select all apply) • Turn client to the side if possible • Pad side rails with available pillows and blankets • Instruct the parents to leave the room • Notify the emergency response team • Monitor duration and progress of the seizure 22. An adolescent boy is hospitalized with full-thickness (third degreed) burns to both hands following a house fire. Three days after his admission to the burned unit, the nurse notes that teenager's hands are becoming more edematous. Which intervention is most important for the nurse to include in this client's plan care? • Record accurate intake and output • Ensure patient intravenous access • Assess radial pulses every 2 hours • Ensure that antibiotics [Show Less]
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2022PEDIATRICS - HESI PRACTICE EXAM
2022PEDIATRICS - HESI PRACTICE EXAM To take the vital signs of a 4-month old child, which order will give the most accurate results? A. Respirat... [Show More] ory rate, heart rate, then rectal temperature B. Heart rate, rectal temperature, then respiratory rate. C. Rectal temperature, heart rate, then respiratory rate D. Rectal temperature, respiratory rate, then heart rate - CORRECT ANSWERA. Respiratory rate, heart rate, then rectal temperature The respiratory rate should be taken first in infants, since touching them or performing unpleasant procedures usually makes them cry, elevating the heart rate and making respirations difficult to count. Rectal temperature is the most invasive procedure, and is mot likely to precipitate crying, so should be done last. When planning the care for a child who has had a cleft lip repair, the nurse knows that crying should be minimized because it A. increases salivation B. increases the respiratory rate C. leads to vomiting D. stresses the suture line - CORRECT ANSWERD. stresses the suture line Prevention of stress on the lip suture line is essential for optimum healing and the cosmetic appearance of a cleft lip repair. Although crying also causes increased salivation, increased respiratory rate and may lead to vomiting, these conditions do not create a problem for the child with a cleft lip repair. A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms is this newborn likely to have exhibited? A. choking, coughing, and cyanosis B. projectile vomiting and cyanosis C. apneic spells and grunting D. scaphoid abdomen and anorexia - CORRECT ANSWERA. choking, coughing, and cyanosis (A) includes the "3 C's" of esophageal atresia caused by the overflow of secretions into the trachea. (B) is characteristic of pyloric stenosis in the infant. (C) could be due to prematurity or sepsis, and grunting is a sign of respiratory distress. (D) is characteristic of a diaphragmatic hernia. Which behavior would the nurse expect a two-year-old child to exhibit? A. build a house with blocks B. ride a tricycle C. display possessiveness of toys D. look at a picture book for 15 minutes - CORRECT ANSWERC. display possessiveness of toys Two-year old children are egocentric and unable to share with other children. (A, B, and D) are behaviors of a preschooler. A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribed dextrose 5% and 0.25% normal saline with 2 mEq KCI/100 mL to be infused at 25mL/hr. Prior to initiating the infusion, the nurse should obtain which assessment finding? A. frequency of emesis is the last 8 hours B. serum BUN and creatinine levels C. current blood sugar level D. appearance of the stool - CORRECT ANSWERB. serum BUN and creatinine levels Regardless of a client's age, adequate renal function must be present before adding potassium to IV fluids. (A) is important in determining the need for fluid replacement. (C) is not indicated. (D) is useful information, but will not impact administration of the prescribed IV solution. A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by which behavior? A. ability to communicate verbally B. response to separation from family C. concern for body integrity D. socialization with other children - CORRECT ANSWERC. concern for body integrity The preschooler's major stressor is concern for his body integrity. He fears that his "insides will leak out". A child undergoing surgery to his genitalia is even more concerned about body integrity. the preschooler is quite verbal so comprehension of the words he uses or hears may be inaccurate, while his imagination and fears may fantasize the reality. (B) is a concern for all children, but of most concern to the toddler. (D) is not a prime concern in this situation. The nurse is teaching a 12-year old male adolescent and his family about taking injections of growth hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly associated with growth hormone therapy should the nurse plan to describe to the child and his family? A. polyuria and polydipsia B. lethargy and fatigue C. increased facial hair D. facial bone structure changes - CORRECT ANSWERA. polyuria and polydipsia Signs and symptoms of diabetes or hyperglycemia need to be reported. those receiving growth hormone should be monitored to detect elevated blood sugars and glucose intolerance. Lethargy and fatigue are associated with any number of health alterations, but is not associated with the growth hormone therapy. Increased facial hair and facial bone structure changes are normal changes that occur with 12-year old males. The nurse is caring for a 12-year old with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). This child should be carefully assessed for which complication? A. poor skin turgor resulting from dehydration B. changes in LOC C. premature aging as the disease progresses D. severe edema from an excess of water and sodium - CORRECT ANSWERB. changes in LOC The child must be monitored for signs and symptoms of hyponatremia, which creates secondary CNS alterations, such as changes in LOC, seizure and coma. Fluid overload occurs with SIADH not dehydration (which occurs with diabetes insipidus). Premature aging is caused by hypersecretion of growth hormone, not SIADH. Severe edema is not found in children with SIADH because edema is caused by an excess of both water and sodium. The mother of a 2-year old boy consults the nurse about her son's increased tempter tantrums. The mother states, "Yesterday he threw a fit in the grocery store, and I did not know what to do. I was embarrassed. What can I do if this occurs again?" Which recommendation is best for the nurse to provide this mother? A. paddle him gently as soon as the behavior is initiated B. immediately put him in "time-out" C. quietly remind him that others are watching him D. walk away from him and ignore the behavior - CORRECT ANSWERD. walk away from him and ignore the behavior The best approach for a toddler is to ignore the attention-seeking behavior. The parent should be somewhat nearby within view of the child but should avoid reinforcing the behavior in any way. Tantrums can sometimes be avoided by talking to the child before the situation occurs. (A, B, and C) would all provide attention for the inappropriate behavior. A hospitalized 16-year old male refuses all visits from his classmates because he is concerned about his distorted appearance. To increase the client's social interaction, what intervention is best for the nurse to initiate? A. encourage the client to use a hand-held video game that is popular with all his friends B. assign a 25 year old female nursing student to offer support to the client C. arrange for an internet connection in the client's room for email communication D. encourage the client's mother to arrange a surprise get together in the cafeteria. - CORRECT ANSWERC. arrange for an internet connection in the client's room for email communication Body image and peer acceptance are key concerns for the adolescent. (C) allows for social interaction without face to face contact, thus protecting his self-image while also promoting social interaction. (A) does not promote social interaction. (B) does not encourage interaction with his own peer group, which is of greater import1ance. (D) does not respect the client's concern about his body image. The parents of a 3-week old infant report that the child eats well but vomits after each feeding. what information is most important for the nurse to obtain? A. description of vomiting episodes in the past 24 hours B. number of wet diapers in last 24 hours C. feeding and sleep schedule D. amount of formula consumed during the past 24 hours - CORRECT ANSWERA. description of vomiting episodes in the past 24 hours A description of the vomiting episodes will assist the nurse in determining the reason for the symptoms, which may be helpful in developing a plan of care for this infant. (B and C) provide related information but are not as helpful as (A). (D) may be related to vomiting but the nurse should first obtain a better description of the vomiting episodes. A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most important instruction for the nurse to include in this client's teaching plan? A. Use sunscreen when lying by the pool. B. cleanse the skin at least 4 times a day. C. take the medication with a glass of milk D. menstrual periods may become irregular - CORRECT ANSWERA. Use sunscreen when lying by the pool. Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe sunburn can occur with minimal sun exposure and clients should be instructed to avoid sunlight and to use sunscreen. (B and D) are not related to tetracyline HCL (Achromycin V) therapy. (C) should be avoided because dairy products interfere with the absorption of tetracyclines. A [Show Less]
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Med Surg V2 PN HESI, OB HESI, Pediatrics HESI PN Review, Maternity NCLEX PN
Med Surg V2 PN HESI, OB HESI, Pediatrics HESI PN Review, Maternity NCLEX PN
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OB HESI, Pediatrics HESI PN Review, Maternity NCLEX PN EXAM 2022
OB HESI, Pediatrics HESI PN Review, Maternity NCLEX PN EXAM 2022 When talking with a pregnant client who is experiencing aching swollen, leg veins, th... [Show More] e nurse would explain that this is most probably the result of which of the following? A. thrombophlebitis B. pregnancy induced hypertension C. pressure on blood vessels from the enlarging uterus D. the force of gravity pulling down on the uterus - CORRECT ANSWERD - Explanation Pressure of the growing uterus on blood vessels results in an increased risk for venous stasis in the lower extremities. Subsequently, edema and varicose vein formation may occur. Thrombophlebitis is an inflammation of the veins due to thrombus formation. Pregnancy-induced hypertension is not associated with these symptoms. Gravity plays only a minor role with these symptoms. Which of the following would cause a false-positive result on a pregnancy test? A. The test was performed less than 10 days after an abortion B. The test was performed too early or too late in the pregnancy C. The urine sample was stored too long at room temperature D. A spontaneous abortion or a missed abortion is impending - CORRECT ANSWERA - Explanation A false-positive reaction can occur if the pregnancy test is performed less than 10 days after an abortion. Performing the tests too early or too late in the pregnancy, storing the urine sample too long at room temperature, or having a spontaneous or missed abortion impending can all produce false- negative results. During a lecture on reproduction, a student nurse asks the instructor what determines the sex of a fetus. Accurate information in response to this question would be: A. "The sex of the fetus is not determined until the eighth week of gestation." B. "The fertilization of the zygote is the point at which sex is determined." C. "Males have one less pair of chromosomes than females." D. "Sex is determined by the chromosomes contributed by the ovum." - CORRECT ANSWERB. Explanation The sex of the fetus is determined at the point that the sperm fertilizes the ovum to form the zygote. Sex is ultimately determined by the chromosome contributed by the sperm. Pediazole is a suspension medication that contains 200 mg erythromycin and 600 mg sulfisoxazole per 5 mL. The physician orders Pediazole 4 mL PO every 12 hours. How many mg of sulfisoxazole is this client receiving in a 24-hour period? A. 160 mg B. 320 mg C. 480 mg D. 960 mg - CORRECT ANSWERD. Explanation 600 mg/ 5 mL = x mg/ 4 mL 2400 = 5x x= 2400/5 x= 480 mg per dose x 2 = 960 mg in 24 hours. A primigravida patient who is 12 weeks pregnant visits a helath promotion program in the community pertaining to the pregnancy care. A group of nursing student is educating the public about measures to prevent discomfort of pregnancy. The primigravida patient asks one of the student about measures on how to prevent heartburn she is experiencing throughout the day. Select all the necessary measures to prevent the primigravia patient's complaint. A. Eating small, frequent meals and avoiding fatty and spicy food B. Eating high fiber foods and increase drinking fluids C. Drinking milk between milk D. Arranging frequent rest periods throughout the day E. Sitting upright for 30 minutes after a meal F. Engaging in regular exercise - CORRECT ANSWERA, C, E The nurse identifies substance abuse behaviors exhibited by a pregnant client during an initial prenatal screening. While promoting a therapeutic and accepting environment, the care managment by the nurse would be MOST appropriate if focused on which of the following? A. Discouraging substance use during pregnancy B. Termination of the pregnancy at an early stage C. Eliminating substance use during pregnancy D. Setting boundaries with the client in regards to substance use - CORRECT ANSWERC. Explanation Use of substances during pregnancy can lead to severe fetal or neonatal abnormalities, complications, and death. The primary goal of nursing care should be prevention or elimination of substance use during pregnancy. This is a dark streak down the midline of the abdomen that may appear as the uterus is enlarging. The LPN correctly describes this to the pregnant woman as? - CORRECT ANSWERLINEA NIGRA Cervical softening and uterine souffle are classified as which of the following? A. diagnostic signs B. presumptive signs C. probable signs D. positive signs - CORRECT ANSWERC. Explanation Cervical softening (Goodell sign) and uterine soufflé are two probable signs of pregnancy.Probable signs are objective findings that strongly suggest pregnancy. Other probable signs include Hegar sign, which is softening of the lower uterine segment; Piskacek sign, which is enlargement and softening of the uterus; serum laboratory tests; changes in skin pigmentation; and ultrasonic evidence of a gestational sac. Presumptive signs are subjective signs and include amenorrhea; nausea and vomiting; urinary frequency; breast tenderness and changes; excessive fatigue; uterine enlargement; and quickening. A client at 36 weeks' gestation is schedule for a routine ultrasound prior to an amniocentesis. After teaching the client about the purpose for the ultrasound, which of the following client statements would indicate to the nurse in charge that the client needs further instruction? A. The ultrasound will help to locate the placenta B. The ultrasound identifies blood flow through the umbilical cord C. The test will determine where to insert the needle D. The ultrasound locates a pool of amniotic fluid - CORRECT ANSWERB. Explanation Before amniocentesis, a routine ultrasound is valuable in locating the placenta, locating a pool of amniotic fluid, and showing the physician where to insert the needle. Color Doppler imaging ultrasonography identifies blood flow through the umbilical cord. A routine ultrasound does not accomplish this. A nursing instructor asks a nursing student to list the functions of the amniotic fluid. The student responds correctly by stating that which of the following are functions of amniotic fluid? Select all that apply. A. Allows for fetal movement B. Is [Show Less]
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Pediatrics - HESI : PN EXAM QUESTIONS AND ANSWERS 2022
Pediatrics - HESI : PN EXAM QUESTIONS AND ANSWERS 2022 A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferre... [Show More] d injection site to administer this immunization? a. Dorsal gluteal b. Vastus lateralis c. Ventral gluteal d. Deltoid - CORRECT ANSWERb. Vastus lateralis Rationale: The preferred intramuscular site for children younger than 2 years of age is the vastus lateralis. A 2-year-old child developed a fever of 103.4° F (39.7° C) and was rushed to the emergency department when the child developed febrile seizures. After the child was stabilized, the health care provider diagnosed otitis media in the child. The concerned caregivers ask the nurse how this can be prevented from happening again. The nurse should reinforce which instructions? a. Contact the child's health care provider if the child starts pulling at the ear. b. If the child develops an elevated temperature, bathe the child in cold water. c. Give the child a bottle to take while in the supine position to relieve the pain. d. Use children's chewable baby aspirin if the child's temperature is over 102° F (38.9° C). - CORRECT ANSWERa. Contact the child's health care provider if the child starts pulling at the ear. Rationale: The parents should be taught to contact the health care provider if the child begins to pull at the ears, an early sign of otitis media. Treating otitis media early can reduce the risk of a high temperature and a resulting febrile seizure. If the child develops an elevated temperature, the child should be bathed in tepid water, not cold water or rubbing alcohol. Taking a bottle in the supine position is not recommended because this increases the risk of developing otitis media. Children should be given acetaminophen as prescribed for pain and fever. Aspirin is not recommended in children due to the risk of Reyes syndrome, a serious neurological disorder. Unfortunately, pleasantly flavored children's chewable aspirin is sometimes described or labeled as "baby aspirin." A 2-year-old child had tympanostomy ventilating tubes inserted into both tympanic membranes (TMs) 1 week earlier. During a postoperative clinic visit, the practical nurse (PN) notes that the child has a purulent discharge from the right ear, and the mother explains that the toddler has had a cold for 3 days. What action should the PN plan to implement? a. Collect a specimen of the otorrhea for culture. b. Refer the child for audiologic screening tests. c. Administer prescribed antibiotics. d. Perform an otoscopic exam for TM tube placement. - CORRECT ANSWERa. Collect a specimen of the otorrhea for culture. Rationale: The presence of the purulent drainage indicates that the middle ear is draining a new infectious process, and a specimen of the otorrhea should be collected for culture. Tympanostomy tubes are surgically placed to manage otitis media with effusion (OME) to provide mechanical drainage of fluid and to equalize pressure within the middle ear. Chronic OME can impede TM and ossicle function, necessitating hearing screening. The immediate problem, however, is infection. A 2-year-old child who is hospitalized with an acute upper respiratory infection (URI) is crying uncontrollably because her mother went to the cafeteria for lunch. Which action should the practical nurse implement? a. Distract the child with a favorite toy. b. Tell the child that her mother will return. c. Take the child to the cafeteria. d. Calm the child with a dietary treat. - CORRECT ANSWERA) Distract the child with a favorite toy. Rationale: The best action is to refocus the child's attention by distracting with a favorite toy. A 3 day infant has had surgery to reconstruct the anus due to an anorectal malformation noted at birth. The nurse will implement which aspect of postoperative care? a. Assess the child's temperature rectally every 4 hours. b. Position the child side-lying prone with the hips elevated. c. Inform the parents toilet training should begin on schedule. d. Passing stools in the urine is expected to occur after surgery. - CORRECT ANSWERb. Position the child side-lying prone with the hips elevated. Rationale: The child should be positioned in the side-lying prone position with the hips elevated to decrease pressure on the perineal sutures. No rectal temperatures should be taken postoperatively, because this could disrupt the sutures. Toilet training is frequently delayed and full continence may not be achieved. It is not normal for the child to pass stools in the urine. A 5-year-old children tells the practical nurse (PN) that she "needs a Band-Aid" when she has an injection. Which action is best for the PN to take? a. Show her that the bleeding has already stopped. b. Explain why a Band-Aid is not needed. c. Ask her why she wants a Band-Aid. d. Apply a Band-Aid over the injection site. - CORRECT ANSWERD) Apply a Band-Aid over the injection site. Rationale: Preschool children sometimes think that any hole (e.g., an injection or incision) made in their bodies allow their "insides to leak out," so applying a Band-Aid over the hole prevents this from occurring. A 6-year-old child arrives to the urgent care center with symptoms of an asthma exacerbation. The child's oxygen saturation is 90%, the pulse is 120 beats/min, and the respiratory rate 32 per minute. The nurse should prepare for which priority intervention? a. Administration of a long-acting bronchodilator b. Monitoring for signs of an infection masked by steroid use c. Administration of oxygen and subcutaneous injection of epinephrine d. Reviewing with the caregivers the possible triggers for an exacerbation of asthma - CORRECT ANSWERc. Administration of oxygen and subcutaneous injection of epinephrine Rationale: The priority of care for an acute asthma attack is oxygen administration and administration of epinephrine, which is a rapid-acting bronchodilator. After the acute attack has subsided, and the child's respiratory status is stable, the nurse can anticipate administration of a long-acting bronchodilator. Monitoring for signs of an infection is important, but the immediate priority is oxygen administration and use of a rapid-acting bronchodilator. Education regarding asthma triggers is also crucial, but should take place after the child is stable. A 7-year-old child is diagnosed with a streptococcal infection of the throat (strept throat). The parent asks the nurse "Why does my child need to take antibiotics? His sister had a sore throat last month and all she took was acetaminophen and diphenhydramine." The nurse responds by explaining that "strept throat" is associated with which complications? (Select all that apply.) a. Rheumatic heart disease b. Ventral septal defects c. Complete heart block d. Nephrotic syndrome e. Acute glomerulonephritis f. Vesicoureteral reflux - CORRECT ANSWERA) Rheumatic heart disease [Show Less]
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Pediatrics HESI PN Review 2022 EXAM A GRADE
Pediatrics HESI PN Review 2022 EXAM A GRADE The practical nurse (PN) is monitoring a child who is manifesting signs of shock after a motor vehicl... [Show More] e collision. Which finding is most important for the PN to report to the charge nurse? a) narrowing pulse pressure b) apprehension c) irritability d) thirst - ANSWERRAnswer: A 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." 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." - ANSWERRAnswer: B 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 d) monitor neurologic functioning - ANSWERRAnswer: C 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). The practical nurse is caring for a 6 year old girl who had surgery 12 hours ago. The child tells the PN that she does not have pain but a few minutes later, tells her parents that she does. What child development concept is relevant to this situation? a) inconsistency in pain reporting suggests that pain not present b) a child may have pain yet deny its presence to the nurse c) truthful reporting of pain should occur by this age d) children use pain experiences to manipulate their parents - ANSWERRAnswer: B Rationale: A child may fear receiving an injection for pain or may believe that pain is a deserved punishment for some misdeed, so the pain is denied (D) when the nurse asks the child, who then readily admits having pain to a parent. This behavior should not be interpreted as (C) but as a valid indication of pain. (A and C) are incorrect interpretations of this behavior. A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst. What should the practical nurse (PN) offer? a) popsicle b) lemonade c) orange juice d) chocolate milk - ANSWERRAnswer: A Rationale: Small amounts of clear liquids without red dyes should be offered to the child. Popsicles (A) are cold and help soothe a dry throat. Citrus drinks (B and C) are acidic and irritate the operative site in the posterior oropharynx. Milk (D) thickens oral mucus which makes swallowing more difficult and causes coughing. The mother of a male newborn calls the clinic to inquire about the formation of a yellow crust over her son's circumcision area. What information should the practical nurse (PN) provide? a) do not remove the yellow crust from the site b) stop using petroleum around the head of the penis c) bring him into the clinic d) tightly fasten the diaper - ANSWERRAnswer: A Rationale: Crust formation is part of the healing process and should be removed (A). (C) is not indicated at this time. The diaper should be fastened loosely, not tightly (D) which can place pressure on the incision site. (B) assists in the healing process and should not be discontinued. The mother of a child with croup is having barking, coughing episodes calls the clinic for assistance. What action should the practical nurse (PN) recommend that the mother implement first? a) take the child outside in the cool air b) bring the child directly to the emergency room c) sit with the child in bathroom with a hot shower running d) have the child drink plenty of fluids - ANSWERRAnswer: C Rationale: Croup (laryngotracheobronchitis) is a viral infection that causes a "barking" cough and varying degrees of inspiratory stridor, which often responds to a high humidity environment. Most children can be managed at home using the stream from a hot shower in a closed bathroom (C) which often stops laryngeal spasm. Increasing the child's fluid intake is important (D), but not a priority at this time.Although exposure to cold air (A) also relieves stridor, parents should be encouraged to use mist humidifier in the child's room. (B) is not necessary unless the child is having increasingly difficulty breathing that may lead to a compromised airway. Which finding should the practical nurse confirm with the parents of an infant who is admitted with possible intussusception? a) red currant jelly stools b) clay colored stools c) constant abdominal pain d) projectile vomiting after meals - ANSWERRAnswer: A Rationale: Red currant jelly stools (A) is a sign of intussusception, which causes a mixture of stool, mucous, and blood as the intestines telescopes inside itself. (D) is associated with pyloric stenosis. (B) is consistent with biliary obstruction. Infants with intussusception usually have periods of severe pain followed by intervals in which they appear comfortable, not (C). The practical nurse (PN) is observing a group of children at a day care center to determine whether children are achieving developmental milestones. Which activity should the PN identify as typical for a 2 year old child's cognitive development? a) has a vocabulary of about 1000 words b) uses short sentences to express self c) initiates play with other children d) recognizes right and wrong - ANSWERRAnswer: B Rationale: Although children develop at different rates, a 2 year old typically uses short sentences to express independence and control (B) and has a vocabulary of up to 300 words, not (A). At the age of 2 years, a toddler is developing negativism without understanding the concepts of right and wrong (D). A 2 year old engages in solitary play and parallel play but does not initiate or cooperative with other children (C) in play, which begins with socialization of the preschool child. The practical nurse (PN) is interviewing a 10 year old girl about school and her extracurricular activities. She responds, "I like school. I play the flute in the school band, and I take tennis lessons." Based on Erikson's psychosocial theory, the PN identifies that this child is in what stage of development? a) identity b) intimacy c) industry d) initiative - ANSWERRAnswer: C Rationale: Erikson's stage of industry (C) for a school aged child is demonstrated by successful participation in new skills and peer activities, such as sports and band. (A, B, and D) are achieved in other age groups. The practical nurse (PN) identifies an increased frequency of otitis media (OM) is children who are coming to the clinic. Based on this finding, which age group should the PN monitor a child for signs and symptoms of OM? a) toddler b) preschooler c) school ager d) adolescent - ANSWERRAnswer: A Rationale: Infants and toddlers (A) are most prone to otitis media due to the anatomical structure of the eustachian tube that allows fluid and microbial entry into the middle ear. (B, C, and D) are most susceptible to acute infectious diseases acquired through environmental transmission from daycare or school settings. The practical nurse (PN) collects information about infant growth and development milestones for infants who come to the clinic for a well child visit. Which findings should the PN document as normal infant growth and development? a) maternal iron stores persist during the first 12 months of life b) anterior fontanel closes by 6 to 10 months of age c) binocularity is well established by 8 months of age d) birth weight double by age 5 months and triples by 1 year - ANSWERRAnswer: D Rationale: Infants gain approximately 1.5 pounds/month until age 5 to 6 months, when the birth weight doubles, and by 1 year of age, the birth weight usually triples (D). The anterior fontanel closes by 12 to 18 months of age, with the average being 14 months, not (B). Binocularity begins to develop by 6 weeks of age and should be well established by age 4 months, not (C). Maternally derived iron stores ares present for the first 5 to 6 months and gradually diminish, which results in an expected lowered hemoglobin levels toward the end of the first 6 months (A). Which nonfood item is the most common cause of respiratory arrest in young children? a) latex balloons b) broken rattles c) buttons d) pacifiers - ANSWERRAnswer: A Rationale: Nonfood items cause the majority of choking deaths in young children. Latex balloons (A), whether partially inflated, uninflated, or popped, are the leading cause of pediatric choking that leads to aspiration of small objects (A,B, and D) because they experience the environment by placing objects in the mouth, but (A) is the leading cause of death causing respiratory obstruction and arrest. The practical nurse (PN) is talking with a group of elementary students about bicycle safety. [Show Less]
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HESI: Pediatrics EXAM 2022 REAL A GRADED
HESI: Pediatrics EXAM 2022 REAL A GRADED What is considered bradycardia in an infant? - CORRECT ANSWERHeart rate less than 90-110 An infant with CHF ... [Show More] taking digoxin has a heart rate of 80bpm, what does this indicate? - CORRECT ANSWERPossible digoxin toxicity Fever due to immunizations may occur. What is contraindicated in this situation? - CORRECT ANSWERAspirin is contraindicated in children d/t risk for Reye's syndrome What is the therapeutic level of theophylline? - CORRECT ANSWERTherapeutic level: 10-20 mcg/dL How long should the Milwaukee brace for scoliosis should be worn? - CORRECT ANSWER23 hours a day, only remove for 1 hour for bathing How is varicella spread? - CORRECT ANSWERDirect or indirect contact of saliva or vesicles. Put on strict isolation to prevent exposure to others. When is varicella most communicable? - CORRECT ANSWER2 days before the rash appears until all lesions are crusted What are the most common presenting symptoms of leukemia? - CORRECT ANSWER-Bone pain r/t leukemic cells invading periosteum -Pallor r/t anemia What are some characteristics of spastic cerebral palsy in an infant? - CORRECT ANSWER-Legs crossing -Stiffness when pulled to a sitting position -Difficulty with fine motor skills What as an infant at risk for when in celiac crisis? - CORRECT ANSWERRisk for fluid volume deficit d/t severe diarrhea--assess for dehydration (mucous membranes and skin turgor) What behavior is common in a 4 year old? - CORRECT ANSWERAggressive behavior is common, they enjoy telling stories. What initial symptom is common for a newborn to exhibit with positive HIV? - CORRECT ANSWERPersistent cold--respiratory tract infections are common, less ability to defend body Why must the heart rate be monitored during an NG tube insertion for a 3-month old? - CORRECT ANSWERHR may decrease because of vagal nerve stimulation How to determine calorie requirement for an infant? - CORRECT ANSWER108 cals/kg/day Common risk factor for a child with developmental dysplasia of the hip? - CORRECT ANSWERInfant in breech position What is often done prior to any invasive procedure for children with valvular damage? - CORRECT ANSWERProphylactic antibiotics What is priority nursing intervention for a child with polycythemia? - CORRECT ANSWERMaintain adequate fluid hydration. What part of the child's body is bigger compared to an adults? - CORRECT ANSWERHead and neck What is the most common cause of acquired aplastic anemia? - CORRECT ANSWERExposure to certain drugs At what age is the infant able to lift and control its head? - CORRECT ANSWER3-4 months What is the proper way to administer eardrops to a child? - CORRECT ANSWERPulled down and back Earliest sign of hydrocephalus in an infant? - CORRECT ANSWERIrritability and poor feeding In children, what is always the initial sign of respiratory distress? - CORRECT ANSWERRestlessness r/t decreasing amts of circulating oxygen A patient with laryngotracheobronchitis cannot speak anymore. What may this indicate? - CORRECT ANSWERThe condition is worsening--impending airway obstruction. Risk for respiratory arrest secondary to edema and inflammation. What breath sound is common with laryngotracheobronchitis? - CORRECT ANSWERInspiratory stridor Asthma discharge education - CORRECT ANSWER-Exercise daily -Remove allergens from sleeping room -See provider for eval every 3-6 months Best way to prevent aspiration - CORRECT ANSWERSide-lying position Most reliable diagnostic test for cystic fibrosis - CORRECT ANSWERQuantitative sweat test--pilocarpine iontophoresis. When should the nurse withhold chest PT? - CORRECT ANSWEREx. when the child is having acute bronchoconstriction/airway edema--lossening mucus plugs could cause airway obstruction What heart defect can result from rheumatic fever in children? - CORRECT ANSWERAortic stenosis What cardiac anomaly produces a left-to-right shunt? - CORRECT ANSWERAtrial septal defect--pressure is greater on the left side of the heart What causes sinus tachycardia in a child? - CORRECT ANSWERFever When may the ductus close in patent ductus arteriosus? - CORRECT ANSWER6 weeks What is the relationship of blood pressure and coarctation of the aorta? - CORRECT ANSWERUpper extremities will have a higher blood pressure A child projectile vomits--what would the nurse suspect? - CORRECT ANSWERPyloric stenosis What comment may suggest nephrotic syndrome? - CORRECT ANSWER"Her clothes are fitting tighter and she has put on more weight than usual."--edema/wt gain What should the urine look like after a toddler gets a procedure done to correct hypospadias? - CORRECT ANSWERClear yellow appearance Nursing interventions for acute glomerulonephritis (AGN) - CORRECT ANSWER-Monitor for acute hypertension -Daily weights w/ strict input and output -Admin of diuretics as ordered 90-90 traction purpose - CORRECT ANSWERAssist in reducing the fracture What type of brace is used for treatment of scoliosis? - CORRECT ANSWERBoston or Wilmington braces What information should be provided about sunscreen and infants? - CORRECT ANSWERSunscreen should not be applied to infants younger than 6 months Discharge instructions for impetigo - CORRECT ANSWER-Gently wash lesions to remove crusting twice a day -Stop the antibiotics as soon as the crusting disappears -Apply antibiotic cream twice a day Tinea pedis - CORRECT ANSWERSuperficial fungal infection on the feet---athelete's foot. 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PEDIATRICS - HESI PRACTICE EXAM With RATIONALE
PEDIATRICS - HESI PRACTICE EXAM With RATIONALE The nurse is giving preoperative instructions to a 14-year old female client who is scheduled for surg... [Show More] ery to correct a spinal curvature. Which statement by the client best demonstrates that learning has taken place? A. I will read all the literature you gave me before surgery. B. I have had surgery before when I broke my wrist in a bike accident, so I know what to expect. C. All the things people have told me will help me take care of my back. D. I understand that I will be in a body cast and I will show you how you taught me to turn. - answerD. I understand that I will be in a body cast and I will show you how you taught me to turn. Outcome of learning is best demonstrated when the client not only verbalizes an understanding, but also can provide a return demonstration. A 14-year old may or may not follow through with reading material and there is no way of measuring that way of learning. Have a previous surgery may help the client understand the surgical process, but wrist surgery is very different from spinal surgery and emergency surgery is different than elective surgery. In (C), the client may be saying what the nurse wants to hear, without expressing any real understanding of what to do after surgery. To take the vital signs of a 4-month old child, which order will give the most accurate results? A. Respiratory rate, heart rate, then rectal temperature B. Heart rate, rectal temperature, then respiratory rate. C. Rectal temperature, heart rate, then respiratory rate D. Rectal temperature, respiratory rate, then heart rate - answerA. Respiratory rate, heart rate, then rectal temperature The respiratory rate should be taken first in infants, since touching them or performing unpleasant procedures usually makes them cry, elevating the heart rate and making respirations difficult to count. Rectal temperature is the most invasive procedure, and is mot likely to precipitate crying, so should be done last. During routine screening at a school clinic, an otoscope examination of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. What action should the nurse take next? A. No action required, as this is an expected finding for a school-aged child B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately. C. Send a note home advising the parents to have the child evaluated by a healthcare provider as soon as possible. d. Call the parents and have them take the child home from school for the rest of the day. - answerB. Ask the child if he/she has had a cold, runny nose, or any ear pain lately. More information is needed to interpret these findings. The tympanic membrane is normally pearly gray, not bulging, and moves when the client blows against resistance or a small puff of air is blown into the ear canal. Since this child's findings are not completely normal, further assessment of history and related signs and symptoms is indicated for accurate interpretation of the findings. (A), (C), and (D) are inappropriate actions based on the data obtained from the otoscope examination. Which restraint should be used for a toddler after a cleft palate repair? A. clove hitch B. Mummy C. elbow D. jacket - answerC. elbow Elbow restraints Elbow restraints prevent children from bending their arms and bringing their hands to the oral surgical site. A clove hitch restrains the hands, but the child can bend and bring their head to their hands. A mummy restraint is used during procedures. A jacket restraint restrains the body torso and is not appropriate. What preoperative nursing intervention should be included in the plan of care for an infant with pyloric stenosis? A. Monitor for signs of metabolic acidosis. B. estimate the quantity of diarrhea stools. C. place in a supine position after feeding D. observe for projectile vomiting. - answerD. observe for projectile vomiting. Projectile vomiting which contributes to metabolic alkalosis, is the classic sign of pyloric stenosis. Estimating the quantity of diarrhea stools is not indicated. Placing the child in a supine position is dangerous due to the potential for aspiration with frequent vomiting. A six-month-old returns from surgery with elbow restraints in place. What nursing care should be included when caring for any restrained child? A. keep restraints on at all times. B. remove restraints one at a time and provide range of motion exercises C. Remove all restraints simultaneously and provide lay activities D. renew the healthcare provider's prescription for restraints every 72 hours. - answerB. remove restraints one at a time and provide range of motion exercises Removing restraints one at a time is safer than removing all of them at once. The child needs to exercise and should not be kept in restraints at all times. The renewal of the healthcare provider's prescription varies with hospitals and it does not really answer the question. A 2-year old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome? A. congenital heart disease B. fragile x-chromosome C. trisomy 13 D. pyloric stenosis - answerA. congenital heart disease Congenital heart disease is the most common associated defect in children with Down syndrome. Trisomy 13 my have seemed possible since Down syndrome is a trisomal chromosomal abnormality o chromosome 21. Fragile x-chromosome is a sex-linked abnormality also causing mental retardation. Pyloric stenosis is not associated with Down syndrome. When assessing a child with asthma, the nurse should expect intercostal retractions during A. inspiration B. coughing C. apneic episodes D. expiration - answerA. inspiration Intercostal retractions result from respiratory effort to draw air into restricted airways. When planning the care for a child who has had a cleft lip repair, the nurse knows that crying should be minimized because it A. increases salivation B. increases the respiratory rate C. leads to vomiting D. stresses the suture line - answerD. stresses the suture line Prevention of stress on the lip suture line is essential for optimum healing and the cosmetic appearance of a cleft lip repair. Although crying also causes increased salivation, increased respiratory rate and may lead to vomiting, these conditions do not create a problem for the child with a cleft lip repair. [Show Less]
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Pediatrics Exam 2 full exam 2022 a grade
1. The nurse teaches parents that the anticholinergic drug oxybutynin is used to treat enuresis. The best response when the parents ask why the drug is bei... [Show More] ng used is: a. It’s an antidepressant that is used to help the child relax b. It will help decrease the spasms sometimes associated with enuresis c. It has an antidiuretic effect, so your child can attend sleepovers d. It will slow the production of urine, so your child does not have to urinate as frequently 2. A nurse is caring for a child who requires intravenous maintenance fluid. The child weighs 30 kg. Calculate the child’s daily maintenance fluid requirements in milliliters. Record you answer using a whole number. Enter numeric value only a. **1700 3. A nurse is admitting a 6-month-old infant who has dehydration. When she tracks the client’s urinary output, which of the following amounts should indicate to the nurse that the treatment has corrected the fluid imbalance? a. 0.5 mL/kg/hr b. 7.5 mL/kg/hr c. 15 mL/kg/hr d. 2 mL/kg/hr 4. A 4-year-old boy is diagnosed with pin worms (enterobius). The parents should be instructed to: (select all that apply) a. Have all children in the household treated at the same time b. Wash and cook all vegetables before eating c. Wash all toys and clothing in hot soapy water d. Have children wear shoes when outdoors 5. The nurse is teaching the parents of a newborn who was born with a high type of imperforate anus the care the newborn will need at home after surgery. The parents need to be aware that the newborn will require which measure temporarily? a. Colostomy b. Intravenous fluids c. Nasal cannula for oxygen d. Nasogastric tube 6. A nurse is caring for a 2 onth old infant who is postoperative following surgical repair of a cleft lip. Which of the following actions should the nurse take? a. Encourage the parents to rock the infant b. Offer the infant a pacifier c. Administer ibuprofen as needed for pain d. Position the infant on her abdomen 7. The nurse is calculating the urinary output for the infant. The infant’s diaper weighed 40 grams prior to placing the diaper on the infant. After removal of the wet diaper, the diaper weighed 75 grams. How many milliliters of urine can the nurse document as urinary output? Record your answer using a whole number. a. 35 b. 30 c. 3500 d. 350 8. A 5-year-old child, a known diabetic, has been admitted with ketoacidosis secondarily to an infection. Which of the physician’s orders should the nurse question? a. Add 4 units NPH insulin to the IV for every 100 cc of IV fluid b. IV DS ½ NS at 80 cc/hr c. Add 100,000 units aqueous penicillin to the IV every hours d. Monitor blood glucose levels q4 hours and prn 9. A nurse is caring for a 7-year-old client who has a diagnosis of upper respiratory infection and a history of type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instructions? a. I will continue to check his blood sugar two times a day b. I will encourage drinking a half a cup of water or sugar-free fluids every 30 minutes c. I will report a change in breathing or any signs of confusion d. I will notify the doctor if the temperature is not controlled with acetaminophen 10. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids? a. D5W b. 0.9 percent Normal Saline (NS) c. Albumin d. D5 0.2 percent (1/2) Normal Saline 11. The mother of an infant who underwent surgery to repair hypospadias asks the nurse why the infant is double-diapered. The nurse would respond that this method of diapering: a. Protects the urinary stent that has been put in place b. Adequately measures the urinary output c. Provides for maximum absorption of urine d. Provides optimal protection of perineal skin from infected urine 12. The nurse is preparing to remove an IV device from the arm of a 6-year-old girl. Which approach is best for minimizing fear and anxiety? a. This won’t be painful, you’ll just feel a tug and a pinch b. The first is for you to help me remove this dressing from your IV c. Be sure to keep your hands clear of the scissors so I don’t cut you d. Please be a big girl and don’t cry when I remove this 13. The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which response from the mother indicates a need for further teaching? a. I can tape a quarter over the hernia to reduce it b. Incarceration is rare, but it can occur c. I need to watch for pain, tenderness, or redness d. My son could have some appearance related self-esteem issues 14. A child with nephrotic syndrome is severely edematous. The primary health care provider has placed the child on bed rest. An important nursing intervention for this child would be to: [Show Less]
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