Hesi Pediatrics Practice Exam GRADED A LATEST VERSION UPDFATED APRIL 2023
The nurse is giving preoperative instructions to a 14 year y/o female
... [Show More] client who is scheduled for surgery 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 acdient, 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 taught me to turn"
(ANS- D
Rationale: Outcome of learning is best demonstrated when the client not only verbalizes an understanding but can also provide a return demonstration (D)
A: 14 y/o might not do that
B: Spinal surgery is different from wrist surgery
C: Client may be saying what the nurse wants to hear w/o expressing any real understanding of what to do after surgery
A 2 y/o 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
(ANS- A
B: Causes mental retardation
D: 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
(ANS- A.
Intercostal retractions result from respiratory effort to draw air into restricted airways
Which behavior would the nurse expect a 2 y/o 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
(ANS- C
Remember 2 y/o are egocentric aka everything is about them so they are unable to share with other children
ABC are behaviors of a preschooler
The mother of a preschool-aged child asks the nurse if it all right to administer Pepto Bismol to her son when he "has a tummy ache". After reminding the mother to check the label of all OTC drugs for prescence of aspirin, which instruction should the nurse include when replying to this mother's question?
A. If the child's tongue darkens, d/c the Pepto Bismol immediately
B. Don't give if the child has chicken pox, the flu, or any other viral illness
C. Avoid the use of Pepto Bismol until the child is at least 16 y/o
D. Pepto Bismol may cause a rebound hyperacidity, worsening the tummy ache (ANS- B
Pepto Bismol contains aspirin and there is the potential of Reye's syndrome.
A: Is a common effect of Pepto bismol doesn't warrant d/c
C: Pepto Bismol doesn't cause rebound hyperacidity
D: Complication of antacids containing calcium
The nurse observes a 4 y/o boy in a daycare setting. Which behavior should the nurse consider normal for this child?
A. Has a temper tantrum when told he must shares his toys
B. Plays by himself most of the day
C. Demonstrates aggressiveness by boasting when telling a story
D. Begins to cry & is fearful when separated from his parents
(ANS- C
4 y/o children are aggressive in their behavior and enjoy "tale telling".
AD: Typical of toddlers. The play of preschooler is cooperative, so playing B is not typical
A burned child is brought to the ER. In estimating the % of the body burned, the nurse uses a modified "rule of nines". Which part of a child's body is calculated as a larger percentage of total body surface than an adult's?
A. Head & Neck
B. Arms & Chest
C. Legs & abs
D. Back & Abdomen
(ANS- A
The nurse receives a lab report stating a child with asthma has theophyline level of 15 mcg/dl. Which action will the nurse take?
A. Pass the information on in the report
B. Notify the healthcare provider bc the value is high
C. Repeat the lab study because the value is too high
D. Hold the next dose of theophylline
(ANS- A.
Therapeutic level of theophyline is 10-20 mcg/dl, so the child's level is within the therapeutic range. This information evaluates the prescribed therapy & should be communicated in the nurse's report
A 12 month old boy is admitted with a respiratory infection and possible pneumonia. He is place din a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant?
A. Give small, frequent feedings of fluids
B. Accurately chart observations regarding breath sounds
C. Have a bulb syringe readily available to remove secretions
D. Encourage older siblings to visit
(ANS- C
Airways is always the priority. A: maintains hydration & prevent tiring but an open airway has a higher priority
B: Important for evaluation of therapy. When asked priority questions, remember Maslow! Physical needs usually have a higher priority than psychosocial needs
D: Open airway is the highest physiological need
All of the following interventions can be used to evaluate the effectiveness of nursing and medical interventions used to treat diarrhea. Which intervention is least useful in the nurse's evaluation of a 20 month old child?
A. Weight diapers
B. Assessing fontanels
C. Checking skin turgor
D. Observing mucous membranes for moisture
(ANS- B
The nurse is assigning care for a 4 y/o with otitis media and is concerned about the child's increasing temperature over the past 24 hours. When planning care for this child, it is important for the nurse to consider that..
A. Only an RN should be assigned to monitor this child's temperature
B. Tympanic measurement of temperature will provide the most accurate reading
C. The licensed practical nurse should be instructed to obtain rectal temperature on this child
D. Healthcare provider should be asked to prescribe the method for measurement of the child's temperatures
(ANS- B
Tympanic membrane sensor is an excellent site because both the eardrum and hypothalamus (temperature regulating center) are perfused by the same circulation. The sensor is unaffected by cerumen and the presence of suppurative or unsupporitve otitis media doesn't effect measurement.
Rule of thumb: Management--sterile procedures should be assigned to licensed personnel. Management skills will be tested on the NCLEX
The nurse is assessing an 8 month old child who has medical DX of Tetrology of Fallot. Which symptom is this client most likely to exhibit?
A. Bradycarida
B. Machinery murmur
C. Weak pedal pulses
D. Clubbed fingers
(ANS-
Cyanotic heart defect >> clubbing
D: Tissue hypoxia
A: It's tachycardia not bradycardia
B: VSD hallmark sign
C: Coarctation of the aorta
As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which child's fontanel finding should be reported to the healthcare provider?
A. 6 month old with failure to thrive that has a closed anterior fontanel
B. 24 month old with gastroenteritis that has a closed posterior fontanel
C. 2 month old with chickenpox that has an open posterior fontanel
D. 28 month old with hydrocephalus that has an open anterior fontanel
(ANS- A
The anterior fontanel shouldn't close until 18 months of age
BC: normal findings
D: A child with hydrocephalus may have a delayed closing of the fontanel
3 month old boy weigh 10 lbs 15 oz has an axillary temperature of 98.9. The nurse determines the daily caloric need for this child is approximately
A. 400 cals per day
B. 500 cals per day
C. 600 cals per day
D. 700 cals per day
(ANS- 1. 10 lbs 15 oz= 10.9 lbs
2. 10.9 lbs / 2.2 kg = 5 kg
3. Infant needs 108 cals/kg/day = 540 cals
4. TEMPERATURE of 1 degree = 10% of 540 = 54 + 540 = 594
>> 600 CALS
The nurse is developing a plan of care for a 3 y/o who is scheduled for a cardiac catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which intervention is best for the nurse to implement?
A. Reassure the parents that a 3 y/o are cooperature therefore less likely to be anxious [Show Less]