PEDIATRIA (HESI-2)
Which toy is most appropriate for a 10 -year-old child with acute rheumatic fever who is on strict bed rest? A• Play dough B• Doctor kit C• Punching bag D• Checkers
D
the nurse is conducting discharge teaching with the mother of a 22 moth-old with respiratory syncytial virus (RSV) who has one younger and older stating living in the home. Which priority instruction should the nurse include in this teaching plan? a- Practice consistent handwashing b- Avoid tobacco use in the home. c- Administer prophylactic antibiotic to both siblings d- Institute airborne precautions for the infected child.
D
4 y/o taken to ER because of fever for last 24 hrs. No cough, pulling at ears, drooling, cyanotic, inspiratory stridor, expiratory wheeze. Which intervention is most important?
Emergency tray
Nurse gets a call from a mother of a 10 y/o that just returned from camp with expanding circular red rash on arm. Mom asks what over the counter product is safe to use. How should the nurse respond?
Explain need for immediate exam
The nurse is assessing an infant with diarrhea and lethargy. Which finding should the nurse identify that is consistent with early dehydration? A• Tachycardia B• Bradycardia. C• Dry mucous membrane. D• Increased skin turgo
A
The nurse is evaluating diet teaching for a client who has Non tropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective? A• Creamed corn B• Pancakes. C• Rye crackers. D• Cooked oatmeal
A
The nurse should instruct the parent of an 8-year-old child who has sickle anemia to alert for which complaint from the child? A• "I'm shorter than everyone else" B• "I'm really hot and thirsty" C• "I don't want to eat any vegetables" D• "I have to urinate every few hours"
B
A male toddler is brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin). What prescription should the nursed implement first? A• Obtain a 12-lead electrocardiogram. B• Give IV digoxin immune fab (Digi bind) C• Prepare for gastric lavage. D• Administer activated charcoal orally.
B
The health care provider prescribes epinephrine 0.01 mg/kg IM for a child with asthma who weighs 55 pounds. The available medication is labeled, 1 mg/ml. Based on the child's weight, how many ml should the nurse administer? (Enter numerical value only. If rounding, round to the nearest hundredth)
0.25 ml 55/2.2=25kg 25x 0.01= 0.25mg 1mg/ml
A child weighing 67 pounds receives a prescription for benztropine (Cogentin) 0.61 mg IV q 12 hours. This drug is available as 1 mg/ml ampoules. How many ml should the nurse administer? (Enter the numeric value only. If rounding is required, round to the nearest hundredth)
0.61 ml
Prescriber prescribes Midazolam 0.08 mg/kg IM times 1 dose during conscious sedation for 2 y/o weighing 29 lbs. how many mg per dose?
1 mg
The healthcare provider prescribes cephalexin 350 mg by mouth every 6 hours for a child who weight 88 Punds. The available suspension is --- Cephalexin suspension 125 mg/5ml.The recommended safe dose range is 25 to 50 mg/24 hours in 4 divided doses. How many militers should the nurse administers based on the child's weight? Numerical
14
10-year-old girl who was bitten by tick a camping trip receives a prescription for tetracycline for Lymer's disease. Which information should the nurse provide to ensure the client understand? A. Do not take with tetracycline with milk or antacids B. Inspect all areas of skin for tick attachment while camping in wooded areas. C. Apply insect repellant in skin and clothes when exposure in vectors is likely. D. Wears sunglasses when outside during the day.
A
A 12-year-old boy with leukemia is being discharged from the hospital with a white blood cell (WBC) count of 4,000/mm. He is scheduled to receive antineoplastic chemotherapy as an outpatient. What instruction should the nurse include in this child's discharge plan? A• Avoid eating at buffets, smorgasbords, and salad bars B• Spend time resting with family pets, bur only cats and dogs C• Have all visitors wear protective masks when coming to the home D• Swim weekly at the neighborhood pool for neuromuscular integrity
A
A 6-year-old child is brought into the healthcare office after stepping on a rusty Nai. Upon inspection the nurse notes that the nail went through shoe and pierced the bottom of the child's foot. Which action should the nurse implement first? a-Cleanse the foot with soap and water and apply an antibiotic ointment as prescribed. b-Provide teaching about the need for tetanus to the given with the next 72 hours. ---respuesta del aula c-Transfer the child to the emergency department to receive a gamma globulin injection. d-Have the parents check the child's temperature c/ 4 h for the next 24h.
A
An adolescent who is taking antiretroviral therapy for HIV infection arrives at the clinic for a follow up visit. Which information is most important for the nurse to obtain? a. Missed medication doses b. A 24-hour dietary recall c. Barrier contraceptive use d. Ingestion of illicit drugs
A
The nurse determines that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis. What action should the nurse take? A• Document the finding. B• Auscultate bowel sounds. C• Palpate scrotum for testicular descent. D• Assess for bladder distention.
A
The nurse is giving an intramuscular injection of an antibiotic to a 16-month-old toddler with pneumonia. The toddler does not have any known allergies and been walking without assistance for one month. Which technique should the nurse select for administration? A• A Administer the injection into the middle of the lateral aspect of the thigh. B• Use a needle length of ½ inch (1.25cm) to avoid deep tissue damage. C• Divide the gluteal area into quarters and give IM into the upper outer quadrant. D• Give in the arm, one to 2 inches (2.5 to 5.0 cm) below the acromion process.
A
The nurse plans to screen only the highest risk children for scoliosis. Which group of children should the nurse screen first? A• Girls between ages 10 and 14 B• Boys between ages 10 and 14 C• Boys and girls between 12 and 14 D• Boys and girls between 8 and 12
A
When assessing an infant with severe diarrhea, the nurse should observe for which change in the breathing pattern? a- Kussmaul respirations. b- Expiratory wheezing c- Cheyne-Stokes respirations d- Audible rhonchi.
A
A 10-year-old boy has been seen frequently by the nurse over the past three weeks after school begins in the fall. He reports headaches, stomach, and difficulty sleeping. What intervention should the nurse implement? A• Conduct a complete neurological assessment B• Ask the boy to describe a typical day at school C• Counsel the parents to play more attention to the child D• Compare the child's vital signs over the past threeweeks
B
A 12-year-old obese male comes to the clinic with his mother and a note from the school nurse for follow-up of Acanthosis Nigricans, a thickening and darkening of the skin. The child is concerned and anxious that he has a serious condition. How should the nurse respond? A• Refer the child immediately to an endocrinologist for treatment B• Ask the child and his mother what he was told about this condition C• Encourage the child to modify his diet and begin an exercise D• Assess the presence of type 2 diabetes mellitus in the family
B
A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist agent albuterol (Proventil). The child's mother tells the nurse that she uses this medication to open her son's airway when he is having trouble breathing. What is the nurse's best response? A• Recommend that the mother bring the child in for immediate. B• Assure the mother that she is using the medication correctly. C• Advise the mother that over-use of the drug may cause chronic. D• Confirm that the medication helps to reduce airway inflammation
B
A male infant with bronchiolitis is brought to the clinic by his mother. The infant is congested and febrile with a capillary refill time of 2 seconds. What information should the nurse discuss with the mother? A• Lay infant flat on back for naps. B• Keep infant isolated from others. C• Limit the amount of oral intake. D• Encourage the infant to play.
B
A mother brings her 2-month-old son to the clinic for a wellbaby exam. During the assessment the nurse finds that the right testicle is not descended into the scrotum, but the left is palpable. Which action should the nurse take? A• Address possible concerns about the child's future fertility. B• Ask if the right testis has been seen in the scrotum before. C• Schedule an IV pyelogram to validate presence of testicle. D• Prepare to obtain a catheterized urine specimen for culture.
B
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family? A• The infant's formula has been changed twice. B• The diapers area shows severe skin breakdown. C• The mother state the baby is irritable during feedings. D• The mother is a single parent and lives with her parents.
B
A toddler with nephrotic syndrome receives a prescription from the healthcare provider for enalapril. Which action should the nurse implement prior to administering the medication? a- Test bilateral reflex responses b- Observe gait and balance while ambulating c- Assess strength and range of motion d- Verify the dosage calculation with another nurse.
B
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? A• Percussion B• Palpation C• Inspection D• Auscultation
B
The mother of a 2-year-old boy consults the nurse about her son's increased temper tantrums. The mother states, "Yesterday he threw a fit in the grocery store, and I did not know what to do. I was so embarrassed. What can I do if this occurs again?" Which recommendation is best for the nurse to provide this mother? A• An Immediately put him in time-out." B• Walk away from him and ignore the behavior. C• Paddle him gently as soon as the behavior is initiated. D• Quietly remind him that others are watching him
B
The nurse is assessing a 9-year-old boy who has been admitted to the hospital with possible acute post-streptococcal glomerulonephritis (APSGN). In obtaining his history, what information is most significant? A• Diuresis during the night. B• A sore throat last week. C• Back pain for a few days. D• A history of hypertension
B
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? A• High fat foods B• Foods sweetened with aspartame C• Wheat products D• High calorie foods
B
The nurse is caring for a 3-year-old child who is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding is an indication of arterial obstruction? A• Blood pressure trend is downward, and pulse is rapid and irregular B• Right foot is cool to the touch and appears pale and blanched. C• Pulse distal to the femoral artery is weaker on the left foot than right foot. D• The pressure dressing at right femoral area is moist and oozing blood
B
The nurse is caring for a one-year-old boy who has type 1 diabetes mellitus (DM). His mother asks how she will recognize hypoglycemia in her infant who cannot tell her how he feels. Which information should the nurse provide? A• The baby's breath smell swells sweet when the sugar and blood ketone levels are high B• Hypoglycemia in infants causes changes in behavior and cold clammy skin C• Weight loss and a good appetite often occur when a baby's glucose levels change D• Excess urination and dry skin are common indicators of hypoglycemia
B
The nurse is evaluating a young child with atopic dermatitis. Which question should the nurse ask the parent while obtaining the child's history? A• Does the child have any nausea or vomiting? B• Has the child displayed any symptoms of asthma or hay fever? C• Can any particular stress be associated with onset of the rash? D• What time of day does the rash appear on the body?
B
The nurse is measuring the frontal occipital circumference (FOC) of a 3-months old infant, and notes that the FOC has increased 5 inches since birth and the child's head appears large in relation to body size. Which action is most important for the nurse to take next? A• Measure the infant's head-to-toe length. B• Palpate the anterior fontanel for tension and bulging C• Observe the infant for sunken eyes. D• Plot the measurement on the infant's growth chart.
B
The nurse is performing a routine examination of a 6- month-old infant at community health clinic. Records indicate that the child weighed 3 kg at birth. The clinic uses lbs to describe weight. When assessing this child, approximately what weight, in lbs, should the nurse consider to be within normal range for this child? A• 15 to 18 lb. B• 12 to 15 lb. C• 9 to 11.5 lb. D• 6 to 7.5 lb.
B
Which instruction should the nurse include in the discharge teaching plan of a 7-year-old? girl with a history of frequent urinary tract infections? A• Take frequent bubble baths B• Monitor for changes in urinary odor C• Check oral temperature daily D• Perform intermittent catheterization
B
The mother of 6-year-old girl is concerned about her child's obesity. The child's weight plots at the 75 percentiles, and height at the 25 percentiles. The child's body mass index (BMI) is at the 85 percentiles for age and gender. Which interventions should the nurse implement? (Select all apply) A• Explain that the child is likely to grow into weight B• Determine the child's usual physical activity pattern C• Obtain the child's 3 - day diet history based on the mother's input D• Inquire as to whether or not the school has a physical education E• Tell the mother that girls hit their growth spurt before boys so eating
B, C, D
A mother is concerned that her 3-year-old son wants to play with female doll figures. The child is not interested in building blocks, trucks, or other typical "boy" toys. How should the nurse respond to the mother's concern? A• Letting male toddlers play with female-typed toys can have negative effects B• Replacing female doll figures with male doll figures reinforces masculinity C• Exploring different roles in imaginary play is typical at this age D• Experimenting with different toys is an acceptable behavior
C
7 years old is admitted to the hospital with persistent vomiting, and a nasogastric tube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider? A• Gastric output of 100 mL in the last 8 hours. B• Shift intake of 640 mL IV fluids plus 30 mL PO ice chips. C• Serum potassium of 3.0 mg/dL. D• Serum pH of 7.45
C
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? A• Determined the pulse deficit B• Calculate the safe dose range C• Administer the scheduled dose D• Review the serum digoxin level
C
A 3-year -old girl who has been blind since birth is hospitalized because of a compound fracture of the femur and is now in traction. Which intervention is best for the nurse to implement to address this child's blindness? A• Play a game where the child must identify unfamiliar sounds in the environment B• Use a touch tour to allow the child to familiarize herself with the room layout C• Request parents bring familiar objects as a stuffed animal from home D• Perform the child's self-care activities until the child is no longer interaction E• Request parents bring familiar objects as a stuffed animal from home
C
A 7-year-old male is referred to the school clinic because he fainted on the playground. His height is 3 feet, 7 inches (107.5cm), he weighs 55 pounds (25 kg), and his body mass index (BMI) IS 20.9. Which assessment finding is most important for the nurse to address? A• He consumed two bottles of water 30 minutes prior to fainting B• Since age 3 he has experienced exercise induced asthma C• Reports drinking 3 to 4 high calorie, carbonated beverages day D• The child's father has a history of fainting when exercising
C
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? A• Record accurate intake and output B• Ensure patient intravenous access C• Assess radial pulses every 2 hours D• Ensure that antibiotics are administered on time
C
Following a motor vehicle collision, a 3-year-old girl has a Spica cast applied. Which toy is best for the nurse for this 3-year-old child? A• Duck that squeaks. B• Fashion doll and clothes C• Set of cloth and hand puppets D• Handheld video game.
C
The nurse in the Emergency Center is triaging an 8- year-old boy who fell from a tree. The child is crying and complaining of pain in the left forearm. Which intervention should the nurse implement first? A• Elevate the child's left arm on a pillow. B• Assess pain level using FACES scale. C• Apply a cold pack to his left forearm. D• Check capillary refill of the nail beds.
C
The nurse is caring for a child newly diagnosed with attention deficit hyperactive disorder (ADHD). The child's mother asks about information of the treatment options. Which information is most helpful for the nurse to provide? a- Emphasize the addictive nature of popular medications b- Offer effective time management strategies. c- Explore the combination of medication and behavioral therapies. d- Discuss dietary changes such as increasing protein intake.
C
The nurse is conducting an admission assessment of an 11-months old infant with congestive heart failure who is scheduled repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower, with pathophysiologic mechanism support these findings. A• The aortic semi lunar valve obstructs blood flow into the systemic circulation B• An opening in the atrial septum causes a murmur due to a turbulent left to right shunt C• The lumen of the aorta reduces the volume of flow to the lower extremities D• The pulmonic valve prevents adequate blood volume
C
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? A• Assess for changes in the vital signs B• Review the child's birth history C• Provide the parents with a list of stimulating activities D• Meet with a social worker to review the results
C
The school nurse is caring for a school age-child who was stung by a wasp on the playground. which finding should proper the nurse is call emergency response team al 911? a- Marked redness b- Hives c- Weezing d- Severe itching ------ fotos hesis
C
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? A• Trampoline activities of school-aged children should be supervised by adults B• Protective gear to prevent neck flexion should be worn during contact sports C• Seat belt and car seat laws for use in motor vehicles should be reinforced D• Monkey bars should be removed from school playgrounds to reduce falls
C
When development a teaching plan for an adolescent male who was recently diagnosed with Type 1 diabetes mellitus, the nurse should instruct the to eat a source of sugar if which symptom occurs? A• Excessive thirst B• Racing pulse C• Profuse perspiration or sweating D• Seeing spots
C
Which client requires immediate intervention by the nurse? A• A child with cystic fibrosis who is constipated B• A toddler with chicken pox who is scratching C• A child with acute renal failure and hyperkalemia D• An adolescent with a migraine and photophobia
C
A 10-year-old girl is diagnosed with inflammatory bowel disease (IBD). Her mother is concerned that she will experience developmental delays as the result of this disorder. How should the nurse respond? A• She is at high risk for a number of different problems, including developmental delays B• Scheduling a private tutor can help to prevent developmental delays C• She will only experience developmental delays if weight loss cannot be controlled D• Growth failure is a concern, but developmental delays are not likely to occur
D
. 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? A• An inguinal hernia is treated as a surgical emergency B• Surgical repair is planned after successful toilet training ---Hesis 2020 C• An inguinal hernia is surgically repaired if persistent diarrhea occurs D• Surgical correction is indicated if the hernia is incarcerated
D
A 4-years-old boy was recently diagnosed with Duchenne muscular dystrophy (DMD). Which characteristic of the disease is most important for the nurse to focus on during the initial teaching? A• Muscular strength can be regained with physical exercise and therapy B• Growth and development have been abnormal since birth C• Respiratory dysfunction and aspiration are prime concerns at this stage of the disease D• Lower legs become progressively weaker, causing a wedding, unsteady gait
D
A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents? A• Permanent life-style changes need to be made to promote safety in the home B• Consistent discipline is needed to help the child control the movements C• Muscle tension is decreased with fine motor skill projects, so these activities should be encouraged D• The chorea or movements are temporary and will eventually disappear
D
A male infant is admitted to the pediatric unit with pertussis and is exhibiting a "whooping-like cough." The mother brings the infant to the nurse's station to seek assistance. Which intervention should the nurse implement first? A• Explain the need to maintain droplet precautions to prevent spread to others on the unit. B• Ask the mother if the cool mist humidifier at the bedside is functioning and releasing mist. C• Give the infant an oral dose of a prescribed antitussive and analgesic/antipyretic. D• Cover the infant's mouth and assist the mother to take the infant back to the room.
D
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? A• Provide parent education to prevent recurrence B• Clearance purulent exudate from the affected ear canal C• Apply a topical antibiotic to the preauricular area D• Ask the mother if the child has had a runny nose
D
A one-month-old male infant is brought to the clinic by his mother who states that her son has been vomiting forcefully after each meal for the last three days. The infant is afebrile, dehydrated, and pyloric stenosis is suspected. What other finding should the nurse identify that are consistent with pyloric stenosis? A• Perianal diaper rash from persistent diarrhea B• Rooting, hunger, and irritability C• Bite-stained emesis D• An olive-shaped mass in the abdominal area
D
An adolescent with non-Hodgkin's lymphoma (NHL) is complaining of sore mouth two days after begging chemotherapy. What activity should the nurse implement? A• Encourage large meals during steroid and chemotherapy B• Provide lemon glycerin swabs and dilute peroxide oral rises C• Recommended fluids using citrus and drinking with a straw D• Frequent use of saline oral rinses and soft sponge toothbrush
D
The mother of an 11 -year-old boy who has juvenile arthritis tells the nurse, "I really don't want my son to become dependent on pain medication, so I only allow him to take it when he is really hurting". Which information is most important for the nurse to provide this mother? A• The nurse use of hot baths can be used as an alternative for pain medication B• The child should be encouraged to rest when he experiences pain C• Encourage quiet activities such as watching television as a pain distracter D• Giving pain medication around the clock helps control the pain
D
The nurse administers digoxin (Lanoxin) to a 9- month-old infant with an apical heart rate of 160 beats per minute. Which apical pulse rate indicates that therapeutic effect of the medication has been achieved? A• 80 beats per minute B• 180 beats per minute C• 60 beats per minute D• 120 beats per minute
D
The nurse is assessing an infant with aortic stenosis and identifies bilateral fine crackles in both lung fields. Which additional finding should the nurse expect to obtain? A• Vigorous feeding and satiation B• Hemiplegia C• Fever D• Hypotension and tachycardia
D
The nurse is caring for a female client with scoliosis who had a posterior spinal fusion and is in a body jacked cast. Which assessment finding indicates to the nurse the client is developing cast syndrome? A• Diminished pulses in the foot. B• Musty, unpleasant odor to cast. C• "Hot spot" felt on cast. D• Abdominal distention
D
The nurse is caring for an infant who was recently diagnosed with a congenital heart defect. Which assessment finding is most important for the nurse to report to the healthcare provider? A• Audible heart murmur B• Poor oral intake and suckling effort C• Heart rate of 162 beasts/minute D• Weight gain of 2.2 lbs. (1kg) in las 48 hours
D
The nurse observes a mother giving her 11-month-old ferrous sulfate, followed by two ounces of orange juice. What should the nurse do next? A• suggest placing the iron drops in the orange juice and feed the infant B• Tell the mother to follow the iron drops with formula instead of orange juice C• instruct the mother to feed the infant nothing in the next 30 minutes after the iron D. Give positive feedback about the way she administered the sulfate
D
When providing care for a child who is in balanced suspension skeletal traction using a Thomas splint and Pearson attachment to the right femur, which intervention is most important for the nurse to implement? A• Assess skin for redness and signs of tissue breakdown B• Change position every 2 hours C• Cleanse pin site as prescribed D• Monitor peripheral pulse and sensation in the leg
D
Which drink choice on a hot day indicates to the nurse that a teenager with sickle cell anemia understands dietary consideration related to the disease? A• Milkshake. B• Iced tea. C• Diet cola. D• Lemonade.
D
Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children? A• Noting a marked weight gain without a gain in height on a growth chart B• Performing head circumference measurements on infants undergone year of age C• Assessing for behavioral problems at home and school by interviewing the parents D• Carefully recording the height and weight of children to detect inappropriate growth rates
D
Which nursing problem has the highest priority when providing preoperative care for an infant born with bladder atrophy? A• Altered urinary elimination related to exposure of bladder. B• Risk for impaired parenting related to appearance of infant. C• Knowledge deficit related to caring for the infant. D• Risk for infection related to impaired skin integrity
D
