HESI Pediatrics

How many days is the neonatal period?

28 days Rationale: The neonatal period is the first 28 days of life.

If hearing loss is detected early, proper intervention can help a child achieve normal language development. Which should be the latest age that hearing loss should be detected to ensure that a child achieves normal language development?

3 months Rationale: If a health care provider detects hearing loss before the child is 3 months old and an intervention is initiated within 6 months, the child can achieve normal language development.

In which settings would the nurse prepare to administer developmental assessment for pediatric clients? A. Home B. School C. Hospital D. Daycare center E. Assisted living center

A. Home B. School C. Hospital D. Daycare center Rationale: Pediatric developmental assessments are performed in many settings, including the home, school, hospital, and daycare center environments. It is unlikely that a pediatric developmental assessment would be performed in an assisted living center.

What is the average optimal blood pressure of an adolescent? A. 85/54 mm Hg B. 95/65 mm Hg C. 105/65 mm Hg D. 110/65 mm Hg

D. 110/65 mm Hg Rationale: The optimal blood pressure of an adolescent is 110/65. The optimal blood pressure of an infant is 85/54 mm Hg. The average optimal pressure of a toddler is 95/65 mm Hg. The average optimal blood pressure seen in children between the ages of 6 and 13 years is 105/65 mm Hg.

Which age should an infant achieve permanent eye color? A. 2 weeks B. 30 months C. 2 months D. 6 months

D. 6 months Rationale: Permanent eye color is usually established between 6 and 12 months of age. Two weeks and 2 months are too early to have developed permanent eye color. A child of age 30 months has long developed permanent eye color.

Which client may have concerns related to sexuality when hospitalized with a chronic illness? A. An 8-year-old B. A 10-year-old C. A 12-year-old D. An 18-year-old

D. An 18-year-old Rationale: An 18-year-old client is an adolescent, which is the stage of development where concerns about sexuality may occur when the client is hospitalized with a chronic illness. The other clients are not developmentally characterized as adolescents; therefore, the nurse would not anticipate an 8-year-old, 10 year-old, or 12-year-old child to have this concern.

The nurse is performing an assessment of fine motor skills on an infant. Which actions would the nurse observe? A. Crawling B. Creeping C. Sitting erect D. Holding a rattle E. Picking up objects F. Holding a baby bottle

D. Holding a rattle E. Picking up objects F. Holding a baby bottle Rationale: Holding a rattle, picking up objects, and holding a baby bottle are demonstrations of fine motor skills. Gross motor skills include crawling, creeping, and sitting erect.

The nurse is preparing to assess several clients at a pediatric clinic. Which client would require a developmental screening versus developmental surveillance during a scheduled health maintenance visit? A. A 9-month-old infant B. A 2-week-old newborn C. A 15-month-old toddler D. A 4-year-old preschooler

A. A 9-month-old infant Rationale: The nurse would conduct a developmental screening for the 9-month-old infant during a scheduled health maintenance visit. The 2-week-old newborn, the 15-month-old toddler, and the 4-year-old preschooler would all require developmental surveillance during a health maintenance visit.

Which theory states that a child's growth's pattern is related to gene activity? A. Gesell's theory B. Piaget's theory C. Erikson's theory D. Havighurst's theory

A. Gesell's theory Rationale: Gesell's theory of development states that each child's pattern of growth is unique and that this pattern is directed by gene activity. Piaget's theory of cognitive development comprises four periods related to age: sensorimotor, preoperational, concrete operations, and formal operations. Erikson's theory of psychosocial development states that an individual needs to accomplish a particular task before mastering the stage and progressing to the next one. Havighurst's theory of stage crisis is based on developmental tasks. This theory incorporates three primary sources for developmental tasks: tasks that surface because of physical maturation, tasks that evolve from personal values, and tasks that are a result of pressures from society.

At which stage of Kohlberg's theory does an individual want to fulfill the expectations of one's immediate group? A. Good boy-nice girl orientation B. Society-maintaining orientation C. Instrumental relativist orientation D. Universal ethical principle orientation

A. Good boy-nice girl orientation Rationale: The good boy-nice girl orientation stage involves an individual who wants to win the approval and maintain the expectations of one's immediate group. During the society-maintaining orientation stage, an individual expands focus from a relationship with others to societal concerns. The instrumental relativist orientation stage involves a child who ants to follow his or her parent's rules. The universal ethical principle orientation stage defines "right" by the decision of conscience according to self-chosen ethical principles.

A teenager is being discharged with a cast. What should the nurse recommend if the client experiences pruritus around the cast edges? A. "Scratch the itchy area gently." B. "Put an ice pack on the affected area." C. "Sprinkle a layer of powder around the itchy spots." D. "Ask your doctor for a prescription for an antihistamine."

B. "Put an ice pack on the affected area." Rationale: An ice pack numbs the area and may temporarily diminish the discomfort. Scratching may break the skin and open an avenue for infection. Powder may become caked and slip under the cast, causing additional discomfort. Also, powder should be avoided because it is toxic if inhaled. Antihistamines are not prescribed all other measures have failed.

Which age should an infant develop binocularity? A. 8 to 9 weeks B. 3 to 4 months C. 7 to 8 months D. 9 to 12 months

B. 3 to 4 months Rationale: Children develop binocularity (the ability to fixate on one visual field with both eyes simultaneously) by 3 to 4 months. Children are not able to fixate on one visual field with both eyes simultaneously as early as 8 to 9 weeks. Children learn to fixate on one visual field with both eyes simultaneously earlier than 7 to 8 months or 9 to 12 months.

How many hours of sleep would the nurse recommend for the 11-year-old client? A. 8 B. 9 C. 11 D. 12

B. 9 Rationale: A school-age client who is 11 years of age would require 9 hours of sleep each night. Ten hours of sleep is not recommended for the school-age client. A 5-year-old school-age client requires 11.5 hours of sleep per night; however, 11 and 12 hours of sleep is not recommended for an 11-year-old school-age client.

Which component of the human personality, according to Freud, allows an individual to judge reality accurately? A. Id B. Ego C. Superego D. Oedipus complex

B. Ego Rationale: According to Freud, the ego allows an individual to judge reality accurately. The id is basic instinctual impulses driven to achieve please. The superego is often referred to as the conscience. The Oedipus complex is a belief that a female child fantasizes about her father as a love interest.

Which of these groups has the highest incidence of lead poisoning? A. Adult B. Toddler C. Adolescent D. School-age child

B. Toddler Rationale: The incidence of lead poisoning is highest in late infancy and toddlerhood. Children at this stage explore the environment and because of their increased level of oral activity, put objects into their mouths. Adults have a greater risk of cardiovascular or pulmonary disease. Drowning and motor vehicle accidents are more common among adolescents. Bicycle accidents are more common among school-aged children.

Which is the average height of a 4-year-old child? A. 2 feet, 10 inches (86.6 cm) B. 3 feet, 1.5 inches (95 cm) C. 3 feet, 4.5 inches (103 cm) D. 3 feet, 7.5 inches (110 cm)

C. 3 feet, 4.5 inches (103 cm) Rationale: The average height of a 4-year-old child is 3 feet, 4.5 inches (103 cm). The average height of a 2-year-old child is 2 feet, 10 inches (86.6 cm). The average height of a 3-year-old child is 3 feet, 1.5 inches (95 cm). The average height of a 5-year-old child is 3 feet, 7.5 inches (110 cm).

The nurse is learning about the shift in total body fluid that occurs from infancy to adulthood. Which percentage of body weight is the weight of the extracellular fluid (ECF) in an infant at term? A. 10% B. 20% C. 44% D. 78%

C. 44% Rationale: The amount of ECF is 44% of the body weight at term. The initial birth weight of a term newborn can decrease by 10% in the first 5 days of life due to ECF compartment contraction, enhanced renal tubular function, and rapidly increasing glomerular filtration rate. The amount of ECF is 20% in adulthood. At birth, 78% of the infant's body weight is water -- ECF occupies a significant part of it.

To which client would the nurse provide education regarding the pubertal growth spurt? A. An 8-year-old school-age male client B. A 16-year-old adolescent male client C. A 12-year-old school-age female client D.. An 18-year-old adolescent female client

C. A 12-year-old school-age female client Rationale: The pubertal growth spurt reaches a peak for female clients at 12 years of age; therefore the nurse would provide education to this client regarding expected growth during this time period. The 8-year-old male client would not be expected to experience the pubertal growth spurt until the ages of 14 years. The 16-year-old and the 18-year-old adolescent clients would have already experience the pubertal growth spurt.

At which stage of development would the nurse anticipate that pediatric clients will begin to show differences in play activities that are related to gender? A. Preschool B. Adolescence C. Late school-age D. Early school-age

C. Late school-age Rationale: During the late school-age years, the nurse would anticipate that pediatric clients will begin to show differences in play activities that are related to gender. There will be very few differences in play activities related to gender during the preschool stage of development. Adolescence involves different social, not play, activities related to gender. The early school-age client will exhibit the same types of play activities related to gender as the preschool-age child.

Which stage of development classifies boys and girls as differing very little in terms of size? A. Toddler B. Preschool C. School-age D. Adolescence

C. School- age Rationale: During the school-age stage of development, boys and girls differ vary little in terms of size. During the toddler, preschool, and adolescence stages of development boys are often larger than girls.

Which of these skills should be present in a 6- to 8-month-old child? A. The child pulls himself or herself up to stand or sit. B. The child is able to pick up small objects. C. The child can sit alone without support. D. The child can place objects into containers.

C. The child can sit alone without support Rationale: A child of 6 to 8 months of age should be able to sit alone without support. A child after 8 months of age should be able to pick up small objects, place objects in containers, and pull himself or herself up to stand or sit.

Which statement is true about Piaget's theory of cognitive development? A. Piaget's theory includes five periods that are related to age. B. In the late preoperational stage, the children experience animism. C. In the preoperational stage, children are able to perform mental operations. D. During the sensorimotor stages, infants develop an action pattern for dealing with their environment.

D. During the sensorimotor stages, infants develop an action pattern for dealing with their environment. Rationale: According to Piaget's theory, during the sensorimotor stage, infants develop a schema or action pattern for dealing with the environment. Piaget's theory includes four periods that are related to age. In the early preoperational stage, children experience animism. During the concrete operations stage, children are able to perform mental operations.

The parents of a preschooler tell the nurse that they try to inculcate good eating habits by asking the child to be at the table until the "plate is clean." Which condition is the child at risk for? A. Anorexia B. Depression C. Aggression D. Poor eating habits

D. Poor eating habits Rationale: Asking the child to be at the table until the "plate is clean" results in overeating and develops poor eating habits later in life. Anorexia is seen if the child does not consume the required amount of food. Depression may be seen in a child if there are any psychological issues. Aggression occurs from sociocultural and familial influences.