Pediatria Hesi (B)

Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children?

• Carefully recording the height and weight of children to detect inappropriate growth rates

Which toy is most appropriate for a 10 -year-old child with acute rheumatic fever who is on strict bed rest?

• Checkers

The nurse is administering an oral medication to a reluctant preschool-age boy. Which intervention should the nurse implement?

• Use straightforward approach with the child

During a well baby clinic visit, the mother of a 6-month-old infant asks the nurse if she can have a prescription for Poly Vi Sol with fluoride. Though the infant is still breast feeding, the mother provides the child with supplemental formula feedings. Which assessment is most important for the nurse to obtain?

• Water source used with supplement feedings

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?

• Weight gain of 2.2 lbs (1kg) in las 48 hours

Which nursing intervention is most important to include in the plan of care for a child with acute glomerulonephritis

• weight the child daily

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?

•Lower legs become progressively weaker, causing a wedding, unsteady gait

In caring for an client with acute epiglottitis, which nursing action takes priority?

•Prepare for endotracheal intubation

The nurse is planning care for a 5 - month-old with gastroesophageal reflux 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?

•Thicken formula with cereal for each feeding

An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The nurse recognizes that surgical correction is designed to achieve which outcome?

Prevent the return of oxygenated blood the lungs.

When administering indomethacin (Indocin) to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome?

• -B Decreased cardiac murmur.

When assessing a newborn, the nurse includes assessment for early signs of congenital hip dysplasia. Which finding is an indication of this condition?

• -C Asymmetry of the gluteal folds.

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?

• -Walk away from him and ignore the behavior.

A female infant recently admitted with vomiting and diarrhea now weighs 10 kg. Her weigh at a previous well-baby visit was 11 kg. What is the percentage of body weight loss for this infant? • 10% • 5% • 9% • 4%

• 9%

The nurse is assessing a 3-year-old boy who attends a daycare center. Following an upper respiratory tract infection, he developed acute otitis media. Which factor places this child at greatest risk for developing acute otitis media?

• A child's Eustachian tube is shorter and straighter than an adult's Eustachian tube.

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?

• Abdominal distention.

An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin (Levaquin) 500 mg orally once daily and metronidazole (Flagyl) 500 mg twice daily. She asks the nurse, "Why do I have to be in the hospital? Why can't I get my treatment at home?" Which purpose should the nurse provide that supports and effective outcome?

• Administration of a supervised parenteral antibiotic protocol.

The clinic nurse is assessing a 3-year -old child with sudden onset of irritability, thick muffled voice, and barking on inspiration. The child is febrile and leaning forward to breathe with tongue protruding, is drooling, and has suprasternal retractions. Which intervention should the nurse implement first?

• Alert the emergency response team

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?

• Ask about client's response to his mother's age

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?

• Ask the boy to describe a typical day at school

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?

• Ask the child and his mother what he was told about this condition

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?

• Assess radial pulses every 2 hours

An infant is admitted for surgery who has a Wilms' tumor. What nursing intervention should the nurse implement during the preoperative period?

• Careful bathing and handling that avoids abdominal manipulation

During her sports physical examination, 15-year -old female requests oral contraceptives. She explains that she is sexually active and does not want her parents to know. What action should the nurse take?

• Counsel the client about the risks and benefits of using oral contraceptives

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?

• Cover the infant's mouth and assist the mother to take the infant back to the room.

When administering indomethacin (Indocin) to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome? • Decreased cardiac murmur • Increased number of red blood cells • Decreased urinary output • Increased respiratory effort

• Decreased cardiac murmur

A child with Grave's Disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?

• Decreased heart rate.

The parents of a 4 week-old infant phone the pediatric clinic to report that their infant eats well but vomits after each feeding. To differentiate between normal regurgitation and pyloric stenosis, which information is most important for the nurse to obtain?

• Degree of forcefulness of vomiting episodes

The nurse is assessing a 6-month old infant. Which response requires further evaluation by the nurse? • Has doubled birth weight • Turn head to locate sound • Plays pick a boo • Demonstrate startle reflex

• Demonstrate startle reflex

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?

• Encourage the client to immunize the children

A child who is preparing to enter the first grade has recurring atopic dermatitis (eczema) and is brought to the clinic because of a recent exacerbation. Which suggestion should the nurse provide this child's parent?

• Ensure that the child's lunch at school is a hypoallergic diet.

A pre-school-age girl who has been taking oral ampicillin (Omnipen, Polycillin) for 3 days for a non-respiratory condition repeatedly tells the nurse that her throat hurts. The child has no evidence of dyspnea or urticaria. Which action should the nurse implement?

• Explain gently that medication must be taken

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?

• Exploring different roles in imaginary play is typical at this age

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?

• Foods sweetened with aspartame

A 6-month-old, diagnosed with short bowel syndrome, began enteral feedings yesterday. To maintain normal growth and development of the child during this period, what action should the nurse include in the infant's plan of care? • Speak to the healthcare provider about instituting physical therapy. • Ensure placement of the nasogastric tube with an abdominal x-ray. • Use sterile technique during feedings. • Give the infant a pacifier during feeding.

• Give the infant a pacifier during feeding.

The nurse is assessing a 2-year-old child. What behavior indicates that the child's language development is within normal limits?

• Half of child's speech is understandable

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?

• Hypoglycemia in infants causes changes in behavior and cold clammy skin

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?

• Hypotension and tachycardia

Which response demonstrates that the mother of a young girl with a urinary tract infection (UTI) understands home care for the child?

• I will bring her back to the doctor's office for another urine test

A 9-year-old boy is diagnosed with diabetes mellitus Type 1. Which stage of Erikson's theory of psychosocial development is the nurse addressing when teaching this client about insulin injections?

• Industry

In developing a plan of care for a child with bacterial meningitis, which intervention should the nurse plan to implement? • Maintain strict insolation after identification of the causative agent. • Maintain Trendelenburg's position to decrease intracranial pressure. • Administer large volumes of intravenous fluids to minimize nephrotoxic effects of antibiotics. • Administer antibiotic therapy until the cerebrospinal fluid finding are negative.

• Maintain strict insolation after identification of the causative agent.

Insulin therapy is initiated for a 12-year-old child who is admitted with diabetic ketoacidosis (DKA). Which action is most important for the nurse to include in the child's plan of care? • A Consult with healthcare provider about use of insulin detemir (Levemir Flex Pen). • Determine the child's compliance schedule for subcutaneous NPH insulin (Humulin N). • Monitor serum glucose for adjustment in infusion rate of Regular insulin (Novolin R). • Demonstrate to parents how to program an insulin pen for daily glucose regulation.

• Monitor serum glucose for adjustment in infusion rate of Regular insulin (Novolin R).

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?

• Pain

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

• Palpation

The teacher notifies the school nurse that a child's nose is bleeding for no apparent reason. What action should the nurse implement first?

• Pinch the nose using thumb and finger for 10 minutes

An infant with tetralogy of Fallot becomes acutely cyanotic and hyper apneic. Which action should the nurse implement first? • Administer morphine sulphate. • Start IV fluids. • Place the infant in a knee-chest position • Provide 100% oxygen by face mask.

• Place the infant in a knee-chest position

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?

• Profuse perspiration

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

• Provide the parents with a list of stimulating activities

A middle school male student was recently diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) and is having trouble with his grades. He is referred to the school nurse by the teacher because he continues to have learning problems. Which action should the school nurse take? • Refer the child to the school counselor for educational testing • Seek the advice of the school principal regarding the child's learning needs • Ask the parents to become involved the child with his homework • Ask the parents to have the child seen by a clinical psychologist

• Refer the child to the school counselor for educational testing

The parents of a newborn infant with hypospadias are concerned about when the surgical correction should occur. What information should the nurse provide?

• Repairs typically should be done before the child is potty trained.

A 7-year-old male is referred to the school clinic because he fainted on the playground. His height is 3 feet, 7 inches (107.5 cm), 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?

• Reports drinking 3 to 4 high calorie, carbonated beverages day

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?

• Request parents bring familiar objects as a stuffed animal from home

Which nursing problem has the highest priority when providing preoperative care for an infant born with bladder atrophy?

• Risk for infection related to impaired skin integrity.

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?

• Seat belt and car seat laws for use in motor vehicles should be reinforced

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?

• Surgical correction is indicated if the hernia is incarcerated

A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). What is the best explanation for this finding?

• The TSH is high because of the low production of T4 by the thyroid

Prior to discharge, the parents of a child with cystic fibrosis are demonstrating chest physiotherapy (CPT) that they will perform for their child at home. Which action requires intervention by the nurse? • Plan to perform CPT when the child awakens in the morning • A Copped hand is used when percussing the lung field • A bronchodilator is administered before starting CPTD. • The child is placed in a supine position to begin percussion

• The child is placed in a supine position to begin percussion

The nurse has provided discharge teaching to the mother of a premature infant. Which statement by the mother would indicated that the understands the importance of making sure that her baby gets the monthly palivizumab (Synagis) injection?

• The medication will protect my baby from respiratory syncytial virus