HESI questions

left lower lob pneumonia , what position should the nurse place toddle to maximize oxygenation?

Right lateral

epiglottitis

SEVERE sore throat, drooling, and leaning forward to breathe.

2 y/o with tracheostomy becomes diaphoretic and has ^HR, increased work of breath, decreased o2 saturation level. First action

Suction the tracheostomy

NOT a good indicator of an impending IV infiltration in an infant?

Lack of blood return coz veins are small and fragile.

left head head off mattress

4 months

patient has tested + for HIV delivers a girl. when she asked whether her baby has AIDS?

"she may have acquired HIV in utero, but we won't know for sure until she's older"

lead poisoning screening in child reaches which age?

18 months, REPEAT again in 24, 30, 36 months.

ratio of anteroposterior-to-lateral diameter to normal in 4 mons

1:1

play ground of 2 year old children, suspect

2 children side by side in the sandbox building sand castles.

mobile provide appropriate visual stimulation for infant

4 months

I. M injection site use for 2 y.o child

ventrogluteal muscle

apical pulse

4th ICS.

introduce solid food when

6 mons

transferring object from 1 hand to

6 months

sit up without support

8 months

do first before administering a liquid medication to an infant?

verify physician order

photo therapy for hyperbilirubinemia, least appropriate?

visual assessment of jaundice - NOT a valid method for assessing jaundice.

late sign of ICP?

vomiting, headache, papilledema

most accurate information about infant's hydration status?

weighing daily

suspect child abuse

welts or bruises in various stages of healing on the trunk. Circular, symmetrical burns on the lower legs. Parent who is hypercritical of the child and pushes the frightened child away.

can we administer immunization in infants with cast?

yes, administered in the thigh, because casts cover the lower legs and feet.

otitis media is more common than younger child coz

Eustachian tubes are shorter and horizontally

3 y/o with viral meningitis. what signs and symptoms would the nurse expect to find during assessment?

FEVER nuchal rigidity irritability photophobia

2 mons hasn't received any immunization, give?

HIB, DTP, Hep B, IPV

24 hr after birth, NOT passed meconium, suspects?

Hirschprung's disease: large bowel disorder c, absence or marked reduction of parasympathetic ganglion cells in a segment of colorectal wall. narrowing impairs intestinal motility and causes severe intractable constipation leading to partial or complete colonic obstruction.

earliest signs of increased intracranial in infant?

^ head circumference

diamond shape

anterior fontanel

digoxin for heart failure, before administering, check for

apical pulse

toddler is brought to Ed with sudden onset of abdominal pain, vomit, stools that look like jelly. Intussusception. intervention

barium enema to confirm and correct

upper airway infection, worsened over days, croup - hoarse voice, inspiration stridor and

barking cough worsen at NIGHT. LOW grade fever gradual onset

how should the nurse position an infant when administering an ORAL medication?

held in bottle-feeding position.

CPR on an infant, where to palpate for pulse

brachial pulse when performing CPR

VSD is receiving digoxin (lanoxin_) to treat heart failure. The nurse should monitor child for early signs of digoxin toxictiy

bradycardia

normal stool colors

breast fed: bright yellow or light green stools with no offensive odor. formula: pale yellow, semi-formed stools with strong odor. FIRST stool: dark green to black, sticky odorless. ( present for the first 3 days) green, watery - diarrhea.

circumferential chest burn, what is the most important factor for the nurse to assess?

breathing pattern: eschar impedes chest expansion in a child with a circumferential chest burn, causing breathing difficulty

hemophilia is hospitalized with multiple injuries after falling off a sliding board X-rays reveal no bone fractures, high priority

check LOC: slurred speech, vomit, headache. factor for blood clotting is absent, increased risk for hemorrhage after injury

before administering a tube feeding to a toddler, which of the following methods should the nurse use to check the placement of NG tube?

check of pH of fluid aspirated from the tube.

toddler is receiving an infusion of total parenteral nutrition (TPN) via broviac catheter, as the child plays, IV tubing disconnected from catheter. as the child plays, the i.V tubing disconnnected from the catheter, what should the nurse do?

clamp the catheter to prevent air entry

toddler in respiratory arrest. nurse will assist with endotracheal intubation and use an uncuffed tube because

cricoid cartilage is the narrowest part of the larynx

baby chokes

deliver 4 back blows. follow 4 chest thrusts to expel the object from the obstructed airway.

necrotizing enterocolitis (NEC) in an infant?

distended abdomen. gastric retention, and blood in stool

IM injection should be avoided?

dorsogluteal muscle

birth weight

double - 6 months triple - 12 months

TE fistula in 1 day old neonate, most appropriate ?

elevate neonate's head and giving NPO

nurse on the pediatric floor is caring for toddler. Nurse should keep in mind that toddlers:

express negativism

3 y.o with acute exacerbation of asthma. chidl's history reveals that child was exposed to chicken pox 1 weak ago. require isolation when?

immediately. incubation period for chickenpox is 2-3 weeks. pt is isolated 1 week after exposure to avoid risk of outbreak. person is infectious from 1 day before eruption of lesions to 6 days after the vesicles form crusts.

early signs of heart failure?

increased respiratory rate and heart rates are EARLIEST signs of heart failure. Decreased UO and weight are LATER signs.

myelomeningocele over the lumbosacral region is scheduled for corrective surgery. Preoperatively, MOST important nursing goal?

infection

agents CAN'T be administered by way of intraosseous infusion?

isoproterenol (isuprel)

8 mons, which toy to promotes cognitive development?

jack in the box

accident prevention

locks cabinet containing toxic substances.

dietary restrictions to the parents of a child with celiac disease, effective teaching

maintain theses restriction for life

Wilm's tumor

malignant kidney tumor that occurs in children younger than 5. rare case occur later in life = adenomyosarcoma.

PKU, need to restrict

meat and dairy product

Hib vaccine

meningitis and bacterial pneumonia

grade 6

murmur can be hard without a stethoscopebrea

grade 4

murmur is associated with precordial thrill (loud murmur)

value of Hb for neonates, 3 months, 3 years and 10 years

neonates: 18-27 3 mons: 10.6-16.5 3 yeas: 9.4-15.5 10 years: 10.7-15.5

determine child's body surface area by using?

nomogram

assess pain in 18 month old child

observe for behavioral changes .

sudden infant death syndrome (SIDS)

occurs more in infants who sleep in prone position

2 1/2 y.o, playing with another child of same age in playroom on the pediatric unit,

parallel

cystic fibrosis, by the time child's discharge, child's parents are able to perform task independently?

performing postural drainage

bacterial meningitis

petechial purpuric rash HYPOTHERMIA

difference between physical therapy and occupational therapy

physical therapist: restore function and mobility, prevent further disability. Occupational therapist: help chronic ill/ disabled to perform ADLs and adapt to limitations.

cystic fibrosis - sweat test

pilocarpine - cholinergic medication that induces sweating is applied to gauge pad and placed on arm, low intensity, painless electrical current is applied for several minutes.

child with celiac disease. AVOID

prepared puddings, ice cream, malted milk, food and beverages containing wheat, rye, oats, or barley

pulmonary congestion

productive cough, fever along with nasal flaring, retractions, chest pain, dyspnea, decreased breath sounds, crackles are indicative pneumococcal pneumonia.

colored blocks

promote gross and fine motor abilities in infants 4-8 mons

nephrotic syndrome. monitor toddler's fluid i&O n checks urine specimens regularly with reagent strip (Labstix). nurse report

proteinuria

celiac disease

protuberant abdomen due to presence of fat, bulky stools, undigested and flatus. concave abdomen, bulges in the groin area, and a palpable abdominal mass aren't associated with celiac.

first step in performing ET or tracheal suctioning in an infant

provide extra oxygen by using a ventilator or through manual bagging

tetralogy of fallot

pulmonic stenosis, atrial septal defect, overriding aorta, and left ventricular hypertrophy

food that is okay to introduce the first year of life?

pureed fruits rice cereal strained vegetables

10 month toys

push toys to promote development of infant's gross and fine motor skills and aids cognitive development.

how to manage for hemophillia

replace clotting factor, infusion of factor, cryoprecipitate, or fresh frozen plasma. NO NEED platelet transfusion.

suspects that a toddler, has been physically abused by his mother. what nurse required to do?

report the case to local authorities

bacterial meningitis

respiratory isolation

3 y/o child be able to perform?

ride a tricycle

infancy through preschool years, major stressor posed by hospitalization

separation from family

objects poses most serious threat to 2 year old in the hospital?

side rails in hallway position.

the nurse is auscultating heart sound is in 2 y/o child. note grade 1 heart murmur.

softer than heart sounds

viral pharyingitis

sore throat, fever general malaise.

to reduce impaired skin integrity to immobility in a toddler, which action should be avoided?

spreading a thin layer of lotion over pressure points

toddler exhibit

strong food preferences

fluid volume deficit s/s

sunken fontanels ^HR, decreased BP concentrated urine with high specific gravity

best approach when trying to take a crying toddler's temperature?

talk to mom first and then toddler.

suspect dehydration in preterm neonate

urine output below 1 ml/hour

grade 2

usually equal in sound to the heart sounds

safe side for injection for infants and small children

vastus lateralis ventrogluteal and deltoid muscles