Peds Hesi 1
A nurse is caring for a child who is postoperative following surgical correction of tetralogy of fallot. Which of the following findings indicates heart failure? a. Exercise intolerance b. Decreased respirations c. Bradycardia d. Weight loss
a. Exercise intolerance
A nurse is performing a physical assessment of a school-age child who has acute glomerulonephritis. Which of the following findings should the nurse expect? a. Facial edema b. Hypotension c. Increased urinary output d. Flushed skin
a. Facial edema
A nurse is caring for an infant who has a patent ductus arteriosus. The nurse should identify that the defect is at which of the following locations of the heart?
At area of aorta
A nurse is preparing to administer morphine 0.2 mg/kg IV to a child who is postoperative and in pain. The child weighs 34 kg. Available is morphine 1 mg/mL solution how many mL should the nurse administer?
6.8 mL
A nurse is developing a plan of care for a child who is dying. Which of the following measures should the nurse include to support the child and his family? a. Maintain consistent nursing staff assignments b. Ask the parents to leave the room for procedures c. Select one family member to receive information d. Limit the number of visitors in the client's room
a. Maintain consistent nursing staff assignments
A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect? a. Hyperactive reflexes b. Ataxia c. Pinpoint pupils d. Hypothermia
b. Ataxia
A nurse in an emergency department is caring for a child who has epiglottitis. Which of the following actions should the nurse take? a. Inspect the tonsils using a tongue depressor b. Collect a throat culture c. Administer IV antibiotics d. Provide nebulizer aerosol therapy
c. Administer IV antibiotics
A nurse is caring for a preschool-age child who has terminal illness. Which of the following findings should the nurse expect? a. Accepts death as inevitable b. Expresses interests in the funeral arrangements c. Feels excessive anxiety about physical changes d. Believes the condition is a punishment
d. Believes the condition is a punishment
A nurse in a community center is providing an in-service for parents about nutritional guideline. Which of the following instructions should the nurse include in the teaching? a. Introduce popcorn as a healthy snack at 12 months of age b. Provide 36 oz of milk per day to a toddler c. Offer 8 to 10 oz of juice per day to a preschooler d. Encourage a 15-year-old to increase calcium intake
d. Encourage a 15-year-old to increase calcium intake
A nurse is planning to perform tracheostomy care for a toddler. Which of the following is an appropriate action for the nurse to take? a. Clean around the stoma with full-strength hydrogen peroxide b. Place the child in trendelenburg position when performing care c. Use clean technique to change the tracheostomy tube d. Have the child flex his head when securing the ties
d. Have the child flex his head when securing the ties
A nurse is preparing to administer ondansetron 0.15 mg/kg IV to a child who is receiving chemotherapy and weighs 29.4 kg. Available is ondansetron 4 mg/2 mL solution. How many mL should the nurse administer? (round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero).
2.2 mL
A nurse is caring for a child who is 2 hr postoperative. Which of the following actions should the nurse take first? (Click the "exhibit" button for additional information about the client. There are three tabs that contain separate categories of data) a. Assess the child's pain level b. Compare the child's pedal pulses c. Determine the child's sedation level d. Recheck the child's temperature
?
A nurse is providing teaching about medication administration to the parents of a toddler who has a new prescription for liquid ferrous sulfate. Which of the following instructions should the nurse include in the teaching? a. "Dilute the drops with water prior to administration" b. "Provide an antacid prior to administration" c. "Report tarry, green stools to the provider" d. "Administer the drops with milk"
a. "Dilute the drops with water prior to administration"
A nurse is providing teaching to a parent of a 2-month-old infant about immunization schedules. Which of the following statements by the parent indicates an understanding of the teaching? a. "My child needs to get the MMR immunization when she's 12 months old" b. "My child needs to get the varicella immunization when she's 6 months old" c. "My child will receive the influenza immunization today" d. "My child will receive the hepatitis A immunization today"
a. "My child needs to get the MMR immunization when she's 12 months old"
A nurse is providing teaching to a parent of a child who has cystic fibrosis and a new prescription for dornase alfa. Which of the following instructions should the nurse include in the teaching? a. "Store the mediation in the refrigerator" b. "Administer every 4 hours as needed for cough" c. "Mix the medication with albuterol solution prior to administration" d. "Use a spacer with this medication"
a. "Store the mediation in the refrigerator"
A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines. Which of the following instructions should the nurse include in the teaching? a. "You can replace milk with nondairy sources of calcium" b. "You can drink milk on an empty stomach" c. "You should consume flavored yogurt instead of plain yogurt" d. "You may tolerate plain milk better than chocolate milk"
a. "You can replace milk with nondairy sources of calcium"
A nurse in an urgent care clinic is prioritizing care for four children. Which of the following children should the nurse assess first? a. A preschool-age child who has a muffled voice and no spontaneous cough b. An adolescent who has a Crohn's disease and a recent weight loss of 5 kg (11 lb) c. A toddler who has nephrotic syndrome and facial edema d. A school-age child who has diabetes mellitus and blood glucose of 200 mg/dL
a. A preschool-age child who has a muffled voice and no spontaneous cough
A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching? a. Apply bactericidal ointment to lesions b. Seal soft toys in a plastic bag for 14 days c. Soak hairbrushes in boiling water for 10 min d. Administer acyclovir PO two times per day
a. Apply bactericidal ointment to lesions
A nurse is creating a plan of care for a school-age child who has nephrotic syndrome. Which of the following interventions should the nurse include? (SATA) a. Assess for protein in the urine b. Obtain a daily weight c. Initiate contact precautions d. Encourage increased fluid intake e. Provide a low-sodium diet
a. Assess for protein in the urine b. Obtain a daily weight e. Provide a low-sodium diet
A school nurse is assessing a 7-year-old student. The nurse should identify which of the following findings as a potential indicator of physical abuse? a. Bruising around the wrists b. Weight in 45th percentile c. Front deciduous teeth missing d. Abrasions on the knees
a. Bruising around the wrists
A nurse is planning care for a newly admitted child who has rotavirus. Which of the following precautions should the nurse plan to initiate? a. Contact b. Protective c. Droplet d. Airborne
a. Contact
A nurse in the emergency department is caring for a child who has a temperature of 39.1 C (102.4 F) and a suspected diagnosis of bacterial meningitis. Which of the following actions should the nurse take first? a. Implement droplet precautions for the child b. Prepare the child for a lumbar puncture c. Administer an antipyretic to the child d. Dim the lights in the child's room
a. Implement droplet precautions for the child
A nurse is planning care for a child who is experiencing sickle cell crisis. Which of the following interventions should the nurse include in the plan of care? a. Initiate bed rest b. Administer meperidine as needed for pain c. Limit fluid intake d. Apply cold compresses to affected joints
a. Initiate bed rest
A nurse is caring for a child who has increased intracranial pressure and is unconscious due to a closed head injury. Which of the following actions should the nurse take? a. Initiate seizure precautions b. Turn the child side to side every 2 hr c. Perform chest percussion as needed d. Maintain the child next in a flexed position
a. Initiate seizure precautions
A nurse is caring an an infant who has hydrocephalus and ventriculoperitoneal shunt malfunction. Which of the following assessment findings indicates that the infant is experiencing increased intracranial pressure? a. Irritability b. Tachycardia c. Increased appetite d. Flat fontanel
a. Irritability
A nurse is planning care for a child who is placed in skin traction. Which of the following is the priority action for the nurse to take? a. Maintain proper body alignment b. Use an alternate pressure mattress c. Monitor pedal pulses d. Increase fluid intake
a. Maintain proper body alignment
A nurse is assessing an infant who has iron deficiency anemia. Which of the following findings should the nurse expect? a. Pale conjunctiva b. Increased hemoglobin level c. Bradycardia d. Hyperactive muscle tone
a. Pale conjunctiva
A nurse is caring for a school-age child who is in 90/90 skeletal traction. Which of the following actions should the nurse take? a. Place the child on an alternating pressure mattress b. Release the traction to allow the child to bathe c. Adjust the weights to allow the child to turn d. Ensure that the pulley mechanisms is attached to the skin
a. Place the child on an alternating pressure mattress
A nurse is caring for a child who received partial-thickness burns to over 50% of his body 10 days ago and has splints over his joints to prevent contractures. Which of the following actions should the nurse take? (SATA) a. Provide a high-calorie diet b. Remove splints during sleep c. Change dressings using aseptic technique d. Administer analgesics IM e. Monitor intake and output
a. Provide a high-calorie diet c. Change dressings using aseptic technique e. Monitor intake and output
A nurse in a provider's office is assessing the vital signs of a 1 year old toddler. Which of the following findings should the nurse report to the provider? a. Respiratory rate 54/min b. Blood pressure 88/42 mmHg c. Heart rate 110/min d. Temperature 37.7 C (99.9 F)
a. Respiratory rate 54/min
A nurse is reviewing the laboratory values of a school-age child who has nephrotic syndrome. Which of the following laboratory values should the nurse expect? a. Serum protein 4.2 g/dL b. BUN 15 mg/dL c. Hgb 12 g/dL d. Serum sodium 144 mg/dL
a. Serum protein 4.2 g/dL
A nurse is providing teaching to an adolescent who has vulvovaginitis. Which of the following statements should the nurse include in the teaching? a. "Wear nylon underwear at night" b. "Apply a warm, moist compress three times per day" c. "Apply scented baby powder to absorb residual moisture" d. "Wear a feminine deodorant pad for vaginal drainage"
b. "Apply a warm, moist compress three times per day"
A nurse is educating an adolescent following the application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching? a. "I should expect my fingers to be swollen for several days." b. "I should elevate my broken arm on pillows at night." c. "I should limit the use of the fingers of my broken arm." d. "I will sprinkle baby powder into the cast if my arm itches."
b. "I should elevate my broken arm on pillows at night."
A nurse is caring for a school-age child who is experiencing pain. Which of the following assessment techniques will provide the nurse with the most accurate information regarding the child's pain? a. Observe the child's facial expressions b. Ask the child to use a FACES rating scale c. Assess the child's pulse and respirations d. Monitor the child's involuntary movements
b. Ask the child to use a FACES rating scale
A nurse is assessing an adolescent who has Cushing's syndrome. Which of the following findings should the nurse expect? a. Advanced bone age b. Blood glucose 320 mg/dL c. Potassium 4.2 mEq/L d. Cachectic appearance
b. Blood glucose 320 mg/dL
A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should identify that which of the following laboratory tests can contribute to confirming this diagnosis? (SATA) a. Blood urea nitrogen (BUN) b. C-reactive protein (CRP) c. Partial thromboplastin time (PTT) d. Erythrocyte sedimentation rate (ESR) e. Antistreptolysin O (ASO) titer
b. C-reactive protein (CRP) d. Erythrocyte sedimentation rate (ESR) e. Antistreptolysin O (ASO) titer
A nurse in an emergency department is assessing a school-age child who has asthma. Which of the following findings should the nurse identify as the priority? a. Pulse rate 118/min b. Decreased breath sounds c. Hyperresonance on percussion d. Nonproductive cough
b. Decreased breath sounds
A nurse is caring for a child who has prescription for fluticasone and has developed white patches and sores in his mouth. Which of the following is an appropriate action for the nurse to take? a. Withhold the medication until the lesions heal b. Encourage the use of a spacer c. Obtain a prescription for oral prednisone d. Collect a culture from the lesions
b. Encourage the use of a spacer
A nurse is caring for a 9-year-old child who has major burns to her face and upper torso. After establishing airway, which of the following actions should the nurse take first? a. Give pain medication b. Initiate crystalloid IV bolus c. Administer a tetanus vaccine d. Begin enteral feedings
b. Initiate crystalloid IV bolus
A nurse is teaching about growth and development to a parent of a 12-year-old child. The nurse should instruct the parent to expect the child to exhibit which of the following characteristics during early adolescence? a. Emotional separation from parents b. Mood swings c. Decelerating growth rate d. Increased self-esteem
b. Mood swings
A nurse is performing a cranial nerve assessment on a school-age child. Which of the following findings indicates proper functioning of the child's trigeminal nerve? a. The child correctly identifies specific scents b. The child has symmetrical jaw strength when biting down c. The child maintains balance when standing with eyes closed d. The child exhibits a gag reflex when stimulated with a tongue blade
b. The child has symmetrical jaw strength when biting down
A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions should the nurse plan to take? a. Test the child without glasses before testing with glasses b. Use a tumbling E chart for the assessment c. Position the child 4.6 meters (15 feet) from the chart d. Assess both eyes together first, then each eye separately
b. Use a tumbling E chart for the assessment
A nurse is reviewing the laboratory report of a school-age child who has bacterial pneumonia. Which of the following laboratory values should the nurse expect? a. Creatinine 0.5 mg/dL b. WBC 18,000/mm3 c. Hgb 14 g/dL d. pH 7.40
b. WBC 18,000/mm3
A nurse is providing teaching to a parent of a child who has HIV. Which of the following statements by the parent indicates an understanding of the teaching? a. "My child will need to repeat his childhood immunization once he is in remission" b. "The risk of transmission decreases once my child is on zidovudine for 2 weeks" c. "I will ensure that my child is tested for tuberculosis every year" d. "My child will need to double his medications for the next 6 months"
c. "I will ensure that my child is tested for tuberculosis every year"
A nurse is providing discharge teaching to a parent of a child who has juvenile idiopathic arthritis and a new prescription for prednisone. Which of the following statements should the nurse include in the teaching? a. "Expect that this medication will stimulate a growth spurt" b. "Limit your child's intake of potassium-rich foods" c. "Monitor your child for indications of infection" d. "Discontinue this medication if gastrointestinal upset occurs"
c. "Monitor your child for indications of infection"
A nurse on a pediatric unit is caring for four children. The nurse should use droplet precaution for which of the following children? a. A preschool-age child who has pediculosis capitis b. A school-age child who has viral conjunctivitis c. A toddler who has seasonal influenza d. An adolescent who has hepatitis A
c. A toddler who has seasonal influenza
A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first? a. A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillin b. A toddler who has a partial-thickness burn on his right hand and requires a dressing change c. An adolescent who has sickle cell anemia and slurred speech d. An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10
c. An adolescent who has sickle cell anemia and slurred speech
A nurse is caring for a 4-year-old child who has meningitis and is receiving gentamicin. Which of the following laboratory values should the nurse report to the provider? a. BUN 12 mg/dL b. BUN 6 mg/dL c. Creatinine 1.4 mg/dL d. Creatinine 0.3 mg/dL
c. Creatinine 1.4 mg/dL
A nurse is caring for a newly admitted toddler who has acute diarrhea. Which of the following actions should the nurse take first? a. Obtain a stool specimen for culture b. Give 0.9% sodium chloride IV bolus c. Initiate contact precautions d. Administer an antibiotic
c. Initiate contact precautions
A nurse is planning care for a school-age child who has autism spectrum disorder. Which of the following actions should the nurse include in the plan? a. Give the child three options when making choices b. Explain procedures in detail to the child c. Introduce the child to new situations slowly d. Stay with the child for long periods of time
c. Introduce the child to new situations slowly
A nurse in a pediatric unit is caring for a school-age child following a cardiac catheterization. Which of the following actions should the nurse take? a. Perform a sterile dressing change 8 hr after the procedure b. Administer meperidine for pain every 4 hr c. Keep the affected extremity straight for 6 hr d. Maintain NPO status for 24 hr following the procedure
c. Keep the affected extremity straight for 6 hr
A nurse is caring for a toddler who has a short leg cast. Which of the following findings should the nurse report to the provider? a. Mobility of the distal extremity b. Positive pedal pulse in the distal extremity c. Pallor of the distal extremity d. Warmness of the distal extremity
c. Pallor of the distal extremity
A nurse is preparing to administer immunizations to a 3-month-old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care? a. Use a 20-gauge needle for the injections b. Apply eutectic mixture of local anesthetics (EMLA) cream immediately before the injections c. Provide a pacifier coated with an oral sucrose solution prior to the injections d. Inject the immunizations into the deltoid muscle
c. Provide a pacifier coated with an oral sucrose solution prior to the injections
A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider? a. Pharyngitis b. Rhinorrhea c. Tachypnea d. Coughing
c. Tachypnea
A nurse is caring for a school-age child who has diabetes mellitus. Which of the following findings should the nurse recognize as being consistent with hyperglycemia? a. Tremors b. Sweating c. Thirst d. Pallor
c. Thirst
A nurse is teaching a parent of a toddler about administering digoxin. Which of the following statements by the parent indicates an understanding of the teaching? a. "I should give the medication with foods that are high in fiber" b. "I should mix the medication with 4 ounces of my child's favorite juice" c. "I should give my child another dose if he vomits right after taking the medication" d. "I should give my child water after giving the medication"
d. "I should give my child water after giving the medication"
A nurse is providing teaching to a parent of an infant who has diaper rash. Which of the following statements by the parent indicates an understanding of the teaching? a. "I will sprinkle talcum powder over the affected area twice daily" b. "I will keep the area warm and moist" c. "I will use antibacterial soap to wash the rash with each diaper change" d. "I will use super-absorbent disposable diapers"
d. "I will use super-absorbent disposable diapers"
A nurse is caring for a preschool-age child who is a 2 hr postoperative following a tonsillectomy and adenoidectomy. Which of the following manifestations should the nurse report to the provider? a. Halitosis b. Tachycardia c. Dark brown emesis d. Blood-tinged mucus
d. Blood-tinged mucus
A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching? a. Place screens on all windows b. Provide balloons for play c. Adjust the water heater temperature to 54 C (129.2 F) d. Check clothing for loose buttons
d. Check clothing for loose buttons
A nurse is providing teaching to the parents of a school-age child newly diagnosed with a seizure disorder. The nurse should teach the parents to take which of the following actions during a seizure? a. Place the child in a prone position b. Insert a tongue blade between the teeth c. Minimize movement of the limbs d. Clear the area of hard objects
d. Clear the area of hard objects
A nurse is providing discharge teaching to the parents of a school-age child following placement of a ventriculoperitoneal shunt. The nurse should determine that the teaching was effective when the parents identify which of the following as an indicator the shunt has been displaced? a. Hyperactive bowel sounds b. Elevated temperature c. Decreased urine output d. Increased sleeping
d. Increased sleeping
A nurse is providing teaching to a parent of an 11-month-old infant who has acute diarrhea and dehydration. Which of the following fluids should the nurse instruct the parent to provide to the infant? a. Glucose water b. Chicken broth c. Half-strength apple juice d. Oral electrolyte solution
d. Oral electrolyte solution
A nurse in an emergency department is caring for a child following an overdose of acetylsalicylic acid. which of the following medications should the nurse plan to administer? a. Flumazenil b. Naloxone c. Midazolam d. Phytonadione
d. Phytonadione
A nurse in the emergency department is assessing a toddler who has hyperpyrexia, severe dyspnea, and is drooling. Which of the following actions should the nurse take first? a. Administer an antibiotic to the toddler b. Obtain a blood culture from the toddler c. Insert an IV catheter for the toddler d. Prepare the toddler for nasotracheal intubation
d. Prepare the toddler for nasotracheal intubation
A nurse is planning care for a child immediately following the insertion of a chest tube for continuous suction with a closed drainage system. Which of the following interventions should the nurse include in the plan of care? a. Ensure continuous bubbling is present in the suction control chamber b. Change the chest tube insertion site dressing every 12 hr c. Report the presence of tidaling of fluid in the water seal chamber d. Record the amount of chest tube drainage every 2 hr.
d. Record the amount of chest tube drainage every 2 hr.
A nurse in a community health clinical is assessing the needs of a single parents who has three young children and works full time. Which of the following resources should the nurse recommend? a. Counselling for depression b. 12-step support group c. Child home health care d. Respite child care
d. Respite child care
A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following actions should the nurse include in the plan of care? a. Cleans the gums with saline soaked gauze b. Moisten the mucosa with lemon glycerin swabs c. Administer oral viscous lidocaine d. Schedule routine oral care every 8 hr
d. Schedule routine oral care every 8 hr
A nurse is assessing an 18-month old child during a well-child visit. Which of the following findings should the nurse report to the provider? a. The child scribbles on the wall with a crayon b. The child consistently throws items to the floor c. The child has frequent temper tantrums d. The child crawls to navigate the room
d. The child crawls to navigate the room
A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is moderately dehydrated? a. Bradycardia b. Capillary refill 1 second c. Respiratory rate 28/min d. Weight loss 7%
d. Weight loss 7%
A nurse is admitting an infant who has GERD. which of the following is the priority assessment finding? a. Weight loss b. Regurgitation c. Excessive crying d. Wheezing
d. Wheezing