2022 HESI Peds 30Q

The nurse has provided home care instructions to the parents of a child who is being discharged after cardiac surgery. Which statement made by the parents indicates a need for further instructions? 1. "A balance of rest and exercise is important." 2. "I can apply lotion or powder to the incision if it is itchy." 3. "Activities in which my child could fall need to be avoided for 2 to 4 weeks." 4. "Large crowds of people need to be avoided for at least 2 weeks after surgery."

*2. "I can apply lotion or powder to the incision if it is itchy."*

child has been tentatively diagnosed with rheumatic fever. The nurse interprets that this diagnosis is consistent with which laboratory result obtained for this child? 1. Elevated antistreptolysin O (ASO) titer 2. Decreased erythrocyte sedimentation rate (ESR) 3. Negative result on antinuclear antibody (ANA) assay 4. Negative result on C-reactive protein (CRP) determination

1 Elevated antistreptolysin O (ASO) titer In the presence of rheumatic fever, the child will exhibit an elevated ASO titer, an elevated ESR, leukocytosis, and a positive result on CRP determination. A positive result on ANA testing is used to diagnose a wide variety of connective-tissue, vascular, and immune complex disorders and also will be positive with rheumatic fever.

12-year-old is admitted to the hospital with a low-grade fever and joint pain. Which diagnostic test finding will assist to determine a diagnosis of rheumatic fever? 1. Presence of Aschoff's bodies 2. Absence of C-reactive protein 3. Presence of Reed-Sternberg cells 4. Decreased antistreptolysin O titer

1 Presence of Aschoff's bodies Rheumatic fever develops after a group A β-hemolytic streptococcal infection, particularly pharyngitis. Initial diagnosis is made by noting the presence of Aschoff's bodies, or hemorrhagic bullous lesions, in the heart, joints, skin, and central nervous system; an elevated antistreptolysin O titer; an elevated C-reactive protein level; and an elevated erythrocyte sedimentation rate. Reed-Sternberg cells are found in Hodgkin's disease.

nurse reviews the laboratory results for a child with rheumatic fever and would expect to note which findings? Select all that apply. 1. Presence of Aschoff's bodies 2. Absence of C-reactive protein 3. Elevated antistreptolysin O titer 4. Presence of Reed-Sternberg cell 5. Elevated erythrocyte sedimentation rate

1. Presence of Aschoff's bodies o 3. Elevated antistreptolysin O titer 5. Elevated erythrocyte sedimentation rate

The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving diuretic therapy. The nurse should use which most appropriate method to assess the urine output? 1. Weighing the diapers 2. Inserting a Foley catheter 3. Comparing intake with output 4. Measuring the amount of water added to formula

1. Weighing the diapers

The nurse is developing a plan of care for a child admitted with a diagnosis of Kawasaki disease. In developing the initial plan of care, the nurse should include to monitor the child for signs of which condition? 1. Bleeding 2. Failure to thrive 3. Heart failure (HF) 4. Decreased tolerance to stimulation

3. Heart failure (HF)

Assessment findings of an infant admitted to the hospital reveal a machinery-like murmur on auscultation of the heart and signs of heart failure. The nurse reviews congenital cardiac anomalies and identifies the infant's condition as which disorder? 1. Aortic stenosis 2. Atrial septal defect 3. Patent ductus arteriosus 4.Ventricular septal defect

3. Patent ductus arteriosus

The nurse is caring for an infant with a diagnosis of tetralogy of Fallot. The infant suddenly becomes cyanotic, and the nurse recognizes that the infant is experiencing a hypercyanotic spell (blue or tet spell). The nurse immediately places the infant in what position? 1. Prone position 2. Knee-chest position 3. High Fowler's position 4. Reverse Trendelenburg's position

2. Knee-chest position

Prostaglandin El is prescribed for a child with transposition of the great arteries. The mother of the child is a registered nurse and asks the nurse why the child needs the medication. What is the most appropriate response to the mother about the action of the medication? 1. Prevents blue (tet) spells 2. Maintains adequate cardiac output 3. Maintains an adequate hormonal level 4. Maintains the position of the great arteries

2. Maintains adequate cardiac output

nurse is reviewing the health record of an infant with a diagnosis of congenital heart disease. The nurse notes documentation in the record that the infant has clubbing of the fingers. The nurse understands that this finding is caused by which problem? 1. Chronic fatigue 2. Poor oxygenation 3. Poor sucking ability 4. Consistent sucking on the fingers

2. Poor oxygenation

The nurse is monitoring an infant with congenital heart disease closely for signs of hear! failure (HF). The nurse should assess the infant for which early sign of HF? 1. Pallor 2. Cough 3. Tachycardia 4. Slow and shallow breathing

3

child is being discharged from the hospital following heart surgery. Prior to discharge, the nurse reviews the discharge instructions with the mother. Which statement by the mother indicates a need for further teaching? 1. "Quiet activities are allowed." 2. "The child should play inside for now." 3. "Visitors are not allowed for 1 month. 4."The regular schedule for naps is resumed."

3. "Visitors are not allowed for 1 month.

child with a diagnosis of tetralogy of Fallot exhibits an increased depth and rate of respirations. On further assessment, the nurse notes increased hypoxemia. The nurse interprets these findings as indicating which situation? 1. Anxiety 2. A temper tantrum 3. A hypercyanotic episode 4. The need for immediate health care provider (HCP) notification

3. A hypercyanotic episode

The nurse is caring for a child with a diagnosis of a right-to-left cardiac shunt. On review of the child's record, the nurse should expect to note documentation of which most common assessment finding? 1. Severe bradycardia 2. Asymptomatic findings 3. Bluish discoloration of the skin 4. Higher than normal body weight

3. Bluish discoloration of the skin

On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease? 1. Cracked lips 2. Normal appearance 3. Conjunctival hyperemia 4. Desquamation of the skin

3. Conjunctival hyperemia

The nurse is reviewing the health care provider's prescriptions for a child with rheumatic fever (RF) who is suspected of having a viral infection. The nurse notes that acetylsalicylic acid (aspirin) is prescribed for the child. Which nursing action is most appropriate? 1. Administer the aspirin if the child's temperature is elevated. 2. Administer the aspirin if the child experiences any joint pain. 3. Consult with the health care provider to verify the prescription. 4. Administer acetaminophen (Tylenol) for temperature elevation.

3. Consult with the health care provider to verify the prescription.

nurse is caring for an infant with congenital heart disease. Which, if noted in the infant, should alert the nurse to the early development of heart failure (HF)? 1. Paleness of the skin 2. Strong sucking reflex 3. Diaphoresis during feeding 4. Slow and shallow breathing

3. Diaphoresis during feeding

The clinic nurse reviews the record of a child just seen by a health care provider and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder? 1. Pallor 2. Hyperactivity 3. Exercise intolerance 4. Gastrointestinal disturbances

3. Exercise intolerance

nurse is assigned to care for an infant with tetralogy of Fallot. The mother of the infant calls the nurse to the room because the infant suddenly seems to be having difficulty breathing. The nurse enters the room and notes that the infant is experiencing a hypercyanotic episode. What is the initial action by the nurse? 1. Place the infant in a prone position. 2. Call a code and notify the supervisor. 3. Place the infant in a knee-chest position. 4. Contact the respiratory therapy department.

3. Place the infant in a knee-chest position.

A health care provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant? 1. During sleep 2. When changing the infant's diapers 3. When the mother is holding the infant 4. When drawing blood for electrolyte level testing

4. When drawing blood for electrolyte level testing

The mother of a child being discharged after heart surgery asks the nurse when the child will be able to return to school. Which is the most appropriate response to the mother? 1. "The child may return to school in 1 week." 2. "The child will not be able to return to school during this academic year." 3. "The child may return to school in 1 week but needs to go half-days for the first 2 weeks." 4. "The child may return to school in 3 weeks but needs to go half-days for the first few days.

4. After heart surgery, the child may be able to return to school in 3 weeks but needs to go half-days for the first few days. The mother also should be told that that the child cannot participate in physical education for 2 months. The remaining options are incorrect.

A child with rheumatic fever will be arriving in the nursing unit for admission. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever? 1. "Has the child complained of back pain?" 2. "Has the child complained of headaches?" 3. "Has the child had any nausea or vomiting?" 4. "Did the child have a sore throat or fever within the last 2 months?"

4. "Did the child have a sore throat or fever within the last 2 months?"

nurse is collecting data on a child with a diagnosis of rheumatic fever (RF) Which question should the nurse initially ask the mother of the child? 1. "Has the child been vomiting?" 2. "Has the child had any diarrhea?" 3. "Does the child complain of chest pain and numbness in the right arm?" 4. "Has the child complained of a sore throat within the past few months?"

4. "Has the child complained of a sore throat within the past few months?"

The nurse is monitoring an infant with heart failure (HF). Which sign alerts the nurse to suspect fluid accumulation and the need to call the health care provider (HCP)? 1. Bradypnea 2. Diaphoresis 3. Decreased blood pressure 4. A weight gain of 1 lb in 1 day

4. A weight gain of 1 lb in 1 day

The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever, knowing that which laboratory study would assist in confirming the diagnosis? 1. Immunoglobulin 2. Red blood cell count 3. White blood cell count 4. Anti-streptolysin O titer

4. Anti-streptolysin O titer

The nurse is teaching cardiopulmonary resuscitation (CPR) to a group of community members. The nurse tells the group that when chest compressions are performed on children and infants, the sternum should be depressed how far? 1. 1½ to 2 inches 2. 2½ to 3 inches 3. Deep enough to make a finger impression 4. One third to one half the depth of the chest

4. One third to one half the depth of the chest

1-year-old infant with a diagnosis of heart failure is prescribed digoxin (Lanoxin). The nurse takes the apical pulse for 1 minute before administering the medication and obtains a result of 102 beats/min. Which action should the nurse take? 1. Retake the apical pulse. 2. Withhold the medication. 3. Administer the medication. 4. Withhold the medication and notify the health care provider.

Administer the medication.

The nursing instructor teaches a group of students about cardiopulmonary resuscitation (CPR). The instructor asks a student to identify the most appropriate location at which to assess the pulse of an infant younger than 1 year of age. Which response would indicate that the student understands the appropriate assessment procedure? 1. Radial artery 2. Carotid artery 3. Brachial artery 4. Popliteal artery

Brachial artery

The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin (Lanoxin). Which statement made by the parent indicates the need for further instructions? 1. "I will not mix the medication with food." 2. "I will take my child's pulse before administering the medication." 3. "If more than one dose is missed, I will call the health care provider." 4. "If my child vomits after medication administration, I will repeat the dose.

If my child vomits after medication administration, I will repeat the dose."

nurse is assessing a newborn with heart failure before administering the prescribed digoxin (Lanoxin). In reviewing the laboratory data, the nurse notes that the newborn has a digoxin blood level of 2.4 ng/mL and an apical heart rate of 98 beats/min. The mother also tells the nurse that the newborn just vomited her formula. Which intervention should the nurse take? 1. Retake the apical pulse. 2. Administer the medication. 3. Withhold the medication for 1 hour. 4. Withhold the medication and notify the health care provider.

Withhold the medication and notify the health care provider.