Peds HESI 2

A nurse is planning a teaching program for a child who was recently diagnosed with type 1 diabetes. What is the nurse's priority concern? 1 Exploring the child's feelings about diabetes 2 The necessity of restricting the child's activities 3 Ensuring that the child learns to monitor blood glucose 4 Helping the child to practice administering insulin injections

1 Helping families understand their feelings about diabetes is essential in assisting them to develop positive attitudes; these attitudes will motivate them to achieve optimal control of the disease and promote a healthy lifestyle for the child. The child should participate in age-appropriate activities; adequate exercise is an important part of the treatment regimen for children who have diabetes. Learning to monitor blood glucose is important; however, if feelings are not addressed first, compliance with glucose monitoring is less likely. Also, the age and developmental level of the child must be considered before teaching can begin. Helping the child to practice administering insulin injections is important; however, if feelings are not addressed first, compliance with insulin administration is less likely.

What is the best way for the nurse to promote the social development of a 9-month-old infant? 1 Engaging in peek-a-boo 2 Offering soft clay to manipulate 3 Providing a pegboard for pounding 4 Demonstrating how to speak words

1 Playing peek-a-boo is age appropriate because it aids the infant's social development by fostering a sense of object constancy and object permanence. Playing with soft clay is age appropriate for the toddler; it promotes gross and fine motor development. Pounding on a pegboard is age appropriate play for toddlers and preschoolers; it helps release tension and develops motor skills. Repeating words is age appropriate for the 1-year-old child.

A 10-year-old child is admitted to the pediatric unit in vaso-occlusive sickle cell crisis. The nurse manager is planning to assign a room. Which child is the best roommate option for this client? 1 Child with thalassemia 2 Child with osteomyelitis 3 Child with viral pneumonia 4 Child with acute pharyngitis

1 Thalassemia is a hemolytic anemia that is not communicable; roommates with infectious diseases should be avoided because a child with sickle cell anemia is susceptible to infection. Osteomyelitis is an infection of the bone, pneumonia is an infection of the lung, and pharyngitis is an upper respiratory infection; therefore none of these children is a suitable roommate.

A 3-year-old child has been observed in the clinic waiting room taking toys from others, tearing pages out of books, and striking the mother. The nurse takes time when interviewing the mother to ask about television habits because of what reason? 1 Viewing violent programs is positively correlated with the development of aggression. 2 The nurse is interested in how much time the mother spends in interactions with the child. 3 Watching Sesame Street and other children's shows results in slow cognitive development. 4 There is a direct connection between the number of hours of television viewed and toddler aggression.

1 Watching violent programs is positively correlated with the development of aggression. Television viewing time does not necessarily have anything to do with interaction time with the mother. Children's shows have not been shown to slow cognitive development. There are no statistics stating specifically that the number of hours of television watched correlates directly with an intensification of aggression.

A nurse plans to teach a school-aged child with type 1 diabetes who is receiving both intermediate-acting insulin (Novolin N) and regular insulin (Novolin R) daily how to self-administer the insulin before discharge. What should the nurse teach the child? 1 Practice using the nonmedicated insulin pen first. 2 Alternate sites until the best one to use is found. 3 Draw up the Novolin N first and then draw up the regular insulin. 4 Self-inject the insulin immediately after being taught the technique.

1 The child's confidence, readiness, and skill for giving self-injections are essential in the long-term management of diabetes, and the child should be taught to practice using the nonmedicated insulin pen. Learning responsibility for injections should be a gradual process that takes place with continuous support and guidance. The sites must be rotated. The recommended procedure is to draw up the regular insulin first and then the intermediate-acting insulin to prevent contamination of the multidose vial of regular insulin with the intermediate-acting insulin.

Which language characteristics should the nurse expect when assessing a preschool-age client during a scheduled health maintenance visit? Select all that apply. 1 Explaining opposites 2 Defining simple objects 3 Describing the use of an object 4 Verbalizing simple classifications 5 Using deviations from grammar rules

1234 The nurse would expect that the preschool-age client is able to explain opposites, define simple objects, describe the use of an object, and verbalize simple classifications. The nurse would not anticipate that the preschool-age client would be able to use deviations from grammar rules.

Which screening report will help the nurse determine skeletal growth in a child? 1 Electroencephalogram reports 2 Radiographs of the hand and wrist 3 Magnetic resonance imaging (MRI) 4 Denver Developmental Screening Test

2 Skeletal growth in a child can be determined from the ossification centers. At 5 to 6 months of age, the capitate and hamate bones in the wrist are the earliest centers. Therefore radiographs of the hand and wrist will help determine skeletal growth in the child. Electroencephalogram reports will help assess a child's brain activity. MRI is used to scan the internal structures of a client. The Denver Developmental Screening Test is used to understand developmental issues of a child.

The parent of a 9-year-old child who has undergone tonsillectomy is receiving discharge instructions. Which statement indicates to the nurse that the parent needs further teaching? 1 "I won't let her use a straw to drink." 2 "Cherry milkshakes will ease the pain." 3 "I shouldn't let her gargle for at least 10 days." 4 "She'll be able to play with friends in 1 week."

2 A serious posttonsillectomy complication is hemorrhage; red liquids are contraindicated because they may mask bleeding. Drinking from a straw produces suction, which may traumatize the surgical site and cause bleeding. Likewise, gargling is traumatic to the surgical site and may precipitate bleeding. Hemorrhage may occur as long as 10 days after surgery; regular activity may be resumed after 1 week if there are no complications.

The client reports excessive bleeding during the menstruation. Which herbal therapies are unlikely to be prescribed by the primary healthcare provider? Select all that apply. 1 Raspberry Correct2 Chamomile 3 Lady's mantle Correct4 Chaste tree fruit 5 Shepherd's purse

2, 4 Chamomile is an antispasmodic agent that helps to reduce breast pain. Chaste tree fruit is used to reduce breast pain by reducing the prolactin levels. Raspberry, lady's mantle, and shepherd's purse are uterotonic drugs used to treat menorrhea.

A toddler has just had a cast applied for a fractured wrist. The wrist and elbow are immobilized. What information should the nurse include in the home care instructions before discharge? Select all that apply. 1 Resume usual activities. 2 Report swelling of fingers. 3 Keep the affected shoulder immobilized. 4 Elevate casted arm when the child is standing. 5 Lower the casted arm when the child is lying down.

2, 4 When swelling of the fingers occurs, the cast may become too tight, resulting in neurovascular damage; permanent damage can occur in 6 to 8 hours. The casted arm should be in a sling when the child is upright to promote venous return. Rest with elevation of the extremity is recommended; strenuous activity should be avoided for several days. Joints above and below the cast should be moved to maintain flexibility. The casted arm should be elevated when the child is resting to promote venous return.

A 2-year-old boy who has fallen from a tree tells his parents and the nurse, "Bad, bad tree." The nurse concludes that the child is within the cognitive developmental norm of which Piaget stage? 1 Concrete operations 2 Concept of reversibility 3 Preconceptual operations 4 Sensorimotor development

3 Attributing lifelike qualities to inanimate objects (animism) is associated with preconceptual thought. Concrete operational thought is achieved in school-age children. Concept of reversibility is a phase of concrete operations achieved by school-age children. Sensorimotor development is related to infants.

What is the most important nursing intervention for minority adolescents? 1 Identifying individuals at risk for substance abuse 2 Providing counseling to adolescents during rehabilitation 3 Helping ensure improved access to appropriate healthcare 4 Guiding minority adolescents to prevent injuries and accidental deaths

3 Minority adolescents experience a greater likelihood of health problems and barriers to healthcare. Hence, helping improve access to appropriate healthcare is the most important intervention for the nurse working with minority adolescents. Identifying individuals who are at risk for substance abuse, providing counseling to adolescents during rehabilitation, and guiding adolescents to help prevent injuries and accidental deaths are applicable to all adolescents.

Which age group would the nurse state engages in associative play? 1 Infants 2 Toddlers 3 Adolescents 4 Preschoolers

4 Preschoolers play with one other child in a cooperative manner in which they make something or play designated roles. Infants do not perform allied play. Parallel play is common among toddlers. In this form of play, each one engages in an independent activity that is similar to, but not influenced by or shared with others. Adolescents spend time with multiple friends at one time.

A child with a diagnosis of tuberculosis is admitted to the pediatric unit. Which location should the nurse select as the best placement for the child? 1 Private room 2 Isolation room 3 Four-bed room 4 Semiprivate room

2 An isolation room is a private room fitted with special air handling and ventilation to prevent the transmission of airborne droplet nuclei 5 micrometers or smaller. It has monitored negative pressure to prevent air from moving from the room into the corridor of the facility. Room air is exchanged 6 to 12 times an hour to the outdoors or through a monitored high-efficiency filtration system. Mycobacterium tuberculosis remains suspended in the air for prolonged periods and is transmitted in air currents. A private room does not have the technical equipment to manage airborne droplet nuclei of 5 micrometers or smaller. Other children and people on the unit will be exposed to the infected individual's pathogens that travel through air currents. A four-bed room or semiprivate room will expose the children and other people on the unit to the infected individual's pathogens.