N483 Exam 2 HESIs
The nurse is teaching the parents of an infant who will have frequent cast changes about cast care. What suggestion should be included in the teaching? 1Assess the skin at the edges of the cast. 2Apply lotion to the skin at the cast's edges. 3Immerse the cast briefly during the tub bath. 4Cover the damp cast edges with adhesive petals.
1Assess the skin at the edges of the cast.
Which type of fracture is most common in preschoolers? 1Greenstick 2Transverse 3Compound 4Comminuted
1Greenstick
Which assessment findings would indicate a possible asthma exacerbation? SATA 1. Fever 2. stridor 3. wheezing 4. tachycardia 5. hypotension
3. wheezing 4. tachycardia
After a cleft lip repair a nurse places elbow restraints on the infant. The parents ask the nurse, "Why does our child have to have restraints?" How should the nurse respond? 1"They're used routinely on infants who have had lip surgery." 2"Legally we're required to put them on infants after lip surgery." 3"The staff can't be with your baby continuously to prevent touching of the mouth." 4"Because we're keeping the arms straight, your baby won't be able to touch the mouth."
4"Because we're keeping the arms straight, your baby won't be able to touch the mouth."
Which item would the nurse use to feed an infant born with a unilateral cleft lip and palate? 1Plastic spoon 2Cross-cut nipple 3Parenteral infusion 4Rubber-tipped syringe
4Rubber-tipped syringe
A nurse is planning home care for a 6-month-old infant who has just been placed in a hip spica cast. What should the nurse emphasize to the parents about cast cleanliness? 1The entire cast should be wrapped in plastic. 2Special precautions are unnecessary for diapering. 3Baby powder should be sprinkled lightly around the diaper area. 4The cast edges in the perineal area should be covered with plastic wrap.
4The cast edges in the perineal area should be covered with plastic wrap.
Which education would the nurse provide the parent of a baby boy born with hypospadias about the age in which the repair of this congenital defect is typically performed? Shortly after birth Between 4 and 5 years of age Just before the onset of puberty After 6 months and before 1 year of age
After 6 months and before 1 year of age
Which finding would the preoperative nurse expect when assessing a child before repair of a ventricular septal defect? Severe cyanosis High H&H levels Bilateral lung sounds with rales and Rhonchi High BP in the arms and low BP in the legs
Bilateral lung sounds with rales and Rhonchi
The mother of an infant with a congenital heart defect who was admitted to the pediatric unit with heart failure asks why her baby must be weighed each morning. The nurse explains that the baby's treatment is based on changes in the daily weight. What complication can be prevented if treatment is successful? Renal failure Fluid retention Digitalis toxicity Protein malnutrition
Fluid retention
An infant who has a congenital heart defect with left-to-right shunting of blood is admitted to the pediatric unit. What early sign of heart failure should the nurse identify? Cyanosis Restlessness Decreased heart rate Increased respiratory rate
Increased respiratory rate
What intervention is included in the nursing care plan for a 4-month-old infant with tetralogy of Fallot and heart failure? Providing small, frequent feedings Positioning the child flat on the back Encouraging nutritional fluids often Measuring the head circumference daily
Providing small, frequent feedings
A 4-month-old infant is admitted to the pediatric unit with a diagnosis of congestive heart failure. Which nursing assessment would most accurately demonstrate improvement in the infant's condition? Decreased tremors Increased hours of sleep More rapid heart rate within 2 days Weight loss during the next 2 days
Weight loss during the next 2 days
Which education would the nurse provide to a school-aged child with cystic fibrosis who asks why he or she has to undergo chest physiotherapy? a. It mobilizes secretions b. It prevents barrel chest c. It dilates the bronchioles d. It provides humidification
a. It mobilizes secretions
Which diagnostic test would the nurse suspect for a 3-month-old infant with chronic constipation and suspected Hirschsprung's Disease? a. sweat test b. guthrie test c. rectal biopsy d. BG level
c. rectal biopsy
The nurse knows that additional discharge instructions are needed for parents whose infant has just undergone corrective surgery for cleft palate when the parent makes which statement? 1 "We need to schedule regular hearing tests, even at this young age." 2 "Lying on the abdomen is prohibited, so we'll keep him in an infant seat." 3 "We know that some difficulty breathing is expected, so we'll position him upright." 4 "We'll use the elbow restraints you provided to keep him from putting his hands in his mouth."
2 "Lying on the abdomen is prohibited, so we'll keep him in an infant seat."
A nurse is providing discharge teaching for the parents of a 6-year-old child with acute laryngotracheobronchitis. What should the nurse instruct the parents to do to control symptoms at home? Mechanically induce vomiting. Call a community emergency service. Administer the prescribed antihistamine. Start a cool-mist humidifier close to the child.
Start a cool-mist humidifier close to the child.
Which assessment would the nurse perform while caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS)? a) Quality of the cry b) Signs of dehydration c) Coughing up of feedings d) Characteristics of the stool
b) Signs of dehydration
For which condition is prophylactic antibiotics prescribed for a 2-year-old child with a cardiac malformation who is awaiting corrective surgery? a. bacterial pneumonia b. laryngotracheobronchitis c. upper respiratory infections d. subacute bacterial endocarditis
d. subacute bacterial endocarditis
Which recommendation from the school nurse to the parent of an older child reflects the safest plan for managing the child's asthma in the school setting? o "Your child's inhaler will be kept locked in the health center." o "I will provide all supervision when your child uses the inhaler." o "Your child's teacher will supervise your child's use of the inhaler." o "I need your permission for your child to carry the inhaler at all times."
o "I need your permission for your child to carry the inhaler at all times."
The nurse is obtaining the health history of a 7-month-old infant who has had repeated episodes of otitis media. which question is most important for the nurse to include in the interview with the mother? 1. "please describe how you position your child during feedings" 2. "tell me how often your child has had ear infections" 3. "what medicine do you give your child for ear infections?" 4. "please describe your oral health practices"
1. "please describe how you position your child during feedings"
A nurse is feeding an infant who recently underwent surgical repair of a cleft lip. What does the nurse plan to do for the infant just after each feeding? 1Burp several times. 2Rinse the suture line. 3Place on the abdomen. 4Hold for several minutes.
2Rinse the suture line.
which parent education would the nurse provide about the frequency of cast changes needed for an infant with talipes equinovarus? a. each week b. once a month c. when cast edges fray d. if cast becomes soiled
a. each week
Which pathophysiological process with the nurse expect to account for growth failure in a four-year-old child with newly diagnosed cystic fibrosis? A. impaired digestion and absorption because of the lack of pancreatic enzymes B. dyspnea and shortness of breath which causes anorexia and disinterest in food C. Increased bowel motility and diarrhea which lead to an adequate absorption of nutrients D. Pulmonary obstruction which causes an oxygen deficient in inadequate tissue nourishment
A. impaired digestion and absorption because of the lack of pancreatic enzymes
A 6-month-old infant has a congenital right-to-left shunt defect of the heart. What clinical findings are expected when the nurse completes a history and physical assessment and reviews the child's laboratory reports? Select all that apply. Orthopnea Tissue hypoxia Increased hematocrit Frequent respiratory infections Bounding pulses in upper extremities
Tissue hypoxia Increased hematocrit
Which nursing intervention would the nurse provide for an infant with an unrepaired cleft lip? a. preventing crying b. modifying feeding c. preventing infection d. minimizing handling
b. modifying feeding
The parents of a 4-year-old child call the health center and report that their child has a fever of 102.6° F (39.2° C), is complaining of a sore throat, and will not lie down, preferring to sit up and lean forward. The child is drooling and looks ill and agitated. In light of this information, what guidance should the nurse provide the family?1 The child needs to be seen immediately by a health care provider. 2The parents should provide cool mist and continue to give fluids to the child. 3The child should receive ibuprofen in an appropriate dose to decrease the fever. 4The parents should call back in several hours and update the health center on the child's condition.
The child needs to be seen immediately by a health care provider.
When preparing a child with asthma for discharge, what instructions must the nurse emphasize to the family? Select all that apply. a. Limit allergens in the home. b. Maintain a dry home environment c. Avoid placing limits on the child's behavior expectations. d. Continue the medications even if the child is asymptomatic. e. Prevent exposure to infection by having the child tutored at home.
a. Limit allergens in the home. d. Continue the medications even if the child is asymptomatic.
Which treatment would the nurse expect for a newborn with developmental dysplasia of the hips? a. a fitted Pavlik harness b. tight swaddling in blankets c. periodic strapping to a cradleboard d. placement in an infant seat on a set schedule
a. a fitted Pavlik harness
An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. In which position would the nurse place the infant to relieve the cyanosis and dyspnea? a. knee-chest b. orthopneic c. lateral recumbent d. semi-fowler
a. knee-chest
Which management strategy is the treatment of choice for hypertrophic pyloric stenosis (HPS)? a. surgery b. daily med during infancy c. slow feeding for several months d. dietary restrictions throughout childhood
a. surgery
Which clinical manifestation would the nurse expect in an infant diagnosed with hypertrophic pyloric stenosis (HPS)? SATA. a. white vomitus b. abdominal pain c. peristaltic wave d. insatiable hunger e. abdominal distention
a. white vomitus c. peristaltic wave d. insatiable hunger
An infant is admitted to the pediatric unit with bronchiolitis caused by respiratory syncytial virus (RSV). Which intervention would the nurse provide for the infant? SATA. a. limiting fluid intake b. instilling saline nose drops c. maintaining contact precautions d. nasal suctioning to remove mucus e. administering inhaled bronchodilators
b. instilling saline nose drops c. maintaining contact precautions d. nasal suctioning to remove mucus
Which would the nurse avoid in an infant with a congenital heart defect after cardiac catheterization? a. offering fluids as tolerated b. performing ROM exercises c. monitoring the apical pulse for rhythm and rate d. assessing the pulses distal to the cath site
b. performing ROM exercises
A 30-month-old toddler is brought to the emergency department in acute respiratory distress, and a diagnosis of laryngotracheobronchitis (viral croup) is made. What is the most important equipment for the nurse to have available when the child is admitted to the pediatric unit? a. IV set b. tracheostomy set c. nasal cannula for oxygen d. crib with padded side rails
b. tracheostomy set
A home care nurse is caring for a 3-month-old infant with developmental dysplasia of the hip (DDH) sees the infant sleeping without the Pavlik harness. Which education would the nurse provide to parents? a. Assure the parent that the harness may be removed for a short nap b. Encourage the parents to reapply the harness after the baby falls asleep c. Explain to the parent the importance of wearing the harness continuously. d. Instruct the parent to eliminate one of the infant's daily naps, thereby reducing the time spent out of the harness.
c. Explain to the parent the importance of wearing the harness continuously.
Which education would the nurse reinforce for a 9-year-old child with cystic fibrosis? a. The chest PT will help you feel better. b. Your meal schedule was designed by the dietician just for you. c. Your mucus is thick because CF interferes with how your mucus glands work. d. The med is scheduled for specific times because your doctor has prescribed it that way.
c. Your mucus is thick because CF interferes with how your mucus glands work.
Which nursing intervention would be the priority for a 4-week-old infant with hypertrophic pyloric stenosis who has been admitted to the pediatric unit for corrective surgery? a. stabilizing VS b. strict I&O documentation c. correcting fluid and electrolyte imbalances d. documenting the amount and character of vomitus
c. correcting fluid and electrolyte imbalances
Which intervention would be included in the plan of care for a child immediately after the application of a spica cast? a. using the crossbar to turn the child b. logrolling the child until the cast is dry c. performing a neurovascular assessment of the legs d. drying the cast with a hair dryer on the cool setting
c. performing a neurovascular assessment of the legs
Which postoperative feeding regimen is most appropriate for the infant who had surgery to correct hypertrophic pyloric stenosis (HPS)? a. thickened formula 24 hrs after surgery b. withholding of feedings for the first 24 hrs c. regular formula feeding within 24 hrs of the surgery d. additional glucose feedings as desired for the first 24 hrs
c. regular formula feeding within 24 hrs of the surgery
Which parent education would the nurse provide to the parents of a newborn placed in a pavlik harness for developmental dysplasia of the hips? a. avoid undershirts or diapers under the harness b. the harness may be adjusted as needed as the baby grows c. apply lotion or baby powder under the harness to prevent skin breakdown d. avoid using the legs to lift the infant's buttocks when changing the diaper at bath time
d. avoid using the legs to lift the infant's buttocks when changing the diaper at bath time