Pedi Hesi

A mother brings her preteen daughter to the clinic for her first female examination. During the health assessment, the nurse should implement which technique to determine if the client has reached menarche? A. Calculate approximate age menstruation should occur B. Palpate for evidence of temporary gynecomastia C. Assess for presence of a supernumerary breast nipple D. Use the Tanner staging to determine sexual maturity

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The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Which finding should the nurse report to the healthcare provider immediately? A. Swelling in the hands or feet B. Jaundice C. Ulcers on the legs D. Chest pain

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A preschool-age child in experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of 102.8 F (39.3C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse prepare the child next? A Obtain bedside trays for intubation or tracheotomy by the healthcare provider B Begin prescribed intravenous antibiotic administration C Provide a nebulizer treatment with bronchodilators D Schedule the child for a stat magnetic resonance imaging (MRI) of the neck

A Obtain bedside trays for intubation or tracheotomy by the healthcare provider

The nurse is assessing a 9-year-old boy who has been admitted to the hospital with possible acute poststreptococcal glomerulonephritis (APSGN). In obtaining his history, what information is most significant. A. A sore throat B. A history of hypertension c. Diuresis during the night d. Back pain for a few days

A. A sore throat

The Nurse is caring for a preschool-aged child with congenital heart defect who is admitted with intermittent low-grade fever, fatigue, and weight loss. Further physical assessment findings include a new murmur, splinter hemorrhages under the nails, and painless red lesions on the palms of the hands. Which diagnostic procedure should the nurse prepare the parents to expect the healthcare provider to prescribe? A. Echocardiogram B. Electrocardiogram C. Chest radiography D. Computerized tomography (CT) scan

A. Echocardiogram

A 6-month-old diagnosed with short bowel syndrome, begins eternal feedings yesterday. To maintain normal growth and development od the child during this period, what action should the nurse include in the infant's plan of care? A. Give the infant a pacifier during feedings B. Use sterile technique during feedings C. Speak to the healthcare provider about instituting physical therapy D. Ensure placement of the nasogastric tube with an abdominal X-ray

A. Give the infant a pacifier during feedings

A 2-year-old child with heart failure is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin, the nurse obtains an apical heart rate of 128 beats/min. What action should the nurse implement? A. Calculate the safe dose range B. Administer the schedule dose C. Review the serum digoxin level D Determine the pulse deficit

B. Administer the schedule dose

A 10-year-old girl is diagnosed with inflammatory bowel disease (IBD) her mother is concerned that she will experience developmental delays as the result of this disorder. Who should the nurse respond? A. Growth failure is a concern, but developmental delays are not likely to occur B Scheduling a private tutor can help to prevent developmental delays C. She will only experience developmental delays if weight loss cannot be controlled D. She is at high risk for a number of different problems including developmental delays

A. Growth failure is a concern, but developmental delays are not likely to occur

The nurse is performing a routine assessment of a 3-year-old at a community health center. Which behavior by the child should alert the nurse to request a follow-up for possible autistic spectrum disorder (ASD)? A. Performs odd repetitive behaviors B. Strokes the hair of a handheld doll C. Has a history of temper tantrums D. Shows indifference to verbal stimulation

A. Performs odd repetitive behaviors

A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement 1st? A. Place the child in a quiet environment B. Apply location to hands and feet C. Make a list of foods that the child likes D. Encourage the parents rest when possible

A. Place the child in a quiet environment

A 6-year-od male with a body mass index (BMI) in the 95th percentile for gender and age arrives at the clinic after a referral from the school nurse. His laboratory findings include a hemoglobin A1C od 5.5, blood pressure in the 50th percentile for age, height in the 75th percentile, and an LDL, cholesterol of 90 mg.dl. Which lifestyle modification should the nurse discuss with the parents? A. Recommend increasing daily fruits and vegetables and daily exercise B. Return in one month for another evaluation of serum lipids and blood pressure C. Instruct the parents to weight the child weekly and measure his BP daily D. See a healthcare provider to further assess for diabetes and hypertension

A. Recommend increasing daily fruits and vegetables and daily exercise

A 3-year-old child with HIV infection is staying with a foster family who is caring for three other children in their home. When one of the children acquires pertussis, the foster parent calls the clinic and asks the nurse what they should do. Which action should the nurse take 1st? A. Review immunization record of the child with an HIV infect B Place the child with an HIV infection in a protective environment C. Report the exposure of the child with HIV to the health department D. Remove the child with an HIV infection from the foster home

A. Review immunization record of the child with an HIV infect

A 7-year-old child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of which illness is most significant. A. Sore throat B Chickenpox C. Mumps D. influenza

A. Sore throat

A male high school student with type 1 diabetes test his blood glucose level before playing a game of soccer, and he obtains a reading of 180 mg/dl (10 mmol/L). Based on this reading, which action should the nurse take? A. Tell him to eat a sandwich and fruit before beginning the game B check his urine for ketones C Give him permission to go ahead and play soccer D call the healthcare provider

A. Tell him to eat a sandwich and fruit before beginning the game

A 9-year-old with celiac disease is admitted to the pediatric unit following an appendectomy. Which food should the nurse remove from this child's meal tray? A. Fruit cup B. Crackers C. Turkey D. Chicken rice soup

B. Crackers

A infant recently admitted with vomiting and diarrhea now weighs 10kg. Her weight at previous visit was 11kg. What is the percentage of baby weight loss for this infant? A 4% B 9% C 10% D 5%

B 9%

The caregiver of a preschooler learns about long-term endocrine dysfunctions resulting from their child's craniospinal radiation. Which statement made by the caregiver should the nurse recognize as needing additional education? A. Follow up at a dentist routinely to monitor for delayed tooth eruption B. Make plans for growth hormone injections to enhance growth C. Onset of cold intolerance and dry skin may indicate a problem D. Development of secondary sex characteristics may be slower

B) make plans for growth hormone injections to enhance growth

The nurse is giving an intramuscular injection of an antibiotic to a 16-month toddler with pneumonia. The toddler does not have any known allergies and has been walking without assistance for one-month, Which technique should the nurse select for administration? A. Used a needle length of ½ inch to avoid deep tissue damage B. Administer the injection into the middle of the lateral aspect of the thigh C. Give in the arm, one to 2 inches below the acromion process D. Divide the gluteal area into quarters and give IM into the upper outer quadrant

B. Administer the injection into the middle of the lateral aspect of the thigh

When administering indomethacin to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome? A. Decreased urinary output B. Decreased cardiac murmur C. Increased number of RBC D. Increased respiratory effort

B. Decreased cardiac murmur

The school nurse is assessing a child who reports having an itchy scalp. The nurse has sent home care instructions for pediculosis capitis for several children at the school. Which assessment should the nurse implement to this child? A. Determine if silvery crusty scales are seen in skin folds B. Inspect hair follicle shafts for adherence of nits C Observe base of neck and forehead for ring-shaped rash D. Look for raised, reddening areas and balding on scalp

B. Inspect hair follicle shafts for adherence of nits

While administering the final dose or oral amoxicillin to a preschool-aged boy, he tells the nurse that his throat hurts. Which intervention is most important for the nurse to implement? A. Document the child's comments B. Inspect the child's oropharynx C. Review the child's history of sore throat D. Assess skin for signs of allergic reaction

B. Inspect the child's oropharynx

A nurse is teaching a class for mothers of premature infants and is asked about " a shot for respiratory virus." What information about palivizumab is correct? A. It must be repeated every two months to be effective B. It is recommended for infants who meet established high-risk criteria C. It is a required immunization for all infants under the age of 3 months D. It provides protection one year with a single injection

B. It is recommended for infants who meet established high-risk criteria

A male child is being prepared for a CT scan when he begins to have a tonic chronic seizure. His mother is hysterical and is trying to hold her child down. What actions should the nurse take (select all that apply) A. Administer and anticonvulsant medication B. Place pillows inside the side rails C. Ask the mother to release the child D. Close blinds room so is darkened E. Monitor the child's airway and tongue

B. Place pillows inside the side rails C. Ask the mother to release the child E. Monitor the child's airway and tongue

The nurse plans to conduct a physical assessment of a toddler. Which protocol is best for the nurse to implement? A. Ensure that the room is warm and undress the child completely B. Prior to helping the child remove their clothing, use a paper doll to demonstrate removal of clothing C. Have the parent remove the child's outer clothing and remove the diaper or training pants when necessary D. Help the child take off their clothes, removing underwear only to conduct examination of the genitalia

B. Prior to helping the child remove their clothing, use a paper doll to demonstrate removal of clothing

The mother of three young children calls the clinic concerned about the recent exposure of her oldest child to chickenpox. The nurse should provide the mother with information about the contagious period for chickenpox. What is the contagious period? A. During the eruption of the vesicles, until crusting occurs B. Two days prior to the onset of the rash, until all lesions are crusted C. Ten days prior to the onset of the rash, until formation of the vesicles D. From the onset of the rash, until the rash is healed

B. Two days prior to the onset of the rash, until all lesions are crusted

A mother brings her 2-month-old son to the clinic for a well-baby exam. During the assessment the nurse finds that the right testicle in not descended into the scrotum, but the left is palpable. Which action should the nurse take? A. prepare to obtain a catheterized urine specimen for culture B address possible concerns about the child's future fertility C Ask if the right testis has been seen in the scrotum before D Schedule an IV pyelogram to validate presence of testicle

C Ask if the right testis has been seen in the scrotum before

A 4-year-old girl returns to the pediatrician's office for a postoperative visit following hospitalization for minor surgery. When observing the child in the waiting area, which behavior should the nurse consider normal for this age child? A. Ignores other children in the play area B. Draws pictures of self with facial features C. "Talks" to an imaginary friend D. Sits quietly in her mother's lap

C. "Talks" to an imaginary friend

A one-month old male infant is brought to the clinic by his mother who states that her son has been vomiting forcefully after each meal for the last three days. The infant is afebrile, dehydrated, and pyloric stenosis is suspected. What other findings should the nurse identify that are consistent with pyloric stenosis? A. Perianal diaper rash from persistent diarrhea B. Rooting, hunger, and irritability C. An olive-shaped mass in the abdominal area D Bile-stained emesis

C. An olive-shaped mass in the abdominal area

A male infant is admitted to the pediatric unit with pertussis and is exhibiting a "whooping-like-cough." The mother brings the infant to the nurse's station to seek assistance. Which intervention should the nurse implement first? A. Explain the need to maintain droplet precautions to prevent spread to others on the unit B. Give the infant an oral dose of a prescribed antitussive and analgesic/antipyretic C. Cover the infant's mouth and assist the mother to take the infant back to the room D. Ask the mother if a cool mist humidifier at the bedside is functioning and releasing mist

C. Cover the infant's mouth and assist the mother to take the infant back to the room

During the physical exam of an 11-year-old girl, the nurse observes budding breast and scant pubic hair. Which Tanner stage should the nurse choose when documenting these findings? A. V B. II C. III D. IV

C. III

The mother of a 14-month-old tells the nurse that she feeds her child nothing but prepared toddler foods and feels they provide the best nutrition for her child but is concerned about the cost. How should the nurse respond? A. Teach the mother how to develop a budget to allow her to continue to provide needed prepared toddler foods. B. Advise the mother that these foods will only be needed until the growth spurt of the toddlers' years to complete C. Reassure the mother that beginning to replace prepared foods with table foods can provide the needed nutrients D. Affirm that these prepared foods are the best way to ensure that the toddler gets all the needed nutrients

C. Reassure the mother that beginning to replace prepared foods with table foods can provide the needed nutrients

The nurse is administering a nebulized albuterol treatment to a young girl who is having an asthmatic exacerbation. The client is unable to hold her lips tightly around the mouthpiece. Which intervention should the nurse implement? A. Encourage the child to keep a tight seal B. Allow the treatment to blow in the face C. Replace the mouthpiece with a mask D. Decrease the nebulizer air flow rate

C. Replace the mouthpiece with a mask

A breastfeeding infant, screened for congenital hypothyroidism is found to have low levels of thyroxine (T4) and high levels of TSH. What is the best explanation for this finding? A. The thyroid gland does not produce normal levels of thyroxine for several weeks after birth B. The Thyroxine level is low because the TSH level is high C. The TSH is high because the low production of T4 by the thyroid D. High Thyroxine levels normally occur in breastfeeding infants

C. The TSH is high because the low production of T4 by the thyroid

A 2-year-old boy who had hypospadias repair yesterday goes to the hospital playroom with his mother. Which activity should the nurse recommend? A. Peddling a tricycle in the hall B. Riding a rocking horse C. Using a large-piece puzzle D. Paying catch ball with others

C. Using a large-piece puzzle

During a well-baby clinic visit, the mother of a 6-month-old infant asks the nurse if she can have a prescription for poly VI sol with fluoride. Though the infant is still breast feeding, the mother provides the child with supplemental formula feedings. Which assessment is most important for the nurse to obtain? A. The newborn's gestational age assessment B. Weight gain and type of formula taken daily C. Water source used with supplemental feedings D. The infant's current hemoglobin and hematocrit

C. Water source used with supplemental feedings

The nurse is assessing a 6-month-old infant. Which response required further evaluation by the nurse? A Has double birth weight B Turns head to locate sound C Plays "peek-a-boo" D Demonstrates startle reflex

D Demonstrates startle reflex

The nurse is communicating with a 12-year-old who is hearing impaired. Which action is best for the nurse to use when attempting to communicate with this child? A. Use a picture boarded to communicate needs B. Convey ideas by writing short sentences C. Attract the child's attention before speaking D Emphasize emotions with facial expressions

D Emphasize emotions with facial expressions

A 9-year-old with leukemia is admitted with a ruptured appendix. A nasogastric tube is inserted and attached to low intermittent suction. Which finding is most important for the nurse to report to the healthcare provider? A. Increased BUN B. Urinary output of 60 ml/hour C. Gastric output of 450 ml in last 24 hours D. Absolute neutrophil count of 400/mm3

D. Absolute neutrophil count of 400/mm3

An infant is admitted for surgery who has Wilms' tumor. Which nursing intervention should the nurse implement during the preoperative period? A. Administer pain medication based on the FACES pain scale B. Include the prone position in the q2h turning schedule C. Give antiemetic medications to prevent nausea and vomiting D. Careful bathing and handling that avoids abdominal manipulation

D. Careful bathing and handling that avoids abdominal manipulation

Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children? A. Assessing for behavioral problems at home and school by interviewing the parents B. Preforming head circumference measurements on infants under one year of age C. Noting a marked weight gain without a gain in height on a growth chart D. Carefully recording the height and weight of children to detect inappropriate growth rates

D. Carefully recording the height and weight of children to detect inappropriate growth rates

The mother of an 11-year-old boy who has juvenile idiopathic arthritis tells the nurse, " I really don't want my son to become dependent on pain medication, so I only allow him to take it when he is really hurting". Which information is most important for the nurse to provide this mother? A. Encourage quite activities such as watching television as a pain distracter B. The use of hot baths can be used as an alternative for pain medication C. The child should be encouraged to rest when he experiences pain D. Giving pain medications around the clock helps control the pain

D. Giving pain medications around the clock helps control the pain

One week after removing a tick, a student arrives at the school nurse's office with reports of flu-like symptoms. Which intervention should the school nurse implement 1st? A. Observe for a rash around the tick bite site B. Measure the student's oral temperature C. Inform the student of Lyme disease signs and symptoms D. Instruct the student's parents to seek medical attention

D. Instruct the student's parents to seek medical attention

The nurse is measuring the frontal occipital circumference (FOC) of a 3- month-old infant, and notes that the FOC has increased 5 inches since birth and the child's head appears large in relation to body size. Which action is most important for the nurse to take next? A. Plot the measurement on the infant's growth chart B. Observe the infant for sunset eyes C. measure the infants head-to-heel length D. Palpate the anterior fontanel for tension and bulging

D. Palpate the anterior fontanel for tension and bulging

The nurse a preparing a 10-year-old child for suturing of a lacerated forehead. Both parents and a 12-year-old sibling are at the child's bedside. Which instructions best supports this family? A. It is best if the sibling goes to the waiting room until the suturing is completed B. All of you should leave while the healthcare provider sutures the child's forehead C While waiting for the healthcare provider, only one visitor may stay with the child D. Please decide who will stay when the healthcare provider begins suturing

D. Please decide who will stay when the healthcare provider begins suturing

The parents of a 3-year-old boy who has Duchenne muscular dystrophy (DMD) asks, " How can our son have this disease? We are wondering if we should have any more children." Which information should the nurse provide to these parents? A. The striated muscle group of males can be impacted by a lack of the protein dystrophin in their mothers B. Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles C. The male infant had a viral infection that went unnoticed and untreated, so muscle damage was incurred D. This is an inherited X- Linked recessive disorder, which primarily affects male children in the family

D. This is an inherited X- Linked recessive disorder, which primarily affects male children in the family

The nurse is caring for a school age- child who has ;laboratory results that reveal the presence of anti-endomysial immunoglobulin G and immunoglobulin A antibodies. The nurse should identify with the parents and child which foods to avoid after discharge to home? A. Swiss cheese B. Sweet potatoes C Orange juice D. Wheat bread

D. Wheat bread