Pediatric HESI
An infant who weighs 7.5 kg is to receive ampicillin (Omnipen) 25 mg/kg I.V. every 6 hours. How many milligrams should the nurse administer per dose? Record your answer using one decimal place.
187.5 mg
A child who weights 25 kg is receiving IV ampicillin 300 mg/kg/24 hours in equally divided doses every 4 hours. How many mg should the nurse administer to the child for each dose?
1875 mg
The nurse plans to administer 10 mcg/kg of digoxin elixir as a loading dose to a child who weighs 55 lbs. Digoxin is available as elixir of 50 mcg/mL. how many mL digoxin elixir should the nurse administer to this child?
5 ml
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 a possible autistic spectrum disorder? a. Performs odd repetitive behaviors b. Shows indifference to verbal stimulation c. Strokes the hair of a hand held doll d. Has a history of temper tantrums
A
Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children? a. Carefully recording the height and weight of children to detect inappropriate growth b. Performing head circumference measurements on infants under one year of age c. Assessing for behavioral problems at home and school by interviewing the parents d. Noting a tracked weight gain without a gain in height on a growth chart
A Carefully recording the height and weight of children to detect inappropriate growth
A 6-year-old girl who has asthma is demonstrating a prolonged expiratory phase and wheezing and has a 35% of personal best peak expiratory flow rate (PEFR) based on these findings, what actions should the nurse take first? a. administer a prescribed bronchodilator b. encourage the child to cough and deep breath c. report findings to the HCP d. determine what triggers precipitated this attack
A administer a prescribed bronchodilator
The nurse is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective? a. creamed corn b. pancakes c. rye crackers d. cooked oatmeal
A creamed corn
2 year old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure?
A describe the side-lying, knees to chest position that must be assumed during the procedure
The nurse plans to screen only the highest risk children for scoliosis. which group of children should the nurse screen first?
A girls between ages 10-14
The nurse is evaluating the effects of thyroid therapy used to treat a 5 months old with hypothyroidism. Which behavior indicates that the treatment has been effective? a. Laughs readily, turns from back to side. b. Has strong Moro and tonic neck reflexes. c. Keeps fists clenched, opens hands when grasping an object. d. Can lift head, but not chest when lying on abdomen.
A laughs readily, turns from back to side
a two year old boy begins to cry when the mother starts to leave. What is the nurse's best response in this situation? a. Let me read this book to you b. Two years old usually stop crying the minute the parent leaves c. Now be a big boy. Mommy will be back soon d. Let's wave bye-bye to mommy
A let me read this book to you
The nurse is assessing an infant with pyloric stenosis. Which pathophysiological mechanism is the most likely consequence of this infant's clinical picture? a. metabolic alkalosis b. respiratory acidosis c. metabolic acidosis d. respiratory alkalosis
A metabolic alkalosis
A child with acute lymphocytic leukemia (ALL) who is receiving chemotherapy via a subclavian IV infusion, has an oral temperature of 103 degrees. In assessing the IV site, the nurse determines that there are no signs of infection at the site. Which intervention is the most important for the nurse to implement? a. Obtain specimen for blood cultures. b. Assess the CBC. c. Monitor the oral temperature every hour. d. Administer acetaminophen as prescribed.
A obtain specimen for culture
The nurse working on the pediatric unit takes two 8-year old girls to the playroom. Which activity is best for the nurse to plan for these girls? a. Selecting a board game b. Playing Doctor and nurse c. Watching cartoon on TV d. Coloring, cutting and pasting
A selecting a board game
The nurse is assessing an infant with diarrhea and lethargy. Which finding should the nurse identify that is consistent with early dehydration? a. tachycardia b. bradycardia c. dry mucous membrane d. increased skin turgor
A tachycardia
The parents of a 3-year-old boy who has DMD ask "how can our son have this disease? we were wondering if we should have any more children." What information should the nurse provide these parents?
A this is an inherited X-linked recessive disorder, which primarily affect male children in the family
A LPN/LVN is developing a plan to teach a mother how to reduce her infant's risk of developing otitis media. Which direction should the nurse include in the teaching plan? a. Administer antibiotics whenever the infant has a cold. b. Place the infant in an upright position when giving a bottle. c. Avoid getting the infant's ears wet while bathing or swimming. d. Clean the infant's external ear canal daily.
B
Intraosseous infusion of a medication would be most appropriate for which child? a. An 18-month-old child with cystic fibrosis b. A 2-year-old child with a ruptured spleen and hypovolemia c. A 4-year-old child with celiac disease d. A 5-year-old child with status asthmaticus
B
When screening a 5-year-old for strabismus, what action should the nurse take a. have the child identify colored patterns on cards b. direct the child through the 6 cardinal positions gaze c. inspect the child for the setting sun sign d. observe the child for blank, sunken eyes
B
The nurse is caring for a 3-year-old child who is 2 hours post-op from a cardiac catheterization via the right femoral artery. which assessment finding is an indication of arterial obstruction? a. Blood pressure trend is downward and pulse is rapid and irregular. b. Right foot is cool to the touch and appears pale and blanched. c. Pulse distal to the femoral artery is weaker on the left foot than right foot. d. The pressure dressing at right femoral area is moist and oozing blood.
B Right foot is cool to the touch and appears pale and blanched
A child with leukemia is admitted for Chemotherapy and the nursing diagnosis "altered nutrition, less those body requirements related to anorexia, nausea and vomiting" is identified. Which intervention the nurse included in this child plan of care? a. Encourage a variety of large portions of food at every meal b. Allow the child to eat any food desired and tolerated c. Recommended eating the food as sibling eat at home d. Restrict food brought form fast food restaurants
B allow the child to eat any food desired and tolerated
During a well baby visit the parents explain that a soft bulge appears in the groin of their 4 month old son when he cries or strain stooling. The infant is schedule for surgical repair of the inguinal; hernia in two weeks. The parent should be instructed to take which measure if the hernia becomes incarcerated prior to the surgery? a. Use rectal thermometer for straining on stool b. Gently manipulate the hernia for reduction c. Offer oral electrolyte fluids for comfort d. Give acetaminophen or aspirin for crying
B gently manipulate the hernia for reduction
While auscultating the lung sounds of a 5-year-old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. What action is best for the nurse to take? a. identify the antibiotic used to treat the pneumonia b. inquire about the use of alternative methods of treatment c. ask the parents if the child has been in a recent accident d. report suspected child abuse to the authorities
B inquire about the use of alternative methods of treatment
The nurse is caring for an infant scheduled for reduction of intussusceptions. The day before the scheduled procedure the infant passes a soft-formed brown stool. Which intervention should the nurse implement? a. Instruct the parents that the infant needs to be NPO. b. Notify the healthcare provider of the passage of brown stool. c. Obtain a stool specimen for laboratory analysis. d. Ask the parents about recent changes in the infant's diet
B notify the healthcare provider of the passage of brown stool
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. measure the infant head-to-toe b. palpate the anterior fontanel for tension and bulging c. observe the infant for sunken eyes d. plot the measurement on the infants growth chart
B palpate the anterior fontanel for tension and bulging
A LPN/LVN is planning care for a 10 yeear old in the acute phase of rheumatic fever. what activity is most appropriate for the nurse to schedule? a. ping-pong b. reading books c. climbing on play equipment d. ambulating without restrictions
B reading books
the nurse is planning for a 5-month-old with GERD whose weight has decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instructions should the nurse provide this mother? a. give small amounts of baby food with each feeding b. thicken formula with cereal for each feeding c. dilute the child's formula with equal parts of water d. offer 10% dextrose in water between most feedings
B thicken formula with cereal for each feeding
A two year old child with a heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin (Lanoxin) the nurse obtains an apical heart rate of 128 bpm. What action should the nurse implement? a. Determine the pulse deficit b. Administer the scheduled dose c. calculate the safe dose range d. review the serum digoxin level
B administer the scheduled dose
A 16 year old male client who has been treated in the past for a seizure disorder is admitted to the hospital. Immediately after admission he begins to have a grand mal seizure. Which action should the nurse take? a.Obtain assistance in holding him to prevent injury b. Observe him carefully c. Call a CODE d. Place a padded tongue blade between the teeth
B observe him carefully
A 2-year-old girl is brought to the clinic by her 17 year old mother. When the nurse observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother? a. A 2-year old should be speaking in 2 word phrases b. Dental caries are associated with drinking soda c. Drinking soda is related to childhood obesity d. Toddlers should be sleeping 10 hours a night e. Toddlers should be drinking from a cup by age 2
B, C, E
A LPN/LVN is reviewing a teaching plan with parents of an infant undergoing repair for a cleft lip. Which instructions are the most appropriate for the nurse to give? Select all that apply. a. Offer a pacifier as needed. b. Lay the infant on his back or side to sleep. c. Sit the infant up for each feeding. d. Loosen the arm restraints every 4 hours. e. clean the suture line after each feeding by dabbing with saline solution f. give the infant extra care and support
B, C, E, F
A LPN/LVN is conducting an infant nutrition class for parents. which foods are appropriate to introduce during the first year of life? SATA a. sliced beef b. pureed fruits c. whole milk d. rice cereal e. strained veggies f. fruit juice
B, D, E
A 4-year-old has just returned from surgery. He has a nasogastric (NG) tube in place and is attached to intermittent suction. The child says to the nurse, "I'm going to throw up." What should the nurse do first? a. notify the HCP because he has an NG tube b. immediately give an anti-emetic iV c. irrigate the NG to ensure patency d. encourage the mother to calm the child down
C
While teaching a parenting class to new parents the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is most important reason for implementing such parenting behaviors? a. children need help in developing social skills b. this age child fears loss of self control c. they provide the child with a sense of security d. children must learn to deal with authority
C they provide the child with a sense of security
A 6-year-old child is admitted to the pediatric unit for evaluation of recurrent abdominal pain. The child has been admitted to the pediatric unit with similar complaints several times in the past few months. The child's symptoms are vague, yet his mother provides detailed information about the problem. The nurse is suspicious of the situation. What should the LPN/LVN do next? a. Request that the parent leave the hospital unit immediately. b. Ask to speak with the child without the parent being present. c. Notify the physician and request assistance from the interdisciplinary team. d. Contact the authorities immediately.
C
An 8-year-old child is suspected of having meningitis. Signs of meningitis include: a. Cullen's sign. b. Koplik's spots. c. Kernig's sign. d. Chvostek's sign.
C
An infant with tetralogy of Fallot becomes acutely cyanotic and hyperpneic. Which action should the nurse implement first? a. administer morphine sulfate b. start IV fluids c. place the infant knee to chest d. provide 100% oxygen via face mask
C Place the infant knee to chest
Following a motor vehicle collision, a 3-year old girl has a spica cast applied. Which toy is best for the nurse for this 3 year old child? a. duck that squeaks b. fashion doll and clothes c. set of cloth and hand puppets d. hand held video game
C Set of cloth and hand puppets
A 7 year old child is admitted to the hospital with acute glomerulonephritis (AGN). When obtaining the nursing history which finding should the nurse expect to obtain? a. High blood cholesterol level on routine screening b. Increased thirst and urination c. A recent strep throat infection d. A recent DPT immunization
C a recent strep throat infection
A toddler is receiving an infusion of total parenteral nutrition via a Broviac catheter. As the child plays, the I.V. tubing becomes disconnected from the catheter. What should the LPN/LVN do first? a. Turn off the infusion pump. b. Position the child on the side. c. Clamp the catheter. d. Flush the catheter with heparin.
C clamp
The nurse finds a 6 month old infant unresponsive and calls for help. After opening the airway and finding the XXXX the infant is still no breathing. Which action should the nurse take? A. Palpate femoral pulse and check for regularity B. Deliver cycles of 30 chest compressions and 2 breaths C. Give two breath that makes the chest rise D. Feel the carotid pulse and check for adequate breathing
C give two breaths that make the chest rise
The nurse is developing the plan of care for a hospitalized child with von Willebrand disease. What priority nursing intervention should be included in this child plan of care a. Reduce exposure to infection b. Eliminate contact with cold grafts (crafts? Is not legible) c. Guard against bleeding injuries d. Reduce contact with other children
C guard against bleeding injuries
The nurse is assessing a child for neurological soft signs, which finding is most likely demonstrated in the child's behavior? a. inability to move tongue in a direction b. Presence of vertigo c. Poor coordination and sense of position d. Loss of visual acuity
C poor coordination and sense of position
A child is brought to the clinic complaining of fever and joins pain, and is DX with rheumatic fever. When planning care for this child what is the goal of nursing care? a. Reduce fever b. Maintain fluid and electrolytes c. Prevent cardiac damage d. Maintain join mobility and function
C prevent cardiac damage
The parents of a newborn infant with hypospadias are concerned about when the surgical correction should occur. What information should the nurse provide? a. Repair should be done by one month to prevent bladder infection. b. To form a proper urethra repair, it should be done after sexual maturity. c. Repairs typically should be done before the child is potty trained. d. Delaying the repair until school age reduces castration fears.
C repairs typically should be done before the child is potty trained
a 7-year-old is admitted to the hospital with persistent vomiting, and a nasogastric tube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider? a. gastric output of 100 mL in the last 8 hours b. shift intake of 640 mL iV fluids plus 30 mL PO ice chips c. serum potassium of 3.0 mg/dL d. serum pH of 7.45
C serum potassium of 3.0
The mother of a 4-month-old asks the nurse for advice in preventing diaper rash. What suggestion should the nurse provider?
C use a barrier cream, such as zinc oxide, which dose not have to be completely removed with each diaper change
Which nursing intervention is most important to include in the plan of care for a child with acute glomerulonephritis A. encourage fluid intake b. promote complete bed rest c. weight the child daily d. administer vitamin supplements
C weigh the child daily
A LPN/LVN is assessing a severely depressed adolescent. Which finding indicates a risk of suicide? a. Excessive talking b. Excessive sleepiness c. a history of cocaine use d. preoccupation with death
D
A boy, age 3, develops a fever and rash and is diagnosed with rubella. His mother has just given birth to a baby girl. Which statement by the mother best indicates that she understands the implications of rubella? a. "I told my husband to give my son aspirin for his fever." b. "I'll ask the physician about giving the baby an immunization shot." c. "I don't have to worry because I've had the measles." d. "I'll call my neighbor who's 2 months pregnant and tell her not to have contact with my son."
D
The mother of a 9 month old who was diagnosed with RSV yesterday calls the clinic to inquire if it will be okay to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide? a. the child will no longer be contagious b. make sure the children are not under 6 months around the child c. the child can be around other children but should wear a mask d. do not expose other children to the child with RSV. It is very contagious without direct contact
D
Which intervention provides the most accurate information about an infant's hydration status? a. Monitoring the infant's vital signs b. Accurately measuring intake and output c. Monitoring serum electrolyte levels d. Weighing the infant daily
D
The HR for a 3 year old with a congenital heart defect has steadily decreased over the last few hours, now it's 76 bpm, the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider? a. Oxygen saturation 94%. b. RR of 25 breaths/minute. c. Urine output 20 mL/hr. d. BP 70/40.
D BP 70/40
A 16 y/o female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Provenfil) meter-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is "beating a mile per minute" Which information is most important for the nurse to obtain? a. When she last took the antihistamine b. When her last Asthma attack occurred c. Duration of most asthmas attacks d. How often the MDI is used daily
D How often the MDI is used daily
The nurse on a pediatric unit observes a distraught mother in the hallway scolding her 3 year old son for wetting his pants. What initial action should the nurse take? A. Suggest that the mother consult a pediatric nephrologists B. Provide disposable training pants while calming the mother C. Refer the mother to a community parent education program D. Inform the mother that toilet training is slower for boys
D Inform the mother that toilet training is slower for boys
A 4-month-old girl is brought to the clinical by her mother because she has had a cold for 2-3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress? a. bilateral bronchial breath sounds b. diaphragmatic respiration c. a resting respiratory rate of 35 breathes/min d. flaring of the nares
D flaring of the nares
The nurse observes a mother giving her 11 month old ferrous sulfate, followed by 2 ounces of orange juice. what should the nurse do next?
D give positive feedback on the way she administered the drug
Which statement by a school aged client going to summer camp indicates the best understanding of the mode of transmission of Lyme disease?
D i have to wear long sleeves and pants when we're hiking around the pond
Which drink choice on a hot day indicates to the nurse that a teenager with sickle cell anemia understands dietary consideration related to the disease? a. milkshake b. iced tea c. diet cola d. lemonade
D lemonade
A child admitted with DKAA is demonstrating Kussmaul repsirations. The nurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration? a. metabolic alkalosis b. respiratory acidosis c. respiratory alkalosis d. metabolic acidosis
D metabolic acidosis
During a well-baby check, the nurse hides a block under the baby's blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing? a. separation anxiety b. associative play c. object prehension d. object permanence
D object permanence
The nurse is preparing a 10-year-old with a lacerated forehead for suturing. Both parents and 12-year-old sibling are at the child's bedside. Which instruction best supports family? a. while waiting for the healthcare provider, only one visitor may stay with the child b. all of you should leave while the HCP sutures the kids forehead c. it is best if the sibling goes to the waiting room until the suturing is completed d. please decide who will stay when the HCP begins suturing
D please decide who will stay when the HCP begins suturing
A 3 year old with HIV infection is staying with a foster family who is caring for 3 other foster children in their home. When one of the children acquires pertussis, the foster mother calls the clinic and asks the nurse what she should do. Which action should the nurse take first? A. Remove the child who has HIV from the foster homeB. Report the exposure of the child with HIV to the health departmentC. Place the child who has HIV in reverse isolationD. Review the immunization documentation of the child who has HIV
D review the immunization documentation of the child who has HIV
The nurse is assessing a 6 month old infant. which response requires further evaluation by the nurse? a. doubled birth weight b. turns head to locate sound c. plays peek a boo d. demonstrates startle reflex
D startle reflex
A mother tells the nurse that her preschool-age daughter with spina bifida sneezes and gets a rash when playing with brightly colored balloons, and that recently she had an allergic reaction after eating kiwifruit and bananas. The LPN/LVN would suspect that the child may have an allergy to:
Latex
