Pediatric HESI study guide
What action does the nurse take when caring for a child who is having a tonic-clonic seizure?
Places the child on the side
When an infant chokes on a piece of food, what is an immediate intervention?
Position the infant in a head-down, face-down position and administer five quick blows between the shoulder blades
The nurse is teaching a group of students about ways to improve communication with families of children with chronic illnesses. What is the most important information that should be included?
"Ensure that the parents' and child's needs are met during this hospitalization."
A parent of a child with a heart defect tells the nurse, "I learned on a medical website that my child's heart condition will never improve." What is the nurse's best response?
"As the validity of a website cannot be assumed, it would be better to clarify this information with your primary health care provider."
A 5-year-old child has a vesicular rash over the body and head and is diagnosed with chickenpox. The child keeps on scratching the skin. What instructions should be given to the parents?
"Give oatmeal baths to the child." "Keep the child at home until the vesicles dry"
After abdominal surgery, a 12-year-old child is receiving morphine (Avinza) for pain control via a patient-controlled analgesia (PCA) infusion. What statement indicates to the nurse that the patient understands the instructions about the PCA pump?
"I can push the button to take a dose of the medicine whenever I feel pain."
A 4-year-old child is playing while the parent is watching television. After some time the child comes to the parent and says, "Dad! Anna broke the glass." There was nobody else in the house at that time. What should be the most appropriate response of the father?
"I see only you here, so you are responsible for that."
A home care nurse is caring for a 4-month-old infant with developmental dysplasia's of the hip (DDH). The baby is in a pavlik harness. The baby's mother tells the nurse, "I don't think my baby will be able to sleep while wearing the harness." What is an appropriate response by the nurse?
"It is important for the harness to be worn continuously."
The parent of an 18-month-old child tells the nurse that the child has become a picky eater and is eating less. What does the nurse teach the parent to improve the eating habits of the child?
"Make sure that one type of food does not touch another type on the same plate"
The nurse teaches a group of nursing students about telephone triage nurse and counseling. Which statements given by a nursing student indicate effective learning?
"Nurses schedule appointments and refer patients to appropriate specialists" "Nurses counsel patients ove the telephone based on the symptoms provided" " Nurses determine the condition of a patient and give direction for further care"
Parents of a child with spinal muscular atrophy (SMA) are concerned their child is not receiving enough oxygenation during sleep. The nurse knows that inadequate oxygenation can lead to hypoxemia. How does the nurse respond to the parent's concerns.
"Use home pulse oximetry"
The parent of a child with a heart disease tells the nurse, "I usually bathe, dress, and fed my child even though I know that my child can do it. I'm worried that my child may come to some harm if I am not present." What is the nurse's best response?
"You can let your child do it and watch from a distance"
Which normal finding does the nurse expect to find when assessing an 8-month-old infant? 1 Doubled birth length 2 Eruption of the upper lateral incisors 3 Eruption of the lower central incisors 4 Equal head and chest circumference
Eruption of the lower central incisors
The nurse finds that a newborn weighs 3 kg (7 lb). By the time the child reaches 2 years, she weighs 12 kg (26 lb). What would be the child's approximate weight by 6 years of age?
20 to 22 kg (44-48 lb)
What is the daily requirement of calcium for children 1 to 3 years of age?
700 mg/day
The nurse is working with an 11-year-old child who has type 1 diabetes mellitus. The nurse advises the child's parents to monitor the glucose levels at home. What should be the blood glucose levels if the diabetes mellitus is well managed?
A random blood glucose level that is consistently less than 200 mg/dL An 8-hour fasting blood glucose level that is regularly less than 126 mg/dL
An 8-year-old female child is diagnosed with moderate cerebral palsy (CP). She recently began participation in a regular classroom for part of the day. Her mother asks the school nurse about having her daughter join the after-school Girl Scout troop. On what knowledge should the nurse's response be based ?
After-school activities often provide children with CP opportunities for socialization and recreation
For which side effect of radiotherapy should the nurse introduce to the patient the idea of a wig or other head covering?
Alopecia
The nurse finds that a child is pale, gets easily fatigued, and has lac of energy. The nurse asks the parents to get a complete blood count (CBC) test. What does the nurse suspect from these symptoms?
Anemia
Which term is used to describe the removal of blood form an individual, separation of the blood into its components, retention of one or more of these components, and reinfusion of the remainder of the blood back into the individual?
Apheresis
The nurse is caring for a Buddhist patient. The nurse finds that the patient has not touched the food tray. The food tray holds chicken, bread, soup, and fruits. What is the most appropriate action by the nurse?
Ask the patient whether there is a problem with the food provided
A 3-year-old has just returned from the post anesthesia care unit after a tonsillectomy and has been transferred into his or her bed. What nursing activities would be preformed writhing the first hour after arrival?
Assess vital signs, including oxygenation saturation, check for bleeding and frequent swallowing, and position the patient on his or her side
One of the goals for children with asthma is to prevent respiratory infection. This is because respiratory infection does what?
Can trigger an episode or aggravate an asthmatic state
A parent reports to the nurse that the child refuses to wear long zipped pants and prefers short button pants. Which characteristic of preoperational thought is exhibited by the child?
Centration
The nurse assesses the growth rate of an infant and notices that the infant has decreased lower limb growth. That growth and development pattern should the nurse document in this child?
Cephalocaudal pattern
A child has just returned from surgery in a hip spica cast. What is the priority nursing intervention?
Check circulation
The nurse is providing care for a child who has a congenital heart defect. The nurse suspects dysrhythmia in the child. What action does the nurse take?
Count the apical rate for 1 full minute
A community nurse is education parents regarding calcium and vitamin D requirements for children aged 1 to 8 years. What information should be included in the session?
Daily calcium requirement for children aged 1 to 3 years in 700 mg Daily calcium requirement for children aged 4 to 8 years is 1000 mg Milk and its products are excellent sources of vitamin D and calcium
When a child experiences decreased muscle strength, tone, and endurance from immobilization, what is a secondary effect?
Decreased exercise tolerance
The nurse is teaching the importance of dental health to a group of parents in the community. Which points does the nurse emphasize in order to prevent dental caries in children?
Demonstrate how to correctly brush their teeth Teach children how to correctly floss their teeth Reduce the intake of fermentable carbohydrates
The health care provider has prescribed cardiac catheterization for a school-aged child. What action does the nurse take to prepare the child and family for the procedure?
Describe the procedure to the child and family step-by-step
The nurse is preparing the playroom on a newly opened pediatric unit. Which items should the nurse include to foster the development of the preschool child?
Dolls, hand puppets, alphabet flash cards, large blocks
The nurse is caring for a child recovering from ankle surgery.the child was administered an anesthetic for pain relief. What does the nurse do to prevent respiratory complications during the postoperative care?
Encourage respiratory movement with incentive spirometers
The nurse is caring for a 2-year-old girl who is unconscious but stable following a car accident. Her parents are staying at the bedside most of the time. What is an appropriate nursing intervention?
Encourage the parents to hold, talk, and sing to her as they usually would.
Which is a priority nursing intervention for a child who is asking to discontinue the anticonvulsant drugs?
Ensure that the dose is decreased gradually
A nurse is presenting a class on injury prevention to parent of preschoolers. Which injuries should the nurse identify as occurring in this age group?
Falls Drowning Poisoning Tricycle and bicycle accidents
What should the nurse working in an outpatient surgery center for children understand?
Families need to be prepared for what to expect after discharge
The nurse is assessing a child with a mitochondrial disorder. What should the nurse communicate to the child's parents?
Give the couple information about family planning Rule out any abnormal causes in the parents' minds Explain that it is a disorder that can happen in subsequent births
The nurse is charting the amount of food that a child ate at breakfast. The child had 2 oz of orange juice out of 4 oz, and two slices of bread out of the three slices. What is an appropriate way to record the information?
Had 2 oz orange juice and 2 slices of bread.
The nurse observes erythema, pain, and edema at a child's intravenous (IV) site with streaking along the vein. What should the nurse do first?
Immediately stop the infusion
The nurse notices that a toddler is more cooperative when taking medicine from a small cup rather than a large cup. This is an example os which characteristic of preoperational thought?
Inability to conserve
Which symptoms does a nurse expect to find in a teething infant?
Irritability Drooling
The nurse is caring for a child with multiple injuries who is comatose. What should the nurse recognized about pain?
It requires astute nursing assessment and management
The parents of a child report that their child has difficulty chewing and they are worried about the arrangement of the child's teeth. What type of dental issue should the nurse assess for in the child?
Malocclusion
An infant is brought to the emergency room with symptoms consistent with gastroesophageal reflux disease. The physician prescribes a trial of medication to evaluate the effectiveness of symptom reduction. Which drug's use is considered controversial?
Metoclopramide
The nurse notes that the parents of a critically I'll shield spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parent more than with the nurses. What should the nurse recognize is true?
Parent-to-parent support is valuable
The nurse is sensing a 5-month-old infant. Which behavior does the nurse observe in the infant?
Picking up a toy and putting it into the mouth
A 16-year-old obese adolescent has body mass index more than 2 units above the 95th percentile for his age and sex approaches the nurse for pharmacological management of obesity. What drug does the nurse expect to be included in the treatment plan in addition to diet management.
Orlistat (Alli)
What is the primary goal in caring for the child with cognitive impairment?
Promoting optimum development
A child requires hospitalization for the treatment of cancer. What suggestion does the nurse give the parents for minimizing potential negative effects of hospitalization in the child?
Provide books to the child to read about being in hospitals
An adolescent who had a lower leg amputated after a motorcycle accident complains of pain in the missing extremity. What is the nurse's most appropriate action?
Reassure the patient that it is normal and is called phantom limb sensation
What is the rationale for elevating an extremity after a soft tissue injury such as a sprained ankle?
Reduces edema formation.
The nurse assesses that the infant has difficulty breathing, decreased heart rate, change in skin color, and an ill-looking appearance.what should be the first nursing intervention in this situation?
Rub the trunk gently to wake the child
The nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt to correct hydrocephalus. In the discussion, what should the nurse include?
Shunt malfunction or infection requires immediate treatment
The nurse is giving sexual education to a group of late adolescents. What sort of language should the nurse use for this audience?
Simple scientific terminology while educating
A pregnant patient visits the primary health care provider for a prenatal checkup. The patient reveals that she occasionally smokes and drinks alcoholic beverages, the nurse expects the health care provider will instruct the patient to stop drinking and smoking. What is the rationale for these instructions?
Smoking and alcohol impair the baby's cognitive development.
Early detection of a hearing impairment is critical because of its effect on areas of a child's life. The nurse should evaluate further for effects of the hearing impairment on what?
Speech development
The nurse is educating new parents about the prevention of sudden infant death syndrome (SIDS). What position does thee nurse tell the parents is the best sleeping position for their infant?
Supine
A parent calls the pediatrician's office because his or her 4-month-old infant has been having watery stools for 24hours. There are no other symptoms. What would the nurse suggest?
Take the patient to the emergency room for evaluation
A 4-month-old infant has been diagnosed with developmental dysplasia of the hip (DDH). What appropriate intervention will follow the diagnosis?
The baby will be set up to be fitted with a Pavlik harness.
The nurse observes on the cardiac monitor that a child admitted with diabetic ketoacidosis has a widening of the QT interval and the appearance of U wave after a flattened T wave. What should the nurse conclude from such an observation?
The child has hypokalemia.
A preschooler is diagnosed with terminal sage bronchial carcinoma. What would the child consider the most probable reason for the condition?
The child would consider it to be a punishment for his or her own actions
The nurse assesses an infant at birth for height, weight, and other vital signs. What should the nurse include in the assessment to identify a conductive hearing disorder?
The infant's response to an auditory stimulus
A 7-year-old patient suffering from enuresis is being treated with TCA imipramine (Tofranil) for 4 to 6 weeks. The patient is not wetting the bed now for a week. The parents ask the nurse whether they can stop the medication. What is an appropriate response of the nurse?
The medicine requires gradual withdrawal over at least 4 weeks
The nurse is assessing a 2-year-old child as part of a genial examination. Which phase of cognitive development does the nurse assess?
The preconceptual stage of the preoperational phase
What is true of nonpharmacologic strategies for pain management?
They may reduce pain perception
A child with asthma is having pulmonary function tests. What is the purpose of the peak expiratory flow rate (PEFR)?
To assess the severity of asthma
The nurse asks the parents of a child who is scheduled for surgery if the child is taking any herbal medicine. What is the rationale for the nurse asking for this information?
To prevent any surgical complications
Parents of a 10-year-old child are concerned that their child recently has been showing signs of low self-esteem. What should the nurse consider when discussing this issue with the parents?
Transitory periods of lowered self-esteem are expected developmentally
The nurse is assessing growth and development in an infant and suspects the child has infantile autism. What observations led the nurse to come to this conclusion?
Unresponsiveness to sounds
The parents tell the nurse that they are having conflicts about independence with their child. The nurse infers from this that the child is which subphase?
middle adolescence subphase
A child with spina bifida has developed a latex allergy from numerous bladder catheterizations and surgeries. A priority nursing intervention is to a. recommend allergy testing. b. provide a latex-free environment. c. use only powder-free latex gloves. d. limit the use of latex products as much as possible.
provide a latex-free environment.