Exit Hesi Pediatrics Evolve

Which interventions should the nurse include when creating a care plan for a child with hepatitis? Select all that apply. 1.Providing a low-fat, well-balanced diet. 2.Teaching the child effective hand-washing techniques. 3.Scheduling playtime in the playroom with other children. 4.Notifying the primary health care provider (PHCP) if jaundice is present. 5.Instructing the parents to avoid administering medications unless prescribed. 6.Arranging for indefinite home schooling because the child will not be able to return to school.

1, 2, 5

A child who is 4 years old is seen for a well-child checkup. He has been regularly receiving immunizations. Which immunizations should the child receive at this visit? Select all that apply. 1.Varicella vaccine 2.Rotavirus vaccine 3.Inactivated polio vaccine 4.Meningococcal conjugate vaccine 5.Haemophilus influenzae type B vaccine 6.Measles, mumps, and rubella (MMR) vaccine

1, 3, 6

A child is admitted to the hospital with a diagnosis of acute bacterial meningitis. In reviewing the primary health care provider's prescriptions, which would the nurse question as appropriate for a child with this diagnosis? 1.Administer an oral antibiotic. 2.Maintain strict intake and output. 3.Draw blood for a culture and sensitivity. 4.Place the child on droplet precautions in a private room.

1.Administer an oral antibiotic.

The nurse has reviewed the primary health care provider's prescriptions for a child suspected of a diagnosis of neuroblastoma and is preparing to implement diagnostic procedures that will confirm the diagnosis. What should the nurse expect to do next to assist in confirming the diagnosis? 1.Collect a 24-hour urine sample. 2.Perform a neurological assessment. 3.Assist with a bone marrow aspiration. 4.Send to the radiology department for a chest x-ray.

1.Collect a 24-hour urine sample.

A child seen in the clinic is found to have rubeola (measles), and the mother asks the nurse how to care for the child. The nurse should tell the mother to implement which action? 1.Keep the child in a room with dim lights. 2.Give the child warm baths to help prevent itching. 3.Allow the child to play outdoors because sunlight will help the rash. 4.Take the child's temperature every 4 hours and administer 1 baby aspirin for fever.

1.Keep the child in a room with dim lights.

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? 1.Limited range of motion in the affected hip 2.An apparent lengthened femur on the affected side 3.Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed 4.Symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table

1.Limited range of motion in the affected hip

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? 1.Meningitis 2.Spinal cord injury 3.Intracranial bleeding 4.Decreased cerebral blood flow

1.Meningitis

The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply. 1.Scarring is less severe in a child than in an adult. 2.A delay in growth may occur after a burn injury. 3.An immature immune system presents an increased risk of infection for infants and young children. 4.Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. 5.The lower proportion of body fluid to body mass in a child increases the risk of cardiovascular problems. 6.Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

2, 3, 6

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action? 1. Initiate strict enteric precautions. 2. Move the infant to a room with another child with RSV. 3. Leave the infant in the present room because RSV is not contagious. 4. Inform the staff that they must wear a mask, gloves, and a gown when caring for the child.

2. Move the infant to a room with another child with RSV.

The nurse is collecting data on a child recently diagnosed with glomerulonephritis. Which question to the mother should elicit data associated with the cause of this disease? 1."Has your child had any nausea or diarrhea?" 2."Have you noticed any rashes on your child?" 3."Did your child recently complain of a sore throat?" 4."Did your child sustain any injuries to the kidney area?"

3."Did your child recently complain of a sore throat?"

A 9-year-old child with leukemia is in remission and has returned to school. The school nurse calls the mother of the child and tells the mother that a classmate has just been diagnosed with chickenpox. The mother immediately calls the clinic nurse because the leukemic child has never had chickenpox. Which is an appropriate response by the clinic nurse to the mother? 1."There is no need to be concerned." 2."Bring the child into the clinic for a vaccine." 3."Keep the child out of school for a 2-week period." 4."Monitor the child for an elevated temperature, and call the clinic if this happens."

2."Bring the child into the clinic for a vaccine."

The nursing student is presenting a clinical conference and discusses the cause of β-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these? 1.A child of Mexican descent 2.A child of Mediterranean descent 3.A child whose intake of iron is extremely poor 4.A breast-fed child of a mother with chronic anemia

2.A child of Mediterranean descent

An adolescent with diabetes receives 30 units of Humulin N insulin at 7:00 a.m. The nurse would monitor for a hypoglycemic episode at what time? 1.At bedtime 2.Before supper 3.At midmorning 4.After breakfast

2.Before supper

A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed because acute lymphocytic leukemia is suspected. The nurse determines that which laboratory result confirms the diagnosis? 1.Lumbar puncture showing no blast cells 2.Bone marrow biopsy showing blast cells 3.Platelet count of 350,000 mm3 (350 × 109/L) 4.White blood cell count 4500 mm3 (4.5 × 109/L)

2.Bone marrow biopsy showing blast cells

A child is sent to the school nurse by the teacher. On assessment of the child, the nurse notes the presence of a rash. The nurse suspects that the child has erythema infectiosum (fifth disease) based on which assessment finding? 1.A discrete rose-pink maculopapular rash on the trunk 2.Erythema on the face, giving a "slapped cheeks" appearance 3.A highly pruritic, profuse macule-to-papule rash on the trunk 4.A discrete pinkish-red maculopapular rash on the arms and trunk

2.Erythema on the face, giving a "slapped cheeks" appearance

The pediatric nursing instructor asks a nursing student to prioritize care for a child diagnosed with sickle cell disease. Which student response correctly identifies the priority of care? 1.Fatigue 2.Hypoxia 3.Delayed growth 4.Avascular necrosis

2.Hypoxia

The nurse is caring for an infant with a diagnosis of tetralogy of Fallot. The infant suddenly becomes cyanotic, and the nurse recognizes that the infant is experiencing a hypercyanotic spell (blue or tet spell). The nurse immediately places the infant in what position? 1.Prone position 2.Knee-chest position 3.High-Fowler's position 4.Reverse Trendelenburg's position

2.Knee-chest position

The mother of an 18-month-old child tells the clinic nurse that the child has been having some mild diarrhea and describes the child's stools as "mushy." The mother tells the nurse that the child is tolerating fluids and solid foods. The most appropriate suggestion regarding the child's diet would be to give the child which items? 1.Applesauce, bananas, wheat toast 2.Mashed potatoes with baked chicken 3.Gelatin, strained cabbage, and custard 4.Fluids only until the "mushy" stools stop

2.Mashed potatoes with baked chicken

The nurse is caring for an infant with gastroenteritis who is being treated for dehydration. The nurse reviews the health record and notes that the primary health care provider has documented that the infant is mildly dehydrated. Which assessment finding should the nurse expect to note in mild dehydration? 1.Anuria 2.Pale skin color 3.Sunken fontanels 4.Dry mucous membranes

2.Pale skin color

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position? 1.Supine 2.Side-lying 3.High-Fowler's 4.Trendelenburg's

2.Side-lying

The clinic nurse is instructing the parent of a child with human immunodeficiency virus (HIV) infection regarding immunizations. The nurse should provide which instruction to the parent? 1.The hepatitis B vaccine will not be given to the child. 2.The inactivated influenza vaccine will be given yearly. 3.The varicella vaccine will be given before 6 months of age. 4.A Western blot test needs to be performed and the results evaluated before immunizations.

2.The inactivated influenza vaccine will be given yearly.

Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? 1."Treatment needs to be started as soon as possible." 2."I realize my infant will require follow-up care until fully grown." 3."I need to bring my infant back to the clinic in 1 month for a new cast." 4."I need to come to the clinic every week with my infant for the casting.

3."I need to bring my infant back to the clinic in 1 month for a new cast."

A child is seen in the health care clinic, and the nurse suspects the presence of pinworm infection (enterobiasis). The nurse instructs the mother as to how to obtain a cellophane tape rectal specimen. Which statement by the mother indicates an understanding of the correct procedure to obtain the specimen? 1."I need to collect the specimen after I give my child a bath." 2."I need to collect the first bowel movement of the day and place it in a sealed container." 3."I need to place a piece of transparent cellophane tape lightly over the anal area as soon as my child awakens and bring it to the clinic for examination." 4."I need to place a piece of transparent cellophane tape lightly over the anal area after my child has a bowel movement and bring it to the clinic for examination."

3."I need to place a piece of transparent cellophane tape lightly over the anal area as soon as my child awakens and bring it to the clinic for examination."

The nurse is reviewing the primary health care provider's documentation in the record of a child admitted with a diagnosis of intussusception. The nurse expects to note that the primary health care provider has documented which manifestation? 1.Scleral jaundice 2.Projectile vomiting 3.Currant jelly-like stools 4.Pale-colored and hard stools

3.Currant jelly-like stools

The nurse is caring for a 7-year-old child with glomerulonephritis and is preparing to discuss the plan of care with the parents. In anticipating this encounter, the nurse recognizes that which is a common reaction of parents to the diagnosis of glomerulonephritis? 1.Fear of the complicated treatment regimen 2.Anger at the child for requiring hospitalization 3.Guilt that they did not seek treatment more quickly 4.Depression that the child may not be able to play sports

3.Guilt that they did not seek treatment more quickly

A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? 1.Injection of factor X 2.Intravenous infusion of iron 3.Intravenous infusion of factor VIII 4.Intramuscular injection of iron using the Z-track method

3.Intravenous infusion of factor VIII

An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? 1.Prone position 2.On the stomach 3.Left lateral position 4.Right lateral position

3.Left lateral position

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the pediatrician's prescriptions and should contact the pediatrician to question which prescription? 1.Obtain daily weight. 2.Provide clear liquid intake. 3.Nasotracheal suction as needed. 4.Maintain a patent intravenous line.

3.Nasotracheal suction as needed.

In caring for a child diagnosed with Hodgkin's disease, which oncologic emergency should the nurse be most concerned about? 1.Hyperleukocytosis 2.Spinal cord compression 3.Superior vena cava syndrome 4.Disseminated intavascular coagulation

3.Superior vena cava syndrome

The nurse is reviewing the immunization schedule for a child with human immunodeficiency virus (HIV) infection with the mother. Which instruction should the nurse provide to the mother? 1.Immunizations will not be given to the child with HIV infection. 2.The immunization schedule is altered because of the HIV infection. 3.The child and the siblings will need to receive inactivated polio vaccine. 4.The child with HIV infection will start immunizations when 3 years old.

3.The child and the siblings will need to receive inactivated polio vaccine

A child is scheduled for a tonsillectomy in a day surgical unit. On the day after surgery, the mother calls the surgical unit and expresses concern because the child has a bad mouth odor. Which response is most appropriate? 1."The child probably has an infection." 2."Have the child gargle with mouthwash every 4 hours." 3."You need to contact the health care provider immediately." 4."Bad mouth odor is normal and may be relieved by drinking more liquids.

4."Bad mouth odor is normal and may be relieved by drinking more liquids.

The nurse is collecting data on a child with a diagnosis of rheumatic fever. Which question should the nurse initially ask the mother of the child? 1."Has the child been vomiting?" 2."Has the child had any diarrhea?" 3."Does the child complain of chest pain and numbness in the right arm?" 4."Has the child complained of a sore throat within the past few months?"

4."Has the child complained of a sore throat within the past few months?"

A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the student nurse to describe the disorder. Which statement by the student nurse indicates correct understanding of this disorder? 1."It is an acute bowel obstruction." 2."It is a condition that causes an acute inflammatory process in the bowel." 3."It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel." 4."It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

4."It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

The mother of a child who has undergone a myringotomy, with insertion of tympanoplasty tubes, telephones and tells the nurse that the tubes have fallen out. Which is the appropriate response to the mother? 1."Bring the child to the nearest emergency department." 2."Replace the tubes immediately so that the opening does not close." 3."Place the tubes in hydrogen peroxide for 1 hour before replacing them in the child's ears." 4."This is not an emergency. I will speak to the primary health care provider and call you right back."

4."This is not an emergency. I will speak to the primary health care provider and call you right back."An adolescent with diabetes receives 30 units of Humulin N insulin at 7:00 a.m. The nurse would monitor for a hypoglycemic episode at what time?

The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever, knowing that which laboratory study would assist in confirming the diagnosis? 1.Immunoglobulin 2.Red blood cell count 3.White blood cell count 4.Antistreptolysin O titer

4.Antistreptolysin O titer

An adolescent is seen in the emergency department for a suspected sprain of the ankle. X-rays have been obtained, and a fracture has been ruled out. Which instruction should the nurse provide to the adolescent regarding home care for treatment of the sprain? 1.Elevate the extremity, and maintain strict bed rest for a period of 7 days. 2.Immobilize the extremity, and maintain the extremity in a dependent position. 3.Apply heat to the injured area every 4 hours for the first 48 hours, and then begin to apply ice. 4.Apply ice to the injured area for a period of 30 minutes every 4 to 6 hours for the first 24 to 48 hours.

4.Apply ice to the injured area for a period of 30 minutes every 4 to 6 hours for the first 24 to 48 hours.

The nurse is caring for a child with a diagnosis of roseola. The nurse provides instructions to the mother regarding prevention of the transmission to siblings and other household members. Which instruction should the nurse provide? 1.Isolate the child from others for 2 weeks because the virus is transmitted by breathing and coughing. 2.Wash sheets and towels used by the child separately in bleach to prevent spread of the infection to others. 3.Have the child use a separate bathroom for urination and bowel movements to prevent the spread of infection. 4.Avoid allowing the children to share drinking glasses or eating utensils because the disease is transmitted through saliva.

4.Avoid allowing the children to share drinking glasses or eating utensils because the disease is transmitted through saliva.

A child is seen in the health care clinic for complaints of fever. On data collection, the nurse notes that the child is pale, tachycardic, and has petechiae. Aplastic anemia is suspected. The nurse should prepare the child to obtain which specimen that will confirm the diagnosis? 1.Platelet count 2.Granulocyte count 3.Red blood cell count 4.Bone marrow biopsy

4.Bone marrow biopsy4.Bone marrow biopsy

The nurse is preparing an infant for surgery to treat Hirschsprung's disease. Which assessment finding is priority to identify and treat? 1.Vomiting and irritability 2.Malnourishment and lethargy 3.Abdominal distension and tenderness 4.Decreased blood pressure and tachycardia

4.Decreased blood pressure and tachycardia

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction? 1.Stress 2.Trauma 3.Infection 4.Fluid overload

4.Fluid overload

The pediatric nurse educator provides a teaching session to the nursing staff regarding hemophilia. Which statement regarding this disorder should the nurse plan to include in the discussion? 1.Males inherit hemophilia from their fathers. 2.Hemophilia is a Y-linked hereditary disorder. 3.Females inherit hemophilia from their mothers. 4.Hemophilia A results from deficiency of factor VIII.

4.Hemophilia A results from deficiency of factor VIII.

A mother brings her child to the well-child clinic and expresses concern to the nurse because the child has been playing with another child diagnosed with hepatitis. The nurse prepares to perform an assessment on the child, knowing that which finding would be of least concern for hepatitis? 1.Jaundice 2.Hepatomegaly 3.Dark-colored, frothy urine 4.Left upper abdominal quadrant pain

4.Left upper abdominal quadrant pain

A child admitted to the hospital with a diagnosis of gastroenteritis and dehydration weighs 17 lb 2 oz (7.8 kg). The parents state that his preadmission weight was 18 lb 4 oz (8.3 kg). Based on weight alone, what type of dehydration does the nurse expect? 1.Mild dehydration 2.Acute dehydration 3.Severe dehydration 4.Moderate dehydration

4.Moderate dehydration

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1.Administer an analgesic. 2.Release the skin traction. 3.Apply ice to the extremity. 4.Notify the primary health care provider (PHCP).

4.Notify the primary health care provider (PHCP).

When collecting the history about a child who presents with signs of glomerulonephritis, the nurse should report which most important finding to the primary health care provider? 1.Child fell off a bike onto the handlebars 2.Nausea and vomiting for the last 24 hours 3.Urticaria and itching for 1 week before diagnosis 4.Streptococcal throat infection 2 weeks before diagnosis

4.Streptococcal throat infection 2 weeks before diagnosis

A primary health care provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant? 1.During sleep 2.When changing the infant's diapers 3.When the mother is holding the infant 4.When drawing blood for electrolyte level testing

4.When drawing blood for electrolyte level testing