Pediatric HESI

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 and 14 b. Boys between ages 10 and 14 c. Boys and girls between ages 8 and 12 d. Boys and girls between ages 12 and 14

a

When screening a 5-year-old for strabismus what action should the nurse take? a. Direct the child through the six cardinal positions of gaze b. Observe the child for blank, sunken eyes c. Inspect the child for the setting-sun sign d. Have the child identify colored patterns on polychromatic cards

a

An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin intravenously. Which findings indicate to the nurse that the child is manifesting a therapeutic response? a. Increased periods of rest b. Decreased urinary output c. Weight gain of 0.5kg/day d. Decreased periorbital edema

d

The mother of a 6 year old girl is concerned about her child's obesity. The child's weight plots at the 75 percentile and height at the 25 percentile. The boy mass index (BMI) is at the 85 percentile for age and gender. Which interventions should the nurse implement? (Select all that apply)

- Obtain the child's 3 day diet history based on the mother's input. - Determine the child's usual activity pattern - Inquire as to whether or not the school has a physical education program !!!NOT!!! - Explain that the child is likely to grow into her weight - Tell the mother that girls hit their growth spurt before boys so eating more is expected

The nurse is administering a secondary infusion of ... 600 mg IV in 100 mL, of D5W over 45 minutes every 8 hours for a child who weights 40 kg. The nurse should program the infusion pump to deliver how many mL/hours? (Enter numeric value only. If rounding is required round to the nearest whole number.)

133

The healthcare provider prescribes cephalexin 350 mg by mouth every 6 hours for a child who weighs 88 pounds. The available suspension is labeled, "Cephalexin Suspension 125 mg/5 mL." The recommended safe dose range is 25 to 50 mg/kg/24 hours in 4 divided doses. How many mililiters should the nurse administer based on the child's weight? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

14

A 6 year old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents? a. The chorea or movements are temporary and will eventually disappear b. Consistent discipline is needed to help the child control the movements c. Muscle tension is decreased with fine motor skill projects so these activities should be encouraged d. Permanent life style changes need to be made to promote safety in the home

a

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 breastfeeding, the mother provides the child with supplemental formula feedings. What assessment is most important for the nurse to obtain? a. Water source used with supplemental feedings b. The newborn's gestational age c. The infant's current H and H d. Weight gain and type of formula taken daily

a

A 6 year old is brought into the healthcare providers office after stepping on a rusty nail. Upon inspection the nurse notes that the nail went through the shoe and pierced the bottom of the child's foot. Which action should the nurse implement first? a. Cleanse the foot with soap and water and apply an antibiotic ointment as prescribed b. Provide teaching about the need for a tetanus booster to be given within the next 72 hours c. Transfer the child to the emergency department to receive a gamma globulin injection d. Have the parent check the child's temperature q4h for the next 24 hours

a

The nurse is admitting a child with a diagnosis of untreated hypoparathyroidism. Which finding indicative of hypocalcemia should the nurse report o the healthcare provider? a. Positive Chvostek sign b. Rapid weight gain c. Positive Coombs test d. Muscular weakness

a

The nurse is educating an adolescent client about the important of regular vaccinations. Which vaccine should the nurse instruct the adolescent to receive every 10 years throughout adulthood? a. Tetanus b. Influenza c. Varicella d. Hepatitis A

a

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 his age child? a. Sits quietly in her mother's lap b. "Talks" to an imaginary friend c. Draws picture of self with facial features d. Ignores other children in the play area

b

A 5-year-old boy is diagnosed with diabetes mellitus Type 1. Which stage of Erikson's theory of psychosocial development is the nurse addressing when teaching this client about insulin injections? a. Initiative b. Industry c. Identity d. Autonomy

b

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 first? a. Apply lotion to hands and feet b. Place the child in a quiet environment c. Make a list of foods the child likes d. Encourage the parents to rest when possible

b

A mother brings her 3-year-old sone to the emergency room and tells the nurse that he has had an upper respiratory infection for the past two days. Assessment of the child reveals a rectal temperature of 102 F (38.9 C). He is drooling and becoming increasingly more restless. What action should the nurse take first? a. Assist the child to lie down and examine his throat b. Notify the healthcare provider and obtain a tracheostomy tray c. Listen to lungs sounds and place him in a mist tent d. Put a cold cloth on his head and administer acetaminophen

b

A toddler with nephrotic syndrome receives a prescription from the healthcare provider for enalapril. Which action should the nurse implement prior to administering the medication? a. Test bilateral reflex responses b. Observe gait and balance while ambulating c. Assess strength and range of motion d. Verify the dosage calculation with another nurse

b

How should the nurse instruct the parents of a 4-month-old with seborrheic dermatitis to shampoo the child's hair? a. Avoid scrubbing the scalp until the scales disappear b. Use a soft brush and gently scrub the area c. Use soap and water and avoid shampoos d. Avoid washing the child's hair more than once a week

b

The nurse administer digoxin to a 9 month old infant with an apical heart rate of 160 beats per minute. Which indicates the medication effect has been achieved? a. 60 beats per minute b. 120 beats per minute c. 180 beats per minute d. 80 beats per minute

b

The nurse is caring for an infant scheduled for reduction of an intussusception. The day before the scheduled procedure the infant passes a soft-formed brown stool. Which intervention should the nurse implement? a. Obtain a stool specimen for laboratory analysis b. Notify the healthcare provider of the passage of brown stool c. Ask the parents about recent changes in the infant's diet d. Instruct the parents that he infant needs to be NPO

b

The nurse is conducting discharge teaching with the mother of a 22 month old with respiratory syncytial virus (RSV) who has one younger and one older sibling living in the home. Which priority instruction should the nurse include in this teaching plan? a. Avoid tobacco use in the home b. Institute airborne precautions for the infected child c. Practice consistent handwashing d. Administer prophylactic antibiotics to both siblings

b

The nurse is planning care for a 4-year-old girl who is diagnosed as having developmental disability. Which should be the primary focus of treatment for this child? a. Ensure her participation in group activities b. Assist in preventing further disability c. Teach her social skills d. Help her achieve her maximum potential

b

What snack is best to provide a 6-year-old child on prescribed bedrest while receiving treatment for osteomyelitis? a. Soup broth b. Milkshake c. Applesauce d. Popsicle

b

Which nursing problem has the highest priority when providing preoperative care for an infant born with bladder exstrophy? a. Risk for impaired parenting related to appearance of infant b. Risk for infection related to impaired skin integrity c. Altered urinary elimination related to exposure of bladder d. Knowledge deficit related to caring for the infant

b

A 17 year old male student with cystic fibrosis talks with the school nurse about his disease and wonders how it will affect getting married. What relevant info would the nurse include in this discussion? a. He should undergo cystic fibrosis screening before having children b. Impotence is a frequent problem for males with cystic fibrosis c. He is likely to have infertility problems and needs further evaluation d. If the father is a carrier 50% of the offspring will have cystic fibrosis

c

A 6-month-old diagnosed with short bowel syndrome began enteral feedings yesterday. To maintain normal growth and development of the child during this period What actions should the nurse include in the infant's plan of care? a. Speak to the healthcare provider about instituting physical therapy b. Use sterile technique during feedings c. Give the infant a pacifier during feedings d. Ensure placement of nasogastric tube with an abdominal x-ray

c

A newborn with a myelomeningocele is admitted to the neonatal intensive care unit. What preoperative nursing intervention should the nurse implement first? a. Apply antibiotic ointment to the exposed area b. Apply a diaper below the myelomeningocele c. Place the infant on the abdomen to protect the sac d. Measure the head circumference while in prone position

c

An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin 500 mg orally once daily and [???] 500 mg twice daily. She asks the nurse, "Why do I have to be in the hospital? Why can't I get my treatment at home." Which purpose should the nurse provide that supports and effective outcome? a. Administration of a supervised parenteral antibiotic protocol b. Implementation of contact precautions to prevent spread of infection c. Detection of early symptoms of Jarisch-Herxheimer reaction d. Collection of serial anaerobic cultures of vaginal discharge

c

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

c

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 strains during stooling. The infant is scheduled for surgical repair of the inguinal hernia in two weeks. The parents should be instructed to take which measure if the hernia becomes incarcerated prior to surgery? a. Give acetaminophen or aspirin for crying b. Use a rectal thermometer for staining on stools c. Gently manipulate the hernia for reduction d. Offer oral electrolyte fluids for comfort

c

The mother of a one-month-old calls the clinic to report that the back of her infant's head is flat. How should the nurse respond? a. Prop the infant in a sitting position with a cushion when not sleeping b. Place a small pillow under the infant's head while lying on the back c. Position the infant on the stomach occasionally when awake and active d. Turn the infant on the left side braced against the crib when sleeping

c

The nurse is caring for a child newly diagnosed with attention deficit hyperactive disorder (ADHD). The child's mother asks about information of the treatment options. Which information is most helpful for he nurse to provide? a. Emphasize the addictive nature of popular medications b. Offer effective time management strategies c. Explore the combination of medication and behavioral therapies d. Discuss dietary changes such as increasing protein intake

c

The nurse is giving instructions to the mother of a 10-year-old boy who is newly diagnosed with type 1 diabetes mellitus (DM). When attempting to teach the mother how to administer subcutaneous insulin injections to the child, the mother tells the nurse she is afraid of needles and cannot perform the procedure. Which intervention should the nurse implement? a. Ask if the father can help with the injections b. Assess the mother's parenting skills c. Determine if the child can administer the insulin d. Encourage the mother to handle the needles

c

The nurse observes a mother giving her 11-month-old ferrous sulfate (iron drops) followed by 2 ounces (60 mL) of orange juice. What should the nurse do next? a. Suggest placing the iron drops in the orange juice and then feeding the infant b. Instruct the mom to feed the infant nothing for 30 min after giving the iron drops c. Give the mom positive feedback about the way she administered the med d. Tell the mother to follow the iron drops with infant formula instead of orange juice

c

The school nurse is caring for a school-age child who was stung by a wasp on the playground. Which finding should prompt the nurse to call the emergency response team at 911? a. Marked redness b. Hives c. Wheezing d. Severe itching

c

To maintain patency of the ductus arteriosus, the nurse administers a prescribed dose of prostaglandin IV to a week old infant diagnosed with transposition of the great vessels. Based on which assessment finding should the nurse stop the med administration immediately? a. Pulse oximeter of 95% b. Respiratory rate of 34 c. Blood pressure of 80/50 d. HR of 50 beats/min

c

When administering indomethacin to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome? a. Increased number of red blood cells b. Increased respiratory effort c. Decrease cardiac murmur d. Decrease urinary output

c

When assessing an infant with severe diarrhea the nurse should observe for which potential change in breathing pattern? a. Cheyne-Stroke respirations b. Expiratory wheezing c. Kussmaul respirations d. Audible rhonchi

c

A 10-year-old girl was bitten by a tick during a camping trip receives a prescription for tetracycline for Lyme's disease. Which information should the nurse ensure the client understands? a. Inspect all areas of skin daily for tick attachment while camping in wooded areas b. Wear sunglasses when outside during the day c. Apply insect repellent to skin and clothes when exposure to vectors is likely d. Don't take tetracyclines with milk or antacids

d

A 5-year-old child is admitted to the pediatric unit with fever and pain secondary to sickle cell crisis. Which intervention should the nurse implement first? a. Administer the initial dose of folic acid PO b. Administer a loading dose of penicillin IM c. Obtain a culture of any sputum or wound drainage d. Initiate normal saline IV at 50 mL/hr

d

A [15 or 16]-year-old adolescent with acute myelocytic leukemia is receiving chemotherapy via an implanted medication pump at the outpatient oncology clinic. What action should the nurse implement when the infusion is complete? a. Administer ondansetron b. Initiate an infusion of normal saline c. Obtain blood sample for RBCs, WBCs, and platelets d. Flush the Mediport with saline and a heparin solution

d

A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (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. High thyroxine levels normally occur in breastfeeding infants d. The TSH is high because of the low production of T4 by the thyroid

d

A clinic nurse is assessing infants and toddlers for fine gross motor development. Which child should the nurse refer to a healthcare provider for further evaluation? a. 3 (1/2)-month-old with diminished Moro reflex b. 5-month-old with use whole hand grasp c. 1 (1/2)-year-old attempting to scribble on paper d. 3-year-old preferring to walk on the tip toes

d

A mother brings her male preschooler to the clinic because he has had diarrhea, vomiting, and high fevers for the past three days. The child begins to talk to his mother when the nurse enters the examination room. What action should the nurse implement to get the child to cooperate? a. Explain to the child the reasons an exam is needed b. Request extra staff to help with the nursing assessments c. Complete the assessment while allowing the child to cry d. Talk to the mother and gradually focus on the child's toys

d

A mother is concerned that her 3 year old son wants to play with female doll figures. The child is not interested in building blocks, trucks, or other typical "boy" toys. How should the nurse respond to the mother's concerns? a. Experimenting with different toys is an acceptable behavior b. Replacing female doll figures with male dole figures reinforces masculinity c. Letting male toddlers play with female-typed toys can have negative effects d. Exploring different roles in imaginary play is typical at this age

d

The mother of an infant born with hypospadias is concerned because she has been told that her child cannot be circumcised according to her Jewish faith tradition. Which response is best for the nurse to provide? a. "I understand your concern. Would you like to talk to the pediatrician?" b. "Your faith is important, but correcting this problem is priority for your son." c. "Circumcising the penis can contribute to frequent urinary infections." d. "During the surgery part of the foreskin is used to repair the meatus."

d

The nurse in the Emergency Center is training an 8-year-old boy who fell from a tree. The child is crying and complaining of pain in the left forearm. Which intervention should the nurse implement first? a. Elevate the child's left arm on a pillow b. Check capillary refill of the nail beds c. Assess pain level using FACES scale d. Apply a cold pack to his left forearm

d

The nurse is conducting an admission assessment of an 11-month-old infant with heart failure who is scheduled for repair of stenosis of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. Which pathophysiology mechanism supports these findings? a. An opening in the atrial septum causes a murmur due to a turbulent .. to right shunt b. The pulmonic valve prevents adequate blood volume into the pulmonary circulation c. The aortic semilunar valve obstructs blood flow into the systemic circulation d. The lumen of the aorta reduces the volume of blood flow to he lower extremities

d

The parents of a 4-week-old infant phone the pediatric clinic to report that their infant eats well but vomits after each feeding. To differentiate between normal regurgitation and pyloric stenosis which info is most important for the nurse to obtain? a. Position of infant when vomiting occurs b. Odor and texture associated with emesis c. Level of infant's distress after vomiting d. Degree of forcefulness of vomiting episodes

d

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

d

Which nutritional information should the nurse plan to provide the mother of a 6-month-old regarding introduction of solid foods? a. Foods are best introduced by mixing them with formula and feeding them to the infant with a feeder bottle. b. Introduce fruits and vegetables simultaneously into the diet c. Begin introducing solid foods into the child's diet after the child reaches one year of age d. Foods should be introduced into a child's diet one at a time, at 4 to 7 day intervals

d

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. Which action is best for the nurse to take? a. Report suspected child abuse to the proper authorities b. Ask the parents if the child has been in a recent accident c. Identify the antibiotic used to treat the pneumonia d. Inquire about the use of alternative methods of treatment

d

While obtaining the vital sings of a 10-year-old child who had a tonsillectomy this morning, the nurse observes the child swallowing every 2 to 3 minutes. Which assessment should the nurse implement? a. Ask the child to speak to evaluate change in voice tone b. Touch the tonsillar pillars to stimulate the gag reflex c. Assess for teeth clenching or grinding d. Inspect the posterior oropharynx

d