2019-2019 HESI PEDS with all the correct answers,solution pack Graded A.

PEDS HESI 1. A mother brings her 8 mo. old baby boy to clinic bc he has been vomitting and had diarrhea for last 3 days. Which assessment is most important for nurse to make? **SEE SCREEN SHOT FOR RATIONALE** a. Asses ...

PEDS HESI 1. A mother brings her 8 mo. old baby boy to clinic bc he has been vomitting and had diarrhea for last 3 days. Which assessment is most important for nurse to make? **SEE SCREEN SHOT FOR RATIONALE** a. Assess infant abdomen for tenderness b. Determine if the infant was exposed to a virus c. Measure the infant’s pulse d. Evaluate the infant’s cry 2. While obtaining the vital signs of a 10 year old who had a tonsillectomy this morning, the nurse observes the child swallowing every 2-3 minutes. Which assessment should the nurse implement? a. Inspect the posterior oropharynx b. Assess for teeth clenching or grinding c. Touch the tonsillar pillars to stimulate the gag reflex d. Ask the child to speak to evaluate change in voice tone 3. The parents of a 3-year old boy who has Duchenne muscular dystrophy ask, “How can our son have this disease? We are wondering if we should have any more children.” What information should the nurse provide to parents? **SEE SCREEN a. This is an inherited X-linked recessive disorder, which primarily affects male children in the family b. The striated muscle groups of males can be impacted by a lack of the protein dystrophin in their mothers c. The male infant had a viral infection that went unnoticed and untreated so muscle damage was incurred d. Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles 4. A 2-week-old female infant is hospitalized for the surgical repair of an umbilical hernia. After returning to the postoperative neonatal unit, her RR and HR have increased during the last hour. Which intervention should the nurse implement? a. Notify the HCP of these findings b. Administer a PRN analgesic prescription c. Record the findings in the child’s record d. Wrap the infant tightly and rock in rocking chair 5. 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 6. A mother brings her 3 month old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family? a. The mother is a single parent and lives with her parents b. The mother states the baby is irritable during feedings c. The infant’s formula has been changed twice d. The diaper area shows severe skin breakdown 7. The nurse determines that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis. What action should the nurse take? a. Document the finding b. Palpate scrotum for testicular descent c. Assess for bladder distension d. Auscultate bowel sounds 8. A 16 year old with acute myelocytic leukemia is receiving chemotherapy (CT) via an implanted medication port at the out-patient oncology clinic. What action should the nurse implement when the infusion is complete? a. Administer Zofran b. Obtain blood samples for RBCs, WBCs, and platelets c. Flush mediport w/ saline and heparin solution d. Initiate an infusion of normal saline 9. A mother brings her 3-week old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicates that the infant’s vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life threatening complication? **SEE SCREEN SHOT FOR RATIONALE** a. Irregular palpable pulse b. Hyperactive bowel sounds c. Underweight for age d. Crying without tears 10. 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 11. Following admission for cardiac catheterization, the nurse is providing discharge teaching to the parents of a 2-year-old toddler with tetralogy of Fallot. What instruction should the nurse give the parents if their child becomes pale, cool, lethargic? a. Encourage oral electrolyte solution intake b. Assess the child to a recumbent position c. Contact their HCP immediately d. Provide a quiet time by holding or rocking the toddler 12. A mother brings her 2 year old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child’s oral temperature is 101.2 F. Which intervention should the nurse implement? **SEE SCREEN SHOT FOR a. Ask the mother if the child has had a runny nose b. Cleanse purulent exudate from the affected ear canal c. Apply a topical antibiotic to the periauricle area d. Provide parent education to prevent recurrence 13. During a follow up clinical visit a mother tells the nurse that her 5 month old son who had surgical correction for tetralogy of fallot has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held and his growth is in the expected range. Which intervention should the nurse implement? **SEE SCREEN SHOT a. Stimulate the infant to cry to produce cyanosis b. Auscultate heart and lungs while infant is held c. Evaluate infant for failure to thrive d. Obtain a 12-lead electrocardiogram 14. The mother of an 11-year old boy who has juvenile 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. The child should be encouraged to rest when he experiences pain b. Encourage quiet activities such as watching television as a pain distracter c. The use of hot baths can be used as an alternative for pain medication d. Giving pain medication around the clock helps control the pain 15. The mother of a 4-month-old baby girl asks the nurse when she should introduce solid foods to her infant. The mother states, “My mother says I should put rice cereal in the baby’s bottle now.” The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior? a. Stops rooting when hungry b. Opens mouth when food comes her way c. Awakens once for nighttime feedings d. Gives up a bottle for a cup 16. A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist agent albuterol (Proventil). The child’s mother tells the nurse that she uses this medication to open her son’s airway when he is having trouble breathing. What is the nurse’s best response? a. Recommend that the mother bring the child in for immediate evaluation b. Advise the mother that over-use of the drug may cause chronic bronchitis c. Assure the mother that she is using the medication correctly d. Confirm that the medication helps to reduce airway inflammation 17. A mother brings her school-aged daughter to the pediatric clinic for evaluation of her anti-epileptic medication regimen. What information should the nurse provide to the mother? a. The medication dose will be tapered over a period of 2 weeks when being discontinued b. If seizures return, multiple medications will be prescribed for another 2 years c. A dose of valproic acid (Depakote) should be available in the event of status epilepticus d. Phenytoin (Dilantin) and phenobarbital (Luminal) should be taken for life 18. A child receives a prescription for amantadine 42 mg PO BID. Amantadine is available as a 50 mg/5 mL syrup. Using a supplied calibrated measuring device, how many mL should the nurse administer per dose? (round to nearest tenth) 0.5 mL 19. A male toddler is brought to the emergency center approximately three hours after swallowing tablets from his grandmother’s bottle of digoxin (Lanoxin). What prescription should the nurse implement first? Administer activated charcoal orally a. Administer activated charcoal b. Prepare gastric lavage c. Obtain a 12-lead electrocardiogram d. Give IV digoxin immune fab (Digibind) 20. An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin IV. Which findings indicate to the nurse that the child is manifesting a therapeutic response? a. Decreased urinary output b. Decreased periorbital edema c. Increased periods of rest d. Weight gain 0.5 kg/day 21. A mother of a 3-year old boy has just given birth to a new baby girl. The little boy asks the nurse, “why is my baby sister eating my mommy’s breast?” how should the nurse respond? Select all that apply a. Remind him that his mother breastfed him too b. Clarify that breastfeeding is the mother’s choice c. Reassure the older brother that it does not hurt his mother d. Explain that newborns get milk from their mothers in this way e. Suggest that the baby can also drink from a bottle 22. A middle school male student was recently diagnosed with attention-deficit hyperactivity disorder (ADHD) and is having trouble with his grades. He is referred to the school nurse by the teacher because he continues to have learning problems. Which action should the school nurse take? a. Ask the parents to have the child seen by a clinical psychologist b. Ask the parents to become involved in helping the child with his homework c. Refer the child to the school counselor for educational testing d. Seek the advice of the school principle regarding the child’s learning needs 23. 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 his hands and feet. Which intervention should the nurse instruct the mother to implement first? * a. Place the child in a quiet environment b. Make a list of foods that the child likes c. Encourage the parents to rest when possible d. Apply lotion to hands and feet 24. The nurse is preparing a teaching plan for the parents of a 6 month-old infant with GERD. What instruction should the nurse include when teaching the parents measures to promote adequate nutrition? a. Alternate glucose water with formula b. Mix the formula with rice cereal c. Add multivitamins with iron to the formula d. Use water to dilute the formula 25. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child’s plan of care? a. Obtain vital signs at onset of fluid overload b. Change IV site dressing q3 days and PRN c. Monitor for signs of facial swelling or urticartia d. Assess for abdominal pain and vomiting 26. The nurse is conducting an admission assessment of an 11-month old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta hat 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. What pathophysiologic mechanisms support these findings? a. The aortic semilunar valve obstructs blood flow into the systemic circulation b. The lumen of the aorta reduces the volume of the blood flow to the lower extremities c. The pulmonic valve prevents adequate blood volume into the pulmonary circulation d. An opening in the atrial septum causes a murmur due to a turbulent left to right shunt 27. A child who is admitted to the hospital with anemia is anxious, fearful, and hyperventilating. The nurse anticipates the child developing which acid base imbalance? a. Metabolic acidosis b. Respiratory acidosis c. Respiratory alkalosis d. Metabolic alkalosis 28. The mother of a toddler reports to the nurse working in the pediatric clinic that her child has had a fever and sore throat for the past two days. The nurse observes several swollen red spots in the child’s body, a few of which are fluid filled blisters. Which action should the nurse implement? a. Obtain fluid culture from blisters b. Administer a fever reducing salicylate c. Cover drainage vesicles with a dressing d. Implement transmission precautions 29. The mother of a 14-year old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide? a. “I will ask the HCP for a psychiatric consult for your child” b. “This type of acting out behavior is normal for adolescents” c. “It is important to focus on your child’s needs at this difficult time” d. “A reaction of anger is your child’s attempt to cope with this loss” 30. The nurse provides information about the human papilloma virus (HPV) vaccine to the mother of a 14-year-old adolescent who came to the clinic this morning complaining of menstrual cramping. Which explanation should the nurse provide to support administering the HPV vaccine to the adolescent who came to the clinic this morning complaining of menstrual cramping. Which explanation should the nurse provide to support administering the HPV vaccine to the adolescent at this visit? a. Use of protective barriers during sexual activity prevents most strains of HPV infection b. Most adolescents are not honest about being sexually active c. Not all strains of HPV will be covered if given at a later date d. Immunity must be established to prevent future HPV infection and risk for cervical cancer 31. An adolescent’s mother calls the primary HCP’s office to inquire about the results of her daughter’s serum test results that were drawn last week. Since it is the teenager’s 18th birthday, how should the nurse respond to this mother’s inquiry? a. Ask when the adolescent was last seen in the clinic b. Tell the mother to have the teenager call the clinic c. Since the serum samples were drawn last week provide the mother with the findings d. Explain that the information cannot be released without the 18-year olds permission 32. The parents of 15-month old boy tell the nurse that they are concerned because their son brings his spoon to his mouth but does not turn it over. What action should the nurse implement first? a. Discuss referral to an occupational therapist b. Question the parents about their concern c. Tell the parents to hold the spoon correctly in the child’s hand d. Suggest longer mealtimes so the child can finish eating 33. A child with Grave’s disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response? a. Increased weight gain b. Decreased heart rate c. Reduce headaches d. Diminished fatigue 34. A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment of the girl is most important for the nurse to obtain? a. Understanding of quality control process used to troubleshoot the pump b. Interpretation of fingerstick glucose levels that influence diet selections c. Knowledge of her glycosylated hemoglobin A1c levels for past year d. Ability to perform the pump for basal insulin with mealtime boluses 35. In developing a behavior modification program for an extremely aggressive 10 year old boy, what should the nurse do first? a. Determine what activities, foods, and toys the child enjoys b. Evaluate the child’s previous reactions to punishment c. Provide the child with positive feedback d. Encourage other children on the unit to describe the token system 36. In assessing a 10-year old newly diagnosed with osteomyelitis, which information s most important for the nurse to obtain? a. Family history of bone disorders b. Recent occurrence of infection c. Cultural heritage and beliefs d. Occurrence of increased fluid intake 37. 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. Permanent life style changes need to be made to promote safety in the home b. The chorea or movements are temporary and will eventually disappear c. Muscle tension is decreased with fine motor project skills, so these activities should be encouraged d. Consistent discipline is needed to help the child control the movements 38. A 3 year-old boy is receiving a weekly chemotherapy treatment. Which toy is best for the nurse to provide for this child? *SC a. Bouncy ball b. Coloring book with crayons c. Duck that squeaks d. Remote-controlled care 39. A 9-week-old infant is scheduled for cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite? **SEE SCREEN SHOT FOR RATIONALE** a. Red blood cell count of 2.3 million/mm3 b. White blood cell count of 10,000/mm3 c. Weight gain of 2 pounds since birth d. Urine specific gravity is 1.011 40. The nurse is caring for a 3-year old child who has been recently diagnosed with cystic fibrosis, which discharge instruction by the nurse is most important to promote pulmonary function? **SEE SCREEN SHOT FOR RATIONALE** a. Chest physiotherapy should be performed before meals and at bedtime b. Cough suppressants can be used up to four times a day for relief c. Oxygen should be given through a nasal cannula between 4-6 L/min d. Exercise is discouraged in order to preserve pulmonary vital capacity 41. An adolescent who is taking antiretroviral therapy for HIV infection arrives at the clinic for a follow up visit. Which information is most important for the nurse to obtain? a. Missed medication doses b. A 24-hour dietary recall c. Barrier contraceptive use d. Ingestion of illicit drugs 42. A 5-year-old boy with leukemia is receiving chemotherapy through a peripherally inserted central catheter (PICC). Twenty minutes after the infusion is begun, the child feels dizzy and complains of itching. Which intervention should the nurse implement first? **SEE SCREEN SHOT FOR RATIONALE** a. Discontinue the medication infusion b. Flush IV line with saline c. Obtain emergency resuscitation equipment d. Measure current blood pressure and pulse 43. A school-aged male is brought to the school nurse after he was thrown off his bicycle into the trunk of a pine tree. The child’s face and arms are speckled with embedded pine bark. He has copious tearing and complains that “there is stuff in my eyes.” Which action should the nurse implement a. Patch both of child’s eyes and send him to the family ophthalmologist b. Use sterile tweezers to lift bark specks from the sclera of each eye c. Instill pain relieving eye drops into each eye and keep head elevated d. Encourage the child to blink frequently to increase bilateral tearing in the eyes 44. A nurse is teaching a class for mothers of premature infants, and is asked about “a shot for respiratory virus.” What information about plaibizumab (Synagis) is correct? a. It is required immunization for all infants under the age of 3 months b. It must be repeated every two months to be effective c. It is recommended for infants who meet established high-risk criteria d. It provides protection for one year with a single injection 45. MISSING 45 46. When assessing a 5-year-old, which ability should the nurse expect the child to be developing at this age? **SEE SC a. Learning to ride a tricycle b. Tying shoelaces c. Buttoning clothes d. Cutting with scissors 47. 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 is not distended into the scrotum but the left is palpable. Which action should the nurse take? a. Ask if the right testis has been seen in the scrotum before b. Address possible concerns about the child’s future fertility c. Schedule an IV pyelogram to validate presence of the testicle d. Prepare to obtain a catheterized urine specimen for culture 48. MISSING 48 49. An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LRHR) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment? **SEE SCREEN SHOT FOR RATIONALE** a. “We should be sure to start our daughter on birth control pills” b. “Our daughter will be on this hormone treatment the rest of her life” c. “We should encourage her to dress in clothing that suits her sexual maturity level” d. “Sexual maturity differences between my daughter and her peers will disappear within a few years” 50. MISSING 50 51. 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? **SEE SC a. Identify the antibiotic used to treat the pneumonia b. Report suspected child abuse to the proper authorities c. Inquire about the use of alternative methods of treatment d. Ask the parents if the child has been in a recent accident 52. Which instructions should the nurse include in the discharge teaching plan of 7 year old girl with history of frequent urinary tract infections? **SEE SCREEN SHOT FOR RATIONALE** a. Take frequent bubble baths b. Perform intermittent catheterization c. Check oral temperature daily d. Monitor for changes in urinary odor 53. A male infant with bronchiolitis is brought to the clinic by his mother. The infant is congested and febrile with a capillary refill of 2 seconds. Which information should the nurse discuss with the mother? **SEE SCREEN SHOT FOR RATIONALE** a. Encourage infant to play b. Limit the amount of oral intake c. Keep infant isolated from others d. Lay infant on back for naps 54. MISSING 54 55. During a routine physical exam, a male adolescent client tells the nurse, “sometimes, my mother gets angry because I want to be with my own friends.” What is the best initial response by the nurse? **SEE SCREEN SHOT FOR RATIONALE** a. Offer reassurance that his mother’s concern is normal b. Determine is his friends are engaged in unsafe behaviors c. Ask about the client’s response to his mother’s anger d. Offer to discuss his concerns together with his mother