Pediatric Hesi (B), Questions with accurate answers, 2022/2023. Rated A

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Pediatric Hesi (B), Questions with accurate answers, 2022/2023. Rated A The nurse is planning care for a 5 - month-old with gastroesophageal reflux disease whose weight has decreased by 3 ounces ... since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instruction should the nurse provide this mother? •Dilute the child's formula with equal parts of water •Offer 10% dextrose in water between most feeding •Give small amounts of baby food with each feeding •Thicken formula with cereal for each feeding - ✔✔•Thicken formula with cereal for each feeding A 4-years-old boy was recently diagnosed with Duchenne muscular dystrophy (DMD). Which characteristic of the disease is most important for the nurse to focus on during the initial teaching? •Muscular strength can be regained with physical exercise and therapy •Growth and development have been abnormal since birth •Respiratory dysfunction and aspiration are prime concerns at this stage of the disease •Lower legs become progressively weaker, causing a wedding, unsteady gait - ✔✔•Lower legs become progressively weaker, causing a wedding, unsteady gait In caring for an client with acute epiglottitis, which nursing action takes priority? •Obtain a stat CBC •Prepare for endotracheal intubation •Auscultate breath sounds •Apply ice packs to the neck - ✔✔•Prepare for endotracheal intubation Which client requires immediate intervention by the nurse? •A toddler with chickenpox who is scratching •An adolescent with a migraine and photophobia •A child with cystic fibrosis who is constipated •A Child with acute renal failure and hyperkalemia - ✔✔•A Child with acute renal failure and hyperkalemia The nurse is conducting an admission assessment of an 11-months old infant with congestive heart failure who is scheduled repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower, with pathophysiologic mechanism support these findings? •The aortic semi lunar valve obstructs blood flow into the systemic circulation •An opening in the atrial septum causes a murmur due to a turbulent left to right shunt •The lumen of the aorta reduces the volume of flow to the lower extremities •The pulmonic valve prevents adequate blood volume - ✔✔•The lumen of the aorta reduces the volume of flow to the lower extremities A child is to receive vancomycin (Vancocin) 20 mg/kg IV one hour before a scheduled procedure. The child weight 77 pounds. How many mg of the medication should the nurse prepare to administer? (Enter numeric value only) - ✔✔ A toddler with hemophilia is being discharged from the hospital. Which teaching should the nurse include in the discharge instructions to the mother? • Apply padding on the sharp corners of the furniture • Prevent the child from running inside the house • Give an 81 mg tablet of aspirin for pain relief • Use a soft toothbrush for frequent cleaning - ✔✔• Apply padding on the sharp corners of the furniture The nurse is using the Stage Questionnaire (b) to assess a 24 - month-old child. What is the best intervention for the nurse to initiate after the assessment is completed? • Assess for changes in the vital signs • Review the child's birth history • Provide the parents with a list of stimulating activities • Meet with a social worker to review the results - ✔✔• Provide the parents with a list of stimulating activities When caring for a child sickle cell disease, the nurse knows that the child will most likely exhibit which sign when experiencing a sickle cell crisis? • Decreased hemoglobin • Pain • Infection • Dehydration - ✔✔• Pain The nurse is administering an oral medication to a reluctant preschool-age boy. Which intervention should the nurse implement? • Advise the parents that they will need to give the medication • Use straightforward approach with the child • Mix the medication in with the child's favorite breakfast cereal • Offer to bring the medicine back later in the day - ✔✔• Use straightforward approach with the child The nurse is planning care for a newborn infant scheduled for a cardiac catheterization. Which occurrence poses the greatest risk for this child? • Loss of pulse proximal to the entry side of the catheter • Allergic response to the plastics in the catheter used for catheterization • Acute hemorrhage from the entry site of the catheter after the procedure • Fever associated with nausea and vomiting after the procedure - ✔✔• Acute hemorrhage from the entry site of the catheter after the procedure The school nurse is presenting a seminar to parents about child safety that focuses on prevention of spinal cord injuries. What information is most important for the nurse include in the teaching plan? • Trampoline activities of school-aged children should be supervised by adults • Protective gear to prevent neck flexion should be worn during contact sports • Seat belt and car seat laws for use in motor vehicles should be reinforced • Monkey bars should be removed from school playgrounds to reduce falls - ✔✔• Seat belt and car seat laws for use in motor vehicles should be reinforced 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 (38 C). Which intervention should the nurse implement? • Provide parent education to prevent recurrence • Clearance purulent exudate from the affected ear canal • Apply a topical antibiotic to the preauricular area • Ask the mother if the child has had a runny nose - ✔✔• Ask the mother if the child has had a runny nose 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 concern? • Letting male toddlers play with female-typed toys can have negative effects • Replacing female doll figures with male doll figures reinforces masculinity • Exploring different roles in imaginary play is typical at this age • Experimenting with different toys is an acceptable behavior - ✔✔• Exploring different roles in imaginary play is typical at this age Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children? • Noting a marked weight gain without a gain in height on a growth chart • Performing head circumference measurements on infants under one year of age • Assessing for behavioral problems at home and school by interviewing the parents • Carefully recording the height and weight of children to detect inappropriate growth rates - ✔✔• Carefully recording the height and weight of children to detect inappropriate growth rates 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 information is most important for the nurse to obtain? • Level of infant's distress after vomiting • Degree of forcefulness of vomiting episodes • Odor and texture associated with emesis • Position of the infant when vomiting occurs - ✔✔• Degree of forcefulness of vomiting episodes A 4-month-old boy has an inguinal hernia that is visible when he cries, but it does not cause him discomfort. His parents ask if the hernia should be repaired now. The nurse's response should be based on what information? • An inguinal hernia is treated as a surgical emergency • Surgical repair is planned after successful toilet training • An inguinal hernia is surgically repaired if persistent diarrhea occurs • Surgical correction is indicated if the hernia is incarcerated - ✔✔• Surgical correction is indicated if the hernia is incarcerated A 2-year-old child with heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 beast| minute. What action should the nurse implement? • Determined the pulse déficit • Calculate the safe dose range • Administer the scheduled dose • Review the serum digoxin level - ✔✔• Administer the scheduled dose The nurse is assisting the mother of child with phenylketonuria (PKU) to select foods that are in keeping with the child's dietary restrictions. Which foods are contraindicated for this child? • High fat foods • Foods sweetened with aspartame • Wheat products • High calorie foods - ✔✔• Foods sweetened with aspartame During a routine physical exam, a male adolescent client tell 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? • Offer to discuss his concerns together with his mother • Ask about client's response to his mother's age • Determine if his friends are engaged unsafe behaviors • Offer reassurance that his mother's concern is normal - ✔✔• Ask about client's response to his mother's age Which response demonstrates that the mother of a young girl with a urinary tract infection (UTI) understands home care for the child? • I will give the antibiotics until she does not complain of burning anymore • I will bring her back to the doctor's office for another urine test • I will make sure she wipes from back to front after she uses the bathroom • I will refill the prescription for antibiotics if her symptoms are skill present after taking these - ✔✔• I will bring her back to the doctor's office for another urine test The nurse is caring for a one-year-old boy who has type 1 diabetes mellitus (DM). His mother asks how will she recognize hypoglycemia in her infant who cannot tell her how he feels. Which information should the nurse provide? • The baby's breath smell swells sweet when the sugar and blood ketone levels are high • Hypoglycemia in infants causes changes in behavior and cold clammy skin • Weight loss and a good appetite often occur when a baby's glucose levels change • Excess urination and dry skin are common indicators of hypoglycemia - ✔✔• Hypoglycemia in infants causes changes in behavior and cold clammy skin An 8 year-old child is admitted to the Emergency Department because of lower right quadrant pain, nausea, and vomiting. Which assessment of the abdomen should the nurse conduct after all other assessments are complete? • Percussion • Palpation • Inspection • Auscultation - ✔✔• Palpation An infant is admitted for surgery who has a Wilms' tumor. What nursing intervention should the nurse implement during the preoperative period? • Administer pain medication based on the FACES pain scale • Give antiemetic medications to prevent nausea and vomiting • Include the prone position in the q2h turning schedule • Careful bathing and handling that avoids abdominal manipulation - ✔✔• Careful bathing and handling that avoids abdominal manipulation A female of child - bearing age receives a rubella vaccination. She has two children at home, ages 13 months and 3 years. Which instruction is most important for the nurse to provide to this client? • Tell the mother to isolate the children for 3 days • Inquire if anyone in the family is allergic to eggs • Encourage the client to immunize the children • Assess family history for incidence of rubella - ✔✔• Encourage the client to immunize the children The teacher notifies the school nurse that a child's nose is bleeding for no apparent reason. What action should the nurse implement first? • Tip the child's head back to avoid swallowing blood • Pinch the nose using thumb and finger for 10 minutes • Insert a sterile cotton ball in the nares that is bleeding • Apply an ice compress to the child's nose right away - ✔✔• Pinch the nose using thumb and finger for 10 minutes 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? • The TSH is high because of the low production of T4 by the thyroid • High thyroxine levels normally occur in breastfeeding infants • The thyroxine levels low because the TSH level is high • The thyroid gland does not produce normal levels of thyroxine for several weeks after birth - ✔✔• The TSH is high because of the low production of T4 by the thyroid When administering indomethacin (Indocin) to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome? • Decreased cardiac murmur • Increased number of red blood cells • Decreased urinary output • Increased respiratory effort - ✔✔• Decreased cardiac murmur A hospitalized child stiffens and stars to seize as the nurse enters the room. What actions should the nurse take? (Select all apply) • Turn client to the side if possible • Pad side rails with available pillows and blankets • Instruct the parents to leave the room • Notify the emergency response team • Monitor duration and progress of the seizure - ✔✔• Turn client to the side if possible • Pad side rails with available pillows and blankets• Monitor duration and progress of the seizure 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? • Refer the child to the school counselor for educational testing • Seek the advice of the school principal regarding the child's learning needs • Ask the parents to become involved the child with his homework • Ask the parents to have the child seen by a clinical psychologist - ✔✔• Refer the child to the school counselor for educational testing An adolescent boy is hospitalized with full-thickness (third degreed) burns to both hands following a house fire. Three days after his admission to the burned unit, the nurse notes that teenager's hands are becoming more edematous. Which intervention is most important for the nurse to include in this client's plan care? • Record accurate intake and output • Ensure patient intravenous access • Assess radial pulses every 2 hours • Ensure that antibiotics are administered on time - ✔✔• Assess radial pulses every 2 hours A 10-year-old boy has been seen frequently by the nurse over the past three weeks after school begins in the fall. He reports headaches, stomach, and difficulty sleeping. What intervention should the nurse implement? • Conduct a complete neurological assessment • Ask the boy to describe a typical day at school • Counsel the parents to play more attention to the child • Compare the child's vital signs over the past three weeks - ✔✔• Ask the boy to describe a typical day at school 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? • Permanent life-style changes need to be made to promote safety in the home • Consistent discipline is needed to help the child control the movements • Muscle tension is decreased with fine motor skill projects, so these activities should be encouraged • The chorea or movements are temporary and will eventually disappear - ✔✔• The chorea or movements are temporary and will eventually disappear A 3-year -old girl who has been blind since birth is hospitalized because of a compound fracture of the femur and is now in traction. Which intervention is best for the nurse to implement to address this child's blindness? • Play a game where the child must identify unfamiliar sounds in the environment • Use a touch tour to allow the child to familiarize herself with the room layout • Request parents bring familiar objects as a stuffed animal from home • Perform the child's self-care activities until the child is no longer in traction - ✔✔• Request parents bring familiar objects as a stuffed animal from home The nurse has provided discharge teaching to the mother of a premature infant. Which statement by the mother would indicated that the understands the importance of making sure that her baby gets the monthly palivizumab (Synagis) injection? • Palivizumab will help with neurological and physical development • The medication will protect my baby from respiratory syncytial virus • Palivizumab will prevent the development retinopathy of premature • The monthly injections will baby's lung mature - ✔✔• The medication will protect my baby from respiratory syncytial virus A 16 -year-old adolescent 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 completed? • Initiate an infusion of normal saline • Administer ondansetron (Zofrant) • Flush the mediport with saline and a heparin solution • Obtain blood samples for RBCs, WBCs, and platelets - ✔✔• Flush the mediport with saline and a heparin solution The nurse is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective? • Can lift head, but not chest when lying on abdomen • Has strong Moro and tonic neck reflexes • Laughs readily, turns from back to side • Keeps fists clenched, opens hands when grasping an object - ✔✔• Laughs readily, turns from back to side A pre-school-age girl who has been taking oral ampicillin (Omnipen, Polycillin) for 3 days for a non-respiratory condition repeatedly tells the nurse that her throat hurts. The child has no evidence of dyspnea or urticaria. Which action should the nurse implement? • Explain gently that medication must be taken • Withhold the medication and notify the healthcare provider • Encourage eating ice chips after taking the medication • Assess apical heart rate and pulse points for irregularities - ✔✔• Explain gently that medication must be taken A 9-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? • Initiative • Industry • Autonomy • Identity - ✔✔• Industry After receiving a single fluid bolus of 20 mg / kg of normal saline, a child's heart rate is 140 beats/ minute, blood pressure is 70/50, and capillary refill is 6 seconds. The child is anxious and crying. Which intervention should the nurse implement first? • Encourage the caregiver to remain at bedside • Repeat the normal saline bolus as prescribed • Allow the child to assist with caregiving • Recommend age appropriate activities - ✔✔• Repeat the normal saline bolus as prescribed The clinic nurse is assessing a 3-year -old child with sudden onset of irritability, thick muffled voice, and barking on inspiration. The child is febrile and leaning forward to breathe with tongue protruding, is drooling, and has suprasternal retractions. Which intervention should the nurse implement first? • Alert the emergency response team • Examine the child's throat for edema • Collect a sputum specimen • Prepare the child for X-ray - ✔✔• Alert the emergency response team The nurse is caring for an infant who was recently diagnosed with a congenital heart defect. Which assessment finding is most important for the nurse to report to the healthcare provider? • Audible heart murmur • Poor oral intake and suckling effort • Heart rate of 162 beasts/minute • Weight gain of 2.2 lbs (1kg) in las 48 hours - ✔✔• Weight gain of 2.2 lbs (1kg) in las 48 hours The nurse administers digoxin (Lanoxin) to a 9-month-old infant with an apical heart rate of 160 beats per minute. Which apical pulse rate indicates that therapeutic effect of the medication has been achieved? • 80 beats per minute • 180 beats per minute • 60 beats per minute • 120 beats per minute - ✔✔• 120 beats per minute Which toy is most appropriate for a 10 -year-old child with acute rheumatic fever who is on strict bed rest? • Play dough • Doctor kit • Punching bag • Checkers - ✔✔• Checkers A 12-year-old obese male comes to the clinic with his mother and a note from the school nurse for follow-up of Acanthosis Nigricans, a thickening and darkening of the skin. The child is concerned and anxious that he has a serious condition. How should the nurse respond? • Refer the child immediately to an endocrinologist for treatment • Ask the child and his mother what he was told about this condition • Encourage the child to modify his diet and begin an exercise • Assess the presence of type 2 diabetes mellitus in the family - ✔✔• Ask the child and his mother what he was told about this condition A 10-year-old girl is diagnosed with inflammatory bowel disease (IBD). Her mother is concerned that she will experience developmental delays as the result of this disorder. How should the nurse respond? • She is at high risk for a number of different problems, including developmental delays • Scheduling a private tutor can help to prevent developmental delays • She will only experience developmental delays if weight loss cannot be controlled • Growth failure is a concern, but developmental delays are not likely to occur - ✔✔• Growth failure is a concern, but developmental delays are not likely to occur Which instruction should the nurse include in the discharge teaching plan of a 7-year-old girl with a history of frequent urinary tract infections? • Take frequent bubble baths • Monitor for changes in urinary odor • Check oral temperature daily • Perform intermittent catheterization - ✔✔• Monitor for changes in urinary odor During her sports physical examination, 15-year -old female requests oral contraceptives. She explains that she is sexually active and does not want her parents to know. What action should the nurse take? • Explain that she needs parental approval to receive contraceptives • Encourage the client to discuss her need for contraceptives with her parents • Counsel the client about the risks and benefits of using oral contraceptives • Tell the client how to receive a variety of oral contraceptives from the clinic - ✔✔• Counsel the client about the risks and benefits of using oral contraceptives A child with acute laryngotracheobronchitis (croup) received epinephrine 2 hours ago in the emergency room, and is now being prepared for discharge to the home. The nurse should instruct the parents to take which action if the child's uncontrolled coughing reoccurs? • Sit with the child in the bathroom with hot steam • Call for emergency transportation to hospital • Administer a dose of the prescribed cough medicine • Increase the fluid intake to liquefy the secretions - ✔✔• Sit with the child in the bathroom with hot steam 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 still breast feeding, the mother provides the child with supplemental formula feedings. Which assessment is most important for the nurse to obtain? • The infant's current hemoglobin and hematocrit • Water source used with supplement feedings • Weight gain and type of formula taken daily • The newborn's gestational age assessment - ✔✔• Water source used with supplement feedings 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? • The nurse use of hot baths can be used as an alternative for pain medication • The child should be encouraged to rest when he experiences pain • Encourage quiet activities such as watching television as a pain distracter • Giving pain medication around the clock helps control the pain - ✔✔• Giving pain medication around the clock helps control the pain An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin intravenously. Which finding indicate to the nurse that the child is manifesting a therapeutic response? • Decreased periorbital edema • Increased periods of rest • Weight gain of 0.5 kg/day • Decreased urinary output - ✔✔• Decreased periorbital edema A 12-year-old boy with leukemia is being discharged from the hospital with a white blood cell (WBC) count of 4,000/mm. He is scheduled to receive antineoplastic chemotherapy as an outpatient. What instruction should the nurse include in this child's discharge plan? • Avoid eating at buffets, smorgasbords, and salad bars • Spend time resting with family pets, bur only cats and dogs • Have all visitors wear protective masks when coming to the home • Swim weekly at the neighborhood pool for neuromuscular integrity - ✔✔• Avoid eating at buffets, smorgasbords, and salad bars The nurse is assessing an 8-month-old who has a cough, axillary temperature of 100 F, and rhinorrhea. What information is most important for the nurse to obtain from this child's mother? • Alcohol and drug intake of the mother • Labor and delivery history of the infant • Immunization status of the infant • Living conditions - ✔✔Immunization status of the infant Which client requires immediate intervention by the nurse? • A child with cystic fibrosis who is constipated • A toddler with chicken pox who is scratching • A child with acute renal failure and hyperkalemia • An adolescent with a migraine and photophobia - ✔✔• A child with acute renal failure and hyperkalemia [Show More]

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