PEDIATRICS - HESI PRACTICE EXAM WITH ANSWERS
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A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse auscultates a loud mu... rmur characteristic of a ventricular septal defect (VSD), and finds the newborn is a cyanotic with a respiratory rate of 64 breaths per minute. What instruction should the nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.) The nurse should provide a factual and reassuring explanation that focuses on individual variations of menarche, which can normally occur between 12 and 18 years of age (C). (A) does not address the adolescent's concern and is judgmental. Menarche is influenced by hereditary, general health, and nutritional status, so (B) is not indicated. (D) dismisses the adolescent's concerns and does not offer factual information. Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically occurs by age 18, so (A) should prompt further investigation to determine the cause of this primary amenorrhea. Children receive tetanus as part of the DPT childhood immunization series, and a booster is not typically given until age 16 (B). Wisdom teeth are the third molar teeth of the permanent dentition and are the last to erupt, so (C) is a normal finding. (D) describes a plantar surface wart, harmless but painful because of the pressure with walking or standing. Sublingual Procardia (B) lowers blood pressure very quickly, and this should be done first. (A) may also be done, but oral diuretics do not work as rapidly as the sublingual antihypertensive. When notifying the healthcare provider, the first thing he/she will want to know is if the PRN antihypertensive has been administered (C). (D) does not consider the seriousness of this finding. The nurse should stay with the client until the blood pressure is reduced. [Show More]
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