Pediatrics HESI 2023
A 6-month-old infant with congestive heart failure (CHF)
is receiving digoxin elixir. Which observation by the nurse
warrants immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute. - ANSWER-
Apical heart rate of 60.
A heart rate of 60 (A) is much lower than normal for a 6-
month-old and warrants immediate intervention. The
normal heart rate for a 6-month-old is 80 to 150 BPM
when awake, and a rate of 70 while sleeping is
considered within normal limits. (B and C) are expected
symptoms of heart failure in an infant. (D) is within
normal limits for an infant.
,The nurse is teaching the parents of a 5-year-old with
cystic fibrosis about respiratory treatments. Which
statement indicates to the nurse that the parents
understand?
Perform postural drainage before starting aerosol
therapy.
Give respiratory treatments when the child is coughing a
lot.
Administer aerosol therapy followed by postural
drainage before meals.
Ensure respiratory therapy is done daily during any
respiratory infection. - ANSWER-Administer aerosol
therapy followed by postural drainage before meals.
Postural drainage for a child with cystic fibrosis is most
effective when performed after nebulization and before
meals (C) or at least 1 hour after eating to prevent
nausea and vomiting. Postural drainage uses gravity to
promote mucous removal after nebulization (A)
,treatments which open the airways. Pulmonary toileting
or respiratory treatments should be given 3 to 4 times
daily, not episodically (B and D).
A female teenager is taking oral tetracycline HCL
(Achromycin V) for acne vulgaris. What is the most
important instruction for the nurse to include in this
client's teaching plan?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular. - ANSWER-Use
sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline
HCL (Achromycin V) therapy. Severe sunburn can occur
with minimal sun exposure and clients should be
instructed to avoid sunlight and to use sunscreen (A). (B
and D) are not related to tetracycline HCL (Achromycin V)
, therapy. (C) should be avoided because dairy products
interfere with the absorption of tetracyclines.
What preoperative nursing intervention should be
included in the plan of care for an infant with pyloric
stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting. - ANSWER-Observe for
projectile vomiting.
Projectile vomiting (D), which contributes to metabolic
alkalosis (A), is the classic sign of pyloric stenosis. (B) is
not indicated. (C) is dangerous, due to the potential for
aspiration with frequent vomiting.
An infant is born with a ventricular septal defect (VSD)
and surgery is planned to correct the defect. The nurse
A 6-month-old infant with congestive heart failure (CHF)
is receiving digoxin elixir. Which observation by the nurse
warrants immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute. - ANSWER-
Apical heart rate of 60.
A heart rate of 60 (A) is much lower than normal for a 6-
month-old and warrants immediate intervention. The
normal heart rate for a 6-month-old is 80 to 150 BPM
when awake, and a rate of 70 while sleeping is
considered within normal limits. (B and C) are expected
symptoms of heart failure in an infant. (D) is within
normal limits for an infant.
,The nurse is teaching the parents of a 5-year-old with
cystic fibrosis about respiratory treatments. Which
statement indicates to the nurse that the parents
understand?
Perform postural drainage before starting aerosol
therapy.
Give respiratory treatments when the child is coughing a
lot.
Administer aerosol therapy followed by postural
drainage before meals.
Ensure respiratory therapy is done daily during any
respiratory infection. - ANSWER-Administer aerosol
therapy followed by postural drainage before meals.
Postural drainage for a child with cystic fibrosis is most
effective when performed after nebulization and before
meals (C) or at least 1 hour after eating to prevent
nausea and vomiting. Postural drainage uses gravity to
promote mucous removal after nebulization (A)
,treatments which open the airways. Pulmonary toileting
or respiratory treatments should be given 3 to 4 times
daily, not episodically (B and D).
A female teenager is taking oral tetracycline HCL
(Achromycin V) for acne vulgaris. What is the most
important instruction for the nurse to include in this
client's teaching plan?
Use sunscreen when lying by the pool.
Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular. - ANSWER-Use
sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline
HCL (Achromycin V) therapy. Severe sunburn can occur
with minimal sun exposure and clients should be
instructed to avoid sunlight and to use sunscreen (A). (B
and D) are not related to tetracycline HCL (Achromycin V)
, therapy. (C) should be avoided because dairy products
interfere with the absorption of tetracyclines.
What preoperative nursing intervention should be
included in the plan of care for an infant with pyloric
stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting. - ANSWER-Observe for
projectile vomiting.
Projectile vomiting (D), which contributes to metabolic
alkalosis (A), is the classic sign of pyloric stenosis. (B) is
not indicated. (C) is dangerous, due to the potential for
aspiration with frequent vomiting.
An infant is born with a ventricular septal defect (VSD)
and surgery is planned to correct the defect. The nurse
