OB/Peds HESI Practice Questions
A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the
student nurse to describe the disorder. Which statement by the student nurse indicates correct
understanding of this disorder?
1.
"It is an acute bowel obstruction."
2.
"It is a condition that causes an acute inflammatory process in the bowel."
3.
"It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the
bowel."
4.
"It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the
bowel." - ANS - 4. it is a condition in which the proximal segment of the bowel prolapses into a
distal segment of the bowel
A 12-year-old child with newly diagnosed thalassemia is brought to the clinic exhibiting delayed
sexual maturation, fatigue, anorexia, pallor, and complaints of headache. The child seems
listless and small for age and has frontal bossing. What should the nurse expect to note on
review of the results of the laboratory tests?
1.Macrocytosis and hyperchromia
2.Excessive red blood cell production
3.Excessive mature erythrocyte proliferation
4.Deficient production of functional hemoglobin - ANS - 4. deficient production of functional hgb
RATIONALE:
Defective hgb is produced as a result of genetically deficient beta-polypeptide. This hgb is
unstable, disintegrates, and damages the erythrocytes. Rapid destruction of the red cells
stimulates rapid production of immature red cells, and the net gain is less than optimally
functioning red cells. Iron from the RBC destruction is stored in the tissues, causing multiple
problems. In thalassemia, immature erythrocytes proliferate, not mature ones. This is a
progressive anemia. The nurse also would note microcytosis and hypochromia
A 12-year-old girl is admitted to the hospital with suspected appendicitis. What nursing
interventions should be implemented preoperatively?
1.Applying a heating pad for 5-minute intervals as prescribed
2.Administering acetaminophen as needed for pain, as prescribed
3.Placing the adolescent in a fetal position, side-lying with legs drawn up to chest
,4.Inserting a nasogastric tube and attaching it to low intermittent suction; measuring drainage as
prescribed - ANS - 3. placing the adolescent in a fetal position, side lying w/ legs drawn up to
chest
RATIONALE:
A pt w/ appendicitis is more comfortable when lying in what is traditionally known as the fetal
position, w/ legs drawn up toward the chest. This flexed positioning assists in decreasing the
pain that comes w/ appendicitis by decreasing the pressure on the abdominal area. A heating
pad can lead to a ruptured appendix. Pain meds are not given to the pt bc they mask the SSx
that accompany a ruptured appendix. A NGT may be necessary post-op for gastric
decompression, or pre-op if perforation occurs.
A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The
nurse expects to provide teaching about which client problem?
1.Odor
2.Nausea
3.Malaise
4.Diarrhea - ANS - 1. odor
RATIONALE:
Encopresis is the repeated voluntary or involuntary passage of feces of normal or near-normal
consistency in places not appropriate for that purpose according to the individual's own
sociocultural setting. SSx include evidence of soiled clothing, scratching or rubbing the anal
area bc of irritation, fecal odor w/o apparent awareness by the child, and social withdrawal
A child admitted to the hospital with a diagnosis of gastroenteritis and dehydration weighs 17
pounds 2 ounces (7.8 kg). The parents state that his preadmission weight was 18 pounds 4
ounces (8.3 kg). Based on weight alone, what type of dehydration does the nurse expect?
1.Mild dehydration
2.Moderate dehydration
3.Severe dehydration
4.Acute dehydration - ANS - 2. mod dehydration
RATIONALE:
Mild dehydration is a weight loss less than 5%; moderate dehydration is 5-10%; severe
dehydration is >10% weight loss. All types of dehydration are acute situations.
A child has been diagnosed with acute otitis media of the right ear. Which interventions should
the nurse include in the plan of care? Select all that apply.
1.Provide a soft diet.
2.Position the child on the left side.
, 3.Administer an antihistamine twice daily.
4.Irrigate the right ear with normal saline every 8 hours.
5.Administer ibuprofen for fever every 4 hours as prescribed and as needed.
6.Instruct the parents about the need to administer the prescribed antibiotics for the full course
of therapy. - ANS - 1. provide soft diet
5. administer ibuprofen for fever q4h as Rx'd and PRN
6. instruct the parents about the need to administer the Rx'd abx for the full course of therapy
RATIONALE:
Acute OM is an inflammatory d/o caused by an infection of the middle ear. The child often has
fever, pain, loss of appetite, and possible ear drainage. The child is also irritable and lethargic
and may roll the head or pull on the or rub the affected ear. Otoscopic exam may reveal a red,
opaque, bulging, and immobile tympanic membrane. Hearing loss may be noted particularly in
chronic OM. The child's fever should be treated with ibuprofen. The child is positioned on his/her
affected side to facilitate drainage. A soft diet is recommended during the acute stage to avoid
pain that can occur w/ chewing. Abx are Rx'd to treat the bacterial infection and should be
administered for the full Rx'd course. The ear should not be irrigated with NS bc it can
exacerbate the inflammation further. Antihistamines are not usually recommended as part of the
therapy
A child is admitted to the pediatric unit with a diagnosis of acute stage Kawasaki disease. Which
assessment findings by the nurse are characteristic of this disorder? Select all that apply.
1.Red throat
2.Cracking lips
3.Conjunctival hyperemia
4.Desquamation of the skin
5.Enlargement of the cervical lymph nodes - ANS - 1. red throat
3. conjuctival hyperemia
5. enlargement of the cervical lymph nodes
RATIONALE:
Kawasaki disease is known as mucocutaneous lymph node syndrome and is an acute systemic
inflammatory disease. Assessment findings in the acute stage include fever, conjunctival
hyperemia, red throat, swollen hands, rash, and enlargement of the cervical lymph nodes.
Desquamation of the skin, cracking lips, joint pain, cardiac manifestations, and thrombocytosis
are characteristics of the subacute stage
A child is brought to the emergency department after being accidentally struck in the lower back
region with a baseball bat. When gathering assessment data, the nurse discovers that the child
has hemophilia. The nurse should immediately assess for which data?
1.Slurred speech
2.Presence of hematuria
A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the
student nurse to describe the disorder. Which statement by the student nurse indicates correct
understanding of this disorder?
1.
"It is an acute bowel obstruction."
2.
"It is a condition that causes an acute inflammatory process in the bowel."
3.
"It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the
bowel."
4.
"It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the
bowel." - ANS - 4. it is a condition in which the proximal segment of the bowel prolapses into a
distal segment of the bowel
A 12-year-old child with newly diagnosed thalassemia is brought to the clinic exhibiting delayed
sexual maturation, fatigue, anorexia, pallor, and complaints of headache. The child seems
listless and small for age and has frontal bossing. What should the nurse expect to note on
review of the results of the laboratory tests?
1.Macrocytosis and hyperchromia
2.Excessive red blood cell production
3.Excessive mature erythrocyte proliferation
4.Deficient production of functional hemoglobin - ANS - 4. deficient production of functional hgb
RATIONALE:
Defective hgb is produced as a result of genetically deficient beta-polypeptide. This hgb is
unstable, disintegrates, and damages the erythrocytes. Rapid destruction of the red cells
stimulates rapid production of immature red cells, and the net gain is less than optimally
functioning red cells. Iron from the RBC destruction is stored in the tissues, causing multiple
problems. In thalassemia, immature erythrocytes proliferate, not mature ones. This is a
progressive anemia. The nurse also would note microcytosis and hypochromia
A 12-year-old girl is admitted to the hospital with suspected appendicitis. What nursing
interventions should be implemented preoperatively?
1.Applying a heating pad for 5-minute intervals as prescribed
2.Administering acetaminophen as needed for pain, as prescribed
3.Placing the adolescent in a fetal position, side-lying with legs drawn up to chest
,4.Inserting a nasogastric tube and attaching it to low intermittent suction; measuring drainage as
prescribed - ANS - 3. placing the adolescent in a fetal position, side lying w/ legs drawn up to
chest
RATIONALE:
A pt w/ appendicitis is more comfortable when lying in what is traditionally known as the fetal
position, w/ legs drawn up toward the chest. This flexed positioning assists in decreasing the
pain that comes w/ appendicitis by decreasing the pressure on the abdominal area. A heating
pad can lead to a ruptured appendix. Pain meds are not given to the pt bc they mask the SSx
that accompany a ruptured appendix. A NGT may be necessary post-op for gastric
decompression, or pre-op if perforation occurs.
A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The
nurse expects to provide teaching about which client problem?
1.Odor
2.Nausea
3.Malaise
4.Diarrhea - ANS - 1. odor
RATIONALE:
Encopresis is the repeated voluntary or involuntary passage of feces of normal or near-normal
consistency in places not appropriate for that purpose according to the individual's own
sociocultural setting. SSx include evidence of soiled clothing, scratching or rubbing the anal
area bc of irritation, fecal odor w/o apparent awareness by the child, and social withdrawal
A child admitted to the hospital with a diagnosis of gastroenteritis and dehydration weighs 17
pounds 2 ounces (7.8 kg). The parents state that his preadmission weight was 18 pounds 4
ounces (8.3 kg). Based on weight alone, what type of dehydration does the nurse expect?
1.Mild dehydration
2.Moderate dehydration
3.Severe dehydration
4.Acute dehydration - ANS - 2. mod dehydration
RATIONALE:
Mild dehydration is a weight loss less than 5%; moderate dehydration is 5-10%; severe
dehydration is >10% weight loss. All types of dehydration are acute situations.
A child has been diagnosed with acute otitis media of the right ear. Which interventions should
the nurse include in the plan of care? Select all that apply.
1.Provide a soft diet.
2.Position the child on the left side.
, 3.Administer an antihistamine twice daily.
4.Irrigate the right ear with normal saline every 8 hours.
5.Administer ibuprofen for fever every 4 hours as prescribed and as needed.
6.Instruct the parents about the need to administer the prescribed antibiotics for the full course
of therapy. - ANS - 1. provide soft diet
5. administer ibuprofen for fever q4h as Rx'd and PRN
6. instruct the parents about the need to administer the Rx'd abx for the full course of therapy
RATIONALE:
Acute OM is an inflammatory d/o caused by an infection of the middle ear. The child often has
fever, pain, loss of appetite, and possible ear drainage. The child is also irritable and lethargic
and may roll the head or pull on the or rub the affected ear. Otoscopic exam may reveal a red,
opaque, bulging, and immobile tympanic membrane. Hearing loss may be noted particularly in
chronic OM. The child's fever should be treated with ibuprofen. The child is positioned on his/her
affected side to facilitate drainage. A soft diet is recommended during the acute stage to avoid
pain that can occur w/ chewing. Abx are Rx'd to treat the bacterial infection and should be
administered for the full Rx'd course. The ear should not be irrigated with NS bc it can
exacerbate the inflammation further. Antihistamines are not usually recommended as part of the
therapy
A child is admitted to the pediatric unit with a diagnosis of acute stage Kawasaki disease. Which
assessment findings by the nurse are characteristic of this disorder? Select all that apply.
1.Red throat
2.Cracking lips
3.Conjunctival hyperemia
4.Desquamation of the skin
5.Enlargement of the cervical lymph nodes - ANS - 1. red throat
3. conjuctival hyperemia
5. enlargement of the cervical lymph nodes
RATIONALE:
Kawasaki disease is known as mucocutaneous lymph node syndrome and is an acute systemic
inflammatory disease. Assessment findings in the acute stage include fever, conjunctival
hyperemia, red throat, swollen hands, rash, and enlargement of the cervical lymph nodes.
Desquamation of the skin, cracking lips, joint pain, cardiac manifestations, and thrombocytosis
are characteristics of the subacute stage
A child is brought to the emergency department after being accidentally struck in the lower back
region with a baseball bat. When gathering assessment data, the nurse discovers that the child
has hemophilia. The nurse should immediately assess for which data?
1.Slurred speech
2.Presence of hematuria
