Exam, Pediatrics HESI PN Review
Questions And Answers
+1uStationu-uCORRECTuuANSWER-presentingupartuisu1ucmubelowutheuischialuspines
+3/+4uStationu-uCORRECTuuANSWER-presentingupartuisuvisibleuatutheuvaginaluopening
0ustationu-uCORRECTuuANSWER-presentingupartuisuenteringutheupelvicuinlet
2uyearuolduisuadmittedutoutheuhospitaluwithupossibleuencehalitis,uanduaulumbarupunctureuisus
cheduled.uWhichuinformationushouldutheunurseuprovideuthisuchilduconcerningutheuprocedur
e?u-uCORRECTuuANSWER-Describeuheuside-
lying,ukneesutouchestupositionuthatumustubeuassumeduduringutheuproceudure
Au12-year-
olduwithutypeu1udiabetesumellitusucomplainsuofuabdominalupainuanduhasuexperienceduincre
aseduthirstuduringutheupreviousu24uhours.uWhatuactionushouldutheupracticalunurseuimpleme
ntufirst?
a.Obtainublooduforuaucompleteublooducountu(CBC)utest.
b.InitiateuD10W uatu50umL/houruIV.
c.Testuurineuforuketonesuanduglucose.
d.Assessutemperatureuandubloodupressure.u-uCORRECTuuANSWER-
c.Testuurineuforuketonesuanduglucose.
Rationale:Thisuchilduisuexhibitingusignsuofuimpendingudiabeticuketoacidosisu(DKA),usoutheuc
hild'suurineushouldubeutesteduforuketonesuanduglucoseutouassessuforuDKA.
Au12-year-
olduwithutypeu1udiabetesumellitusucomplainsuofuabdominalupainuanduhasuexperienceduincre
aseduthirstuduringutheupreviousu24uhours.uWhatuactionushouldutheupracticalunurseuimpleme
ntufirst?u-uCORRECTuuANSWER-Testuurineuforuketonesuanduglucose.
Au14-
weekugestationaluclient,uwhouweighedu125upoundsubeforeupregnancy,ucomesuintoutheuhealt
huclinicuforuauprenataluappointment.uTheuclient'suweightutodayuisu129upounds.uWhatuactionus
houldutheupracticalunurseu(PN)uimplement?u-uCORRECTuuANSWER-
Documentutheufindinguinutheumedicalurecord.
,Au15-year-
oldumaleuwithumildumentaluretardationuwhouisuhospitalizeduforuminorusurgeryutellsuaufemaleu
practicalunurseu(PN),u"Wow,uyouuhaveubiguones."uWhichuresponseuisubestuforutheuPNutouma
ke?
a.u"Douyouureallyuthinkuso?"
b.u"Thatulanguageuisunotupermitted."
c.u"Youushoulduntuspeakutoumeulikeuthat,usuchulanguageuoffendsume."
d.u"Illunotifyuyouruparentsuifuyouucontinueutoutalkuthatuway."u-uCORRECTuuANSWER-
b.u"Thatulanguageuisunotupermitted."
Rationale:Limitusettinguisunecessaryuforuinappropriateubehavioruorusuggestiveuinteraction.u
Setsulimitsuwithoututhreateninguorudegradingutheuclient.
Au15-year-
oldumaleuwithumildumentaluretardationuwhouisuhospitalizeduforuminorusurgeryutellsuaufemaleu
practicalunurseu(PN),u"Wow,uyouuhaveubiguones."uWhichuresponseuisubestuforutheuPNutouma
ke?u-uCORRECTuuANSWER-Thatulanguageuisunotupermitted."
Au16uyearuoldufemaleustudentuwithuauhistoryuofuasthmaucontrolleduwithubothuanuoraluantihist
amineuanduanualbuterolu(Provenfil)umetre-
doseuinhaleru(MDI)ucomesutoutheuschoolunurse.uTheustudentucomplainsuthatusheucannotusle
epuatunight,ufeelsushakyuanduheruheartufeelsulikeuituisu"beatinguaumileuperuminute"uWhichuinfo
rmationuisumostuimportantuforutheunurseutouobtain?u-uCORRECTuuANSWER-
HowuoftenutheuMDIuisuusedudaily
Au16uyearuoldumaleuwhouhasubeenutreateduinutheupastuforuauseizureudisorderuisuadmittedutout
heuhospital.uImmediatelyuafteruadmissionuheubeginsutouhaveuauGranduMaluseizure.uWhichua
ctionushouldutheunurseutake?u-uCORRECTuuANSWER-observeuhimucarefully
Au2uyearuolduboyubeginsutoucryuwhenutheumotherustartsutouleave.uWhatuisutheunurse'subesture
sponseutoutheusituation?u-uCORRECTuuANSWER-letumeureaduthisubookutouyou
Au2uyearuolduchilduwhouisuhospitalizeduhasubecomeuwithdrawnuanduquietuonutheufourthudayu
afteruadmission.uTheuparentuexpressesuconcernuaboututhisuchangeuinubehavior.uWhichuexp
lanationushouldutheupracticalunurseu(PN)uprovide?uTheuchilduis
a)uExperiencingutheudespairustageuofuseparation
b)uDetachinguemotionallyufromutheufamily
c)uProtestingutheuseparationufromutheuparents
d)uAdjustingutouhospitalizationu-uCORRECTuuANSWER-Answer:uA
Rationale:
Inutheudespairustageuofuseparationu(A),utheuchilduexhibitsusignsuofuhopelessnessuandubeco
mesuquiet,uwithdrawn,uanduapathetic.uToddlersudounotureadilyu"adjust"utouhospitalizationu(D
)uanduseparationufromucaregivers.uDuringutheudetachmentustageu(B)uwhichuoccursuafterupro
,longeduseparation,utheuchildubecomesuinteresteduinutheuenvironmentuandubeginsutouplay.uIn
utheuprotestustageu(C),utheuchilduisulikelyutoucryuanduresistucareubyuothers,uanduisuinconsolabl
e.
Au2uyearuolduchilduwithuHFuisuadmitteduforureplacementuofuaugraftuforucoarcionuofutheuaorta.u
Priorutouadministeringutheunextudoseuofudigoxinu(Lanoxin)utheunurseuobtainsuanduapicaluhea
rturateuatu128ubpm.uWhatuactionushouldutheunurseuimplement?u-uCORRECTuuANSWER-
Administerutheuscheduledudose
Au2-month-
olduinfantuisuscheduledutoureceiveutheufirstuDPTuimmunization.uWhatuisutheupreferreduinjecti
onusiteutouadministeruthisuimmunization?
a.uDorsalugluteal
b.uVastusulateralis
c.uVentralugluteal
d.uDeltoidu-uCORRECTuuANSWER-b.uVastusulateralis
Rationale:Theupreferreduintramuscularusiteuforuchildrenuyoungeruthanu2uyearsuofuageuisutheu
vastusulateralis.
Au2-month-
olduinfantuisuscheduledutoureceiveutheufirstuDPTuimmunization.uWhatuisutheupreferreduinjecti
onusiteutouadministeruthisuimmunization?u-uCORRECTuuANSWER-Vastusulateralis
Au2-year-
olduchilduhadutympanostomyuventilatingutubesuinserteduintoubothutympanicumembranesu(T
Ms)u1uweekuearlier.uDuringuaupostoperativeuclinicuvisit,utheupracticalunurseu(PN)unotesuthatut
heuchilduhasuaupurulentudischargeufromutheurightuear,uandutheumotheruexplainsuthatutheutodd
leruhasuhaduaucolduforu3udays.uWhatuactionushouldutheuPNuimplement?u-
uCORRECTuuANSWER-Collectuauspecimenuofutheuotorrheauforuculture.
Au2-year-
olduchilduhadutympanostomyuventilatingutubesuinserteduintoubothutympanicumembranesu(T
Ms)u1uweekuearlier.uDuringuaupostoperativeuclinicuvisit,utheupracticalunurseu(PN)unotesuthatut
heuchilduhasuaupurulentudischargeufromutheurightuear,uandutheumotheruexplainsuthatutheutodd
leruhasuhaduaucolduforu3udays.uWhatuactionushouldutheuPNuplanutouimplement?
a.uCollectuauspecimenuofutheuotorrheauforuculture.
b.uReferutheuchilduforuaudiologicuscreeningutests.
c.uAdministeruprescribeduantibiotics.
d.uPerformuanuotoscopicuexamuforuTMutubeuplacement.u-uCORRECTuuANSWER-
a.uCollectuauspecimenuofutheuotorrheauforuculture.
Rationale:Theupresenceuofutheupurulentudrainageuindicatesuthatutheumiddleuearuisudrainingu
aunewuinfectiousuprocess,uanduauspecimenuofutheuotorrheaushouldubeucollecteduforuculture.u
Tympanostomyutubesuareusurgicallyuplacedutoumanageuotitisumediauwithueffusionu(OME)uto
uprovideumechanicaludrainageuofufluiduandutouequalizeupressureuwithinutheumiddleuear.uChr
, onicuOMEucanuimpedeuTMuanduossicleufunction,unecessitatinguhearinguscreening.uTheuim
mediateuproblem,uhowever,uisuinfection.
Au2-year-
olduchilduwhouisuhospitalizeduwithuanuacuteuupperurespiratoryuinfectionu(URI)uisucryinguunco
ntrollablyubecauseuherumotheruwentutoutheucafeteriauforulunch.uWhichuactionushouldutheupra
cticalunurseuimplement?
a.uDistractutheuchilduwithuaufavoriteutoy.
b.uTellutheuchilduthatuherumotheruwillureturn.
c.uTakeutheuchildutoutheucafeteria.
d.uCalmutheuchilduwithuaudietaryutreat.u-uCORRECTuuANSWER-
a.uDistractutheuchilduwithuaufavoriteutoy.
Rationale:Theubestuactionuisutourefocusutheuchild'suattentionubyudistractinguwithuaufavoriteuto
y.
Au2-year-
olduchilduwhouisuhospitalizeduwithuanuacuteuupperurespiratoryuinfectionu(URI)uisucryinguunco
ntrollablyubecauseuherumotheruwentutoutheucafeteriauforulunch.uWhichuactionushouldutheupra
cticalunurseuimplement?u-uCORRECTuuANSWER-Distractutheuchilduwithuaufavoriteutoy.
Au3uyearuolduboyucries,ukicks,uanduclingsutouhisufatheruwhenutheuparentsutryutouleaveutheuhos
pitaluroom.uTheuparentsuexpressutheiruconcernutoutheupracticalunurseu(PN).uWhaturesponseu
shouldutheuPNuprovide?
a)u"Ituisunotuhelpfuluforuparentsutoustayuwithuchildrenuduringuhospitalization."
b)u"Youruchild'subehavioruindicatesuauneeduforuaupsychologicaluconsultation."
c)u"Youucanuavoiduthisuifuyouuwaitutouleaveuafteruyouruchildufallsuasleep."
d)u"Youruchilduisushowinguaunormaluresponseutoutheustressuofuhospitalization."u-
uCORRECTuuANSWER-Answer:uD
Rationale:
Theuchilduisuexhibitinguauhealthyuattachmentutoutheufatheru(D).uLeavinguwhileuyouruchilduisua
sleepucreatesumistrustuinutheuchildu(C).uTouminimizeutheuchild'sustressuhospitalupolicyuoftenu
requireusomeoneutoustayuwithutheiruchilduduringuhospitalization,unotu(A).uTheuchild'subehavi
orurepresentsutheuprotestustageuofuseparationuandudoesunoturepresentumaladaptiveubehavi
oru(B).
Au3uyearuolduboyuinuaudaycareufacilityuscratchesuhisuheadufrequentlyuandutheunurseuconfirm
sutheupresenceuofuheadulice.uTheunurseuwashesutheuchild'suhairuwithupermethrinu(Nix)usham
poouanducalluhisuparents.uWhatuinstructionsushouldutheunurseuprovideutoutheuparentsuaboutu
treatmentuofuheadulice?u-uCORRECTuuANSWER-
Washutheuchild'subedulinensuanduclothinguinuhotusoapyuwater