Pediatrics HESI Questions and Correct
Answers
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. |- |CORRECT |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. |- |CORRECT |
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. |- |CORRECT |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. |- |CORRECT |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 |recognizes |that |surgical |correction |is |designed |to |achieve |which |outcome?
,| Stop |the |flow |of |unoxygenated |blood |into |systemic |circulation.
| Increase |the |flow |of |unoxygenated |blood |to |the |lungs. |
| Prevent |the |return |of |oxygenated |blood |to |the |lungs. |
|Reduce |peripheral |tissue |hypoxia |and |nailbed |clubbing |- |CORRECT |ANSWER✔✔-Prevent |the |
return |of |oxygenated |blood |to |the |lungs. |
Closure |of |VSDs |stops |oxygenated |blood |from |being |shunted |from |the |left |ventricle |to |the |
right |ventricle |(C). |VSDs |are |acyanotic |defects, |which |means |that |no |unoxygenated |blood |
enters |the |systemic |circulation |(A |and |B). |(D) |is |common |with |Tetrology |of |Fallot, |which |is |a |
cyanotic |defect.
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 |murmur |characteristic |of |a |ventricular |septal |defect |(VSD), |and |finds |the |
newborn |is |acyanotic |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.)
A. |Monitor |the |the |infant's |weight |and |number |of |wet |diapers |per |day. |
B. |Increase |the |infant's |intake |per |feeding |by |1 |to |2 |ounces |per |week. |
C. |Mix |the |dose |of |prophylactic |antibiotic |in |a |full |bottle |of |formula.
D. |Allow |the |infant |to |rest |and |refeed |on |demand |or |every |2 |hours.
E. |Use |a |softer |nipple |or |increase |the |size |of |the |nipple |opening. |- |CORRECT |ANSWER✔✔-A. |
Monitor |the |the |infant's |weight |and |number |of |wet |diapers |per |day.
B. |Increase |the |infant's |intake |per |feeding |by |1 |to |2 |ounces |per |week. |
D. |Allow |the |infant |to |rest |and |refeed |on |demand |or |every |2 |hours.
E. |Use |a |softer |nipple |or |increase |the |size |of |the |nipple |opening.
Antibiotic |prophylaxis |is |recommended |for |infants |with |VSDs, |but |should |not |be |mixed |in |a |
bottle |of |formula |(C) |because |it |is |difficult |to |ensure |that |the |total |dose |is |consumed.
, They |should |be |monitored |for |weight |gain |and |at |least |6 |wet |diapers |per |day |(A). |A |one-
month |old |infant |should |ingest |2 |to |4 |ounces |of |formula |per |feeding |and |progress |to |about |30
|ounces |per |day |by |4-months |of |age |(B)
Preoperative |nursing |care |for |a |child |with |Wilms' |tumor |should |include |which |intervention?
| Gently |percuss |the |abdomen |for |evidence |of |trapped |air.
| Observe |the |abdomen |for |any |noticeable |discolorations.
| Apply |cold |compresses |to |the |abdomen |to |reduce |edema.
|Put |a |sign |on |the |bed |reading, |"DO |NOT |PALPATE |ABDOMEN." |- |CORRECT |ANSWER✔✔-Put |a |
sign |on |the |bed |reading, |"DO |NOT |PALPATE |ABDOMEN."
Prevention |of |abdominal |palpation |(D) |minimizes |the |risk |of |rupturing |the |encapsulated |tumor
|and |subsequent |metastasis. |(A) |is |unnecessary, |and |this |action |could |traumatize |the |tumor |in |
the |same |manner |as |palpation. |(B |and |C) |are |incorrect |since |the |abdomen |is |not |discolored |
and |cold |compresses |are |not |indicated.
At |8 |a.m. |the |unlicensed |assistive |personnel |(UAP) |informs |the |charge |nurse |that |a |female |
adolescent |client |with |acute |glomerulonephritis |has |a |blood |pressure |of |210/110. |The |4 |a.m. |
blood |pressure |reading |was |170/88. |The |client |reports |to |the |UAP |that |she |is |upset |because |
her |boyfriend |did |not |visit |last |night. |What |action |should |the |nurse |take |first?
| Give |the |client |her |9 |a.m. |prescription |for |an |oral |diuretic |early.
| Administer |PRN |prescription |of |nifedipine |(Procardia) |sublingually. |
| Notify |the |healthcare |provider |and |inform |the |nursing |supervisor |of |the |client's |condition.
|Attempt |to |calm |the |client |and |retake |the |blood |pressure |in |thirty |minutes. |- |CORRECT |
ANSWER✔✔-Administer |PRN |prescription |of |nifedipine |(Procardia) |sublingually.
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.
Answers
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. |- |CORRECT |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. |- |CORRECT |
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. |- |CORRECT |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. |- |CORRECT |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 |recognizes |that |surgical |correction |is |designed |to |achieve |which |outcome?
,| Stop |the |flow |of |unoxygenated |blood |into |systemic |circulation.
| Increase |the |flow |of |unoxygenated |blood |to |the |lungs. |
| Prevent |the |return |of |oxygenated |blood |to |the |lungs. |
|Reduce |peripheral |tissue |hypoxia |and |nailbed |clubbing |- |CORRECT |ANSWER✔✔-Prevent |the |
return |of |oxygenated |blood |to |the |lungs. |
Closure |of |VSDs |stops |oxygenated |blood |from |being |shunted |from |the |left |ventricle |to |the |
right |ventricle |(C). |VSDs |are |acyanotic |defects, |which |means |that |no |unoxygenated |blood |
enters |the |systemic |circulation |(A |and |B). |(D) |is |common |with |Tetrology |of |Fallot, |which |is |a |
cyanotic |defect.
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 |murmur |characteristic |of |a |ventricular |septal |defect |(VSD), |and |finds |the |
newborn |is |acyanotic |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.)
A. |Monitor |the |the |infant's |weight |and |number |of |wet |diapers |per |day. |
B. |Increase |the |infant's |intake |per |feeding |by |1 |to |2 |ounces |per |week. |
C. |Mix |the |dose |of |prophylactic |antibiotic |in |a |full |bottle |of |formula.
D. |Allow |the |infant |to |rest |and |refeed |on |demand |or |every |2 |hours.
E. |Use |a |softer |nipple |or |increase |the |size |of |the |nipple |opening. |- |CORRECT |ANSWER✔✔-A. |
Monitor |the |the |infant's |weight |and |number |of |wet |diapers |per |day.
B. |Increase |the |infant's |intake |per |feeding |by |1 |to |2 |ounces |per |week. |
D. |Allow |the |infant |to |rest |and |refeed |on |demand |or |every |2 |hours.
E. |Use |a |softer |nipple |or |increase |the |size |of |the |nipple |opening.
Antibiotic |prophylaxis |is |recommended |for |infants |with |VSDs, |but |should |not |be |mixed |in |a |
bottle |of |formula |(C) |because |it |is |difficult |to |ensure |that |the |total |dose |is |consumed.
, They |should |be |monitored |for |weight |gain |and |at |least |6 |wet |diapers |per |day |(A). |A |one-
month |old |infant |should |ingest |2 |to |4 |ounces |of |formula |per |feeding |and |progress |to |about |30
|ounces |per |day |by |4-months |of |age |(B)
Preoperative |nursing |care |for |a |child |with |Wilms' |tumor |should |include |which |intervention?
| Gently |percuss |the |abdomen |for |evidence |of |trapped |air.
| Observe |the |abdomen |for |any |noticeable |discolorations.
| Apply |cold |compresses |to |the |abdomen |to |reduce |edema.
|Put |a |sign |on |the |bed |reading, |"DO |NOT |PALPATE |ABDOMEN." |- |CORRECT |ANSWER✔✔-Put |a |
sign |on |the |bed |reading, |"DO |NOT |PALPATE |ABDOMEN."
Prevention |of |abdominal |palpation |(D) |minimizes |the |risk |of |rupturing |the |encapsulated |tumor
|and |subsequent |metastasis. |(A) |is |unnecessary, |and |this |action |could |traumatize |the |tumor |in |
the |same |manner |as |palpation. |(B |and |C) |are |incorrect |since |the |abdomen |is |not |discolored |
and |cold |compresses |are |not |indicated.
At |8 |a.m. |the |unlicensed |assistive |personnel |(UAP) |informs |the |charge |nurse |that |a |female |
adolescent |client |with |acute |glomerulonephritis |has |a |blood |pressure |of |210/110. |The |4 |a.m. |
blood |pressure |reading |was |170/88. |The |client |reports |to |the |UAP |that |she |is |upset |because |
her |boyfriend |did |not |visit |last |night. |What |action |should |the |nurse |take |first?
| Give |the |client |her |9 |a.m. |prescription |for |an |oral |diuretic |early.
| Administer |PRN |prescription |of |nifedipine |(Procardia) |sublingually. |
| Notify |the |healthcare |provider |and |inform |the |nursing |supervisor |of |the |client's |condition.
|Attempt |to |calm |the |client |and |retake |the |blood |pressure |in |thirty |minutes. |- |CORRECT |
ANSWER✔✔-Administer |PRN |prescription |of |nifedipine |(Procardia) |sublingually.
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.
