PEDIATRICS Exam
HESI RN PEDIATRICS V3 3 FULL SET EXAMS WITH
CORRECT ANSWERS (NGN-STYLE QUESTIONS &
CASE SCENARIOS) Answers with detailed
Rationale
A 3-month-old infant returns from surgery with elbow restraints and a Logan's bow over a cleft lip suture line.
Which intervention should the nurse implement to maintain suture line integrity during the initial postoperative
period?
A.Place the infant upright in an infant seat position.
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PEDIATRICS Exam
B.Provide mittens with the use of elbow restraints.
C.Use soft rubber catheters for nasal suctioning.
D.Apply water-soluble lubricant to the suture line. - Correct Answer :ANS: A
The use of an infant seat simulates a supine position with the head elevated (A) and also prevents aspiration.
Prone positioning should be avoided to prevent disruption of the protective Logan's bow and prevent the infant
from rubbing the face on the bed surface. Mittens (B) are not necessary and decrease the ability to provide
sensory comfort, such as hand holding. Nasal suctioning (C) should be avoided to prevent trauma or dislodging
clots at the surgical site. Water-soluble lubricant (D) will dry the suture line and cause crusting, which
predisposes the suture line to poor healing and scarring.
Which nursing diagnosis has the highest priority when planning care for an infant with eczema?
A.High risk for altered parenting related to feelings of inadequacy
B.Altered comfort (pruritus) related to vesicular skin eruptions
C.Altered health maintenance related to knowledge deficit of treatment
D.Risk for impaired skin integrity related to eczema - Correct Answer :ANS: B
Altered comfort (pruritus) (B) has the highest priority because itching will cause the infant to scratch, creating
complications such as scarring or infection. (A, C, and D) are all important nursing diagnoses and should be
considered when developing the infant's plan of care, but they do not have the priority of (B).
A mother calls the clinic because her 6-year-old son, who has been taking prescribed antibiotics for 7 of the
previous 10 days, continues to have a cough that she reports is worsening. Further questioning by the nurse
reveals that the cough is nonproductive. What advice should the nurse provide to this mother?
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PEDIATRICS Exam
A.Watch the boy a few more days and see if the cough begins to produce sputum.
B.The full 10-day course of antibiotics must be completed before effectiveness can be evaluated.
C.Give the child plenty of fluids and an over-the-counter cough suppressant.
D.Bring the child to the clinic today for an examination related to the cough. - Correct Answer :ANS: D
The child should be evaluated as soon as possible for pneumonia (D). Antibiotics usually improve symptoms
during the first few days of treatment but should be continued for the full prescribed course. A continued cough
after 7 days of antibiotic treatment may indicate an infectious process in the lower lungs, which could cause a
nonproductive cough. Children with pneumonia can deteriorate unexpectedly and rapidly and can become
seriously ill, with no sputum production (A). (B) delays evaluation too long. Although giving fluids is advisable,
cough suppressants might mask symptoms of a serious condition (C).
A 6-month-old male infant is admitted to the postanesthesia care unit with elbow restraints in place. He has an
endotracheal tube and is ventilator-dependent but will be extubated soon following recovery from anesthesia.
Which nursing intervention should be included in this child's plan of care?
A.Keep restraints on at all times to prevent unplanned extubation.
B.Remove restraints one at a time and provide range-of-motion exercises.
C.Remove all restraints simultaneously and provide play activities.
D.Document the reason for application of the restraints every 72 hours. - Correct Answer :ANS: B
Removing restraints one at a time (B) is safer than (C). The infant should have the restrained extremities
assessed frequently for signs of neurologic or vascular impairment, and range-of-motion exercises should be
performed with these assessments. Under no circumstances should restraints be applied to the client
continuously (A). Documentation of assessment findings regarding the restrained extremities must occur much
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PEDIATRICS Exam
more frequently than every 72 hours (D); however, the reason for using restraints must be justified and should
be stated in the medical record.
The nurse is assessing a male adolescent client's knowledge of contraception. The teen states, "I have all the
info I need." What is the best response by the nurse?
A."Tell me what you know about birth control."
B."Do you know how to apply a condom?"
C."Teen pregnancy should not be taken lightly."
D."You need to visit with your guidance counselor." - Correct Answer :ANS: A
Teens often obtain information from peers, which may not be accurate. Knowing the source of the information
may assist the nurse in evaluating the information that the teenager has regarding contraception (A). It would
be best for the nurse to ask a more general question, such as (A). (B) is narrow in focus. (C and D) are blocks to
any further communication.
In making the initial assessment of a 2-hour-old infant, which finding should lead the nurse to suspect a
congenital heart defect?
A.Irregular respiration and heart rate
B.Gagging
C.Blue feet and hands
D.Diminished femoral pulses - Correct Answer :ANS: D
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