HESI PEDIATRICS ACTUAL QUESTIONS WITH
VERIFIED SOLUTIONS
◉ 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."
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.
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.
◉ The nurse is assessing an 8-month-old child who has a medical
diagnosis of Tetrology of Fallot. Which symptom is this client most
likely to exhibit?
Bradycardia.
Machinery murmur.
Weak pedal pulses.
Clubbed fingers.
Answer: Clubbed fingers.
,Tetrology of Fallot, a cyanotic heart defect, causes clubbing of fingers
and toes (D) due to tissue hypoxia. Tachycardia, not (A), is a
manifestation of congenital heart disease. (B) is a classic sign of
ventricular septal defect. (C) is characteristic of coarctation of the
aorta.
◉ Surgery is being delayed for an infant with undescended testes. In
collaboration with the healthcare provider and the family, which
prescription should the nurse anticipate?
A trial of adrenocorticotrophic hormone injections.
Frequent stimulation of the cremasteric reflex.
A trial of human chorionic gonadotrophic hormone.
Frequent warm baths to gently dilate the scrotal area.
Answer: A trial of human chorionic gonadotrophic hormone.
A trial of HCG (human chorionic gonadotrophic hormone) (C) may
aid in testicular descent, but does not replace surgical repair for true
undescended testes. Undescended testes (cryptorchidism) may be
found in the inguinal canal due to exaggerated cremasteric reflex.
(A) is not indicated. Stimulation of the cremasteric reflex causes the
testes to ascend rather than descend in the scrotum (B). (D) may
relax the cremasteric muscle, but may not cause the testes to
descend.
, ◉ A preschool-age child who is hospitalized for hypospadias repair
is most strongly influenced by which behavior?
Ability to communicate verbally.
Response to separation from family.
Concern for body integrity.
Socialization with other children.
Answer: Concern for body integrity.
The preschooler's major stressor is concern for his body integrity
(C). He fears that his "insides will leak out." A child undergoing
surgery to his genitalia is even more concerned about body integrity.
The preschooler is quite verbal, so comprehension of the words he
uses or hears may be inaccurate, while his imagination and fears
may fantasize the reality (A). (B) is a concern for all children, but of
most concern to the toddler. (D) is not a prime concern in this
situation.
◉ A six-month-old returns from surgery with elbow restraints in
place. What nursing care should be included when caring for any
restrained child?
Keep restraints on at all times.
Remove restraints one at a time and provide range of motion
exercises.
Remove all restraints simultaneously and provide play activities.
VERIFIED SOLUTIONS
◉ 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."
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.
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.
◉ The nurse is assessing an 8-month-old child who has a medical
diagnosis of Tetrology of Fallot. Which symptom is this client most
likely to exhibit?
Bradycardia.
Machinery murmur.
Weak pedal pulses.
Clubbed fingers.
Answer: Clubbed fingers.
,Tetrology of Fallot, a cyanotic heart defect, causes clubbing of fingers
and toes (D) due to tissue hypoxia. Tachycardia, not (A), is a
manifestation of congenital heart disease. (B) is a classic sign of
ventricular septal defect. (C) is characteristic of coarctation of the
aorta.
◉ Surgery is being delayed for an infant with undescended testes. In
collaboration with the healthcare provider and the family, which
prescription should the nurse anticipate?
A trial of adrenocorticotrophic hormone injections.
Frequent stimulation of the cremasteric reflex.
A trial of human chorionic gonadotrophic hormone.
Frequent warm baths to gently dilate the scrotal area.
Answer: A trial of human chorionic gonadotrophic hormone.
A trial of HCG (human chorionic gonadotrophic hormone) (C) may
aid in testicular descent, but does not replace surgical repair for true
undescended testes. Undescended testes (cryptorchidism) may be
found in the inguinal canal due to exaggerated cremasteric reflex.
(A) is not indicated. Stimulation of the cremasteric reflex causes the
testes to ascend rather than descend in the scrotum (B). (D) may
relax the cremasteric muscle, but may not cause the testes to
descend.
, ◉ A preschool-age child who is hospitalized for hypospadias repair
is most strongly influenced by which behavior?
Ability to communicate verbally.
Response to separation from family.
Concern for body integrity.
Socialization with other children.
Answer: Concern for body integrity.
The preschooler's major stressor is concern for his body integrity
(C). He fears that his "insides will leak out." A child undergoing
surgery to his genitalia is even more concerned about body integrity.
The preschooler is quite verbal, so comprehension of the words he
uses or hears may be inaccurate, while his imagination and fears
may fantasize the reality (A). (B) is a concern for all children, but of
most concern to the toddler. (D) is not a prime concern in this
situation.
◉ A six-month-old returns from surgery with elbow restraints in
place. What nursing care should be included when caring for any
restrained child?
Keep restraints on at all times.
Remove restraints one at a time and provide range of motion
exercises.
Remove all restraints simultaneously and provide play activities.
