2022 HESI RN PEDS_merged

2022 HESI Pediatric (PEDS) RN Exit Exam: V1 & V2 1 = A 2 = D 3 = B 4 = A 5 = A 6 = C 7 = D 8 = C 9 = A 10 = A or B? 11 = A (I believe) 12 = B 13 = C 14 = B, C, E (I believe) 15 = A 16 = D 17 = B 18 = B 19 = C 20 = D 21 = D (I believe) 22 = C 23 = D 24 = B 25 = not sure on this one?! 26 = C 27 = C 28 = I put B ( but I’m not sure) (not sure on this one?) 31 = D 33 = D (I believe) 34 = C 35 = B 36 = B (Believe) 37 = C (I believe) 38 = A 39 = D 40 = (not sure on this one? Couldn’t find online) 41 = A 42 = A 43 = D 44 = B 48 = D 49 = C 51 = (not sure couldn’t find it online) 53 = B ( I think) 54 = A 2022 HESI Pediatric (PEDS) RN Exam 1. The nurse is caring for a 3-year-old child who is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding is an indication of arterial obstruction? Right foot is cool to the touch and appears pale and blanched 2. An infant with Tetralogy of Fallot becomes acutely cyanotic and hyperpneic. Which action should the nurse implement first? Place the infant in a knee- chest position 3. A child admitted with diabetic ketoacidosis is demonstrating Kussmaul respirations. The nurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration? Metabolic Acidosis 4. Patient with diarrhea for 3 days – what does this cause? Metabolic Alkalosis? 5. Which drink choice on a hot day indicates to the nurse that a teenager with sickle cell anemia understands dietary considerations related to the disease? Lemonade 6. The HR for a 3-year-old with CHF has steadily decreased over the last few hours, now is 76 bpm, the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a heDaolwtnhlcoaadreedpbryo: vCiHdReIrS?JABYP|7m0a/ 7. 2-year-old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure? Describe he side-lying, knees to chest position that must be assumed during the procedure 8. Patient has low platelets. Bleeding precaution 9. The nurse is assessing an infant with pyloric stenosis. Which pathophysiological mechanism is the most likely consequence of this infant's clinical picture? Metabolic Alkalosis 10. A month old girl is brought to the clinic by her mother because she has had a cold for 2 to 3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress? Flaring of the nares 11. During a well-baby visit the parents explain that the soft bulge appears in the groin of their 4 month old son when he cries or strains with stool. The infant is scheduled for surgical repair of the inguinal hernia in 2 weeks. The parent should be instructed to take which measure if the hernia becomes incarcerated prior to surgery? Gently manipulate the hernia for reduction 12. The nurse is developing the plan of care for a hospitalized child with von Willebrand disease. What priority nursing intervention should be included in this child’s plan of care? Guard against bleeding injuries 13. How should then nurse instruct the parents of a 4-month-old with seborrheic dermatitis (cradle cap) to shampoo the child’s hair? use a soft brush and gently scrub the area 14. The mother of a one-month-old calls the clinic to report that the back of her infant’s head is flat. How should the nurse respond? Position the infant on the stomach occasionally when awake and active 15. A 7-year-old child is admitted to the hospital with acute glomerulonephritis (AGN). When obtaining the nursing history which finding should the nurse expect to obtain? A recent strep throat infection 16. In assessing a 10-year-old newly diagnosed with osteomyelitis, which information is most for the nurse to obtain? recent recurrence of infection 17. A mother brings her 8-month-old baby boy to the clinic because he has been vomiting and had diarrhea for the last 3 days. Which assessment is more important for the nurse to make? Measure the infant's pulse. 18. Following admission for a cardiac catheterization, the nurse is providing discharge teaching to the parents of a 2-year-old toddler with Tetralogy of Fallot. What instruction should the nurse give the parents if their child becomes pale, cool, and lethargic? Contact their healthcare provider immediately. 19. A mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2 F. Which intervention should the nurse implement? Ask the mother if the child has had a runny nose 20. During a follow-up clinical visit a mother tells the nurse that her 5-month-old son who had surgical correction for Tetralogy of Fallot has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held and his growth is in the expected range. Which intervention should the nurse implement? Auscultate heart and lungs while infant is held. 21. An adolescent's mother calls the primary HCP's office to inquire about the results of her daughter's serum test results that were drawn last week. Since it is the teenager's 18th birthday, how should the nurse respond to this mother's inquiry? Explain that the information cannot be released without the 18-year old’s permission 22. Albumin 25% IV is prescribed for a child with nephrotic syndrome. Which assessment finding indicates to the nurse that the medication is having the desired effect? Reduction of edema 23. An infant with Tetralogy of Fallot becomes acutely cyanotic and hyperpneic. Which action should the nurse implement first? Place the infant in a knee- chest position 24. A 3-month-old with myelomeningocele and atonic bladder is catheterized every 4 hours to prevent urinary retention. The home health nurse notes that the child has developed episodes of sneezing, urticaria, watery eyes, and a rash in the diaper area. What action is most important for the nurse to take? Change to latex-free gloves when handling infant 25. The nurse is examining an infant for possible cryptorchidism. Which exam technique should be used? Place the infant in a warm room and use a calm approach 26. In caring for an client with acute epiglottitis, which nursing action takes priority? Prepare for endotracheal intubation 27. A toddler with hemophilia is being discharged from the hospital. Which teaching should the nurse include in the discharge instructions to the mother? Apply padding on the sharp corners of the furniture 28. When caring for a child sickle cell disease, the nurse knows that the child will most likely exhibit which sign when experiencing a sickle cell crisis? Pain 29. The nurse is administering an oral medication to a reluctant preschool-age boy. Which intervention should the nurse implement? Use straightforward approach with the child 30. The nurse is planning care for a newborn infant scheduled for a cardiac catheterization. Which occurrence poses the greatest risk for this child? Acute hemorrhage from the entry site of the catheter after the procedure 31. A mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2 F (38 C). Which intervention should the nurse implement? Ask the mother if the child has had a runny nose 32. The parents of a 4 week-old infant phone the pediatric clinic to report that their infant eats well but vomits after each feeding. To differentiate between normal regurgitation and pyloric stenosis, which information is most important for the nurse to obtain? Degree of forcefulness of vomiting episodes 33. The teacher notifies the school nurse that a child's nose is bleeding for no apparent reason. What action should the nurse implement first? Pinch the nose using thumb and finger for 10 minutes 34. A hospitalized child stiffens and stars to seize as the nurse enters the room. What actions should the nurse take? (Select all apply) • Turn client to the side if possible • Pad side rails with available pillows and blankets • Monitor duration and progress of the seizure 35. A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents? The chorea or movements are temporary and will eventually disappear 36. A 9-year-old boy is diagnosed with diabetes mellitus Type 1. Which stage of Erikson's theory of psychosocial development is the nurse addressing when teaching this client about insulin injections? Industry 37. The nurse is assessing an 8-month-old who has a cough, axillary temperature of 100 F, and rhinorrhea. What information is most important for the nurse to obtain from this child's mother? Immunization status of the infant 38. A breast-feeding mother returns to work when her infant is 5 months old. She is having difficulty pumping enough milk to meet her infant's dietary requirements. Which suggestion should the nurse provide to this mother? Supplement with an iron-rich formula 39. A child with possible Duchenne muscular dystrophy (DMD) undergoes an electromyogram (EMG). Following the procedure, the child's parents tell the nurse that the child is complaining of sore muscle. How should the nurse respond? Offer reassurance that muscle soreness following these procedures is temporary and does not indicate a problem 40. The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours and is now at 76 beats/minute; the previous reading 4 hours ago was 110 beats/minute. Which additional clinical finding should be reported immediately to the healthcare provider? Blood pressure of 70/40 41. A 12-year-old is admitted to the hospital with possible encephalitis, and a lumbar puncture is schedule. Which information should the nurse provide concerning to this procedure? Describe the side-lying, knee to the chest position that must be assumed during the procedure 42. A child who has been vomiting for 3 days is admitted for correction of fluid and electrolyte imbalances. What acid base imbalance is this child likely to exhibit? Metabolic alkalosis 43. Several children at a day camp return from playing in a tick-infested field. What action should the camp nurse take first? Observe the children's skin for attached ticks. 44. An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin (Levaquin) 500 mg orally once daily and metronidazole (Flagyl) 500 mg twice daily. She asks the nurse, "Why do I have to be in the hospital? Why can't I get my treatment at home?" Which purpose should the nurse provide that supports and effective outcome? Administration of a supervised parenteral antibiotic protocol 45. Insulin therapy is initiated for a 12-year-old child who is admitted with diabetic ketoacidosis (DKA). Which action is most important for the nurse to include in the child's plan of care? Monitor serum glucose for adjustment in infusion rate of Regular insulin (Novolin R). 46. A 6-month-old, diagnosed with short bowel syndrome, began enteral feedings yesterday. To maintain normal growth and development of the child during this period, what action should the nurse include in the infant's plan of care? Give the infant a pacifier during feeding 47. The nurse is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective? Rice 48. While teaching a parenting class to new parents the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is the most important reason for implementing such parenting behaviors? They provide the child with a sense of security 49. The mother of a 4-month-old asks the nurse for advice in preventing diaper rash. What suggestion should the nurse provide? Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change. 50. A 3-year-old with HIV infection is staying with a foster family who is caring for 3 other foster children in their home. When one of the children acquires pertussis, the foster mother calls the clinic and asks the nurse what she should do. Which action should the nurse take first? Review the immunization documentation of the child who has HIV 51. A child with leukemia is admitted for Chemotherapy and the nursing diagnosis "altered nutrition, less those body requirements related to anorexia, nausea and vomiting" is identified. Which intervention the nurse included in this child plan of care? Allow the child to eat any food desired and tolerated 52. Prior to discharge, the parents of a child with cystic fibrosis are demonstrating chest physiotherapy (CPT) that they will perform for their child at home. Which action? Percussion and postural drainage. 53. The nurse plans to screen only the highest risk children for scoliosis. Which group of children should the nurse screen first? Girls between ages 10 and 14 54. A mother brings her 8 mo. old baby boy to clinic because he has been vomiting and had diarrhea for last 3 days. Which assessment is most important for nurse to make? Measure the infant's pulse 55. Nurse gets a call from a mother of a 10 y/o that just returned from camp with expanding circular red rash on arm. Mom asks what over the counter product is safe to use. How should the nurse respond? Explain need for immediate exam ` HESI RN PEDIATRICS NEW FILE TESTED 2022 1. A nurse is providing teaching to the parents of an infant who is to undergo pilocarpine iontophoresis testing for cystic fibrosis. Which of the following statements should the nurse include teaching? “The test will measure the amount of chloride in your baby’s sweat.” 2. A nurse in prioritizing care for four clients. Which of the following clients should the nurse assess first? An adolescent who has sickle cell anemia and slurred speech 3. A nurse is providing teaching to a parent of a child who has cystic fibrosis and a new prescription for dornase alfa. Which of the following instructions should the nurse include the teaching? “Store the medication in the refrigerator.” 4. A nurse is caring for a child who has bacterial meningitis. Which of the following criteria indicates the nurse should remove the child from droplet precautions? Antibiotics initiated 24 hr ago 5. A nurse is assessing a school age child who has type 1 DM. The nurse notes that the child is diaphoretic. Which of the following actions should the nurse take? Obtain a blood glucose level 6. A nurse is caring for a child who is terminally ill. The parents tell the nurse that their child is going to be fine because they heard about another child who survived the same illness. Which of the following responses should the nurse make? “Tell me what you know about your child’s illness.” 7. A nurse is assessing a toddler who has cystic fibrosis. Which of the following findings should the nurse expect? Steatorrhea 8. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching? Apply bactericidal ointment to lesions 9. A nurse is preparing to administer naproxen 150 mg PO to a child who is experiencing pain. Available is naproxen 125 mg/ 5 ml solution. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 6 ml 10. A nurse is assessing a 6-month old patient at a well-child visit. Which of the following findings should the nurse expect? a. Closed posterior fontanel (8 weeks). 11. A nurse is caring for a 2-year old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose? a. ?? 12. A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client’s plan of care? a. Encourage fluid intake at and between meals. 13. A nurse is planning care for a child who has suspected epiglottis. Which of the following actions should the nurse take? a. place the child in an upright position 14. A nurse is instructing a group of clients regarding calcium rich food. Which of the following should the nurse include in the teaching as the best source of calcium? a. 1 cup milk 15. A nurse is caring for an 8-month-old infant who screams when the parent leaves the room. The parent begins to cry and says “ I don’t understand why my child is so upset. I’ve never seen my child act this way around others before.” Which of the following statements should the nurse make? a. “This is a normal, expected reaction for a child of this age.” 16. A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child’s cooperation? a. Offer the child a choice of taking it with juice or water. 17. A nurse is caring for a client who requires droplet precautions. Which of the following Personal protective equipment should the nurse wear when setting up the meal tray? a. Mask 18. A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of The following actions by the client indicates an understanding of the teaching? a. The client holds his breath 10 seconds after inhaling the medication. 19. A nurse is caring for a 2-month-old infant who is post-operative following surgical repair of a cleft lip. Which of the following actions should the nurse take? a. Administer ibuprofen as needed for pain. 20. A nurse is caring for a child who has Kawasaki disease. Which of the following systems Should the nurse monitor in response to this diagnosis? a. Cardiovascular 21. A nurse is providing teaching to a client who has oral candidiasis and a new script for Nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching? a. “I will store the medicine at room temp” 22. A nurse is caring for a child who has been diagnosed with pertussis. Which type of precautions should the nurse take when caring for this child? Droplet precautions 23.A 7-year old girl is being seen at a healthcare clinic; the nurse suspects that the child is being neglected and physically abused at home. Beyond physical markings on the child, which of the following can also indicate signs of a child being abused or neglected? Select all that apply. The patient is wearing dirty, poorly-fitted clothes The patient misses school approximately once per week The child has body odor and rotting teeth 24.A nurse who works in the pediatric unit walks into a 3-year-old patient’s room and finds him lying on the floor. His parents are with him and they tell the nurse, “he fell out of bed!” Which response from the nurse is the most appropriate? Assist the patient back to bed, assess him for injuries and file an incident report 25. The nurse is conducting a physical examination in the ER of a child following a comprehensive health history. What should be the focus of the physical examination? Chief complaint 26. Which would be least effective in gaining the cooperation of a toddler during a physical examination? Tell the child that another child the same age wasn’t afraid. 27. The nurse is preparing a nursing care plan for an 8-year old child hospitalized for cardiac surgery. Which are examples of interventions that nurses perform in the “building a trusting relationship” stage? Select all that apply. Preparing the child for a procedure by playing games Explaining in simple terms what will be happening during surgery Giving the child a favorite toy to cuddle with following a painful procedure 28.A nurse is caring for a 13-year-old girl who is sexually active and whose partner is her 19-yearold boyfriend. The girl asks the nurse not to tell her parents about her sexual activity. This patient’s situation is best described as: statutory rap 29. An 11-year-old boy has been diagnosed with depression after his parents’ divorce. The nurse understands that depression in most children of this age most commonly manifests as: Lack of interest with friends and families 30. During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse’s best response? “Tell me what concerns you.” 31. What is the role of the peer group in the life of school-age children? Provides them with security as they gain independence from their parents. 32. For which child would nonopioid analgesics be recommended? A child with juvenile arthritis 33.A nurse is working with a child who has a learning disability because she is unable to discriminate between different speech sounds. This disorder is most accurately described as: phonological processing deficit 34. The nurse is caring for an 11-year-old child who is experiencing pain related to chemotherapy treatment. What is a behavioral factor that might affect the child’s pain experience? Participation in normal routine activities 35. A nurse is presenting an in-service about the use of postural drainage for infants who have cystic fibrosis. Which of the following positions should the nurse identify as being contraindicated for the infant? a. Trendelenburg? 36. A nurse is caring for a client who has a prescription for digoxin 0.25mg PO daily. The amount available is 0.125mg tab. The client’s current vital signs are: BP 144/96, hear rate 54/min, respirations 18/min, and temperature 98.6 F. Which of the following actions should the nurse take? a. Withhold for decreased pulse rate. 37. A nurse is speaking with the mother of a 6-year-old child. Which of the following statements by the mother should concern the nurse? a. “My teacher says my child has to squint to see the board.” 38. A nurse is conducting a primary survey of a client who has sustained life-threatening injuries Do to a motor-vehicle crash. Identify the sequence of actions the nurse should take. 1. Open airway using a jaw-thrust maneuver 2. Determine effectiveness of ventilator efforts 3. Establish IV access 4. Glasgow Coma Scale assessment 5. Remove clothing for a thorough assessment. 39. A nurse is reinforcing teaching about food choices with the mother of an 8-month-old infant. Which of the following statements by the mother indicates a need for further teaching? a. “I will give my child strained carrots and mashed egg yolks.” 40. A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take? a. Inspect the mouth for signs of inhalation injuries 41. A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client? a. Private room 42. A nurse is reviewing the lab findings for a client who has ITP. Which of the following findings should the nurse expect to be decreased? a. Platelets 43. A nurse is assessing a client who has SLE. Which of the following findings should the nurse expect? a. Facial rash 44. A nurse is creating a plan of care for a school-age child who has nephrotic syndrome. Which of the following interventions should the nurse include? (Select all that apply) • Provide a low-sodium diet • Assess for protein in the urine • Obtain a daily weight 45. A nurse in a pediatric unit is caring for a school-age child following a cardiac catheterization. Which of the following interventions would the nurse take? • Keep the affected extremity straight for 6 hrs. 46. A nurse is teaching a parent of a toddler about administering digoxin. Which of the following statements by the parent indicates understanding of the teaching? • “I should give my child water after giving the medication.” 47. A nurse is caring for a 9-year-old child who has major burns to her face and upper torso. Which of the following actions should the nurse take first? • Give pain medication 48. A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following should the nurse include in the plan of care? • Cleanse the gums with saline soaked gauze 49. A nurse in a community health clinic is assessing the needs of a single parent who has three young children and works full time. Which of the following resources should the nurse recommend? • Respite child care 50. A nurse is caring for a child who has a prescription for fluticasone and has developed white patches and sores in his mouth. Which of the following is an appropriate action for the nurse to take? • Collect a culture from the lesions 51. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching? • Apply bactericidal ointment to lesions 52. A nurse in an emergency department is caring for a child who has epiglottis. Which of the following actions should the nurse take? • Provide nebulizer aerosol therapy 53. A nurse is planning care for a child who is placed in skin traction. Which of the following is the priority action for the nurse to take? • Maintain proper body alignment 54. A nurse is preparing to administer ondansetron 0.15 mg/kg IV to a child who is receiving chemotherapy and weighs 29.4 kg. Available is ondansetron 4 mg/2 mL solution. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero) • Answer: 2.2 mL 55. A nurse is performing a physical assessment of a school-age child who has acute glomerulonephritis. Which of the following findings should the nurse expect? • Facial edema RN HESI Pediatrics Retake Exam V2 RN HESI PEDIATRICS RETAKE EXAMRN HESIPediatrics Retake Exam RN HESI Pediatrics Retake Exam Question 1 A nurse is preparing for the admission of a child with a diagnosis of acute-stage Kawasaki disease. On assessment of the child, the nurse expects to note which clinical manifestation of the acute stage of the disease? Conjunctival hyperemia Question 2 Which signs and symptoms would lead a nurse to suspect a child has tetralogy of Fallot? Select all that apply. Murmur History of squatting Cyanosis Tachypnea Question 3 A nurse is caring for an infant with congenital heart disease is monitoring the infant closely for signs of congestive heart failure (CHF). The nurse assess the infant for which early sign of CHF? Tachycardia Question 4 A child with Kawasaki disease is receiving low-dose aspirin. The mother calls the clinic and states that the child has been exposed to influenza. Which recommendation should the nurse make? Select all that apply. Stop the aspirin Watch for fever. Question 5 Discharge teaching for a 3-month old with a cardiac defect who is to receive digoxin should include which information? Select all that apply. Give medications at regular intervals. Notify the healthcare provider of poor feeding or vomiting. Notify the healthcare provider if more than two consecutive doses are missed. Question 6 When developing the discharge teaching plan for a child with chronic renal failure and the family, the nurse should emphasize restriction of which nutrient? Phosphorus Question 7 A nurse is developing a plan of care who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. Time the seizure Stay with the child Move furniture away from the child Question 8 A nurse develops a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which items need to be placed at the child’s bedside. Suction equipment and oxygen Question 9 A nurse is caring for an infant with a diagnosis of hydrocephalus. Preoperatively, a priority nursing intervention is to: Reposition the infant frequently Question 10 A 10-year-old child with asthma is treated for acute exacerbation in the ER. A nurse caring for the child monitors for which of the following, knowing it indicates the worsening of the condition? Decreased wheezing Question 11 Which assessment findings should alert the nurse to suspect that a toddler is experiencing respiratory distress? Select all that apply. Coughing Respiratory rate of 45 Restlessness Diaphoresis Question 12 When preparing the teaching plan for the mother of a child with asthma, what information should the nurse include as a sign to alert the mother that her child is having an asthma attack? Wheezing on expiration. Question 13 Which factor, if described by the parents of a child with cystic fibrosis, indicates understanding the underlying problem of the disease? An abnormality in the body’s mucus secreting glands Question 14 What type of diet should the nurse teach the parents to give an older infant with cystic fibrosis? High-calorie diet Question 15 A new mother expresses concern to a nurse regarding sudden infant syndrome (SIDS). She asks the nurse how to position her new infant for sleep. The nurse appropriately tells the mother that the infant should be placed on the: Back rather than on the stomach. Question 16 The mother of a hospitalized 2-year-old with CROUP ask a nurse why the physician did not prescribe antibiotics. The appropriate response is: “Antibiotics are not indicated unless a bacterial infection is present” Question 17 A child with laryngotracheobronchitis (CROUP) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. The appropriate nursing action is to: Let the mother hold the child and direct the cool mist over the child’s face Question 18 A nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions would the nurse include in the plan of care? Select all that apply. Place the infant in a private room Ensure that nurses caring for the infant with RSV do not care for other high-risk children. Question 19 A 7-year old child with a history of asthma controlled without medications is referred to the school nurse by the teacher because of persistent coughing. What should the nurse do first? Call a parent to obtain more information. Question 20 When providing end-of-life care to a 4-year-old child who is dying of cancer, which of the following interventions would the nurse utilize to ensure that she is providing adequate pain control? Encourage the child to verbalize pain by using the appropriate pain scale Question 21 A nurse is caring for a 9-year-old patient who is considered a fall risk because of her history of seizures. Which of the following interventions should be implemented to prevent falls in a pediatric patient? Select all that apply. Keep the patient’s bed in the lowest position Provide non-slip socks for the patient to wear while ambulating Move furniture and room items so that there is a clear walkway Question 22 A nurse is caring for a baby who was born 72 hours ago. The nurse notes that the child has not had a bowel movement or has passed meconium stool on her shift. She checks the records and notes that the child has not had any bowel movements documented since he was born. What action should the nurse perform next? Contact the physician and report the situation Question 23 The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is “too wet.” The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially? Apply direct pressure above the catheterization site. Question 24 The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next? Administer next dose as ordered in 12 hours. Question 25 A physician orders a medication dosage that is above the safe dosage range. The nurse administers the medication without questioning the dosage. What error did the nurse make? The nurse violated one of the “rights” of medication administration due to not calculating the dosage based on patient's safe range. Question 26 A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material? Soak in the bathtub Question 27 A child is being cared for in the ICU after suffering a head injury. The patient requires a ventilator and he is sedated. The child is at risk of pressure ulcers because of his immobility. Which of the following nursing interventions is most appropriate to prevent skin breakdown in this child? Turn or reposition the child in bed every 2 hours Question 28 Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm. What priority nursing intervention should occur at this time? Calmly ask the child to point to where the pain is worse and to wiggle his fingers. Question 29 The nurse is caring for a 4-year-old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child’s cooperation? “Can you blow this cotton ball across the tray?” Question 30 The nurse is caring for a 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child? Provide age-appropriate toys and games. Question 31 The nurse is caring for infants having the condition failure to thrive (FTT). Which infants would be at risk for this condition? Select all that apply. A newborn baby with tetralogy of Fallot An infant with a cleft palate An infant born to an impoverished mother An infant with bronchopulmonary dysplasia Question 32 A nurse is working with a family whose child has an intellectual disability that occurred as a result of trauma. Which of the following situations would best describe an example of this type of event? Falling down a flight of stairs Question 33 A nurse is reviewing the policies for safety with a family who’s 1-year-old child has been admitted to the pediatric unit. Which information would the nurse most likely give to the parents about maintaining the child’s safety while he is a patient in the pediatric unit? Parents who are staying with the child should not fall asleep while holding the child, but should keep him in his bed Question 34 The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which question would be most likely to elicit valuable information? “What are your new classmates like?” Question 35 Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized? Tachypnea with retractions Question 36 Which of the following situations would involve mandatory reporting? A nurse suspects that an 11-year-old child is being abused in his home Question 37 The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a tube. The nurse is reviewing interventions to promote growth and development. Which response from the mother indicates and need for further teaching? “We need to keep feeding time very quiet.” Question 38 The nurse is administering pain medication for an 8 year old child with continuous pain from internal injuries. Which method would be ordered to dispense the medication? Administer the medication around the clock at timed intervals Question 39 The student nurse is learning about the effects of heat and cold when used in a pain management plan. What accurately describes one of these effects? Cold alters capillary permeability. Question 40 An 8-year-old is undergoing surgery for an appendectomy. Which of the following best explains informed consent when caring for this child? The child participates in the decision making about the procedure. Question 41 When assessing a 2-year-old child with a Wilms Tumor, what should the nurse avoid? Palpating the child’s abdomen Question 42 A nurse is assessing an 8-year old with diabetes who is experiencing hyperglycemia. Which symptoms indicate that hypoglycemia requires immediate intervention. Select all that apply. Weakness Thirst Dizziness Question 43 A clinic nurse reads the results of a Mantoux test on a 3-year-old child. The results indicate an area of induration measuring 10mm. The nurse would interpret these results as: Positive Question 44 A nurse is performing a clinic intake assessment on a 16-year-old patient. When the nurse asks the patient about alcohol consumption, the patient admits that he sometimes drinks to excess with his friends. Which response should the nurse utilize to talk about this topic with the patient? Explain short- and long-term effects of alcohol use on health Question 45 The nurse is caring for a 4-year-old girl with special care needs in the hospital. Which intervention would have the most positive effect on this child? Helping her do a simple craft project Question 46 A nurse is working with the family of a 1-day-old infant who was born prematurely and who is dying, which of the following interventions would most likely demonstrate that the nurse recognizes the family’s grief in this situation? Letting the family baptize the child and dress him Question 47 The nurse is caring for a hospitalized 13-year-old girl who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond? “Let’s work together to plan your day along with your treatments.” Question 48 The nurse is teaching the student nurse how to perform a physical assessment based on the child’s developmental stage. Which statement accurately describes a recommended guideline for setting the tone of the examination for a school-age-child? Include the child in all parts of the examination, speak to the caregiver before and after the examination. Question 49 The parents of a 12-year-old girl complain to the nurse that their daughter never listens to them when they talk. Which of the following skills should the nurse teach to the parents about conflict resolution with their child? Practice active listening with the child Question 50 The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which would be a priority intervention to help satisfy this preschool child’s basic needs? Explain necessary procedures in a simple language that she will understand. Question 51 The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which question would be most likely to elicit valuable information? “Do you like your new school?” Question 52 M.B. is a 17 year old patient who is being seen for a sports physical. He is accompanied by his parents who are present while the nurse takes the patient’s history. The nurse notes a certain amount of tension when discussing the teen’s high-risk behaviors. The nurse wants to establish a relationship of confidentiality with the patient, in case he wants to discuss private matters but doesn’t want to talk in front of his parents. Which one of the following statements made by the nurse is correct? “You can have your parents stay while I examine you or they can wait outside until we are done." Question 52 The parents of a child with autism talk with a nurse about their feelings of being overwhelmed in caring for their child. They state that they do not get a break from their child, his needs are almost more than they can handle, and they are considering divorce. Which of the following initial responses from the nurse is most important? “You may want to talk with a respite provider who can care for your child sometimes.” Question 53 The nurse is caring for children who are receiving IV therapy in the hospital setting. For which children would a central venous device be indicated? A child who is receiving chemotherapy for leukemia Question 54 A 3-year-old child with a tracheostomy will soon be discharged. What most important recommendation should the nurse share with the family? Avoid exposure to noxious fumes such as paint or varnish. Question 55 A 16-year-old patient is being seen for treatment of an inguinal hernia. The patient’s parents are with him while he talks to the physician but he does not want the recommended treatment. The parents are considering his position as a mature minor to let him make the decision. Which of the following best describes a mature minor? A minor patient who is considered developmentally old enough to make the decision to consent or refuse. Question 56 A community health nurse is teaching a new mother about caring for her baby. The mother is worried about her child developing food allergies and asks the nurse what she can do to prevent it. Which information is most appropriate in this situation? Tell the mother not to introduce solid foods in the baby’s diet until he is at least 4 to 6 months’ old Question 57 The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury? Recommend raising the bed’s side rails when a caregiver is not present. Question 58 The nurse is preparing a presentation to a local parent group about pediatric health supervision. Which would the nurse emphasize as the focus? Injury prevention or wellness? Correct answer Injury prevention, however if you selected wellness you can fight it b/c of textbook Question 59 The nurse is preparing to administer insulin to a diabetic child. Which would be the recommended route for this administration? Subcutaneous Question 60 The nurse is preparing to obtain a blood specimen via capillary heel puncture. Which action would be most appropriate for the nurse to do? Wipe away the first drop of blood with dry gauze. Question 61 The nurse tells a joke to a 12-year-old to distract him from a painful procedure. What pain management technique is the nurse using? Distraction Question 62 Prior to administering morphine to a 10-year-old child, the nurse reviews the adverse effects of the drug. Which system is primarily affected by the drug, causing most of the adverse effects? Central nervous system Question 63 A 4-year-old child is being prepared for surgery for an umbilical hernia repair. Which best identifies the most appropriate method of providing comfort for a child before surgery? Allow a support person, such as a parent, to remain with the child as long as possible Question 64 The nurse is weighing an underweight infant diagnosed with failure to thrive (FTT) and notes that the baby does not make eye contact and is less active than other infants. What would be a probable cause for the FTT related to the infant’s body language? Maternal abuse Question 65 The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting? Regression Question 66 A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. What nursing intervention is a priority for this child? Monitoring and maintaining systemic blood pressure Question 67 A community health nurse provides screening for a family whose child has a likelihood of developing cystic fibrosis because of their genetic background. Which of the following community health intervention does this describe? Risk identification Question 68 A nurse who works in the newborn nursery must check a blood glucose level on an infant. The nurse performs the heel stick using a retractable lancet. Following the procedure, what should the nurse do with the lancet? Place it in a sharps container Question 69 The nurse is performing a physical examination on a sleeping newborn. Which body system should the nurse examine last? Throat Question 70 A nurse is caring for a child who has been diagnosed with pertussis. Which type of precautions should the nurse take when caring for this child? Droplet precautions Question 71 A 7-year old girl is being seen at a healthcare clinic; the nurse suspects that the child is being neglected and physically abused at home. Beyond physical markings on the child, which of the following can also indicate signs of a child being abused or neglected? Select all that apply. The patient is wearing dirty, poorly-fitted clothes The patient misses school approximately once per week The child has body odor and rotting teeth Question 72 A nurse who works in the pediatric unit walks into a 3-year-old patient’s room and finds him lying on the floor. His parents are with him and they tell the nurse, “he fell out of bed!” Which response from the nurse is the most appropriate? Assist the patient back to bed, assess him for injuries and file an incident report Question 73 The nurse is conducting a physical examination in the ER of a child following a comprehensive health history. What should be the focus of the physical examination? Chief complaint Question 74 Which would be least effective in gaining the cooperation of a toddler during a physical examination? Tell the child that another child the same age wasn’t afraid. Question 75 The nurse is preparing a nursing care plan for an 8-year old child hospitalized for cardiac surgery. Which are examples of interventions that nurses perform in the “building a trusting relationship” stage? Select all that apply. Preparing the child for a procedure by playing games Explaining in simple terms what will be happening during surgery Giving the child a favorite toy to cuddle with following a painful procedure Question 76 A nurse is caring for a 13-year-old girl who is sexually active and whose partner is her 19-year- old boyfriend. The girl asks the nurse not to tell her parents about her sexual activity. This patient’s situation is best described as: statutory rape Question 77 A nurse has just administered medication via an orogastric tube. What is the priority nursing action following administration? Flush the tube. Question 78 Which of the following best describes the role of a child life specialist on an interdisciplinary team? A person who helps a child and his family to prepare for procedures and hospitalization in a developmentally appropriate way. Question 79 A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority? Protecting the child from harm during the seizure Question 80 The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which response from the mother indicates a need for further teaching? “I should position him on his abdomen with knees bent.” Question 81 The nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). What accurately describes the use of TPN? It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals. Question 82 The nurse uses the FLACC behavioral scale to assess a 6-year-old’s level of postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the child is experiencing: Severe pain Question 83 A school-aged child with an infectious disease is placed on transmission-based precautions. Which nursing diagnosis would be the priority? Social isolation related to infectivity and inability to go to the playroom Question 84 The nurse is teaching the family of an infant with cerebral palsy how to administer a Diazepam (Valium) pill by gastrostomy tube. What should the nurse include in the teaching session? (Select all that apply) The pill should be crushed and mixed with a small amount of water. Question 85 The nurse is preparing to administer medication to a child with a gastronomy tube in place. What is a recommended guideline for this procedure? Select all that apply. Verify proper tube placement prior to instilling medication. Crush tablets and mix with warm water to prevent tube occlusion. Open up capsules and mix the contents with warm water Flush the tube with water after administering medications Question 86 The nurse working in the emergency room monitors the admission of children. Statistically, for which disorder would children younger than 5 most commonly be admitted? Respiratory disorders Question 87 The nurse is caring for a toddler with special needs. Which developmental tasks related to toddlerhood might be delayed in the child with special needs? Developing language and motor skills Question 88 The nurse is caring for a special needs infant. Which intervention will be most important in helping the child reach her maximum developmental potential? Directing her parents to an early intervention program Question 89 The parents of a 4-month old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant? Assign her to the same nurse as much as possible Question 90 The nurse is providing home care for a 1-year-old girl who is technologically dependent. Which intervention will best support the family process? Creating schedules for therapies and interventions Question 91 The nurse is caring for an 8-year-old boy hospitalized or a bone marrow transplant. His parents are in and out of his room throughout the day. Which behaviors of the child would alert the nurse that he is in the second stage of separation anxiety? He sits quietly and is uninterested in playing and eating. Question 92 A mother has brought her 5-year-old son into the healthcare clinic for a physical to prepare for kindergarten. The nurse is reviewing the child’s immunization history and notes that he has had one MMR vaccine in his life. Which response of the nurse is the most appropriate? “He will need one MMR before he starts kindergarten.” Question 93 After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections? Neutrophils Question 94 An 11-year-old boy has been diagnosed with depression after his parents’ divorce. The nurse understands that depression in most children of this age most commonly manifests as: Lack of interest with friends and families Question 95 During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse’s best response? “Tell me what concerns you.” Question 96 What is the role of the peer group in the life of school-age children? Provides them with security as they gain independence from their parents. Question 97 For which child would nonopioid analgesics be recommended? A child with juvenile arthritis Question 98 A nurse is working with a child who has a learning disability because she is unable to discriminate between different speech sounds. This disorder is most accurately described as: phonological processing deficit Question 99 The nurse is caring for an 11-year-old child who is experiencing pain related to chemotherapy treatment. What is a behavioral factor that might affect the child’s pain experience? Participation in normal routine activities