RN HESI

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? Highcalorie 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-yearold 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 shortand 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 activiti