HESI RN PEDIATRICS ACTUAL EXAM 2024

The nurse is assessing a 9-year-old bow who has been admitted to the hospital with possible acute poststreptoccocal glomerulonephritis (APSGN). In obtaining his history, what info is MOST significant? A - a sore throat last week B - hx of HTN C - diuresis during the night D - back pain for a few days - A The nurse is measuring the frontal occipital circumference (FOC) of a 3-month-old infant, and notes that the FOC has increased 5 inches (12.7cm) since birth and the child's head appears large in relation to body size. Which action is MOST important for the nurse to take next? A - plot the measurement on the infant's growth chart B - observe the infant for sunset eyes C - measure the infant's head-to-heel length D - palpate the anterior fontanel for tension and bulging - D A female infant recently admitted with vomiting and diarrhea now weighs 10 kg. Her weigh at a previous well-baby visit was 11 kg. What is the percentage of body weight loss for this infant? A - 4% B - 9% C - 10% D - 5% - B A male high school student with Type 1 diabetes tests his blood glucose level before playing a game of soccer and he obtains a reading of 180 mg/dL (10 mmol/L). Based on the reading, which action should the nurse take? A - tell him to eat a sandwich and fruit before beginning the game B - Check his urine for ketones C -give him permission to go ahead and play soccer D- call the healthcare provider - A A 7-year-old child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health hx from the child's mother, the recent occurrence of which illness is MOST significant? A - sore throat B - chickenpox C - mumps D - influenza - A A mother brings her 2-month-old son to the clinic for a well baby exam. During the assessment, the nurse finds that the right testicle is not descended into the scrotum, but the left is palpable. Which action should the nurse take? A- prepare to obtain a catheterized urine specimen for culture B - address possible concerns about the child's future fertility C - ask if the right teste has been seen in the scrotum before D - schedule an IV pyelogram to validate presence of testeicle - C The nurse is assessing a 6-month-old infant. Which response requires further evaluation by the nurse? A - has doubled birth weight B - turns head to locate sound C - plays "peek-a-boo" D- demonstrates startle reflex - D A 4-year-old girl returns to the pediatrician's office for a postoperative visit following hospitalization for minor surgery. When observing the child in the waiting area, which behavior should the nurse consider normal for this age child? A - ignores other children in the play area B - draws picture of self with facial features C - "talks" to imaginary friend D - sits quietly in her mother's lap - C A preschool-aged child is experiencing respiratory distress is brought to the emergency department by the parents. the child is anxious, has a temperature of 102.8 F (39.3 C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse prepare the child for next? A - obtain bedside trays for intubation or tracheotomy by the healthcare provider B - begin prescribed intravenous antibiotic administration C - provide a nebulizer treatment with bronchodilators D - schedule the child for a stat MRI of the neck - A The nurse is caring for a preschool-aged child with a congenital heart defect who is admitted with intermittent low-grade fever, fatigue, and weight loss. Further physical assessment findings include a new murmur, splinter hemorrhages under the nails, and painless red lesions on the palms of the hands. Which diagnostic procedure should the nurse prepare the parents to expect the healthcare provider to prescribe? A - echocardiogram B - electrocardiogram C - chest radiography D - CT scan - A A 6 year old male with a BMI in the 95th percentile for gender and age arrives at the clinic after a referral from the school nurse. His laboratory findings include hemoglobin A1c of 5.5%, BP in the 50th percentile for age, height in the 75th percentile, and an LDL cholesterol of 90 mg/dL (2.33mmol/L). Which lifestyle modification should the nurse discuss with the parents? A - recommend increasing daily fruits and vegetable and daily exercise B - return in one month for another evaluation of serum lipids and blood pressure C - instruct the parents to weigh the child weekly and measure his BP daily D - see a healthcare provider to further assess for diabetes and hypertension - A When administering indomethacin to a premature infant who has a patent ductus arteriosus, the nurse should anticipate which outcome? A - decreased urinary output B - decreased cardiac murmur C - increased number of red blood cells D - increased respiratory effort - B A 2 year old boy who had hypospadias repair yesterday goes to the hospital playroom with his mother. Which activity should the nurse recommend? A - peddling a tricycle in the hall B - riding a rocking horse C - using a large-piece puzzle D - playing catch ball with others - C A male child is being prepared for a CT scan when he begins to have a tonic clonic seizure. His mother is hysterical and is trying to hold the child down. What actions should the nurse take? SATA A - administer an anticonvulsant medication B - place pillows inside the side rails C - ask the mother to release the child D - close blinds so the room is darkened E - monitor the child's airway and tongue - B, C, E A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first? A - place the child in a quiet environment B - apply lotion to hands and feet C - make a list of foods that the child likes D - encourage the parents rest when possible - A The nurse is caring for a school age child who has laboratory results that reveal the presence of anti-glandin and anti-endomysial immunoglobulin G and immunoglobulin A antibodies. The nurse should identify with the parent and child which food to avoid after discharge to home? A - swiss cheese B - sweet potatoes C - orange juice D - wheat bread - D The nurse is giving an intramuscular injection of an antibiotic to a 16 month old toddler with pneumonia. The toddler does not have any known allergies and has been walking without assistance for one month. Which technique should the nurse select for administration? A - use a needle length of 1/2 in (1.25 cm) to avoid deep tissue damage B - administer the injection into the middle of the lateral aspect of the thigh C - give in the arm, one to 2 in (2.5 - 5.0 cm) below the acromion process D - divide the gluteal area into quarters and give IM into the upper outer quadrant - B While administering the final dose of oral amoxicillin to a preschool aged boy, he tells the nurse that his throat hurts. Which intervention is MOST important for the nurse to implement? A - document the child's comments B - inspect the child's oropharynx C - review the child's hx of sore throats D - assess skin for signs of allergic reaction - B The mother of a 14 month old tells the nurse that she feeds her child nothing but prepared toddler foods and feels they provide the best nutrition for her child, but is concerned about the cost. How should the nurse respond? A - teach the mother how to develoop a budget to allow her to continue to provide the needed prepared toddler foods B - advise the mother that these foods will only be needed until the growth spurt of the toddler years is complete C - reassure the mother that beginning to replace prepared foods with table foods can provide the needed nutrients D - affirm that these prepared foods are the best way to ensure that the toddler gets all the needed nutrients - C Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children? A - assessing for behavioral problems at home and school by interviewing the parents B - performing head circumference measurements on infants under one year of age C - noting a marked weight gain without a gain in height on a growth chart D - carefully recording the height and weight of children to detect inappropriate growth rates - D The nurse is communicating with a 12 year old with a hearing impaired. Which action is best for the nurse to use when attempting to communicate with this child? A - use a picture board to communicate needs B - convey ideas by writing short sentences C - attract the child's attention before speaking D - emphasize emotions with facial expressions - D During the physical exam of an 11 year old girl, the nurse observes budding breasts and scant pubic hair. Which Tanner stage should the nurse choose when documenting these findings? A - V B - II C - III D - IV - C A 9 year old with leukemia is admitted with a ruptured appendix. A nasogastric tube is inserted and attached to low intermittent suction. Which finding is MOST important for the nurse to report to the healthcare provider? A - increased BUN B - urinary output of 60 mL/hr C - gastric output of 450 mL in the last 24 hrs D - absolute neutrophil count of 400/mm^3 - D A 2-year old child with HF is admitted to replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin, the nurse obtains an apical heart rate of 128 beats/minute. What action should the nurse implement? A - calculate the safe dose range B - administer the schedule dose C - review the serum digoxin level D - determine the pulse deficit - B A mother brings her preteen daughter to the clinic for her first female exam. During the health assessment, the nurse should implement which technique to determine if the client has reached the age of menarche? A - calculate the approximate age menstruation should occur B - palpate for evidence of temporary gynecomastia C - assess for presence of a supernumerary breast nipple D - use the Tanner staging to determine sexual maturity - D