PEDS HESI REMEDIATION
A 10-year-old child has undergone a cardiac catheterization through the left femoral artery.
During a postprocedural assessment, the nurse finds the left foot is pulseless and cool to touch.
Which is the likely cause?
A. hemorrhage
B. hematoma
C. fasciculation
D. tamponade - ANS-B. hematoma
Cardiac catheterization is a routine diagnostic procedure; however, it is not without risks. Loss of
pulse in the catheterized extremity is likely due to a hematoma and requires immediate
intervention to restore circulation.
A 10-year-old client with a recent history of playing in the woods, presents to the school nurse's
clinic with localized skin eruptions on the hands and feet which are streaked, consisting of
blisters discharging clear fluid that are painful and itchy. What should the school nurse suspect
to be the causative agent?
A. sun burn
B. poison ivy
C. insect bite
D. heat rash
Contact with the oil called "Urushiol" which is found in poison ivy, oak and sumac may produce
an allergic reaction. Symptoms include localized, streaked, or oozing blisters. These skin lesions
are usually painful and itchy. - ANS-
A 10-year-old client with asthma arrives at an urgent care clinic with apparent bronchial
constriction. Which class of drugs should the nurse expect to be administered for this condition?
A. methylxanthines
B. anticholinergic
C. long-acting beta2 agonists
D. oral corticosteroids - ANS-D. oral corticosteroids
Corticosteroids are fast-acting anti-inflammatory drugs. They are used to treat reversible airflow
obstruction, control symptoms, and reduce bronchial constriction with the fewest side effects.
A 12-month-old client is being discharged with a body spica cast. Which information should the
nurse include in the parents' discharge teaching plan?
A. foul odor from cast may indicate infection or skin breakdown
B. pillows should not be placed under cast
C. the child can safely transported in a stroller
D. use pillows to elevate the child's head - ANS-A. foul odor from cast may indicate infection or
skin breakdown
Care of a child in a body spica cast can be challenging for parents at home. Skin under the cast
should be protected from injury and debris, so parents should be instructed that a foul odor from
,the cast can be indicative of skin breakdown or infection and to contact their health care
provider.
A 12-year-old athlete reports severe ankle pain and an audible "popping" sound in the ankle
after a fall at soccer practice. The nurse upon inspection observes moderate swelling, bruising,
and joint instability. Initial radiographs of the ankle appear normal. Which type of injury should
the nurse suspect?
A. strain
B. sprain
C. fracture
D. dislocation - ANS-B. Sprain
The ankle is a common site for sprain injuries. Ankle sprains can range from mild (grade 1) to
severe (grade 3), with complete tearing of a ligament in the most severe sprains. A "popping"
sound is likely an indication of a partial or complete ligament tear; joint instability may be
detected at the end-ranges of passive motion.
A 15-year-old client presents with a lump and persistent pain in the right upper thigh area, and is
subsequently diagnosed with a high-grade osteosarcoma. The nurse should anticipate which
plan of treatment for this client?
A. hot/cold topical applications
B. amputation of the limb
C. electrical stimulation therapy
D. prolonged immobilization - ANS-B. amputation of the limb
Osteosarcoma is the most common bone cancer in childhood and considered one of the most
fatal. Treatment generally includes chemotherapy and amputation of the affected limb. As of
today, there is no meedical set plan of care.
A child diagnosed with HIV is being enrolled in a new school. Who has the right to inform the
school of this child's HIV status?
A. doctors or nurses
B. social workers
C. parents or legal guardians
D. child welfare department - ANS-C. parents or legal guardians
Confidentiality is a major issue in school attendance. The parents or legal guardians have the
right to decide whether or not to inform the school of their child's HIV status.
A child has been diagnosed with chicken pox and the nurse teaches the parent not to give the
child aspirin. Which condition may result when a child with chickenpox is given aspirin?
A. Reye's syndrome
B. Huntingtons disease
c. Raynaud syndrome
D. purpura disorder - ANS-A. reye's syndrome
Reye's syndrome is a rare, but serious condition that causes brain and liver damage that has
been linked with aspirin use in children, when given to treat a viral infections, such as chicken
pox. Reye's syndrome can be prevented by avoiding the use of aspirin in children.
A child is admitted with a diagnosis of suspected acute lymphoblastic leukemia (ALL). Which
test is performed to confirm this diagnosis of childhood leukemia?
A. cerebral spinal fluid analysis
, B. bone marrow aspiration
C. CBC
D. genetic testing - ANS-B. bone marrow aspiration
ALL is a form of cancer in which high numbers of abnormal white blood cells are produced. A
bone marrow biopsy that reveals primary blast cells is confirmation of a leukemia.
A child is brought to the emergency department after ingesting a large amount of household
drain cleaner. Which is the nurse's first priority when caring for this client?
A. perform NG suctioning
B. Assess and maintain an open airway
C. give small amounts of water to ingest
D. Obtain chest and abdomen radiographs - ANS-B. assess and maintain an open airway
Ingestion of corrosive household agents may cause airway obstruction due to rapidly developing
laryngeal edema. The first priority is to assess and monitor the client's airway.
A child recently underwent cardiac surgery and is admitted with a suspected diagnosis of
infective endocarditis. Which presentation should the nurse expect when assessing this client?
A. bradycardia, lethargy, speech disturbances
B. high fever, irregular movement of joints, involuntary facial grimaces
c. tachycardia, chest pain, swollen and painful joints
D. low grade fever, anorexia, splinter hemorrhages under the nails - ANS-D. low grade fever,
anorexia, splinter hemorrhages under the nails
Children who undergo cardiac surgery are at higher risk for infection. Common clinical signs and
symptoms of infective endocarditis are unexplained fever (low-grade and intermittent), anorexia,
malaise, and splinter hemorrhages under the nails
A child with severe burns begins to exhibit decreased level of consciousness and lethargy four
days after being admitted to the burn unit. The nurse's assessment reveals a low-grade fever,
but the client's other vital signs are stable. The nurse should be alert for which potential
complication?
A. respiratory failure
B. dehydration
C. sepsis
D. hypovolemia - ANS-C. sepsis
Dead tissue and exudate associated with burned skin provides a fertile field for bacterial growth.
If the burn site is contaminated with infectious material, sepsis may occur. Decreased level of
consciousness and lethargy are early signs of sepsis.
A five-year-old client who had been prescribed amoxicillin, presents to the clinic with urticaria.
Which medication is recommended for initial treatment of this condition?
A. epinephrine
B. diphenhydramine
C. ibuprofen
D. doxepin - ANS-B. diphenhydramine
Medications are a common cause of anaphylaxis in children. Acute urticaria, also known as
hives, is a skin reaction common side effect associated with amoxicillin. First-line treatment
consists administration of an antihistamines, such as diphenhydramine orally, followed by
hydrocortisone topically dependent upon the severity of the urticaria.
A 10-year-old child has undergone a cardiac catheterization through the left femoral artery.
During a postprocedural assessment, the nurse finds the left foot is pulseless and cool to touch.
Which is the likely cause?
A. hemorrhage
B. hematoma
C. fasciculation
D. tamponade - ANS-B. hematoma
Cardiac catheterization is a routine diagnostic procedure; however, it is not without risks. Loss of
pulse in the catheterized extremity is likely due to a hematoma and requires immediate
intervention to restore circulation.
A 10-year-old client with a recent history of playing in the woods, presents to the school nurse's
clinic with localized skin eruptions on the hands and feet which are streaked, consisting of
blisters discharging clear fluid that are painful and itchy. What should the school nurse suspect
to be the causative agent?
A. sun burn
B. poison ivy
C. insect bite
D. heat rash
Contact with the oil called "Urushiol" which is found in poison ivy, oak and sumac may produce
an allergic reaction. Symptoms include localized, streaked, or oozing blisters. These skin lesions
are usually painful and itchy. - ANS-
A 10-year-old client with asthma arrives at an urgent care clinic with apparent bronchial
constriction. Which class of drugs should the nurse expect to be administered for this condition?
A. methylxanthines
B. anticholinergic
C. long-acting beta2 agonists
D. oral corticosteroids - ANS-D. oral corticosteroids
Corticosteroids are fast-acting anti-inflammatory drugs. They are used to treat reversible airflow
obstruction, control symptoms, and reduce bronchial constriction with the fewest side effects.
A 12-month-old client is being discharged with a body spica cast. Which information should the
nurse include in the parents' discharge teaching plan?
A. foul odor from cast may indicate infection or skin breakdown
B. pillows should not be placed under cast
C. the child can safely transported in a stroller
D. use pillows to elevate the child's head - ANS-A. foul odor from cast may indicate infection or
skin breakdown
Care of a child in a body spica cast can be challenging for parents at home. Skin under the cast
should be protected from injury and debris, so parents should be instructed that a foul odor from
,the cast can be indicative of skin breakdown or infection and to contact their health care
provider.
A 12-year-old athlete reports severe ankle pain and an audible "popping" sound in the ankle
after a fall at soccer practice. The nurse upon inspection observes moderate swelling, bruising,
and joint instability. Initial radiographs of the ankle appear normal. Which type of injury should
the nurse suspect?
A. strain
B. sprain
C. fracture
D. dislocation - ANS-B. Sprain
The ankle is a common site for sprain injuries. Ankle sprains can range from mild (grade 1) to
severe (grade 3), with complete tearing of a ligament in the most severe sprains. A "popping"
sound is likely an indication of a partial or complete ligament tear; joint instability may be
detected at the end-ranges of passive motion.
A 15-year-old client presents with a lump and persistent pain in the right upper thigh area, and is
subsequently diagnosed with a high-grade osteosarcoma. The nurse should anticipate which
plan of treatment for this client?
A. hot/cold topical applications
B. amputation of the limb
C. electrical stimulation therapy
D. prolonged immobilization - ANS-B. amputation of the limb
Osteosarcoma is the most common bone cancer in childhood and considered one of the most
fatal. Treatment generally includes chemotherapy and amputation of the affected limb. As of
today, there is no meedical set plan of care.
A child diagnosed with HIV is being enrolled in a new school. Who has the right to inform the
school of this child's HIV status?
A. doctors or nurses
B. social workers
C. parents or legal guardians
D. child welfare department - ANS-C. parents or legal guardians
Confidentiality is a major issue in school attendance. The parents or legal guardians have the
right to decide whether or not to inform the school of their child's HIV status.
A child has been diagnosed with chicken pox and the nurse teaches the parent not to give the
child aspirin. Which condition may result when a child with chickenpox is given aspirin?
A. Reye's syndrome
B. Huntingtons disease
c. Raynaud syndrome
D. purpura disorder - ANS-A. reye's syndrome
Reye's syndrome is a rare, but serious condition that causes brain and liver damage that has
been linked with aspirin use in children, when given to treat a viral infections, such as chicken
pox. Reye's syndrome can be prevented by avoiding the use of aspirin in children.
A child is admitted with a diagnosis of suspected acute lymphoblastic leukemia (ALL). Which
test is performed to confirm this diagnosis of childhood leukemia?
A. cerebral spinal fluid analysis
, B. bone marrow aspiration
C. CBC
D. genetic testing - ANS-B. bone marrow aspiration
ALL is a form of cancer in which high numbers of abnormal white blood cells are produced. A
bone marrow biopsy that reveals primary blast cells is confirmation of a leukemia.
A child is brought to the emergency department after ingesting a large amount of household
drain cleaner. Which is the nurse's first priority when caring for this client?
A. perform NG suctioning
B. Assess and maintain an open airway
C. give small amounts of water to ingest
D. Obtain chest and abdomen radiographs - ANS-B. assess and maintain an open airway
Ingestion of corrosive household agents may cause airway obstruction due to rapidly developing
laryngeal edema. The first priority is to assess and monitor the client's airway.
A child recently underwent cardiac surgery and is admitted with a suspected diagnosis of
infective endocarditis. Which presentation should the nurse expect when assessing this client?
A. bradycardia, lethargy, speech disturbances
B. high fever, irregular movement of joints, involuntary facial grimaces
c. tachycardia, chest pain, swollen and painful joints
D. low grade fever, anorexia, splinter hemorrhages under the nails - ANS-D. low grade fever,
anorexia, splinter hemorrhages under the nails
Children who undergo cardiac surgery are at higher risk for infection. Common clinical signs and
symptoms of infective endocarditis are unexplained fever (low-grade and intermittent), anorexia,
malaise, and splinter hemorrhages under the nails
A child with severe burns begins to exhibit decreased level of consciousness and lethargy four
days after being admitted to the burn unit. The nurse's assessment reveals a low-grade fever,
but the client's other vital signs are stable. The nurse should be alert for which potential
complication?
A. respiratory failure
B. dehydration
C. sepsis
D. hypovolemia - ANS-C. sepsis
Dead tissue and exudate associated with burned skin provides a fertile field for bacterial growth.
If the burn site is contaminated with infectious material, sepsis may occur. Decreased level of
consciousness and lethargy are early signs of sepsis.
A five-year-old client who had been prescribed amoxicillin, presents to the clinic with urticaria.
Which medication is recommended for initial treatment of this condition?
A. epinephrine
B. diphenhydramine
C. ibuprofen
D. doxepin - ANS-B. diphenhydramine
Medications are a common cause of anaphylaxis in children. Acute urticaria, also known as
hives, is a skin reaction common side effect associated with amoxicillin. First-line treatment
consists administration of an antihistamines, such as diphenhydramine orally, followed by
hydrocortisone topically dependent upon the severity of the urticaria.
