Pediatrics HESI
A 15-month-old is admitted to the pediatric unit with a history of a recent upper respiratory
infection. Which symptom is consistent with the diagnosis of laryngotracheobronchitis (croup)?
Select all that apply.
1.Reported inspiratory stridor which is worse at night.
2.Suprasternal retractions are present upon examination.
3.The toddler has a barking, seal-like, harsh cough.
4.Lung sounds have inspiratory wheezing.
5.Lung sounds with crackles in the bases bilaterally. -
1,2,3
A four-year-old is presented to the urgent care center with a history of a sudden onset of a severe
sore throat. He began drooling and has difficulty swallowing. The temperature is 102.2F (39.0C).
Lung sounds are clear and there is no cough. The child is very anxious and flushed and is leaning
forward in a tripod position. Based on these symptoms, the nurse anticipates a diagnosis of:
1.Acute Asthma Attack
2.Laryngotracheomalacia
3.Acute laryngotracheobronchitis (Croup)
4.Acute Epiglottitis -
4
Which should the nurse expect to be included in the treatment of the client experiencing acute
asthma symptoms? Select all that apply.
1.Bronchodilators
2.Corticosteroids
3.Oxygen
4.Montelukast (Singular)
5.Immediate Intubation -
1, 2, 3
The nurse understands that in a child with cystic fibrosis (CF) which vitamin absorption is
impaired? Select all that apply.
1.A
2.B
3.C
4.D
5.E -
1, 3, 4, 5
Which indicates the earliest sign of hemorrhage in a child who has just had a tonsillectomy?
1.Frequent swallowing
2.Labored respirations
3.Tachypnea stridor
4.Dark brown emesis -
1
1
,A child with chronic otitis media has bilateral myringotomy tubes placed. Which statement would
indicate that the parent understands education about myringotomy tubes?
1."The tubes have to be surgically removed in 9 months or so."
2."The tubes were placed to equalize pressure."
3."These tubes won't affect my child being able to go swimming in the summer."
4."My child will still need to be on Amoxicillin prophylactically for six months." -
2
The nurse should instruct the parent whose child is diagnosed with respiratory syncytial virus
(RSV) to notify the healthcare provider for which issue? Select all that apply.
1.The child is not eating
2.There is a decrease in wet diapers
3.There is increased work of breathing
4.The child develops yellow drainage from the nose
5.Only when the child wheezes -
1, 2, 3
Which are signs and symptoms of respiratory distress in a two-month-old? Select all that apply.
1.Nasal flaring
2.Intercostal retractions
3.Coughing
4.Bronchovesicular lung sounds
5.Grunting -
1, 2, 5
You are teaching a family with a child who has cystic fibrosis (CF) about chest physiotherapy
treatment (CPT). Which of the following teaching points are correct to include? SATA
1.It should be performed three to four times a day.
2.It may cause bronchospasm.
3.It is all right to percuss over the spine or internal organs.
4.When manually percussing you should use a cupped hand.
5.CPT can be done at any time including after eating. -
1, 2, 4
Which child does the nurse anticipate to be most at risk for being hospitalized for respiratory
syncytial virus (RSV)?
1.A three-month-old who was born at 30 weeks gestation
2.A 18-month-old with a tracheostomy
3.A four-year-old with a ventricular septal defect (VSD)
4.A five-year-old who was term but has never received any immunizations -
1
The nursing student asks the nurse about genetic implications related to cystic fibrosis (CF). How
should the nurse respond?
1."It is inherited as an autosomal dominant trait."
2."It is a genetic defect found primarily in non-Caucasian people."
3."If it is present in a child, both parents are carriers of the defective gene."
4."There is a 50% chance the siblings of an affected child will also be affected." -
3
2
,what is the gold standard test in cystic fibrosis -
sweat test
A measurement of the maximum flow of air that can be forcefully exhaled in 1 second, a key
measurement of pulmonary function -
Peak expiratory flow rate
provides an objective method of evaluating the presence and degree of lung dz, as well as the
response of therapy -
Pulmonary Function Test (PFT)
cessation of breathing for more than 20 sec or for a shorter period of time when associated w/
hypoxemia or bradycardia -
apnea
a medical emergency that can result in respiratory failure and death if untreated -
status asthmaticus
involves stimulating the production of sweat w/ a special device, collecting sweat and measuring
the sweat electrolytes. Used in the diagnosis of cystic fibrosis -
sweat chloride test
inability of the respiratory apparatus to maintain adequate oxygenation of the blood w/ or w/out
carbon dioxide retention -
respiratory failure
a serious obstructive inflammatory process in the upper airway may see absence of a cough but
drooling and agitation -
acute epiglottitis
in general applies to 2 conditions: increased work of breathing w/ near normal gas exchange
function or the inability to maintain normal blood gas tensions that develops from carbon dioxide
retention w/ subsequent hypoxemia and acidosis -
respiratory insuffuecuency
upper airway infection characterized by hoarseness and a barking cough -
croup
earliest manifestation of cystic fibrosis where the small intestine is blocked w/ thick meconium in
the newborn -
meconium ileus
the child insists on sitting upright and leaning foward w/ the chin thrust out, mouth open and tongue
protruding to facilitate breathing -
tripod
irritants such as house dust mites, tobacco smoke, mold or pets -
3
, allergens
a serious possibly life-threatening obstructive inflammatory process of the upper trachea w/ features
of croup and epiglottitis -
bacterial tracheitis
considered to be the corner stone treatment for children and adolescents w/ cystic fibrosis -
airway clearance therapies
The nurse in the emergency department (ED) is assessing a school-age child with a new
ventriculoperitoneal (VP) shunt. The child is being seen for lethargy, irritability, vomiting, severe
headache, and a fever of 102.4°. What initial action should the nurse expect would be taken?
1.An admission to the hospital for IV fluids and monitoring
2.Give mannitol for increased intracranial pressure.
3.Obtain a CT scan of the brain with X-rays of the chest and abdomen.
4.A surgical intervention for hydrocephalus -
3
A nurse in the emergency department (ED) is assessing a pre-school age client who had a febrile
seizure at home. The parent is very concerned and asks the nurse if this is very serious. How should
the nurse respond?
1."Yes, the child is likely to get brain damage when a fever gets too high."
2."Generally they are not. But it is best to treat a fever when it starts."
3."No, they don't cause any issues."
4."Yes, you should consider this a medical emergency any time something like this occurs." -
2
The nurse is doing post-procedure education with a school-age child after a lumbar puncture. What
factor is important for the nurse to emphasize?
1.The child will be NPO for 6 hours post-procedure.
2.The child will need to lay flat for 4 to 24 hours.
3.The child will need hourly vital signs for the first 6 hours post-procedure.
4.The child will need to be assessed for adequate urinary elimination within 4 hours post-procedure.
-
2
The nurse is assigned an adolescent client with newly diagnosed meningitis and is going in the
client's room to hang the antibiotics. What personal protective equipment (PPE) should the nurse
put on?
1.Gown and gloves
2.Gown, mask, and gloves
3.Gown, goggles, mask, and gloves
4.Gloves -
2
A mother is talking to the nurse and is concerned that her infant will get meningitis and die like her
cousin's child did many years ago. The mother asks the nurse, "What is the best way I can protect
my child?" How should the nurse respond?
1."There is no way to prevent it, unfortunately, but you must be quick to respond to any symptoms."
4
A 15-month-old is admitted to the pediatric unit with a history of a recent upper respiratory
infection. Which symptom is consistent with the diagnosis of laryngotracheobronchitis (croup)?
Select all that apply.
1.Reported inspiratory stridor which is worse at night.
2.Suprasternal retractions are present upon examination.
3.The toddler has a barking, seal-like, harsh cough.
4.Lung sounds have inspiratory wheezing.
5.Lung sounds with crackles in the bases bilaterally. -
1,2,3
A four-year-old is presented to the urgent care center with a history of a sudden onset of a severe
sore throat. He began drooling and has difficulty swallowing. The temperature is 102.2F (39.0C).
Lung sounds are clear and there is no cough. The child is very anxious and flushed and is leaning
forward in a tripod position. Based on these symptoms, the nurse anticipates a diagnosis of:
1.Acute Asthma Attack
2.Laryngotracheomalacia
3.Acute laryngotracheobronchitis (Croup)
4.Acute Epiglottitis -
4
Which should the nurse expect to be included in the treatment of the client experiencing acute
asthma symptoms? Select all that apply.
1.Bronchodilators
2.Corticosteroids
3.Oxygen
4.Montelukast (Singular)
5.Immediate Intubation -
1, 2, 3
The nurse understands that in a child with cystic fibrosis (CF) which vitamin absorption is
impaired? Select all that apply.
1.A
2.B
3.C
4.D
5.E -
1, 3, 4, 5
Which indicates the earliest sign of hemorrhage in a child who has just had a tonsillectomy?
1.Frequent swallowing
2.Labored respirations
3.Tachypnea stridor
4.Dark brown emesis -
1
1
,A child with chronic otitis media has bilateral myringotomy tubes placed. Which statement would
indicate that the parent understands education about myringotomy tubes?
1."The tubes have to be surgically removed in 9 months or so."
2."The tubes were placed to equalize pressure."
3."These tubes won't affect my child being able to go swimming in the summer."
4."My child will still need to be on Amoxicillin prophylactically for six months." -
2
The nurse should instruct the parent whose child is diagnosed with respiratory syncytial virus
(RSV) to notify the healthcare provider for which issue? Select all that apply.
1.The child is not eating
2.There is a decrease in wet diapers
3.There is increased work of breathing
4.The child develops yellow drainage from the nose
5.Only when the child wheezes -
1, 2, 3
Which are signs and symptoms of respiratory distress in a two-month-old? Select all that apply.
1.Nasal flaring
2.Intercostal retractions
3.Coughing
4.Bronchovesicular lung sounds
5.Grunting -
1, 2, 5
You are teaching a family with a child who has cystic fibrosis (CF) about chest physiotherapy
treatment (CPT). Which of the following teaching points are correct to include? SATA
1.It should be performed three to four times a day.
2.It may cause bronchospasm.
3.It is all right to percuss over the spine or internal organs.
4.When manually percussing you should use a cupped hand.
5.CPT can be done at any time including after eating. -
1, 2, 4
Which child does the nurse anticipate to be most at risk for being hospitalized for respiratory
syncytial virus (RSV)?
1.A three-month-old who was born at 30 weeks gestation
2.A 18-month-old with a tracheostomy
3.A four-year-old with a ventricular septal defect (VSD)
4.A five-year-old who was term but has never received any immunizations -
1
The nursing student asks the nurse about genetic implications related to cystic fibrosis (CF). How
should the nurse respond?
1."It is inherited as an autosomal dominant trait."
2."It is a genetic defect found primarily in non-Caucasian people."
3."If it is present in a child, both parents are carriers of the defective gene."
4."There is a 50% chance the siblings of an affected child will also be affected." -
3
2
,what is the gold standard test in cystic fibrosis -
sweat test
A measurement of the maximum flow of air that can be forcefully exhaled in 1 second, a key
measurement of pulmonary function -
Peak expiratory flow rate
provides an objective method of evaluating the presence and degree of lung dz, as well as the
response of therapy -
Pulmonary Function Test (PFT)
cessation of breathing for more than 20 sec or for a shorter period of time when associated w/
hypoxemia or bradycardia -
apnea
a medical emergency that can result in respiratory failure and death if untreated -
status asthmaticus
involves stimulating the production of sweat w/ a special device, collecting sweat and measuring
the sweat electrolytes. Used in the diagnosis of cystic fibrosis -
sweat chloride test
inability of the respiratory apparatus to maintain adequate oxygenation of the blood w/ or w/out
carbon dioxide retention -
respiratory failure
a serious obstructive inflammatory process in the upper airway may see absence of a cough but
drooling and agitation -
acute epiglottitis
in general applies to 2 conditions: increased work of breathing w/ near normal gas exchange
function or the inability to maintain normal blood gas tensions that develops from carbon dioxide
retention w/ subsequent hypoxemia and acidosis -
respiratory insuffuecuency
upper airway infection characterized by hoarseness and a barking cough -
croup
earliest manifestation of cystic fibrosis where the small intestine is blocked w/ thick meconium in
the newborn -
meconium ileus
the child insists on sitting upright and leaning foward w/ the chin thrust out, mouth open and tongue
protruding to facilitate breathing -
tripod
irritants such as house dust mites, tobacco smoke, mold or pets -
3
, allergens
a serious possibly life-threatening obstructive inflammatory process of the upper trachea w/ features
of croup and epiglottitis -
bacterial tracheitis
considered to be the corner stone treatment for children and adolescents w/ cystic fibrosis -
airway clearance therapies
The nurse in the emergency department (ED) is assessing a school-age child with a new
ventriculoperitoneal (VP) shunt. The child is being seen for lethargy, irritability, vomiting, severe
headache, and a fever of 102.4°. What initial action should the nurse expect would be taken?
1.An admission to the hospital for IV fluids and monitoring
2.Give mannitol for increased intracranial pressure.
3.Obtain a CT scan of the brain with X-rays of the chest and abdomen.
4.A surgical intervention for hydrocephalus -
3
A nurse in the emergency department (ED) is assessing a pre-school age client who had a febrile
seizure at home. The parent is very concerned and asks the nurse if this is very serious. How should
the nurse respond?
1."Yes, the child is likely to get brain damage when a fever gets too high."
2."Generally they are not. But it is best to treat a fever when it starts."
3."No, they don't cause any issues."
4."Yes, you should consider this a medical emergency any time something like this occurs." -
2
The nurse is doing post-procedure education with a school-age child after a lumbar puncture. What
factor is important for the nurse to emphasize?
1.The child will be NPO for 6 hours post-procedure.
2.The child will need to lay flat for 4 to 24 hours.
3.The child will need hourly vital signs for the first 6 hours post-procedure.
4.The child will need to be assessed for adequate urinary elimination within 4 hours post-procedure.
-
2
The nurse is assigned an adolescent client with newly diagnosed meningitis and is going in the
client's room to hang the antibiotics. What personal protective equipment (PPE) should the nurse
put on?
1.Gown and gloves
2.Gown, mask, and gloves
3.Gown, goggles, mask, and gloves
4.Gloves -
2
A mother is talking to the nurse and is concerned that her infant will get meningitis and die like her
cousin's child did many years ago. The mother asks the nurse, "What is the best way I can protect
my child?" How should the nurse respond?
1."There is no way to prevent it, unfortunately, but you must be quick to respond to any symptoms."
4
