2024|HESI Pediatrics Exam |2024-2025 REAL
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The nurse is planning postoperative care
for a child who has had a cleft lip repair.
What is the most important reason to D. Crying stresses the suture line
minimize this child's crying during the
recovery period? Rationale:
A. Tear formation increases salivation. Prevention of stress on the lip suture line
B. This behavior increases respirations. is essential for optimum healing and the
C. Excessive hysteria can lead to vomit- cosmetic appearance of a cleft lip repair.
ing.
D. Crying stresses the suture line
An infant is receiving digoxin for conges- B. Obtain a therapeutic drug level.
tive heart failure. The apical heart rate
is assessed at 80 beats/min. What inter- Rationale:
vention should the nurse implement? Sinus bradycardia (heart rate <90 to 110
A. Call for a portable chest radiograph. beats/min in an infant) is an indication
B. Obtain a therapeutic drug level. of digoxin toxicity, so assessment of the
C. Reassess the heart rate in 30 minutes. client's digoxin level has the highest pri-
D. Administer digoxin immune Fab stat. ority
The nurse admits a child to the intensive
care unit with a possible diagnosis of C. Place a do not palpate abdomen sign
Wilms tumor - What is the most safety on head of bed
precaution for child?
A. maintain NPO status Rationale:
B. Limit visitors to the immediate family Protect child from injury; place a sign
C. Place a do not palpate abdomen sign on bed stating "no abdominal palpation"
on head of bed (to prevent accidental fragmentation and
D. Encourage ambulation in the pre-op- dislodging into the abdominal cavity).
erative period
The nurse is preparing a teaching plan
for the mother of a child who has been
diagnosed with celiac disease. Choosing B. Baked chicken, coleslaw, soda, and
which lunch will be within the therapeutic frozen fruit dessert
management of a child with celiac dis-
ease? Rationale:
A. Turkey salad, milk, and oatmeal cook- A child with celiac disease is managed
ies on a gluten-free diet, which eliminates
B. Baked chicken, coleslaw, soda, and
frozen fruit dessert
, 2024|HESI Pediatrics Exam |2024-2025 REAL
Study online at https://quizlet.com/_hm0jqs
C. Tuna salad sandwich on whole wheat
bread, milk, and ice cream food products containing oats, wheat,
D. Turkey sandwich on rye bread, orange rye, or barley.
juice, and fresh fruit
B. Remove restraints one at a time and
provide range-of-motion
A 6-month-old male infant is admitted to
the postanesthesia care unit with elbow
Rationale:
restraints in place. He has an endotra-
Removing restraints one at a time is safer
cheal tube and is ventilator-dependent
than option C. The infant should have
but will be extubated soon following re-
the restrained extremities assessed fre-
covery from anesthesia. Which nursing
quently for signs of neurologic or vascu-
intervention should be included in this
lar impairment, and range-of-motion ex-
child's plan of care?
ercises should be performed with these
A. Keep restraints on at all times to pre-
assessments. Under no circumstances
vent unplanned extubation.
should restraints be applied to the client
B. Remove restraints one at a time
continuously. Documentation of assess-
and provide range-of-motion exercises.
ment findings regarding the restrained
C. Remove all restraints simultaneously
extremities must occur much more fre-
and provide play activities.
quently than every 72 hours; however,
D. Document the reason for application
the reason for using restraints must be
of the restraints every 72 hours.
justified and should be stated in the med-
ical record
The nurse assigns an unlicensed assis-
tive personnel (UAP) to provide morning
A. Use designated isolation precautions.
care to a newly admitted child with bac-
terial meningitis. What is the most impor-
Rationale:
tant instruction for the nurse to review
All these are important measures to re-
with the UAP?
view with the UAP, but the most important
A. Use designated isolation precautions.
is option A. Improper use of isolation pre-
B. Keep the lighting in the room dim.
cautions can place other staff and clients
C. Allow the parents to assist with care.
at risk for infection.
D. Report any pain that the child experi-
ences.
C. Place the child on a clear liquid diet
Rationale:
Intussusception, an invagination or tele-
, 2024|HESI Pediatrics Exam |2024-2025 REAL
Study online at https://quizlet.com/_hm0jqs
scoping of one portion of the intestine
into another, causes intestinal obstruc-
The nurse is caring for a child with intus- tion in children (usually occurs between 3
susception who is scheduled for a bari- months and 5 years of age). Nonsurgical
um enema prior to a surgical procedure. treatment is attempted with hydrostatic
Which action should the nurse take first? pressure created by barium instillation,
A. Evacuate the bowel of impacted feces which often reduces the area of bow-
B. Administer magnesium sulfate el intussusception. In preparation for a
C. Place the child on a clear liquid diet barium enema, the client should first be
D. Assess the stool for white color placed on a clear liquid diet for the entire
day; then magnesium sulfate is adminis-
tered for bowel evacuation.
C. Breech presentation
A 3-week-old infant is referred to an or-
Rationale:
thopedic clinic because the pediatrician
Developmental dysplasia of the hip
heard a click when flexing the child's right
(DDH) occurs more often in infants
hip during a routine physical examina-
who present in the breech position, not
tion. The orthopedic physician suspects
the vertex (head-first) position. Twice
that the child might have developmental
as many females as males present in
dysplasia of the hip (DDH). The parents
the breech position; thus, 80% of chil-
ask the nurse to identify risk factors com-
dren with DDH are females, not males.
monly associated with DDH. Which re-
Of breech presentations, 60% occur
sponse is accurate?
with first-born children, not subsequent
A. Vertex delivery
siblings, possibly because of the un-
B. Male gender
stretched uterus and compaction of the
C. Breech presentation
surrounding abdominal contents, which
D. Second-born child
tend to increase compression on the
uterus in the nulliparous woman.
The nurse is teaching the parents of a
2-year-old child with a congenital heart
B. Exhibits a sudden and unexplained
defect about signs and symptoms of con-
weight gain
gestive heart failure. Which information
about the child is most important for
Rationale:
the parents to report to the health care
Sudden and unexplained weight gain
provider?
can indicate fluid retention and is a sign
A. Sits or squats frequently when playing
outdoors
Study online at https://quizlet.com/_hm0jqs
The nurse is planning postoperative care
for a child who has had a cleft lip repair.
What is the most important reason to D. Crying stresses the suture line
minimize this child's crying during the
recovery period? Rationale:
A. Tear formation increases salivation. Prevention of stress on the lip suture line
B. This behavior increases respirations. is essential for optimum healing and the
C. Excessive hysteria can lead to vomit- cosmetic appearance of a cleft lip repair.
ing.
D. Crying stresses the suture line
An infant is receiving digoxin for conges- B. Obtain a therapeutic drug level.
tive heart failure. The apical heart rate
is assessed at 80 beats/min. What inter- Rationale:
vention should the nurse implement? Sinus bradycardia (heart rate <90 to 110
A. Call for a portable chest radiograph. beats/min in an infant) is an indication
B. Obtain a therapeutic drug level. of digoxin toxicity, so assessment of the
C. Reassess the heart rate in 30 minutes. client's digoxin level has the highest pri-
D. Administer digoxin immune Fab stat. ority
The nurse admits a child to the intensive
care unit with a possible diagnosis of C. Place a do not palpate abdomen sign
Wilms tumor - What is the most safety on head of bed
precaution for child?
A. maintain NPO status Rationale:
B. Limit visitors to the immediate family Protect child from injury; place a sign
C. Place a do not palpate abdomen sign on bed stating "no abdominal palpation"
on head of bed (to prevent accidental fragmentation and
D. Encourage ambulation in the pre-op- dislodging into the abdominal cavity).
erative period
The nurse is preparing a teaching plan
for the mother of a child who has been
diagnosed with celiac disease. Choosing B. Baked chicken, coleslaw, soda, and
which lunch will be within the therapeutic frozen fruit dessert
management of a child with celiac dis-
ease? Rationale:
A. Turkey salad, milk, and oatmeal cook- A child with celiac disease is managed
ies on a gluten-free diet, which eliminates
B. Baked chicken, coleslaw, soda, and
frozen fruit dessert
, 2024|HESI Pediatrics Exam |2024-2025 REAL
Study online at https://quizlet.com/_hm0jqs
C. Tuna salad sandwich on whole wheat
bread, milk, and ice cream food products containing oats, wheat,
D. Turkey sandwich on rye bread, orange rye, or barley.
juice, and fresh fruit
B. Remove restraints one at a time and
provide range-of-motion
A 6-month-old male infant is admitted to
the postanesthesia care unit with elbow
Rationale:
restraints in place. He has an endotra-
Removing restraints one at a time is safer
cheal tube and is ventilator-dependent
than option C. The infant should have
but will be extubated soon following re-
the restrained extremities assessed fre-
covery from anesthesia. Which nursing
quently for signs of neurologic or vascu-
intervention should be included in this
lar impairment, and range-of-motion ex-
child's plan of care?
ercises should be performed with these
A. Keep restraints on at all times to pre-
assessments. Under no circumstances
vent unplanned extubation.
should restraints be applied to the client
B. Remove restraints one at a time
continuously. Documentation of assess-
and provide range-of-motion exercises.
ment findings regarding the restrained
C. Remove all restraints simultaneously
extremities must occur much more fre-
and provide play activities.
quently than every 72 hours; however,
D. Document the reason for application
the reason for using restraints must be
of the restraints every 72 hours.
justified and should be stated in the med-
ical record
The nurse assigns an unlicensed assis-
tive personnel (UAP) to provide morning
A. Use designated isolation precautions.
care to a newly admitted child with bac-
terial meningitis. What is the most impor-
Rationale:
tant instruction for the nurse to review
All these are important measures to re-
with the UAP?
view with the UAP, but the most important
A. Use designated isolation precautions.
is option A. Improper use of isolation pre-
B. Keep the lighting in the room dim.
cautions can place other staff and clients
C. Allow the parents to assist with care.
at risk for infection.
D. Report any pain that the child experi-
ences.
C. Place the child on a clear liquid diet
Rationale:
Intussusception, an invagination or tele-
, 2024|HESI Pediatrics Exam |2024-2025 REAL
Study online at https://quizlet.com/_hm0jqs
scoping of one portion of the intestine
into another, causes intestinal obstruc-
The nurse is caring for a child with intus- tion in children (usually occurs between 3
susception who is scheduled for a bari- months and 5 years of age). Nonsurgical
um enema prior to a surgical procedure. treatment is attempted with hydrostatic
Which action should the nurse take first? pressure created by barium instillation,
A. Evacuate the bowel of impacted feces which often reduces the area of bow-
B. Administer magnesium sulfate el intussusception. In preparation for a
C. Place the child on a clear liquid diet barium enema, the client should first be
D. Assess the stool for white color placed on a clear liquid diet for the entire
day; then magnesium sulfate is adminis-
tered for bowel evacuation.
C. Breech presentation
A 3-week-old infant is referred to an or-
Rationale:
thopedic clinic because the pediatrician
Developmental dysplasia of the hip
heard a click when flexing the child's right
(DDH) occurs more often in infants
hip during a routine physical examina-
who present in the breech position, not
tion. The orthopedic physician suspects
the vertex (head-first) position. Twice
that the child might have developmental
as many females as males present in
dysplasia of the hip (DDH). The parents
the breech position; thus, 80% of chil-
ask the nurse to identify risk factors com-
dren with DDH are females, not males.
monly associated with DDH. Which re-
Of breech presentations, 60% occur
sponse is accurate?
with first-born children, not subsequent
A. Vertex delivery
siblings, possibly because of the un-
B. Male gender
stretched uterus and compaction of the
C. Breech presentation
surrounding abdominal contents, which
D. Second-born child
tend to increase compression on the
uterus in the nulliparous woman.
The nurse is teaching the parents of a
2-year-old child with a congenital heart
B. Exhibits a sudden and unexplained
defect about signs and symptoms of con-
weight gain
gestive heart failure. Which information
about the child is most important for
Rationale:
the parents to report to the health care
Sudden and unexplained weight gain
provider?
can indicate fluid retention and is a sign
A. Sits or squats frequently when playing
outdoors
