Pediatrics HESI 2023
Study online at https://quizlet.com/_hm1koq
1. A 6-month-old infant with congestive Apical heart rate of 60.
heart failure (CHF) is receiving digoxin
elixir. Which observation by the nurse A heart rate of 60 (A) is much lower than normal
warrants immediate intervention? for a 6-month-old and warrants immediate inter-
Apical heart rate of 60. vention. The normal heart rate for a 6-month-old
Sweating across the forehead. is 80 to 150 BPM when awake, and a rate of 70
Doesn't suck well. while sleeping is considered within normal limits.
Respiratory rate of 30 breaths per (B and C) are expected symptoms of heart failure
minute. in an infant. (D) is within normal limits for an infant.
2. The nurse is teaching the parents of Administer aerosol therapy followed by postural
a 5-year-old with cystic fibrosis about drainage before meals.
respiratory treatments. Which state-
ment indicates to the nurse that the Postural drainage for a child with cystic fibrosis
parents understand? is most effective when performed after nebuliza-
Perform postural drainage before tion and before meals (C) or at least 1 hour after
starting aerosol therapy. eating to prevent nausea and vomiting. Postural
Give respiratory treatments when the drainage uses gravity to promote mucous removal
child is coughing a lot. after nebulization (A) treatments which open the
Administer aerosol therapy followed airways. Pulmonary toileting or respiratory treat-
by postural drainage before meals. ments should be given 3 to 4 times daily, not
Ensure respiratory therapy is done episodically (B and D).
daily during any respiratory infection.
3. A female teenager is taking oral tetra- Use sunscreen when lying by the pool.
cycline HCL (Achromycin V) for acne
vulgaris. What is the most important Photosensitivity is a common side effect of tetracy-
instruction for the nurse to include in cline HCL (Achromycin V) therapy. Severe sunburn
this client's teaching plan? can occur with minimal sun exposure and clients
Use sunscreen when lying by the should be instructed to avoid sunlight and to use
pool. sunscreen (A). (B and D) are not related to tetra-
Cleanse the skin at least 4 times a cycline HCL (Achromycin V) therapy. (C) should be
, Pediatrics HESI 2023
Study online at https://quizlet.com/_hm1koq
day. avoided because dairy products interfere with the
Take the medication with a glass of absorption of tetracyclines.
milk.
Menstrual periods may become irreg-
ular.
4. What preoperative nursing interven- Observe for projectile vomiting.
tion should be included in the plan of
care for an infant with pyloric steno- Projectile vomiting (D), which contributes to meta-
sis? bolic alkalosis (A), is the classic sign of pyloric
Monitor for signs of metabolic acido- stenosis. (B) is not indicated. (C) is dangerous,
sis. due to the potential for aspiration with frequent
Estimate the quantity of diarrhea vomiting.
stools.
Place in a supine position after feed-
ing.
Observe for projectile vomiting.
5. An infant is born with a ventricu- Prevent the return of oxygenated blood to the
lar septal defect (VSD) and surgery lungs.
is planned to correct the defect. The
nurse recognizes that surgical correc- Closure of VSDs stops oxygenated blood from be-
tion is designed to achieve which out- ing shunted from the left ventricle to the right ven-
come? tricle (C). VSDs are acyanotic defects, which means
Stop the flow of unoxygenated blood that no unoxygenated blood enters the systemic
into systemic circulation. circulation (A and B). (D) is common with Tetrology
Increase the flow of unoxygenated of Fallot, which is a cyanotic defect.
blood to the lungs.
Prevent the return of oxygenated
blood to the lungs.
Reduce peripheral tissue hypoxia and
nailbed clubbing
, Pediatrics HESI 2023
Study online at https://quizlet.com/_hm1koq
6. A 3-week-old newborn is brought to A. Monitor the the infant's weight and number of
the clinic for follow-up after a home wet diapers per day.
birth. The mother reports that her B. Increase the infant's intake per feeding by 1 to
child bottle feeds for 5 minutes only 2 ounces per week.
and then falls asleep. The nurse aus- D. Allow the infant to rest and refeed on demand
cultates a loud murmur characteristic or every 2 hours.
of a ventricular septal defect (VSD), E. Use a softer nipple or increase the size of the
and finds the newborn is acyanotic nipple opening.
with a respiratory rate of 64 breaths
per minute. What instruction should Antibiotic prophylaxis is recommended for infants
the nurse provide the mother to en- with VSDs, but should not be mixed in a bottle of
sure the infant is receiving adequate formula (C) because it is difficult to ensure that the
intake? (Select all that apply.) total dose is consumed.
A. Monitor the the infant's weight and
They should be monitored for weight gain and at
number of wet diapers per day.
least 6 wet diapers per day (A). A one-month old
B. Increase the infant's intake per
infant should ingest 2 to 4 ounces of formula per
feeding by 1 to 2 ounces per week.
feeding and progress to about 30 ounces per day
C. Mix the dose of prophylactic antibi-
by 4-months of age (B)
otic in a full bottle of formula.
D. Allow the infant to rest and refeed
on demand or every 2 hours.
E. Use a softer nipple or increase the
size of the nipple opening.
7. Preoperative nursing care for a child Put a sign on the bed reading, "DO NOT PALPATE
with Wilms' tumor should include ABDOMEN."
which intervention?
Gently percuss the abdomen for evi- Prevention of abdominal palpation (D) minimizes
dence of trapped air. the risk of rupturing the encapsulated tumor and
Observe the abdomen for any notice- subsequent metastasis. (A) is unnecessary, and
able discolorations. this action could traumatize the tumor in the same
Apply cold compresses to the ab- manner as palpation. (B and C) are incorrect since
, Pediatrics HESI 2023
Study online at https://quizlet.com/_hm1koq
domen to reduce edema. the abdomen is not discolored and cold compress-
Put a sign on the bed reading, "DO es are not indicated.
NOT PALPATE ABDOMEN."
8. At 8 a.m. the unlicensed assistive Administer PRN prescription of nifedipine (Procar-
personnel (UAP) informs the charge dia) sublingually.
nurse that a female adolescent client
with acute glomerulonephritis has a Sublingual Procardia (B) lowers blood pressure
blood pressure of 210/110. The 4 a.m. very quickly, and this should be done first. (A) may
blood pressure reading was 170/88. also be done, but oral diuretics do not work as
The client reports to the UAP that she rapidly as the sublingual antihypertensive. When
is upset because her boyfriend did not notifying the healthcare provider, the first thing
visit last night. What action should the he/she will want to know is if the PRN antihyper-
nurse take first? tensive has been administered (C). (D) does not
Give the client her 9 a.m. prescription consider the seriousness of this finding. The nurse
for an oral diuretic early. should stay with the client until the blood pressure
Administer PRN prescription of is reduced.
nifedipine (Procardia) sublingually.
Notify the healthcare provider and
inform the nursing supervisor of the
client's condition.
Attempt to calm the client and retake
the blood pressure in thirty minutes.
9. The nurse is assessing an Clubbed fingers.
8-month-old child who has a medical
diagnosis of Tetrology of Fallot. Which Tetrology of Fallot, a cyanotic heart defect, causes
symptom is this client most likely to clubbing of fingers and toes (D) due to tissue
exhibit? hypoxia. Tachycardia, not (A), is a manifestation
Bradycardia. of congenital heart disease. (B) is a classic sign
Machinery murmur. of ventricular septal defect. (C) is characteristic of
coarctation of the aorta.
Study online at https://quizlet.com/_hm1koq
1. A 6-month-old infant with congestive Apical heart rate of 60.
heart failure (CHF) is receiving digoxin
elixir. Which observation by the nurse A heart rate of 60 (A) is much lower than normal
warrants immediate intervention? for a 6-month-old and warrants immediate inter-
Apical heart rate of 60. vention. The normal heart rate for a 6-month-old
Sweating across the forehead. is 80 to 150 BPM when awake, and a rate of 70
Doesn't suck well. while sleeping is considered within normal limits.
Respiratory rate of 30 breaths per (B and C) are expected symptoms of heart failure
minute. in an infant. (D) is within normal limits for an infant.
2. The nurse is teaching the parents of Administer aerosol therapy followed by postural
a 5-year-old with cystic fibrosis about drainage before meals.
respiratory treatments. Which state-
ment indicates to the nurse that the Postural drainage for a child with cystic fibrosis
parents understand? is most effective when performed after nebuliza-
Perform postural drainage before tion and before meals (C) or at least 1 hour after
starting aerosol therapy. eating to prevent nausea and vomiting. Postural
Give respiratory treatments when the drainage uses gravity to promote mucous removal
child is coughing a lot. after nebulization (A) treatments which open the
Administer aerosol therapy followed airways. Pulmonary toileting or respiratory treat-
by postural drainage before meals. ments should be given 3 to 4 times daily, not
Ensure respiratory therapy is done episodically (B and D).
daily during any respiratory infection.
3. A female teenager is taking oral tetra- Use sunscreen when lying by the pool.
cycline HCL (Achromycin V) for acne
vulgaris. What is the most important Photosensitivity is a common side effect of tetracy-
instruction for the nurse to include in cline HCL (Achromycin V) therapy. Severe sunburn
this client's teaching plan? can occur with minimal sun exposure and clients
Use sunscreen when lying by the should be instructed to avoid sunlight and to use
pool. sunscreen (A). (B and D) are not related to tetra-
Cleanse the skin at least 4 times a cycline HCL (Achromycin V) therapy. (C) should be
, Pediatrics HESI 2023
Study online at https://quizlet.com/_hm1koq
day. avoided because dairy products interfere with the
Take the medication with a glass of absorption of tetracyclines.
milk.
Menstrual periods may become irreg-
ular.
4. What preoperative nursing interven- Observe for projectile vomiting.
tion should be included in the plan of
care for an infant with pyloric steno- Projectile vomiting (D), which contributes to meta-
sis? bolic alkalosis (A), is the classic sign of pyloric
Monitor for signs of metabolic acido- stenosis. (B) is not indicated. (C) is dangerous,
sis. due to the potential for aspiration with frequent
Estimate the quantity of diarrhea vomiting.
stools.
Place in a supine position after feed-
ing.
Observe for projectile vomiting.
5. An infant is born with a ventricu- Prevent the return of oxygenated blood to the
lar septal defect (VSD) and surgery lungs.
is planned to correct the defect. The
nurse recognizes that surgical correc- Closure of VSDs stops oxygenated blood from be-
tion is designed to achieve which out- ing shunted from the left ventricle to the right ven-
come? tricle (C). VSDs are acyanotic defects, which means
Stop the flow of unoxygenated blood that no unoxygenated blood enters the systemic
into systemic circulation. circulation (A and B). (D) is common with Tetrology
Increase the flow of unoxygenated of Fallot, which is a cyanotic defect.
blood to the lungs.
Prevent the return of oxygenated
blood to the lungs.
Reduce peripheral tissue hypoxia and
nailbed clubbing
, Pediatrics HESI 2023
Study online at https://quizlet.com/_hm1koq
6. A 3-week-old newborn is brought to A. Monitor the the infant's weight and number of
the clinic for follow-up after a home wet diapers per day.
birth. The mother reports that her B. Increase the infant's intake per feeding by 1 to
child bottle feeds for 5 minutes only 2 ounces per week.
and then falls asleep. The nurse aus- D. Allow the infant to rest and refeed on demand
cultates a loud murmur characteristic or every 2 hours.
of a ventricular septal defect (VSD), E. Use a softer nipple or increase the size of the
and finds the newborn is acyanotic nipple opening.
with a respiratory rate of 64 breaths
per minute. What instruction should Antibiotic prophylaxis is recommended for infants
the nurse provide the mother to en- with VSDs, but should not be mixed in a bottle of
sure the infant is receiving adequate formula (C) because it is difficult to ensure that the
intake? (Select all that apply.) total dose is consumed.
A. Monitor the the infant's weight and
They should be monitored for weight gain and at
number of wet diapers per day.
least 6 wet diapers per day (A). A one-month old
B. Increase the infant's intake per
infant should ingest 2 to 4 ounces of formula per
feeding by 1 to 2 ounces per week.
feeding and progress to about 30 ounces per day
C. Mix the dose of prophylactic antibi-
by 4-months of age (B)
otic in a full bottle of formula.
D. Allow the infant to rest and refeed
on demand or every 2 hours.
E. Use a softer nipple or increase the
size of the nipple opening.
7. Preoperative nursing care for a child Put a sign on the bed reading, "DO NOT PALPATE
with Wilms' tumor should include ABDOMEN."
which intervention?
Gently percuss the abdomen for evi- Prevention of abdominal palpation (D) minimizes
dence of trapped air. the risk of rupturing the encapsulated tumor and
Observe the abdomen for any notice- subsequent metastasis. (A) is unnecessary, and
able discolorations. this action could traumatize the tumor in the same
Apply cold compresses to the ab- manner as palpation. (B and C) are incorrect since
, Pediatrics HESI 2023
Study online at https://quizlet.com/_hm1koq
domen to reduce edema. the abdomen is not discolored and cold compress-
Put a sign on the bed reading, "DO es are not indicated.
NOT PALPATE ABDOMEN."
8. At 8 a.m. the unlicensed assistive Administer PRN prescription of nifedipine (Procar-
personnel (UAP) informs the charge dia) sublingually.
nurse that a female adolescent client
with acute glomerulonephritis has a Sublingual Procardia (B) lowers blood pressure
blood pressure of 210/110. The 4 a.m. very quickly, and this should be done first. (A) may
blood pressure reading was 170/88. also be done, but oral diuretics do not work as
The client reports to the UAP that she rapidly as the sublingual antihypertensive. When
is upset because her boyfriend did not notifying the healthcare provider, the first thing
visit last night. What action should the he/she will want to know is if the PRN antihyper-
nurse take first? tensive has been administered (C). (D) does not
Give the client her 9 a.m. prescription consider the seriousness of this finding. The nurse
for an oral diuretic early. should stay with the client until the blood pressure
Administer PRN prescription of is reduced.
nifedipine (Procardia) sublingually.
Notify the healthcare provider and
inform the nursing supervisor of the
client's condition.
Attempt to calm the client and retake
the blood pressure in thirty minutes.
9. The nurse is assessing an Clubbed fingers.
8-month-old child who has a medical
diagnosis of Tetrology of Fallot. Which Tetrology of Fallot, a cyanotic heart defect, causes
symptom is this client most likely to clubbing of fingers and toes (D) due to tissue
exhibit? hypoxia. Tachycardia, not (A), is a manifestation
Bradycardia. of congenital heart disease. (B) is a classic sign
Machinery murmur. of ventricular septal defect. (C) is characteristic of
coarctation of the aorta.
