HESI RN PEDIATRIC EXAM STUDY GUIDE

Which client requires immediate intervention by the RN? • A child with cystic fibrosis who is constipated. • A toddler with chicken pox who is scratching, • A child with acute renal failure and hyperkalemia. • An adolescent with a migraine and photophobia. A 7 year old male is referred to the school clinic because he fainted on the playground. His height is 3 feet, 7 inches (107.5 cm), he weighs 55 pounds (25 kilograms), and his body mass index (BMI) is 20.9. Which assessment finding is most important for the RN to address? • He consumed2 bottles of water in 30 minutes prior to fainting. • Since age 3 he has experienced exercise induced asthma. • Reports drinking 3-4 high calorie, carbonated beverages daily. • The child’s father has a history of fainting when exercising. The RN of a 6 year old girl is concerned about her child’s obesity. The child’s weight plots at the 75th percentile, and height at the 25th percentile. The child’s body mass index (BMI) is at the 85th percentile for age and gender. Which interventions should the RN implement? (Select All That Apply) • Explain that the child is likely to grow into her weight. • Determine the child’s usual physical activity pattern. • Obtain the child’s 3- day diet history based on the mothers input. • Inquire as to whether or not the school has a physical education program. • Tell the mother that girls hit their growth spurt before boys so eating more is expected. (B, C, and D) are correct. The child’s growth parameters, particularly her BMI, indicate that she is overweight. (B and D) assess for the child’s level of activity, which should be evaluated and increased if possible. (C) Provides information about the quantity and quality of the child’s dietary intake, which is information that is needed to create an individualized diet teaching plan. (A) Does not consider the serious health and psychological consequences associated with childhood obesity. Girls do not hit their growth spurt before boys in preadolescence, but this child is only 6 years of age and the child’s obesity should not be negated because of this growth and development expectation. (e) A toddler with hemophilia is being discharged from the hospital. Which teaching should the RN include in the discharge instructions to the mother? • Apply padding on the sharp corners of the furniture. • Prevent the client from running inside the house. • Give an 81 mg tablet of aspirin for pain relief. • Use a soft bristle toothbrush from frequent cleaning. The RN is examining an infant for possible cryptorchidism. Which examine technique should be used? • Place the infant in a side lying position to facilitate the exam. • Hold the penis and extract the foreskin gently. • Cleanse the penis with an antiseptic-soaked pad. • Place the infant in a warm room and use a calm approach. An infant who has been diagnosed with a tracheoesophageal fistula (TEF). What nursing intervention is indicated for this infant prior to surgical repair? • Provide frequent sips of liquid. • Give isotonic enemas as prescribed. • Maintain nothing by mouth status. • Prepare the infant for a barium enema. An adolescent with non- Hodgkin’s lymphoma (NHL) is complaining of a sore mouth two days after beginning chemotherapy. What activity should the RN implement? • Encourage large meals during steroid and chemotherapy. • Provide lemon glycerin swabs and dilute peroxide oral rinses. • Recommend fluids using citrus juices and drinking with a straw. • Frequent use of saline oral rinses and a soft sponge toothbrush. .........................................................................................CONTINUED