OB PEDS HESI EXIT EXAM 2024 / HESI OB PEDS EXIT
TEST BANK EXAM ACTUAL 350 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
A 3-year-old boy is brought to the emergency room because he swallowed an entire bottle of children's
vitamin pills. Which intervention should the nurse implement first?
Insert N/G tube for gastric lavage.
Determine the child's pulse and respirations.
Assess the child's level of consciousness.
Administer an IV D5/0.25 NS as prescribed. - ANSWER-Determine the child's pulse and respirations.
The most important principle in dealing with a poisoning is to treat the child first, not the poison. Initiate
immediate life support measures with assessment of vital signs (B), in particular, respirations. Inserting
an airway or initiating mechanical ventilation may be necessary. Assessment and identification of the
poison should occur prior to (A). (C and D) should occur after assessing the airway.
To take the vital signs of a 4-month-old child, which order provides the most accurate results?
Respiratory rate, heart rate, then rectal temperature.
Heart rate, rectal temperature, then respiratory rate.
Rectal temperature, heart rate, then respiratory rate.
Rectal temperature, respiratory rate, then heart rate. - ANSWER-Respiratory rate, heart rate, then
rectal temperature.
The respiratory rate should be taken first (A) in infants, since touching them or performing unpleasant
procedures usually makes them cry, elevating the heart rate and making respirations difficult to count
(B). Rectal temperature is the most invasive procedure, and is most likely to precipitate crying, so should
be done last (C and D).
The parents of a 3-week-old infant report that the child eats well but vomits after each feeding. What
information is most important for the nurse to obtain?
Description of vomiting episodes in past 24 hours.
Number of wet diapers in last 24 hours.
,Feeding and sleep schedule.
Amount of formula consumed during the past 24 hours. - ANSWER-Description of vomiting episodes
in past 24 hours.
A description of the vomiting episodes (A) will assist the nurse in determining the reason for the
symptoms, which may be helpful in developing a plan of care for this infant. (B and C) provide related
information but are not as helpful as (A). (D) may be related to the vomiting, but the nurse should first
obtain a better description of the vomiting episodes.
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribes
dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be infused at 25 ml/hour. Prior to
initiating the infusion, the nurse should obtain which assessment finding?
Frequency of emesis in the last 8 hours.
Serum BUN and creatinine levels.
Current blood sugar level.
Appearance of the stool. - ANSWER-Serum BUN and creatinine levels.
Regardless of a client's age, adequate renal function must be present before adding potassium to IV
fluids (B). (A) is important in determining the need for fluid replacement. (C) is not indicated. (D) is useful
information, but will not impact administration of the prescribed IV solution.
Which finding in a 19-year-old female client should trigger further assessment by the nurse?
Menstruation has not occurred.
Reports no tetanus immunization since childhood.
Denies having any wisdom teeth.
History of painful, inward growth on bottom of foot. - ANSWER-Menstruation has not occurred.
Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically
occurs by age 18, so (A) should prompt further investigation to determine the cause of this primary
amenorrhea. Children receive tetanus as part of the DPT childhood immunization series, and a booster is
not typically given until age 16 (B). Wisdom teeth are the third molar teeth of the permanent dentition
and are the last to erupt, so (C) is a normal finding. (D) describes a plantar surface wart, harmless but
painful because of the pressure with walking or standing.
,The nurse is giving a liquid iron preparation to a 3-year-old child. Which technique should the nurse
implement to engage the child's cooperation?
Use a colorful straw.
Mix the medication in water.
Administer the medication using an oral syringe.
Ask the pharmacy to provide an enteric tablet. - ANSWER-Use a colorful straw.
A liquid iron preparation administered through a straw may help the child to accept the medication since
young children consider drinking from a colorful straw fun (A). (B) may cause staining of the child's teeth.
(C) is often used if the child is uncooperative. (D) is ineffective and should be requested from the
healthcare provider.
When evaluating the effectiveness of interventions to improve the nutritional status of an infant with
gastro-esophageal reflux, which intervention is most important for the nurse to implement?
Record weight daily.
Assess for signs of anemia.
Document sleeping patterns.
Teach parenting skills. - ANSWER-Record weight daily.
The most definitive measure of improved nutrition in an infant is obtaining the child's daily weight (A).
(B, C, and D) may also be useful, but they are not as definitive as a daily weight measurement.
A three-month old boy weighing 10 lbs 15 oz has an axillary temperature of 98.9° F. The nurse
determines the daily caloric need for this child is approximately
400 calories per day.
500 calories per day.
600 calories per day.
700 calories per day. - ANSWER-600 calories per day.
, 10 lbs 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2; 10.9/2.2 = 4.954 kg, rounded to 5 kg.
An infant requires 108 calories/kg/day (108 × 5 = 540 calories/day). However, this infant requires 10%
more calories because he has one degree temperature elevation. 10% of 540 is 54 and 540 + 54 = 594.
This infant will require approximately 600 calories/day. Tough question! You know that 400 calories are
too few and 700 are too much, and a temperature elevation necessitates consumption of more calories,
so choose the higher of the two choices left!
Which measurements should be used to accurately calculate a pediatric medication dosage? (Select all
that apply.)
Child's height and weight.
Adult dosage of medication.
Body surface area of child.
Average adult's body surface area.
Average pediatric dosage of medication.
Nomogram determined mathematical constant. - ANSWER-Child's height and weight.
Body surface area of child.
Nomogram determined mathematical constant.
Correct selections are (A, C, and F). The most accurate calculations of pediatric dosages use the child's
height and weight (A). The child's BSA is calculated using the square root of weight in kg times height in
cm divided by 3600 or the square root of weight in lb times height in inches divided by 3131 (C), then the
child's BSA is multiplied by the recommended published dose per BSA. The nomogram (F) is used to plot
the child's height and weight, and the point at which they intersect is the BSA mathematical constant
used to calculate the child's dose. (B, D, and E) are not used to calculate pediatric dosages.
The nurse is assessing a 2-year-old. What behavior indicates that the child's language development is
within normal limits?
Is able to name four colors.
Can count five blocks.
Is capable of making a three word sentence.
Half of child's speech is understandable. - ANSWER-Half of child's speech is understandable.
TEST BANK EXAM ACTUAL 350 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
A 3-year-old boy is brought to the emergency room because he swallowed an entire bottle of children's
vitamin pills. Which intervention should the nurse implement first?
Insert N/G tube for gastric lavage.
Determine the child's pulse and respirations.
Assess the child's level of consciousness.
Administer an IV D5/0.25 NS as prescribed. - ANSWER-Determine the child's pulse and respirations.
The most important principle in dealing with a poisoning is to treat the child first, not the poison. Initiate
immediate life support measures with assessment of vital signs (B), in particular, respirations. Inserting
an airway or initiating mechanical ventilation may be necessary. Assessment and identification of the
poison should occur prior to (A). (C and D) should occur after assessing the airway.
To take the vital signs of a 4-month-old child, which order provides the most accurate results?
Respiratory rate, heart rate, then rectal temperature.
Heart rate, rectal temperature, then respiratory rate.
Rectal temperature, heart rate, then respiratory rate.
Rectal temperature, respiratory rate, then heart rate. - ANSWER-Respiratory rate, heart rate, then
rectal temperature.
The respiratory rate should be taken first (A) in infants, since touching them or performing unpleasant
procedures usually makes them cry, elevating the heart rate and making respirations difficult to count
(B). Rectal temperature is the most invasive procedure, and is most likely to precipitate crying, so should
be done last (C and D).
The parents of a 3-week-old infant report that the child eats well but vomits after each feeding. What
information is most important for the nurse to obtain?
Description of vomiting episodes in past 24 hours.
Number of wet diapers in last 24 hours.
,Feeding and sleep schedule.
Amount of formula consumed during the past 24 hours. - ANSWER-Description of vomiting episodes
in past 24 hours.
A description of the vomiting episodes (A) will assist the nurse in determining the reason for the
symptoms, which may be helpful in developing a plan of care for this infant. (B and C) provide related
information but are not as helpful as (A). (D) may be related to the vomiting, but the nurse should first
obtain a better description of the vomiting episodes.
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribes
dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be infused at 25 ml/hour. Prior to
initiating the infusion, the nurse should obtain which assessment finding?
Frequency of emesis in the last 8 hours.
Serum BUN and creatinine levels.
Current blood sugar level.
Appearance of the stool. - ANSWER-Serum BUN and creatinine levels.
Regardless of a client's age, adequate renal function must be present before adding potassium to IV
fluids (B). (A) is important in determining the need for fluid replacement. (C) is not indicated. (D) is useful
information, but will not impact administration of the prescribed IV solution.
Which finding in a 19-year-old female client should trigger further assessment by the nurse?
Menstruation has not occurred.
Reports no tetanus immunization since childhood.
Denies having any wisdom teeth.
History of painful, inward growth on bottom of foot. - ANSWER-Menstruation has not occurred.
Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically
occurs by age 18, so (A) should prompt further investigation to determine the cause of this primary
amenorrhea. Children receive tetanus as part of the DPT childhood immunization series, and a booster is
not typically given until age 16 (B). Wisdom teeth are the third molar teeth of the permanent dentition
and are the last to erupt, so (C) is a normal finding. (D) describes a plantar surface wart, harmless but
painful because of the pressure with walking or standing.
,The nurse is giving a liquid iron preparation to a 3-year-old child. Which technique should the nurse
implement to engage the child's cooperation?
Use a colorful straw.
Mix the medication in water.
Administer the medication using an oral syringe.
Ask the pharmacy to provide an enteric tablet. - ANSWER-Use a colorful straw.
A liquid iron preparation administered through a straw may help the child to accept the medication since
young children consider drinking from a colorful straw fun (A). (B) may cause staining of the child's teeth.
(C) is often used if the child is uncooperative. (D) is ineffective and should be requested from the
healthcare provider.
When evaluating the effectiveness of interventions to improve the nutritional status of an infant with
gastro-esophageal reflux, which intervention is most important for the nurse to implement?
Record weight daily.
Assess for signs of anemia.
Document sleeping patterns.
Teach parenting skills. - ANSWER-Record weight daily.
The most definitive measure of improved nutrition in an infant is obtaining the child's daily weight (A).
(B, C, and D) may also be useful, but they are not as definitive as a daily weight measurement.
A three-month old boy weighing 10 lbs 15 oz has an axillary temperature of 98.9° F. The nurse
determines the daily caloric need for this child is approximately
400 calories per day.
500 calories per day.
600 calories per day.
700 calories per day. - ANSWER-600 calories per day.
, 10 lbs 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2; 10.9/2.2 = 4.954 kg, rounded to 5 kg.
An infant requires 108 calories/kg/day (108 × 5 = 540 calories/day). However, this infant requires 10%
more calories because he has one degree temperature elevation. 10% of 540 is 54 and 540 + 54 = 594.
This infant will require approximately 600 calories/day. Tough question! You know that 400 calories are
too few and 700 are too much, and a temperature elevation necessitates consumption of more calories,
so choose the higher of the two choices left!
Which measurements should be used to accurately calculate a pediatric medication dosage? (Select all
that apply.)
Child's height and weight.
Adult dosage of medication.
Body surface area of child.
Average adult's body surface area.
Average pediatric dosage of medication.
Nomogram determined mathematical constant. - ANSWER-Child's height and weight.
Body surface area of child.
Nomogram determined mathematical constant.
Correct selections are (A, C, and F). The most accurate calculations of pediatric dosages use the child's
height and weight (A). The child's BSA is calculated using the square root of weight in kg times height in
cm divided by 3600 or the square root of weight in lb times height in inches divided by 3131 (C), then the
child's BSA is multiplied by the recommended published dose per BSA. The nomogram (F) is used to plot
the child's height and weight, and the point at which they intersect is the BSA mathematical constant
used to calculate the child's dose. (B, D, and E) are not used to calculate pediatric dosages.
The nurse is assessing a 2-year-old. What behavior indicates that the child's language development is
within normal limits?
Is able to name four colors.
Can count five blocks.
Is capable of making a three word sentence.
Half of child's speech is understandable. - ANSWER-Half of child's speech is understandable.
