pediatric hesi
"A 10-month-old infant is hospitalized for respiratory syncytial virus (RSV). Using knowledge of
growth and development according to Erik Erikson and Jean Piaget, the nurse should do which
of the following to meet the infant's developmental needs?"
a. wash hands, wear a mask and keep the infant as quiet as possible
b. follow the home feeding schedule and allow the infant to be held only when the parents visit
c. restrain the infant continuously to prevent tubes from being dislodged
d. provide a consistent routine, as well as touching, rocking, and cuddling throughout the
hospitalization - ANS-provide a consistent routine, as well as touching, rocking, and cuddling
throughout the hospitalization
\"A 12-year-old child is seen in the health care clinic. During the assessment, which finding
would suggest to the nurse that the child is experiencing a disruption in the development of
self-concept?"
a. the child has a part-time babysitting job
b. the child enjoys playing chess and mastering new skills with this game
c. the child has many friends
d. the child has an intimate relationship with a significant other - ANS-the child has an intimate
relationship with a significant other
\"A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To
assess adequacy of support for the child's psychosocial needs, the nurse would ask the parents
which question?"
a. what signs and symptoms has your child been having?
b. Will a family member be able to stay with the child most of the time?
c. how long have you known your child's diagnosis?
d. What are your child's favorite books, activities and toys? - ANS-b. Will a family member be
able to stay with the child most of the time?
\"A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To
assess adequacy of support for the child's psychosocial needs, the nurse would ask the parents
which question?"
a. what signs and symptoms has your child been having?
b. Will a family member be able to stay with the child most of the time?
c. How long have you known your child's diagnosis?
d. what are your child's favorite books, activities and toys? - ANS-Will a family member be able
to stay with the child most of the time?
\"A child with a tracheal obstruction is brought to the emergency room by emergency medical
services. The child has aspirated a marble, and the foreign body is removed in the emergency
room by direct laryngoscopy. After the procedure, the nurse informs the mother of the child
that:"
a. the child will need to be hospitalized for observation
b. the child may go home with a prescription for antibiotics
c. the child will need to return to the hospital for a chest x-ray in 1 week
,d. the child will require a bronchoscopy for follow up evaluation in 1 month - ANS-the child will
need to be hospitalized for observation
\"A client is unable to expectorate sputum for a sputum sample, and the nurse is preparing to
obtain the sample via saline inhalation. The nurse instructs the client to inhale the warm saline
vapor via nebulizer by:"
a. hold the nebulizer under the nose
b. keeping the lips closed lightly over the mouthpiece
c. keeping the lips closed tightly over the mouthpiece
d. alternating one vapor breath with one breath from room air - ANS-keeping the lips closed
lightly over the mouthpiece
\"A client taking albuterol (Ventolin) experiences a severe episode of wheezing, which the nurse
interprets as bronchospasm. A telephone call is made to the physician's office to report the
occurrence. The nurse does which of the following while waiting for the physician to return the
call?"
a. administer the next dose of albuterol as scheduled
b. withholds the next dose of albuterol
c. administer a double dose of albuterol
d. administers half the dose of albuterol - ANS-withholds the next dose of albuterol
\"A client with gastroesophageal reflux disease (GERD) complains of chest discomfort that feels
like heartburn, especially following each meal. After teaching the client to take antacids as
prescribed, the nurse suggests that the client lie in which position during sleep?"
a. with the head of the bed elevated 6 to 8 inches
b. flat
c. supine with the head of the bed flat
d. on the stomach with the head of the bed flat - ANS-a. with the head of the bed elevated 6 to 8
inches
\"A hospitalized toddler cries when anyone enters the room, and kicks, yells, and clings to the
parents if they try to leave. Based on these data, the nurse determines that the priority nursing
diagnosis is:"
a. fear related to unfamiliar surroundings
b. deficient divisional activity related to developmental stage
c. compromised family coping related to the sick child
d. delayed growth and development related to overprotective parenting - ANS-a. fear related to
unfamiliar surroundings
\"A mother tells the nurse that her child does not want anything to do with toilet training and yells
"NO!" consistently when she tries to toilet train. The child is 2 years old. According to Erikson,
the nurse interprets that the child is experiencing which psychosocial crisis?"
a. autonomy vs shame and doubt
b. initiative vs guilt
c. industry vs inferiority
d. trust vs mistrust - ANS-Autonomy vs shame and doubt
\"A newborn infant is diagnosed with hypospadias, and the mother asks the nurse about the
disorder. The nurse bases the response on which of the following?"
,a. it is a congenital anomaly in which the actual opening of the urethra meatus is below the
normal placement on the glans penis
b. it occurs when one or both testes fail to descend through the inguinal canal into the scrotal
sac
c. it is a congenital anomaly in which the actual opening of the urethral meatus is dorsal to the
urethral opening
d. it is a congential anomaly characterized by the extrusion of the urinary bladder to the outside
of the body - ANS-it is a congenital anomaly in which the actual opening of the urethra meatus
is below the normal placement on the glans penis
\"A nurse gathers assessment data from a client admitted to the hospital with gastrointestinal
reflux disease (GERD) who is scheduled for a Nissen fundoplication. Based on an
understanding of this disease, the nurse determines that the client may be at risk for which
complication?"
a. diarrhea
b. belching
c. aspiration
d. abdominal pain - ANS-c. aspiration
\"A nurse is caring for a child with intussusception. During care, the child passes a normal brown
stool. The most appropriate nursing action is to:"
a. report the passage of a normal brown stool to the physician
b. prepare the child and parents for the possibility of surgery
c. note the child's physical symptoms
d. prepare the child for hydrostatic reduction - ANS-report the passage of a normal brown stool
to the physician
\"A nurse is providing instructions to the mother of a child with a diagnosis of strabismus of the
left eye, and the nurse reviews the procedure for patching the child. The nurse determines that
the mother understands the procedure if the mother makes which statement?"
a. I will place the patch on the right eye
b. I will place the patch on both eyes
c. I will place the patch on the left eye
d. I will alternate the patch from the right to the left eye every hour - ANS-I will place the patch
on the right eye
\"Methylphenidate hydrochloride (Ritalin) is prescribed for a 10-year-old child diagnosed with
attention deficit hyperactivity disorder, and the nurse provides instructions to the mother about
administration of the medication. The nurse determines that the mother understands the
instructions when the mother states:"
a. I will give my child the medication at bedtime so that he will be rested and alert for school the
next day
b. I will give my child the medication after meals to obtain the full effects of the medication
c. I will give my child the medication at breakfast and lunch to prevent insomnia
d. I will give my child the medication with water to prevent kidney damage - ANS-I will give my
child the medication at breakfast and lunch to prevent insomnia
\"When administering a liquid medication to an uncooperative toddler, the nurse would
implement which strategy?"
, a. allow the parents to remain the room
b. remove the child to another room away from the parents
c. restrain the child in a high chair
d. restrain the child in a papoose restraining device - ANS-allow the parents to remain the room
\"When obtaining a history from parents of a 5 month old child suspected of having
intussusception, which assessment area would be most important for the nurse to address?"
a. pattern of abdominal pain
b. known allergies
c. dietary intake during the past 24 hours
d. usual pattern of bowel movements - ANS-pattern of abdominal pain
\1. Apnea of infancy has been diagnosed in an infant who will soon be discharged with home
monitoring. Part of the discharge teaching by the nurse for the parents includes:
A. administration of IV fluids.
B. cardiopulmonary resuscitation.
C. reassurance that the infant cannot be electrocuted during monitoring.
D. advisement that the infant not be left with other caretakers, such as babysitters. - ANS-B.
cardiopulmonary resuscitation.
CPR is essential for parents and caregivers to know.
A. administration of IV fluids.
Most likely, the child will not have venous access, so home IV therapy is not necessary.
C. reassurance that the infant cannot be electrocuted during monitoring.
The monitor is insulated and grounded.
D. advisement that the infant not be left with other caretakers, such as babysitters.
The parents should arrange for other caregivers to help out. All need to be taught how to use
the monitoring equipment and how to perform CPR.
\10. Cystic fibrosis may affect single or multiple systems of the body. The primary factor
responsible for possible multiple clinical manifestations is:
A. mechanical obstruction caused by increased viscosity of mucous gland secretions.
B. atrophic changes in mucosal wall of intestines.
C. hypoactivity of the autonomic nervous system.
D. hyperactivity of sweat glands. - ANS-A. mechanical obstruction caused by increased viscosity
of mucous gland secretions.
Children with cystic fibrosis have thick mucous gland secretions. The viscous secretions
obstruct small passages in organs such as the pancreas.
B. atrophic changes in mucosal wall of intestines.
Thick mucous secretions are the probable cause of the multiple body system involvement.
C. hypoactivity of the autonomic nervous system.
There is an identified autonomic nervous system anomaly, but it is not hypoactivity.
D. hyperactivity of sweat glands.
The sweat glands are not hyperactive. The child loses a greater amount of salt because of
abnormal chloride movement.
"A 10-month-old infant is hospitalized for respiratory syncytial virus (RSV). Using knowledge of
growth and development according to Erik Erikson and Jean Piaget, the nurse should do which
of the following to meet the infant's developmental needs?"
a. wash hands, wear a mask and keep the infant as quiet as possible
b. follow the home feeding schedule and allow the infant to be held only when the parents visit
c. restrain the infant continuously to prevent tubes from being dislodged
d. provide a consistent routine, as well as touching, rocking, and cuddling throughout the
hospitalization - ANS-provide a consistent routine, as well as touching, rocking, and cuddling
throughout the hospitalization
\"A 12-year-old child is seen in the health care clinic. During the assessment, which finding
would suggest to the nurse that the child is experiencing a disruption in the development of
self-concept?"
a. the child has a part-time babysitting job
b. the child enjoys playing chess and mastering new skills with this game
c. the child has many friends
d. the child has an intimate relationship with a significant other - ANS-the child has an intimate
relationship with a significant other
\"A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To
assess adequacy of support for the child's psychosocial needs, the nurse would ask the parents
which question?"
a. what signs and symptoms has your child been having?
b. Will a family member be able to stay with the child most of the time?
c. how long have you known your child's diagnosis?
d. What are your child's favorite books, activities and toys? - ANS-b. Will a family member be
able to stay with the child most of the time?
\"A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To
assess adequacy of support for the child's psychosocial needs, the nurse would ask the parents
which question?"
a. what signs and symptoms has your child been having?
b. Will a family member be able to stay with the child most of the time?
c. How long have you known your child's diagnosis?
d. what are your child's favorite books, activities and toys? - ANS-Will a family member be able
to stay with the child most of the time?
\"A child with a tracheal obstruction is brought to the emergency room by emergency medical
services. The child has aspirated a marble, and the foreign body is removed in the emergency
room by direct laryngoscopy. After the procedure, the nurse informs the mother of the child
that:"
a. the child will need to be hospitalized for observation
b. the child may go home with a prescription for antibiotics
c. the child will need to return to the hospital for a chest x-ray in 1 week
,d. the child will require a bronchoscopy for follow up evaluation in 1 month - ANS-the child will
need to be hospitalized for observation
\"A client is unable to expectorate sputum for a sputum sample, and the nurse is preparing to
obtain the sample via saline inhalation. The nurse instructs the client to inhale the warm saline
vapor via nebulizer by:"
a. hold the nebulizer under the nose
b. keeping the lips closed lightly over the mouthpiece
c. keeping the lips closed tightly over the mouthpiece
d. alternating one vapor breath with one breath from room air - ANS-keeping the lips closed
lightly over the mouthpiece
\"A client taking albuterol (Ventolin) experiences a severe episode of wheezing, which the nurse
interprets as bronchospasm. A telephone call is made to the physician's office to report the
occurrence. The nurse does which of the following while waiting for the physician to return the
call?"
a. administer the next dose of albuterol as scheduled
b. withholds the next dose of albuterol
c. administer a double dose of albuterol
d. administers half the dose of albuterol - ANS-withholds the next dose of albuterol
\"A client with gastroesophageal reflux disease (GERD) complains of chest discomfort that feels
like heartburn, especially following each meal. After teaching the client to take antacids as
prescribed, the nurse suggests that the client lie in which position during sleep?"
a. with the head of the bed elevated 6 to 8 inches
b. flat
c. supine with the head of the bed flat
d. on the stomach with the head of the bed flat - ANS-a. with the head of the bed elevated 6 to 8
inches
\"A hospitalized toddler cries when anyone enters the room, and kicks, yells, and clings to the
parents if they try to leave. Based on these data, the nurse determines that the priority nursing
diagnosis is:"
a. fear related to unfamiliar surroundings
b. deficient divisional activity related to developmental stage
c. compromised family coping related to the sick child
d. delayed growth and development related to overprotective parenting - ANS-a. fear related to
unfamiliar surroundings
\"A mother tells the nurse that her child does not want anything to do with toilet training and yells
"NO!" consistently when she tries to toilet train. The child is 2 years old. According to Erikson,
the nurse interprets that the child is experiencing which psychosocial crisis?"
a. autonomy vs shame and doubt
b. initiative vs guilt
c. industry vs inferiority
d. trust vs mistrust - ANS-Autonomy vs shame and doubt
\"A newborn infant is diagnosed with hypospadias, and the mother asks the nurse about the
disorder. The nurse bases the response on which of the following?"
,a. it is a congenital anomaly in which the actual opening of the urethra meatus is below the
normal placement on the glans penis
b. it occurs when one or both testes fail to descend through the inguinal canal into the scrotal
sac
c. it is a congenital anomaly in which the actual opening of the urethral meatus is dorsal to the
urethral opening
d. it is a congential anomaly characterized by the extrusion of the urinary bladder to the outside
of the body - ANS-it is a congenital anomaly in which the actual opening of the urethra meatus
is below the normal placement on the glans penis
\"A nurse gathers assessment data from a client admitted to the hospital with gastrointestinal
reflux disease (GERD) who is scheduled for a Nissen fundoplication. Based on an
understanding of this disease, the nurse determines that the client may be at risk for which
complication?"
a. diarrhea
b. belching
c. aspiration
d. abdominal pain - ANS-c. aspiration
\"A nurse is caring for a child with intussusception. During care, the child passes a normal brown
stool. The most appropriate nursing action is to:"
a. report the passage of a normal brown stool to the physician
b. prepare the child and parents for the possibility of surgery
c. note the child's physical symptoms
d. prepare the child for hydrostatic reduction - ANS-report the passage of a normal brown stool
to the physician
\"A nurse is providing instructions to the mother of a child with a diagnosis of strabismus of the
left eye, and the nurse reviews the procedure for patching the child. The nurse determines that
the mother understands the procedure if the mother makes which statement?"
a. I will place the patch on the right eye
b. I will place the patch on both eyes
c. I will place the patch on the left eye
d. I will alternate the patch from the right to the left eye every hour - ANS-I will place the patch
on the right eye
\"Methylphenidate hydrochloride (Ritalin) is prescribed for a 10-year-old child diagnosed with
attention deficit hyperactivity disorder, and the nurse provides instructions to the mother about
administration of the medication. The nurse determines that the mother understands the
instructions when the mother states:"
a. I will give my child the medication at bedtime so that he will be rested and alert for school the
next day
b. I will give my child the medication after meals to obtain the full effects of the medication
c. I will give my child the medication at breakfast and lunch to prevent insomnia
d. I will give my child the medication with water to prevent kidney damage - ANS-I will give my
child the medication at breakfast and lunch to prevent insomnia
\"When administering a liquid medication to an uncooperative toddler, the nurse would
implement which strategy?"
, a. allow the parents to remain the room
b. remove the child to another room away from the parents
c. restrain the child in a high chair
d. restrain the child in a papoose restraining device - ANS-allow the parents to remain the room
\"When obtaining a history from parents of a 5 month old child suspected of having
intussusception, which assessment area would be most important for the nurse to address?"
a. pattern of abdominal pain
b. known allergies
c. dietary intake during the past 24 hours
d. usual pattern of bowel movements - ANS-pattern of abdominal pain
\1. Apnea of infancy has been diagnosed in an infant who will soon be discharged with home
monitoring. Part of the discharge teaching by the nurse for the parents includes:
A. administration of IV fluids.
B. cardiopulmonary resuscitation.
C. reassurance that the infant cannot be electrocuted during monitoring.
D. advisement that the infant not be left with other caretakers, such as babysitters. - ANS-B.
cardiopulmonary resuscitation.
CPR is essential for parents and caregivers to know.
A. administration of IV fluids.
Most likely, the child will not have venous access, so home IV therapy is not necessary.
C. reassurance that the infant cannot be electrocuted during monitoring.
The monitor is insulated and grounded.
D. advisement that the infant not be left with other caretakers, such as babysitters.
The parents should arrange for other caregivers to help out. All need to be taught how to use
the monitoring equipment and how to perform CPR.
\10. Cystic fibrosis may affect single or multiple systems of the body. The primary factor
responsible for possible multiple clinical manifestations is:
A. mechanical obstruction caused by increased viscosity of mucous gland secretions.
B. atrophic changes in mucosal wall of intestines.
C. hypoactivity of the autonomic nervous system.
D. hyperactivity of sweat glands. - ANS-A. mechanical obstruction caused by increased viscosity
of mucous gland secretions.
Children with cystic fibrosis have thick mucous gland secretions. The viscous secretions
obstruct small passages in organs such as the pancreas.
B. atrophic changes in mucosal wall of intestines.
Thick mucous secretions are the probable cause of the multiple body system involvement.
C. hypoactivity of the autonomic nervous system.
There is an identified autonomic nervous system anomaly, but it is not hypoactivity.
D. hyperactivity of sweat glands.
The sweat glands are not hyperactive. The child loses a greater amount of salt because of
abnormal chloride movement.
