PEDIATRICS - HESI PRACTICE EXAM
A 2 year old child recently diagnosed with hemophilia A is discharged home. What information
should the nurse include in a teaching plan about home care?
A. Minimize interactive play with other children to lessen chances for injury
B. give low-dose children's chewable aspirin in orange flavor for joint discomfort
C. use a firm and dry toothbrush to clean teeth at least twice per day
D. apply pressure and ice for bleeding while elevating and resting the extremity. - ANS-D. apply
pressure and ice for bleeding while elevating and resting the extremity.
Hemophilia, a blood disorder, causes joint bleeding which is treated with rest, ice, compression,
and elevation (RICE)
\A 2-year old with gastro-esophageal reflux has developed a fear of eating. What instruction
should the nurse include in the parents' teaching plan?
A. invite other children home to share meals
B. accept that he will eat when he is hungry
C. reward the child with a nap after eating
D. consistently follow a set mealtime routine. - ANS-D. consistently follow a set mealtime
routine.
A 2-year old child is comforted by consistency. (A) is contraindicate because 2 year olds may
participate in parallel activities with other children but are too young to feel comfort and support
by the presence of other children when anxious or afraid. (B) may or may not be true and does
not address the child's fears. The child with reflux should remain upright at least 2 hours after
eating to reduce symptoms.
\A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician
prescribed dextrose 5% and 0.25% normal saline with 2 mEq KCI/100 mL to be infused at
25mL/hr. Prior to initiating the infusion, the nurse should obtain which assessment finding?
A. frequency of emesis is the last 8 hours
B. serum BUN and creatinine levels
C. current blood sugar level
D. appearance of the stool - ANS-B. serum BUN and creatinine levels
Regardless of a client's age, adequate renal function must be present before adding potassium
to IV fluids. (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.
\A 6 year old is admitted to the pediatric unit after falling off a bicycle. Which intervention should
the nurse implement to assist the child's adjustment to hospitalization?
A. explain hospital schedules to the child, such as mealtimes.
B. use terms, such as "honey" and "dear" to show a caring attitude.
C. provide a list of rules that limits visitation of siblings in the hospital
, D. orient the parents to the hospital unit and refreshment areas. - ANS-A. explain hospital
schedules to the child, such as mealtimes.
Altered daily schedules and loss of rituals are upsetting to children and increase separation
anxiety, and active sensitivity to the needs of children can minimize the negative effects of
hospitalization. Explaining the hospital schedules and establishing an individual schedule
familiarizes the child to the hospital environment and decreases anxiety. (B) depersonalizes the
child who should be addressed by name. Family and sibling visitation should be recommended
and encouraged without limitation. Although (D) should be implemented, the direct involvement
of the school-aged child incorporates the child's sense of initiate and cooperation.
\A child with cystic fibrosis is having stools that float and are foul smelling. Which descriptive
term should the nurse use to document the finding?
A. diarrhea
B. rhinorrhea
C. galactorrhea
D. steatorrhea - ANS-D. steatorrhea
Steatorrhea is defined as stools with an abnormally high fat content that are usually foul
smelling and float on water
\A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the
most important instruction for the nurse to include in this client's teaching plan?
A. Use sunscreen when lying by the pool.
B. cleanse the skin at least 4 times a day.
C. take the medication with a glass of milk
D. menstrual periods may become irregular - ANS-A. Use sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe
sunburn can occur with minimal sun exposure and clients should be instructed to avoid sunlight
and to use sunscreen. (B and D) are not related to tetracyline HCL (Achromycin V) therapy. (C)
should be avoided because dairy products interfere with the absorption of tetracyclines.
\A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse
suspects that the infant may have an esophageal atresia. Which symptoms is this newborn
likely to have exhibited?
A. choking, coughing, and cyanosis
B. projectile vomiting and cyanosis
C. apneic spells and grunting
D. scaphoid abdomen and anorexia - ANS-A. choking, coughing, and cyanosis
(A) includes the "3 C's" of esophageal atresia caused by the overflow of secretions into the
trachea. (B) is characteristic of pyloric stenosis in the infant. (C) could be due to prematurity or
sepsis, and grunting is a sign of respiratory distress. (D) is characteristic of a diaphragmatic
hernia.
A 2 year old child recently diagnosed with hemophilia A is discharged home. What information
should the nurse include in a teaching plan about home care?
A. Minimize interactive play with other children to lessen chances for injury
B. give low-dose children's chewable aspirin in orange flavor for joint discomfort
C. use a firm and dry toothbrush to clean teeth at least twice per day
D. apply pressure and ice for bleeding while elevating and resting the extremity. - ANS-D. apply
pressure and ice for bleeding while elevating and resting the extremity.
Hemophilia, a blood disorder, causes joint bleeding which is treated with rest, ice, compression,
and elevation (RICE)
\A 2-year old with gastro-esophageal reflux has developed a fear of eating. What instruction
should the nurse include in the parents' teaching plan?
A. invite other children home to share meals
B. accept that he will eat when he is hungry
C. reward the child with a nap after eating
D. consistently follow a set mealtime routine. - ANS-D. consistently follow a set mealtime
routine.
A 2-year old child is comforted by consistency. (A) is contraindicate because 2 year olds may
participate in parallel activities with other children but are too young to feel comfort and support
by the presence of other children when anxious or afraid. (B) may or may not be true and does
not address the child's fears. The child with reflux should remain upright at least 2 hours after
eating to reduce symptoms.
\A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician
prescribed dextrose 5% and 0.25% normal saline with 2 mEq KCI/100 mL to be infused at
25mL/hr. Prior to initiating the infusion, the nurse should obtain which assessment finding?
A. frequency of emesis is the last 8 hours
B. serum BUN and creatinine levels
C. current blood sugar level
D. appearance of the stool - ANS-B. serum BUN and creatinine levels
Regardless of a client's age, adequate renal function must be present before adding potassium
to IV fluids. (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.
\A 6 year old is admitted to the pediatric unit after falling off a bicycle. Which intervention should
the nurse implement to assist the child's adjustment to hospitalization?
A. explain hospital schedules to the child, such as mealtimes.
B. use terms, such as "honey" and "dear" to show a caring attitude.
C. provide a list of rules that limits visitation of siblings in the hospital
, D. orient the parents to the hospital unit and refreshment areas. - ANS-A. explain hospital
schedules to the child, such as mealtimes.
Altered daily schedules and loss of rituals are upsetting to children and increase separation
anxiety, and active sensitivity to the needs of children can minimize the negative effects of
hospitalization. Explaining the hospital schedules and establishing an individual schedule
familiarizes the child to the hospital environment and decreases anxiety. (B) depersonalizes the
child who should be addressed by name. Family and sibling visitation should be recommended
and encouraged without limitation. Although (D) should be implemented, the direct involvement
of the school-aged child incorporates the child's sense of initiate and cooperation.
\A child with cystic fibrosis is having stools that float and are foul smelling. Which descriptive
term should the nurse use to document the finding?
A. diarrhea
B. rhinorrhea
C. galactorrhea
D. steatorrhea - ANS-D. steatorrhea
Steatorrhea is defined as stools with an abnormally high fat content that are usually foul
smelling and float on water
\A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the
most important instruction for the nurse to include in this client's teaching plan?
A. Use sunscreen when lying by the pool.
B. cleanse the skin at least 4 times a day.
C. take the medication with a glass of milk
D. menstrual periods may become irregular - ANS-A. Use sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe
sunburn can occur with minimal sun exposure and clients should be instructed to avoid sunlight
and to use sunscreen. (B and D) are not related to tetracyline HCL (Achromycin V) therapy. (C)
should be avoided because dairy products interfere with the absorption of tetracyclines.
\A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse
suspects that the infant may have an esophageal atresia. Which symptoms is this newborn
likely to have exhibited?
A. choking, coughing, and cyanosis
B. projectile vomiting and cyanosis
C. apneic spells and grunting
D. scaphoid abdomen and anorexia - ANS-A. choking, coughing, and cyanosis
(A) includes the "3 C's" of esophageal atresia caused by the overflow of secretions into the
trachea. (B) is characteristic of pyloric stenosis in the infant. (C) could be due to prematurity or
sepsis, and grunting is a sign of respiratory distress. (D) is characteristic of a diaphragmatic
hernia.
