peds Hesi 2022-2023 Flashcards


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1

The nurse is caring for a 3 y.o. child who is 2 hours post-op from a cardiac catherization via the right femoral artery which assessment finding is an indication of arterial obstruction

Right foot is cool to the touch & appears pale and blanched

2

Following a motor vehicle collision a 3 year old girl has a spica cast applied which toy is best for the nurse for this 3 year old child

Set cloth and hand puppets

3

An infant with tetralogy of Fallot becomes acutely cyanotic and hyperpneic which action should the nurse implement

Place the infant in a knee chest position

4

A child admitted with diabetic ketoacidosis is demonstrating Kussmaul respirations. The nurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration?

Metabolic acidosis

5

A 7-year-old is admitted to the hospital with persistent vomiting, and a nasogastric tube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider?

Serum potassium of 3.0 mg/dL

6

The nurse is evaluating diet teaching for a client who has non tropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective?

Creamed corn.

7

During a well-baby check, the nurse hides a block under the baby’s blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing?

Object permanence.

8

The nurse is measuring the frontal occipital circumference (FOC) of a 3-months old infant, and notes that the FOC has increased 5 inches since birth and the child’s head appears large in relation to body size. Which action is most important for the nurse to take next?

Palpate the anterior fontanel for tension and bulging.

9

The nurse is preparing a 10-year-old with a lacerated forehead for suturing. Both parents and 12-year-old sibling are at the child’s bedside. Which instruction best supports family?

Please decide who will stay when the healthcare provider begins suturing.

10

The nurse is planning for a 5-month-old with gastroesophageal reflux disease whose weight has decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instructions should the nurse provide this mother?

Thicken formula with cereal for each feeding.

11

While teaching a parenting class to new parents the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is the most important reason for implementing such parenting behaviors?

They provide the child with a sense of security.

12

The parents of a newborn infant with hypospadias are concerned about when the surgical correction should occur. What information should the nurse provide?

Repairs typically should be done before the child is potty trained.

13

Which drink choice on a hot day indicates to the nurse that a teenager with sickle cell anemia understands dietary consideration related to the disease?

Lemonade.

14

The nurse is assessing an infant with diarrhea and lethargy. Which finding should the nurse identify that is consistent with early dehydration?

Tachycardia.

15

While auscultating the lung sounds of a 5-year-old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. What action is best for the nurse to take?

Inquire about the use of alternative methods of treatment

16

A child witch acute lymphocytic leukemia (ALL) who is receiving chemotherapy via a subclavian IV infusion, has an oral temperature of 103 degrees. In assessing the IV site, the nurse determines that there are no signs of infection at the site. Which intervention is the most important for the nurse to implement?

Obtain specimen for blood cultures.

17

A child who weighs 25 kg is receiving IV ampicillin 300 mg/kg/24 hours in equally divided doses every 4 hours. How many mg should the nurse administer to the child for each dose.

Ans. 300 x 25 = 7500/4 = 1875

18

The nurse is caring for an infant scheduled for reduction of intussusceptions. The day before the scheduled procedure the infant passes a soft-formed brown stool. Which intervention should the nurse implement?

Notify the healthcare provider of the passage of brown stool.

19

The mother of a 4-month-old asks the nurse for advice in preventing diaper rash. What suggestion should the nurse provide?

Use a barrier cream, such as zinc oxide, which does not have to be completely

20

Which statement by a school aged client going to summer camp indicates the best understanding of the mode of transmission of Lyme disease?

I have to wear long sleeves and pants when we’re hiking around the pond

21

The nurse is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective?

Laughs readily, turns from back to side.

22

The HR for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours, now it’s 76 bpm, the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider?

BP70/40.

23

A 2-year-old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure?

Describe the side-lying, knees to chest position that must be assumed during the procedure.

24

The parents of a 3-year-old boy who has Duchenne muscular dystrophy (DMD) asks, “how can our son have this disease? We are wondering if we should have any more children.” What information should the nurse provide these parents?

This is an inherited x-linked recessive disorder, which primarily affects male children in the family.

25

The nurse finds a 6-month-old infant unresponsive and calls for help. After opening the airway and finding the XXXX the infant is still not breathing. Which action should the nurse take?

Give two breaths that makes the chest rise.

26

A 3-year-old with HIV infections is staying with a foster family who is caring for 3 other foster children in their home. When one of the children acquires pertussis, the foster mother calls the clinic and asks the nurse what she should do. Which action should the nurse take first?

Review the immunization documentation of the child who has HIV.

27

A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is “beating a mile per minute.” Which information is most important for the nurse to obtain?

How often the MDI is used daily.

28

The nurse is assessing a child for neurological soft signs, which finding is most likely demonstrated in the child’s behavior?

Poor coordination and sense of position.

29

The nurse is assessing an infant with pyloric stenosis. Which pathophysiological mechanism is the most likely consequence of this infant’s clinical picture?

Metabolic alkalosis.

30

A 4-month-old girl brought to the clinic by her mother because she has had a cold for 2 or 3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress?

Flaring of the nares.

31

A two-year-old boy begins to cry when the mother starts to leave. What is the nurse’s best response in this situation?

Let me read this book to you.

32

A two-year-old child with a heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 bpm. What action should the nurse implement?

Administer the scheduled dose.

33

A child with leukemia is admitted for Chemotherapy and the nursing diagnosis “altered nutrition, less than body requirements related to anorexia, nausea and vomiting” is identified. Which intervention the nurse included in this child plan of care?

Allow the child to eat any food desired and tolerated.

34

A 6-year-old who has asthma is demonstrating a prolonged expiratory phase and wheezing and has a 35% of personal best peak expiratory flow rate (PEFR). Based on these findings, which action should the nurse take first?

Administer a prescribed bronchodilator.

35

The nurse plans to administer 10 mcg/kg of digoxin elixir as a loading dose to a child who weighs 55 pounds. Digoxin is available as elixir of 50 mcg/mL. How many mL of the digoxin elixir should the nurse administer to this child?

Ans. 55 lbs = 25 kg x 10 mcg = 250/50 = 5

36

The nurse observes a mother giving her 11-month-old ferrous sulfate, followed by two

ounces of orange juice. What should the nurse do next?

Give positive feedback about the way she administered the sulfate.

37

Which nursing intervention is the most important to include in the plan of care for a child with acute glomerulonephritis?

Weigh the child daily.

38

During a well-baby visit, the parents explain that a soft bulge appears in the groin of their 4-month-old son when he cries or strains stooling. The infant is scheduled for surgical repair of the inguinal hernia in two weeks. The parent should be instructed to take which measures if the hernia becomes incarcerated prior to the surgery?

Gently manipulate the hernia for reduction.

39

A 16-year-old male client who has been treated in the past for a seizure disorder is admitted to the hospital. Immediately after admission, he begins to have a grand mal seizure. Which action should the nurse take?

Observe him carefully.

40

The mother of a 9-month-old who was diagnosed with respiratory syncytial virus yesterday calls the clinic to inquire if it will be alright to take her infant to the first b-day party of a friend’s child the following day. What response should the nurse provide this mother

Do not expose other children to RSV. It is very contagious even without direct contact.

41

When screening a 5-year-old for strabismus, what action should the nurse take?

Direct the child through the six cardinal positions of gaze.

42

The nurse is assessing a 6-month-old infant. Which response requires further evaluation by the nurse?

Demonstrate startle reflex.

43

A child is brought to the clinic complaining of fever and joint pain and is diagnosed with rheumatic fever. When planning care for this child, what is the goal of nursing care?

Prevent cardiac damage.

44

The nurse working on the pediatric unit takes two 8-year-old girls to the playroom.Which activity is best for the nurse to plan for these girls?

Selecting a board game.

45

The nurse is developing the plan of care for a hospitalized child with Von Willebrand disease. What priority nursing intervention should be included in this child plan of care?

Guard against bleeding injuries.

46

How should the nurse instruct the parents of a 4-month-old with seborrheic dermatitis(cradle cap) to shampoo the child’s hair?

Use a soft brush and gently scrub the area.

47

Prior to discharge, the parents of a child with cystic fibrosis are demonstrating chest physiotherapy (CPT) that they will perform for their child at home. Which action requires intervention by the nurse?

The child is placed in a supine position to begin percussion.

48

When assessing the breath sounds of an 18-month-old child who is crying, what action should the nurse take?

Allow the child to initially play with the stethoscope to distract during auscultation.

49

The mother of a one-month-old calls the clinic to report that the back of her infant is flat.How should the nurse respond?

Position the infant on the stomach occasionally when awake and active.

50

Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children?

Carefully recording the height and weight of children to detect inappropriate growth.

51

A 7-year-old child is admitted to the hospital with acute glomerulonephritis (AGN).When obtaining the nursing history, which finding should the nurse expect to obtain?

A recent strep throat infection.

52

The nurse plans to screen only the highest risk children for scoliosis. Which group of children should the nurse screen first?

Girls between ages 10 and 14.

53

In assessing a 10-year-old newly diagnosed with osteomyelitis, which information is most for the nurse to obtain?

Recent recurrence of infections.

54

A 3-year-old boy in a daycare facility scratches his head frequently and the nurse confirms the presence of head lice. The nurse washes the child’s hair with permethrin (Nix) shampoo and call his parents. What instructions should the nurse provide to the parents about treatment of head lice?

Wash the child’s bed linens and clothing in hot soapy water.

55

The nurse on a pediatric unit observes a distraught mother in the hallway scolding her 3- year-old son for wetting his pants. What initial action should the nurse take?

Inform the mother that toilet training is slower for boys.