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Exam Solution zm
Pediatrics HESI Questions and Correct Answers 2026 A zm zm zm zm zm zm zm
+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFI
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ED ANSWERS (4A203) zm zm
QUESTION 1 zm
A 6-month-
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old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observ
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ation by the nurse warrants immediate intervention? Apical heart rate of 60. Sweating
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across the forehead. Doesn't suck well. Respiratory rate of 30 breaths per minute.
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ANSWER
Apical heart rate of 60. A heart rate of 60 (
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A) is much lower than normal for a 6-month-
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old and warrants immediate intervention. The normal heart rate for a 6-month-
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old is 80 to 150 BPM when awake, and a rate of 70 while sleeping is considered within normal limi
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ts. (B and
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C) are expected symptoms of heart failure in an infant. (
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D) is within normal limits for an infant.
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QUESTION 2 zm
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. W
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hat is the most important instruction for the nurse to include in this client's teaching
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plan? Use sunscreen when lying by the pool. Cleanse the skin at least 4 times a day. T
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ake the medication with a glass of milk. Menstrual periods may become irregular.
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ANSWER
Use sunscreen when lying by the pool. Photosensitivity is a common side effect of tetracycline HCL (
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Achromycin V) therapy. Severe sunburn can occur with minimal sun exposure and clients should be
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instructed to avoid sunlight and to use sunscreen (A). (B and
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D) are not related to tetracycline HCL (Achromycin V) therapy. (
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C) should be avoided because dairy products interfere with the absorption of tetracyclines.
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QUESTION 3 zm
,What preoperative nursing intervention should be included in the plan of care for an
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infant with pyloric stenosis? Monitor for signs of metabolic acidosis. Estimate the qua
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ntity of diarrhea stools. Place in a supine position after feeding. Observe for projectile
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mvomiting.
ANSWER
Observe for projectile vomiting. Projectile vomiting (D), which contributes to metabolic alkalosis (A),
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is the classic sign of pyloric stenosis. (
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B) is not indicated. (
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C) is dangerous, due to the potential for aspiration with frequent vomiting.
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QUESTION 4 zm
Preoperative nursing care for a child with Wilms' tumor should include which interve
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ntion? Gently percuss the abdomen for evidence of trapped air. Observe the abdomen
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for any noticeable discolorations. Apply cold compresses to the abdomen to reduce ed
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ema. Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
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ANSWER
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN." Prevention of abdominal palpation (
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D) minimizes the risk of rupturing the encapsulated tumor and subsequent metastasis. (
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A) is unnecessary, and this action could traumatize the tumor in the same manner as palpation. (B
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and
C) are incorrect since the abdomen is not discolored and cold compresses are not indicated.
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QUESTION 5 zm
The nurse is assessing an 8-month-
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old child who has a medical diagnosis of Tetrology of Fallot. Which symptom is this cl
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ient most likely to exhibit? Bradycardia. Machinery murmur. Weak pedal pulses. Clubb
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ed fingers.
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ANSWER
Clubbed fingers. Tetrology of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes (
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D) due to tissue hypoxia. Tachycardia, not (A), is a manifestation of congenital heart disease. (
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B) is a classic sign of ventricular septal defect. (
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C) is characteristic of coarctation of the aorta.
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QUESTION 6 zm
Surgery is being delayed for an infant with undescended testes. In collaboration with t
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he healthcare provider and the family, which prescription should the nurse anticipate
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? A trial of adrenocorticotrophic hormone injections. Frequent stimulation of the crem
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asteric reflex. A trial of human chorionic gonadotrophic hormone. Frequent warm bat
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hs to gently dilate the scrotal area.
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,ANSWER
A trial of human chorionic gonadotrophic hormone. A trial of HCG (human chorionic gonadotrophic
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hormone) ( zm
C) may aid in testicular descent, but does not replace surgical repair for true undescended testes. U
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ndescended testes (cryptorchidism) may be found in the inguinal canal due to exaggerated cremaste
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ric reflex. (
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A) is not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather than des
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cend in the scrotum (B). (
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D) may relax the cremasteric muscle, but may not cause the testes to descend.
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QUESTION 7 zm
A preschool-
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age child who is hospitalized for hypospadias repair is most strongly influenced by w
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hich behavior? Ability to communicate verbally. Response to separation from family. C
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oncern for body integrity. Socialization with other children.
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ANSWER
Concern for body integrity. The preschooler's major stressor is concern for his body integrity (C). H
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e fears that his "insides will leak out." A child undergoing surgery to his genitalia is even more conc
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erned about body integrity. The preschooler is quite verbal, so comprehension of the words he uses
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mor hears may be inaccurate, while his imagination and fears may fantasize the reality (A). (
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B) is a concern for all children, but of most concern to the toddler. (
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D) is not a prime concern in this situation.
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QUESTION 8 zm
A six-month-
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old returns from surgery with elbow restraints in place. What nursing care should be
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included when caring for any restrained child? Keep restraints on at all times. Remov
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e restraints one at a time and provide range of motion exercises. Remove all restraint
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s simultaneously and provide play activities. Renew the healthcare provider's prescrip
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tion for restraints every 72 hours.
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ANSWER
Remove restraints one at a time and provide range of motion exercises. Removing restraints one at
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a time (
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B) is safer than removing all of them at once (C). The child needs to exercise and should not be ke
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pt in restraints at all times (A). The renewal of the healthcare provider's prescription varies with ho
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spitals (D), and it does not really answer the question.
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QUESTION 9 zm
All of the following interventions can be used to evaluate the effectiveness of nursing
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and medical interventions used to treat diarrhea. Which intervention is least useful in
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the nurse's evaluation of a 20-month-
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, old child? Weighing diapers. Assessing fontanels. Checking skin turgor. Observing muc
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ous membranes for moisture.
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ANSWER
Assessing fontanels. All of these interventions evaluate fluid status in infants. But, how old is this ch
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ild? Posterior fontanel closes at 2 months and anterior fontanel closes by 18 months of age (B)! Re
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member normal growth and development!
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QUESTION 10 zm
The nurse receives a lab report stating a child with asthma has a theophylline level of
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15 mcg/dl. What action will the nurse take? Pass the information on in the report. N
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otify the healthcare provider because the value is high. Repeat the lab study because t
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he value is too high. Hold the next dose of theophylline.
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ANSWER
Pass the information on in the report. The therapeutic level of theophylline is 10 to 20 mcg/dl, so t
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he child's level is within the therapeutic range. This information evaluates the prescribed therapy an
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d should be communicated in the nurse's report (A). (B, C, and
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D) would be inappropriate actions in view of the laboratory finding.
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QUESTION 11 zm
The nurse is having difficulty communicating with a hospitalized 6-year-
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old child. Which approach by the nurse is most helpful in establishing communication
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? Engage the child through drawing pictures. Suggest that the parent read a book to t
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he child. Provide paper and pencil for the child to keep a diary. Ask the parent if the
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child is always uncommunicative.
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ANSWER
Engage the child through drawing pictures. Drawing pictures (
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A) is a valuable form of non-
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verbal communication. As the nurse and child look at the drawings, a verbal story can be told that
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projects the child's thinking. ( zm zm zm zm
B) may distract the child, but does not establish communication with the nurse. (
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C) is useful for an older child who is able to write. (
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D) is important, but engaging the child is more effective in establishing communication patterns.
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QUESTION 12 zm
The nurse is caring for a 12-year-
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old with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). This child should
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be carefully assessed for which complication? Poor skin turgor resulting from dehydra
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tion. Changes in level of consciousness. Premature aging as the disease progresses. Se
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vere edema from an excess of water and sodium.
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Exam Solution zm
Pediatrics HESI Questions and Correct Answers 2026 A zm zm zm zm zm zm zm
+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFI
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ED ANSWERS (4A203) zm zm
QUESTION 1 zm
A 6-month-
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old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observ
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ation by the nurse warrants immediate intervention? Apical heart rate of 60. Sweating
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across the forehead. Doesn't suck well. Respiratory rate of 30 breaths per minute.
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ANSWER
Apical heart rate of 60. A heart rate of 60 (
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A) is much lower than normal for a 6-month-
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old and warrants immediate intervention. The normal heart rate for a 6-month-
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old is 80 to 150 BPM when awake, and a rate of 70 while sleeping is considered within normal limi
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ts. (B and
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C) are expected symptoms of heart failure in an infant. (
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D) is within normal limits for an infant.
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QUESTION 2 zm
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. W
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hat is the most important instruction for the nurse to include in this client's teaching
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plan? Use sunscreen when lying by the pool. Cleanse the skin at least 4 times a day. T
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ake the medication with a glass of milk. Menstrual periods may become irregular.
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ANSWER
Use sunscreen when lying by the pool. Photosensitivity is a common side effect of tetracycline HCL (
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Achromycin V) therapy. Severe sunburn can occur with minimal sun exposure and clients should be
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instructed to avoid sunlight and to use sunscreen (A). (B and
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D) are not related to tetracycline HCL (Achromycin V) therapy. (
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C) should be avoided because dairy products interfere with the absorption of tetracyclines.
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QUESTION 3 zm
,What preoperative nursing intervention should be included in the plan of care for an
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infant with pyloric stenosis? Monitor for signs of metabolic acidosis. Estimate the qua
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ntity of diarrhea stools. Place in a supine position after feeding. Observe for projectile
zm zm zm zm zm zm zm zm zm zm zm zm zm z
mvomiting.
ANSWER
Observe for projectile vomiting. Projectile vomiting (D), which contributes to metabolic alkalosis (A),
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is the classic sign of pyloric stenosis. (
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B) is not indicated. (
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C) is dangerous, due to the potential for aspiration with frequent vomiting.
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QUESTION 4 zm
Preoperative nursing care for a child with Wilms' tumor should include which interve
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ntion? Gently percuss the abdomen for evidence of trapped air. Observe the abdomen
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for any noticeable discolorations. Apply cold compresses to the abdomen to reduce ed
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ema. Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
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ANSWER
Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN." Prevention of abdominal palpation (
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D) minimizes the risk of rupturing the encapsulated tumor and subsequent metastasis. (
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A) is unnecessary, and this action could traumatize the tumor in the same manner as palpation. (B
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and
C) are incorrect since the abdomen is not discolored and cold compresses are not indicated.
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QUESTION 5 zm
The nurse is assessing an 8-month-
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old child who has a medical diagnosis of Tetrology of Fallot. Which symptom is this cl
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ient most likely to exhibit? Bradycardia. Machinery murmur. Weak pedal pulses. Clubb
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ed fingers.
zm
ANSWER
Clubbed fingers. Tetrology of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes (
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D) due to tissue hypoxia. Tachycardia, not (A), is a manifestation of congenital heart disease. (
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B) is a classic sign of ventricular septal defect. (
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C) is characteristic of coarctation of the aorta.
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QUESTION 6 zm
Surgery is being delayed for an infant with undescended testes. In collaboration with t
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he healthcare provider and the family, which prescription should the nurse anticipate
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? A trial of adrenocorticotrophic hormone injections. Frequent stimulation of the crem
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asteric reflex. A trial of human chorionic gonadotrophic hormone. Frequent warm bat
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hs to gently dilate the scrotal area.
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,ANSWER
A trial of human chorionic gonadotrophic hormone. A trial of HCG (human chorionic gonadotrophic
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hormone) ( zm
C) may aid in testicular descent, but does not replace surgical repair for true undescended testes. U
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ndescended testes (cryptorchidism) may be found in the inguinal canal due to exaggerated cremaste
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ric reflex. (
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A) is not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather than des
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cend in the scrotum (B). (
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D) may relax the cremasteric muscle, but may not cause the testes to descend.
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QUESTION 7 zm
A preschool-
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age child who is hospitalized for hypospadias repair is most strongly influenced by w
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hich behavior? Ability to communicate verbally. Response to separation from family. C
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oncern for body integrity. Socialization with other children.
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ANSWER
Concern for body integrity. The preschooler's major stressor is concern for his body integrity (C). H
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e fears that his "insides will leak out." A child undergoing surgery to his genitalia is even more conc
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erned about body integrity. The preschooler is quite verbal, so comprehension of the words he uses
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mor hears may be inaccurate, while his imagination and fears may fantasize the reality (A). (
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B) is a concern for all children, but of most concern to the toddler. (
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D) is not a prime concern in this situation.
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QUESTION 8 zm
A six-month-
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old returns from surgery with elbow restraints in place. What nursing care should be
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included when caring for any restrained child? Keep restraints on at all times. Remov
zm zm zm zm zm zm zm zm zm zm zm zm zm
e restraints one at a time and provide range of motion exercises. Remove all restraint
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s simultaneously and provide play activities. Renew the healthcare provider's prescrip
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tion for restraints every 72 hours.
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ANSWER
Remove restraints one at a time and provide range of motion exercises. Removing restraints one at
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a time (
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B) is safer than removing all of them at once (C). The child needs to exercise and should not be ke
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pt in restraints at all times (A). The renewal of the healthcare provider's prescription varies with ho
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spitals (D), and it does not really answer the question.
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QUESTION 9 zm
All of the following interventions can be used to evaluate the effectiveness of nursing
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and medical interventions used to treat diarrhea. Which intervention is least useful in
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the nurse's evaluation of a 20-month-
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, old child? Weighing diapers. Assessing fontanels. Checking skin turgor. Observing muc
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ous membranes for moisture.
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ANSWER
Assessing fontanels. All of these interventions evaluate fluid status in infants. But, how old is this ch
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ild? Posterior fontanel closes at 2 months and anterior fontanel closes by 18 months of age (B)! Re
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member normal growth and development!
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QUESTION 10 zm
The nurse receives a lab report stating a child with asthma has a theophylline level of
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15 mcg/dl. What action will the nurse take? Pass the information on in the report. N
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otify the healthcare provider because the value is high. Repeat the lab study because t
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he value is too high. Hold the next dose of theophylline.
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ANSWER
Pass the information on in the report. The therapeutic level of theophylline is 10 to 20 mcg/dl, so t
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he child's level is within the therapeutic range. This information evaluates the prescribed therapy an
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d should be communicated in the nurse's report (A). (B, C, and
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D) would be inappropriate actions in view of the laboratory finding.
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QUESTION 11 zm
The nurse is having difficulty communicating with a hospitalized 6-year-
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old child. Which approach by the nurse is most helpful in establishing communication
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? Engage the child through drawing pictures. Suggest that the parent read a book to t
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he child. Provide paper and pencil for the child to keep a diary. Ask the parent if the
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child is always uncommunicative.
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ANSWER
Engage the child through drawing pictures. Drawing pictures (
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A) is a valuable form of non-
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verbal communication. As the nurse and child look at the drawings, a verbal story can be told that
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projects the child's thinking. ( zm zm zm zm
B) may distract the child, but does not establish communication with the nurse. (
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C) is useful for an older child who is able to write. (
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D) is important, but engaging the child is more effective in establishing communication patterns.
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QUESTION 12 zm
The nurse is caring for a 12-year-
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old with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). This child should
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be carefully assessed for which complication? Poor skin turgor resulting from dehydra
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tion. Changes in level of consciousness. Premature aging as the disease progresses. Se
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vere edema from an excess of water and sodium.
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