OB/PEDIATRICS HESI PRACTICE EXAM
Questions and Answers
1. The RN is monitoring an infant with CHD closely for SSx of HF. The
RN should assess the infant for which early sign of HF?
1.Pallor
2.Cough
3.Tachycardia
4.Slow and shallow breathing: 3. tachycardia
RATIONALE:
HF is the inability of the heart to pump a sufficient amt of blood to meet the O2 and metabolic needs of
the body. The early SSx of HF include tachycardia, tachypnea, profuse scalp sweating, fatigue &
irritability, sudden weight gain, and resp distress. A cough may occur in HF as a result of mucosal
swelling & irritation, but is not an early sign. Pallor may be noted in an infant w/ HF, but is not an early
sign.
2. The nurse reviews the laboratory results for a child with a
suspected diag- nosis of rheumatic fever, knowing that which
laboratory study would assist in confirming the diagnosis?
1. Immunoglobulin
2. Red blood cell count
,3. White blood cell count
4. Anti-streptolysin O titer: 4. anti-streptolysin O titer
RATIONALE:
Rheumatic fever is an inflammatory autoimmune disease that affects the CT of the heart, joints, skin
(SQ tissues), BV, and CNS. A Dx of rheumatic fever is confirmed by the presence of 2 major
manifestations or 1 major and 2 minor manifestations from the Jones criteria. In addition, evidence
of a recent strep infection is confirmed by a + anti-streptolysin O titer, streptozyme assay, or anti-
DNase B assay.
3. On assessment of a child admitted with a diagnosis of acute-stage
Kawasaki disease, the nurse expects to note which clinical
manifestation of the acute stage of the disease?
1. Cracked lips
2. Normal appearance
3. Conjunctival hyperemia
4. Desquamation of the skin: 3. conjunctival hyperemia
RATIONALE:
Kawasaki disease, aka mucocutaneous lymph node syndrome, is an acute systemic inflammatory illness.
In the acute stage, the child has a fever, conjunctival hyperemia, red throat, swollen hands, rash, and
enlargement of the cervical lymph nodes. In the subacute stage, cracking lips and fissures,
desquamation of the skin on the tips of the fingers and toes, joint pain, cardiac manifestations, and
,thromobocytosis occur. In the convalescent stage, the child appears normal, but SSx of inflammation
may be present
4. The mother of a child being discharged after heart surgery
asks the nurse when the child will be able to return to school.
Which is the most appropriate response to the mother?
1. "The child may return to school in 1 week."
2. "The child will not be able to return to school during this academic
year."
3. "The child may return to school in 1 week but needs to go half-
days for the first 2 weeks."
4. "The child may return to school in 3 weeks but needs to go half-
days for the first few days.": 4. "The child may return to school in 3 weeks but needs to go
half-days for the 1st few days"
RATIONALE:
After heart surgery, the child may be able to return to school in 3 weeks but needs to go half-days for the
1st few days. The mother also should be told that the child cannot participate in PE for 2 months.
5. Prostaglandin E1 is prescribed for a child with transposition of the
great arteries. The mother of the child is a registered nurse and
asks the nurse why the child needs the medication. What is the
most appropriate response to the mother about the action of the
medication?
, 1. Prevents blue (tet) spells
2.Maintains adequate cardiac
output
3. Maintains an adequate hormonal level
4. Maintains the position of the great arteries: 2. maintains adequate CO
RATIONALE:
A child with transposition of the great arteries may receive prostaglandin E1 temporarily to increased blood
mixing if systemic and pulmonary mixing is inadequate to maintain adequate CO.
6. The nurse is assessing a newborn with heart failure before
administering the prescribed digoxin. In reviewing the laboratory
data, the nurse notes that the newborn has a digoxin blood level
of 1.6 ng/mL (2.05 mmol/L) and an apical heart rate of 90
beats/min. The mother also tells the nurse that the newborn just
vomited her formula. Which intervention should the nurse take?
1.Retake the apical pulse.
2.Administer the medication.
3.Withhold the medication for 1 hour.
4.Withhold the medication and notify the health care provider.: 4.
withhold the med and notify HCP
RATIONALE:
The apical pulse rate for a newborn is 120-160 bpm. The therapeutic dig level is 0.5-0.8. Bc the apical
rate is low and the dig blood level is elevated, indicating toxicity, the RN would withhold the med and
Questions and Answers
1. The RN is monitoring an infant with CHD closely for SSx of HF. The
RN should assess the infant for which early sign of HF?
1.Pallor
2.Cough
3.Tachycardia
4.Slow and shallow breathing: 3. tachycardia
RATIONALE:
HF is the inability of the heart to pump a sufficient amt of blood to meet the O2 and metabolic needs of
the body. The early SSx of HF include tachycardia, tachypnea, profuse scalp sweating, fatigue &
irritability, sudden weight gain, and resp distress. A cough may occur in HF as a result of mucosal
swelling & irritation, but is not an early sign. Pallor may be noted in an infant w/ HF, but is not an early
sign.
2. The nurse reviews the laboratory results for a child with a
suspected diag- nosis of rheumatic fever, knowing that which
laboratory study would assist in confirming the diagnosis?
1. Immunoglobulin
2. Red blood cell count
,3. White blood cell count
4. Anti-streptolysin O titer: 4. anti-streptolysin O titer
RATIONALE:
Rheumatic fever is an inflammatory autoimmune disease that affects the CT of the heart, joints, skin
(SQ tissues), BV, and CNS. A Dx of rheumatic fever is confirmed by the presence of 2 major
manifestations or 1 major and 2 minor manifestations from the Jones criteria. In addition, evidence
of a recent strep infection is confirmed by a + anti-streptolysin O titer, streptozyme assay, or anti-
DNase B assay.
3. On assessment of a child admitted with a diagnosis of acute-stage
Kawasaki disease, the nurse expects to note which clinical
manifestation of the acute stage of the disease?
1. Cracked lips
2. Normal appearance
3. Conjunctival hyperemia
4. Desquamation of the skin: 3. conjunctival hyperemia
RATIONALE:
Kawasaki disease, aka mucocutaneous lymph node syndrome, is an acute systemic inflammatory illness.
In the acute stage, the child has a fever, conjunctival hyperemia, red throat, swollen hands, rash, and
enlargement of the cervical lymph nodes. In the subacute stage, cracking lips and fissures,
desquamation of the skin on the tips of the fingers and toes, joint pain, cardiac manifestations, and
,thromobocytosis occur. In the convalescent stage, the child appears normal, but SSx of inflammation
may be present
4. The mother of a child being discharged after heart surgery
asks the nurse when the child will be able to return to school.
Which is the most appropriate response to the mother?
1. "The child may return to school in 1 week."
2. "The child will not be able to return to school during this academic
year."
3. "The child may return to school in 1 week but needs to go half-
days for the first 2 weeks."
4. "The child may return to school in 3 weeks but needs to go half-
days for the first few days.": 4. "The child may return to school in 3 weeks but needs to go
half-days for the 1st few days"
RATIONALE:
After heart surgery, the child may be able to return to school in 3 weeks but needs to go half-days for the
1st few days. The mother also should be told that the child cannot participate in PE for 2 months.
5. Prostaglandin E1 is prescribed for a child with transposition of the
great arteries. The mother of the child is a registered nurse and
asks the nurse why the child needs the medication. What is the
most appropriate response to the mother about the action of the
medication?
, 1. Prevents blue (tet) spells
2.Maintains adequate cardiac
output
3. Maintains an adequate hormonal level
4. Maintains the position of the great arteries: 2. maintains adequate CO
RATIONALE:
A child with transposition of the great arteries may receive prostaglandin E1 temporarily to increased blood
mixing if systemic and pulmonary mixing is inadequate to maintain adequate CO.
6. The nurse is assessing a newborn with heart failure before
administering the prescribed digoxin. In reviewing the laboratory
data, the nurse notes that the newborn has a digoxin blood level
of 1.6 ng/mL (2.05 mmol/L) and an apical heart rate of 90
beats/min. The mother also tells the nurse that the newborn just
vomited her formula. Which intervention should the nurse take?
1.Retake the apical pulse.
2.Administer the medication.
3.Withhold the medication for 1 hour.
4.Withhold the medication and notify the health care provider.: 4.
withhold the med and notify HCP
RATIONALE:
The apical pulse rate for a newborn is 120-160 bpm. The therapeutic dig level is 0.5-0.8. Bc the apical
rate is low and the dig blood level is elevated, indicating toxicity, the RN would withhold the med and
