2022 HESI Peds 2
How much does the birth length increase by 12 months? When does it double? when does
child reach 50% of adult height? (answer)50%, 4 years, 2 years
when should birth weight double? triple? quadruple? (answer)6 months, 12 months, 30
months
When does posterior fontanel close? anterior? (answer)8 weeks, 12-18 months
turn head to sound? steady head control? (answer)3 months, four months,
transfer objects from hand to hand? pincer grasp? (answer)7 months, 10-12 months
sit unsupported? crawl/wave bye-bye? (answer)8 months, 10 months
throw a ball overhand? kick ball? (answer)18 months, 24 months
speak 2-3 word senteces?3-4 words? (answer)2 years, 3 years
infant birth-1 year-eriksons development (answer)trust vs. mistrust
nursing implications for hospital and appropriate toys for hospital. (answer)emerging
skills may disapper, parents a huge part of care and routine should be kept as normal as
possible. mobiles, rattles, squeky toys, balls, colored blocks and picture books
when can a child use scissors? tie shoes? (answer)4 months, 5 months
feeds self with spoon and cup? (answer)2 years
toddler 1-3yo-eriskons development (answer)autonomy vs. shame and doubt
Nursing implications/toys for toddlers (answer)give simple and brief explanations before
procedure-security objects or favorite home toy is always good. Expect regression
(bedwetting), tell parents to explain plans to child and keep routine as normal as possible.
toys include hammer/mallet, push-pull toys, stuffed animals. Mobility is important for
development so a playroom visit is encouraged. Support autonomy by providing guided
choices when appropriate. Temper tantrums are NORMAL, replaced at about 5 yo with
more independence
Preschool-child (3-6 yo) gains how many lbs each year and grows how much? (answer)5
lbs, 2.5-3 inches
thinking is_____ and ______ (answer)egocentric and concrete
sentences of how many words for preschool? (answer)5-8
child learns sexual identity, and imaginary friends/fears are common
(answer)masturbation and curiosity are common
Preschool-eriksons development (answer)initiative vs. guilt
,2022 HESI Peds 2
Nursing implications for preschool (answer)emphasize EGOCENTRICITY. explain that h e or
she did not cause illness and procedures are not punishment.use simple words.
therapeutic/medical play is helpful. Fear of mutilation is common (bandaid might help).
Toys and play include coloring books, cutting and pasting, dolls, puzzles, etc. Let child
handle equipment and prepare child for procedure.
School age (6-12yo) (answer)loss of primary teeth, dress self completely, egocentric
thinking replaced by social awareness. Understands past, present and future and learns
cause-and effect relationship.
School age-eriksons development (answer)Industry vs. inferiority, they like to do and
accomplish things.
Nursing implications and toys for school age (answer)maintaining contact with peers and
school activities is important. explanation for all procedures is improtant (verbal, handling
equipment, pictures, books). Privacy and modesty are BIG (close curtains, privacy during
baths.) participation in care and planning helps. Toys include board games, video games
and hobbies.
Tanner stages of pubertal development:girls (answer)Girls: breast changes-> rapid
increase in height and weight-> pubic hair->axillary hair->meunstruation-> rapid decline in
linear growth
Tanner stages of pubertal development: boys (answer)Boys: enlargement of testicles,
growth of pubic hair,axillary hair, facial hair and body hair->rapid increase in height-
>changes in larynx and voice->nocturnal emissions->abrupt deceleration in linear growth
Adolescents (12-19yo)-when do boys/girls finish growth? (answer)girls-15 boys-17,
secondary sex characteristics develop
adult like/abstract thinking begins when? (answer)about 15-family conflicts may develop
Adolescent-eriskons development (answer)identity vs role confusion
Nursing implications for adolscents (answer)maintain peer and school contact, body
image is HUGE, teaching about procedures should include time when parents are not
present .Parental consent also needed for treatment. For prolonged hospitalization, the
need to maintain identity (clothes, posters, visitors, teen night). When teaching the focus
should be on here and now, "how will this affect me today?"
Age groups concepts of bodily injury- 6 months, toddlers, preschool, school-age and
adolescents (answer)6 months- cognitive development allows them to remember pain
toddler-fear intrusive procedures
preschool- fear body mutilation
,2022 HESI Peds 2
school age- fear loss of control of their bodies
adolescents- major concern is body image
Pain in pediatrics has shown to be _____ which can result in ______
(answer)undertreated, complications (delayed recovery, nutrition alterations)
Nursing assessment of pain (answer)3 yo-can tell you where pain is. observe for
nonverbal signs-grimacing, difficulty feeding. Observe for physiologic responses too!
(usually acute pain)-increased HR, RR, diaphoresis, decreased O2 levels
Appropriate pain rating scales for various children (answer)CRIES-32-60 weeks
Pain rating scale (PRS)-1 yo-3yo
FACES/poker chip- preschool and older
numeric pain scale-9 years and up
oucher pain scale-kids3-12 yo with pictures of culturally specific levels of pain
FLACC- nonverbal child- facial expression, leg movement, activity, cry, consolability.
Age appropriate non-pharmacological interventions (answer)infants-pacifier, rock to
sleep, holding
toddlers/preschoolers-distraction with books, music, TV etc
school aged and adolescents- guided imagery
Vaccines (answer)Patient history should be obtained prior to administering certain
immunizations b/c reaction to other or current health conditions may contraindicate
some immunizations.
DTaP: hx of reactions, seizures, neuro symptoms after previous vaccine or systemic
allergic reactions
MMR: history of anaphylactic reaction to eggs or neomycin
MMR (answer)12-15 months and again at 4-6 years
contraindicated with eggs or neomycin anaphylaxis and immunodeficient kids.
administer SQ at seperate sites
may have light rash 2 weeks after
DTaP-diptheria, pertussis, tetanus (answer)start @ 2 months and 3 doses at 2 month
intervals
booster at 15-18 months and again at 4-6 years
, 2022 HESI Peds 2
IM
not given past 7 yo- they receive Td
contraindications:
-encephalopathy wihtin 7 days of previous DTaP
-history of seizures
-tell parents to being tylenol after administration
Polio Vaccine (answer)2 months and 4 months, booster from 6-18 months and 4-6 years.
SQ or IM
contraindicated in those with allergic reaction to neomycin or streptomycin
Hib (influenza B) (answer)covers children thorugh 5yo
no contraindications
Hep B (answer)may be given at birth
Varicella (answer)is safe for kids with asymptomatic HIV
must be at least 12 months
give MMR same day or within 30 days (different site)
TB screen (answer)Mantoux test (PPD)- can begin at 12 months
HESI hints for vaccinations (answer)1.) common cold is not a contraindication for
vaccinations
2.)SQ instead of intradermal TB test invalidates it
3.) nurse teaching followin immunizations- irritabilty, fever (102) redness and soreness at
injection site are normal for 2-3 days after DTaP and IPV.
call HCP for seizures, high fever and high pitched crying
warm washcloth and "bicycling legs" help reduces soreness
Communicable diseases: Rubeola (measles) (answer)transmitted by direct contact with
droplets
contagious during prodromal period characterized by fever adn upper respiratory
symptoms
classic Sx:
How much does the birth length increase by 12 months? When does it double? when does
child reach 50% of adult height? (answer)50%, 4 years, 2 years
when should birth weight double? triple? quadruple? (answer)6 months, 12 months, 30
months
When does posterior fontanel close? anterior? (answer)8 weeks, 12-18 months
turn head to sound? steady head control? (answer)3 months, four months,
transfer objects from hand to hand? pincer grasp? (answer)7 months, 10-12 months
sit unsupported? crawl/wave bye-bye? (answer)8 months, 10 months
throw a ball overhand? kick ball? (answer)18 months, 24 months
speak 2-3 word senteces?3-4 words? (answer)2 years, 3 years
infant birth-1 year-eriksons development (answer)trust vs. mistrust
nursing implications for hospital and appropriate toys for hospital. (answer)emerging
skills may disapper, parents a huge part of care and routine should be kept as normal as
possible. mobiles, rattles, squeky toys, balls, colored blocks and picture books
when can a child use scissors? tie shoes? (answer)4 months, 5 months
feeds self with spoon and cup? (answer)2 years
toddler 1-3yo-eriskons development (answer)autonomy vs. shame and doubt
Nursing implications/toys for toddlers (answer)give simple and brief explanations before
procedure-security objects or favorite home toy is always good. Expect regression
(bedwetting), tell parents to explain plans to child and keep routine as normal as possible.
toys include hammer/mallet, push-pull toys, stuffed animals. Mobility is important for
development so a playroom visit is encouraged. Support autonomy by providing guided
choices when appropriate. Temper tantrums are NORMAL, replaced at about 5 yo with
more independence
Preschool-child (3-6 yo) gains how many lbs each year and grows how much? (answer)5
lbs, 2.5-3 inches
thinking is_____ and ______ (answer)egocentric and concrete
sentences of how many words for preschool? (answer)5-8
child learns sexual identity, and imaginary friends/fears are common
(answer)masturbation and curiosity are common
Preschool-eriksons development (answer)initiative vs. guilt
,2022 HESI Peds 2
Nursing implications for preschool (answer)emphasize EGOCENTRICITY. explain that h e or
she did not cause illness and procedures are not punishment.use simple words.
therapeutic/medical play is helpful. Fear of mutilation is common (bandaid might help).
Toys and play include coloring books, cutting and pasting, dolls, puzzles, etc. Let child
handle equipment and prepare child for procedure.
School age (6-12yo) (answer)loss of primary teeth, dress self completely, egocentric
thinking replaced by social awareness. Understands past, present and future and learns
cause-and effect relationship.
School age-eriksons development (answer)Industry vs. inferiority, they like to do and
accomplish things.
Nursing implications and toys for school age (answer)maintaining contact with peers and
school activities is important. explanation for all procedures is improtant (verbal, handling
equipment, pictures, books). Privacy and modesty are BIG (close curtains, privacy during
baths.) participation in care and planning helps. Toys include board games, video games
and hobbies.
Tanner stages of pubertal development:girls (answer)Girls: breast changes-> rapid
increase in height and weight-> pubic hair->axillary hair->meunstruation-> rapid decline in
linear growth
Tanner stages of pubertal development: boys (answer)Boys: enlargement of testicles,
growth of pubic hair,axillary hair, facial hair and body hair->rapid increase in height-
>changes in larynx and voice->nocturnal emissions->abrupt deceleration in linear growth
Adolescents (12-19yo)-when do boys/girls finish growth? (answer)girls-15 boys-17,
secondary sex characteristics develop
adult like/abstract thinking begins when? (answer)about 15-family conflicts may develop
Adolescent-eriskons development (answer)identity vs role confusion
Nursing implications for adolscents (answer)maintain peer and school contact, body
image is HUGE, teaching about procedures should include time when parents are not
present .Parental consent also needed for treatment. For prolonged hospitalization, the
need to maintain identity (clothes, posters, visitors, teen night). When teaching the focus
should be on here and now, "how will this affect me today?"
Age groups concepts of bodily injury- 6 months, toddlers, preschool, school-age and
adolescents (answer)6 months- cognitive development allows them to remember pain
toddler-fear intrusive procedures
preschool- fear body mutilation
,2022 HESI Peds 2
school age- fear loss of control of their bodies
adolescents- major concern is body image
Pain in pediatrics has shown to be _____ which can result in ______
(answer)undertreated, complications (delayed recovery, nutrition alterations)
Nursing assessment of pain (answer)3 yo-can tell you where pain is. observe for
nonverbal signs-grimacing, difficulty feeding. Observe for physiologic responses too!
(usually acute pain)-increased HR, RR, diaphoresis, decreased O2 levels
Appropriate pain rating scales for various children (answer)CRIES-32-60 weeks
Pain rating scale (PRS)-1 yo-3yo
FACES/poker chip- preschool and older
numeric pain scale-9 years and up
oucher pain scale-kids3-12 yo with pictures of culturally specific levels of pain
FLACC- nonverbal child- facial expression, leg movement, activity, cry, consolability.
Age appropriate non-pharmacological interventions (answer)infants-pacifier, rock to
sleep, holding
toddlers/preschoolers-distraction with books, music, TV etc
school aged and adolescents- guided imagery
Vaccines (answer)Patient history should be obtained prior to administering certain
immunizations b/c reaction to other or current health conditions may contraindicate
some immunizations.
DTaP: hx of reactions, seizures, neuro symptoms after previous vaccine or systemic
allergic reactions
MMR: history of anaphylactic reaction to eggs or neomycin
MMR (answer)12-15 months and again at 4-6 years
contraindicated with eggs or neomycin anaphylaxis and immunodeficient kids.
administer SQ at seperate sites
may have light rash 2 weeks after
DTaP-diptheria, pertussis, tetanus (answer)start @ 2 months and 3 doses at 2 month
intervals
booster at 15-18 months and again at 4-6 years
, 2022 HESI Peds 2
IM
not given past 7 yo- they receive Td
contraindications:
-encephalopathy wihtin 7 days of previous DTaP
-history of seizures
-tell parents to being tylenol after administration
Polio Vaccine (answer)2 months and 4 months, booster from 6-18 months and 4-6 years.
SQ or IM
contraindicated in those with allergic reaction to neomycin or streptomycin
Hib (influenza B) (answer)covers children thorugh 5yo
no contraindications
Hep B (answer)may be given at birth
Varicella (answer)is safe for kids with asymptomatic HIV
must be at least 12 months
give MMR same day or within 30 days (different site)
TB screen (answer)Mantoux test (PPD)- can begin at 12 months
HESI hints for vaccinations (answer)1.) common cold is not a contraindication for
vaccinations
2.)SQ instead of intradermal TB test invalidates it
3.) nurse teaching followin immunizations- irritabilty, fever (102) redness and soreness at
injection site are normal for 2-3 days after DTaP and IPV.
call HCP for seizures, high fever and high pitched crying
warm washcloth and "bicycling legs" help reduces soreness
Communicable diseases: Rubeola (measles) (answer)transmitted by direct contact with
droplets
contagious during prodromal period characterized by fever adn upper respiratory
symptoms
classic Sx:
