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Maternity and Peds Hesi Review 3

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Maternity and Peds Hesi Review 3

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Maternity and Peds Hesi Review 3
MP Hesi Review #3
1. Mother of a preschool-aged child calls school RN to report her child was bitten by a tick while on a school outing last wk. Mother tells RN she removed tick &
flushedit down toilet. What action should school RN take? Schedule test for Lyme disease if rash appears.
2. Dr. prescribes phenytoin (Dilantin) for school-aged child diagnosed with tonic-clonic epilepsy. Which info should RN provide parents when teaching about
seizuremanagement with phenytoin? Monitor child’s serum phenytoin levels routinely while taking Dilantin.
3. During newborn admission assessment, RN palpates newborn’s scrotum & does not feel the testicles. Which assessment technique should RN perform next to
verifyabsence of testes: Perform transillumination of scrotal sac to visualize shadows of testes.
4. The parents of a 14-month-old-child who is hospitalized due to febrile seizures tell RN that they fear their child will have lifelong seizures. What info should
RNconvey to these parents? Reassure the parents that febrile seizures decrease as child grows older.
5. In determining the one min Apgar score of a male infant, RN assesses a heart rate of 120 beats per min & 44 respirations per min. He has a loud cry with
stimulation, good muscle tone, & his color is acrocyanotic. What Apgar score should RN assign? 9
6. School-aged child with otitis media receives prescription for azithromycin (Zithromax) 100 mg once, then 50 mg daily for 4 days. Med available in solution
containing 200 mg/5 ml. How many ml should RN give on first day? 2.5
7. 39-wk-gestational multigravida is admitted to L & D with spontaneous rupture of membranes (SROM) & contractions occurring every 2-3 mins. A vaginal exam
indicates that cervix is dilated 6 cm, 90% effaced, & the fetus is at a +2 station. During last 45 mins FHR has ranged between 170 & 180 beats/min. What action
shouldRN implement? Take oral maternal temp.
8. During admission of newborn, RN identifies localized swelling that does not cross suture line on the posterior area of the parietal bone. What action
should RNimplement? Notify Dr of cephalhematoma.
9. Mother of 6 y/o girl is concerned about her child’s obesity. The child’s weight plots at 75 percentile, & the height at the 25 percentile. The child’s BMI is at
85 percentile for age & gender. Which interventions should RN implement? SATA: Determine child’s usual physical activity pattern, Ask if school has PE
program, Obtain child’s 3-day diet history based on mother’s input.
10. Woman 36-wks & Rh negative admitted to L & D with abdominal cramping. She is placed on strict bedrest & FHR & contraction pattern are monitored with
externalfetal monitor. Two hrs later, RN notes large amount of bright red vaginal bleeding. Highest priority nursing action? Assess FHR & Pt’s contraction
pattern.
11. Nutritional info RN should give mother of 6-mo-old on introducing solid foods? Introduce foods one at a time, at 4-7 day intervals.
12. Digoxin is prescribed to 3-month-old with congenital heart disease. RN should teach parents to do what if they miss giving a dose of this med? If less than
four hrshave elapsed, give the missed dose.
13. A 10 y/o boy has been seen frequently by the school RN over the past three wks after school begins in the fall. He reports headaches, stomach aches, &
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difficultysleeping. What intervention should RN implement? a. Ask the boy to describe a typical day at school.




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14. Pt who had her first baby three months ago & is breastfeeding tells RN that she is currently using the same diaphragm that she used before becoming pregnant.
Whatinfo should RN provide this Pt? Use other form of conception until new diaphragm obtained.
15. In assessing child with suspected bacterial meningitis, RN should anticipate a recent history of which problem? a. Ear ache
16. Following the vaginal delivery of a 10-pound infant, RN assesses a new mother’s vaginal bleeding & finds that she has saturated two pads in 30 mins & has a
boggyuterus. What action should RN implement first? a. Perform fundal massage until firm.
17. Mother brings her 3 y/o son to ER & tells RN he has had an upper respiratory infection for past two days. Assessment of child reveals rectal temp of 102 F.
He isdrooling & becoming increasingly more restless. First RN acton? d. Notify Dr & obtain a tracheostomy tray.
18. Mother brings 3-month-old to clinic because baby does not sleep through the night. Which finding is most significant in planning care for this family? diaper
area shows severe skin breakdown.
19. Pt 18-wks was informed this morning that she has elevated alpha-fetoprotein (AFP) level. After Dr. leaves room, Pt asks what she should do next. What info
should RNprovide? Explain sonogram should be scheduled for definitive results.
20. A 4 y/o boy was recently diagnosed with Duchenne muscular dystrophy (DMD). Which characteristic of the disease is most important for RN to focus on
during theinitial teaching? c. Lower legs become progressively weaker, causing a waddling, unsteady gait.
21. While caring for laboring Pt on continuous fetal monitoring, RN notes FHR pattern that falls & rises abruptly with “V” shaped appearance. First RN action?
Changematernal position.
22. Woman returns to clinic for 2-wk postpartum checkup & has signs of left breast mastitis. Which instructions should RN suggest Pt follow at home? SATA:
Wear brawith good breast support, Take antibitotics at regular intervals, Apply warm compress to left breast.
23. A one-month old male infant is brought to clinic by his mother who states son has been vomiting forcefully after each meal for last three days. Infant is
afebrile, dehydrated, & pyloric stenosis is suspected. What other findings should RN identify that are consistent with pyloric stenosis? olive-shaped mass in
abdominal area
24. Babysitter of 7 y/o with type 1 diabetes calls clinic to report that child is very irritable, perspiring, & shaking. Which instructions should RN provide to the
babysitter? Give child 8oz glass of milk.
25. Pt in preterm labor has had infusion of mag sulfate running for 8 hrs. Current findings: RR 14 breaths/min; urine output 25 ml/hr; DTRs 1+; serum mag level 8
mEq/L. Based on these findings, what conclusion should RN reach? c. Findings indicate potential toxicity to magnesium sulfate & close follow-up is indicated.
26. Teen with pelvic inflammatory disease (PID) is admitted to hospital after 14 days of taking levofloxacin (Levaquin) 500 mg orally once daily & metronidazole
(Flagyl)500 mg twice daily. She asks RN, “Why do I have to be in hospital? Why can’t I get my Tx at home?” Which purpose should RN provide that supports
effective outcome? Administration of a supervised parenteral antibiotic protocol.
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MP Hesi Review #3

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