HESI RN EXIT EXAM-NEW FILE TESTED 2022

PEDIATRIC EXIT HESI 1 yr old child with neuroblastoma crying continuously and curled into a fetal position. Most important Give a prescribed analgesic Mother brings her newborn to the well clinic for the 1 month check-up. Nurse reviews infant record and identifies that received first dose of HBV immunization on discharge. When should next be During this visit, one month of age When obtaining a throat culture from a 6 yr old with possible strep, which action Swab the child’s erythematous oropharyngeal surfaces or tonsillar pustules Infant is treated for intussusceptions with hydrostatic reduction. What instructions in parents teaching plan Signs and symptoms of recurrence Mother of 5 yr old boy calls the ER and reports pot of hot soup pulled off stove onto her child’s right arm and leg. Do first Place him in a cool bath and remove clothing Child swallowed corrosive substance. What should mom do immediately Call poison control Teen demanding mom to stay in hospital room Patient is insecure Question refers to baby soft spot and sutures Document Newborn baby with flea-like rash normal and will disappear Toddler needing genitals checked, what should nurse do examine genitals last Baby acting jittery check glucose level Gullain Barre syndrome Patient with severe cold week ago Celiac Disease Patient with fever of 101-best nursing Dx r/t temperature elevation Where to administer shot for 4 year old RSV needs contact precautions Cystic Fibrosis Skin tastes salty Gullain Barre syndrome Weakness progresses from legs upward –respiratory arrest Post strep URI diseases and conditions Acute glumerulonephritis Rheumatic fever Scarlet fever Patient in traction Provide age-appropriate toys Sweat test used in Cycstic fibrosis Current jelly stool with blood and mucus, sausage-shaped mass in RUQ intussusception Patient with pyloric stenosis Olive-shaped mass in epigastric area with projectile vomiting Milestones to know (several Qs) Birth weight doubles at 6 months and triples at 12 months Birth length increases by 50% at 12 months and doubles at 4 years Post fontanel closes by 8 weeks Anterior fontanel closes by 12-18 months Moro reflex disappears at 4 months Steady head control achieved at 4 months Turns over at 5-6 months Head to hand transfers at 7 months Sits unsupported at 8 months Crawls at 10 months Walks 10-12 months Cooing at 2 months Monosyllabic babbling at 3-6 months, linking syllables at 6-9 months Mama/dada and other single words at 9-12 months Throws ball overhand at 18 months Daytime toilet training at 18 months-2 years 2-3 word sentences at 2 years 50% of adult height at 2 years Uses scissors at 4 years Ties shoes at 5 years Autosomal Recessive Diseases CF, PKU, Sickle Cell, Tay-Sachs, Albinism Autosomal Dominant Diseases Huntington’s, Marfans, Polydactyl, Achondroplasia, Polycystic kidney 50% if one parent has the disease X-linked recessive Diseases MD, Hemophilia A Females are carries and never have the disease Males have the disease Down syndrome (Trisomy 21) Simian creases on palms, hypotonia, protruding tongue, upward and outward slant of the eyes, low ears PKU Avoid phenylalanine (aspartame/NutraSweet) Testing for PKU Guthrie test Care of patient with myelomeningocele Cover with moist sterile water soaked gauze and keep from pressure Indicators of IICP in infants Bulging fontanels, high pitched cry, increased head circumference, wide suture lines, lethargy Avoid in patients with IICP Suctioning, coughing, straining and bending Water retention, fluid overload, dilutional hyponatremia SIADH (too much ADH) CF kids need enzymes sprinkled on their foods NO MMR immunization for kids with Hx of allergic rxn to eggs or neomycin Child is drooling, tongue protrusion, chin out, and complains of sore throat Epiglotitis Hypoxic episodes relieved by squatting or knee-chest position TET spells On a hot day, what kind of drink should a teenager with sickle-cell anemia drink? Lemonade Why would you teach parents of toddlers and infants discipline and limit settings? Give the child a sense of security 3 ½ stands only on their tip toes Abnormal How to check strabismus in a 4 year old Cardinal signs of gaze Calculate doses on weight A mother brings in her 6 month old, what statement made by the mother indicates that the child is on track developmentally My baby cries when she is around strangers A 5-year-old Chinese boy has round circular symmetrical bruises all over his chest. What should you do Ask the parents if they practice any alternative therapies, like cupping How would you wash the hair of a baby with cradle cap Look up answer A babysitter is taking care of a child who suddenly becomes shaky, irritable, and diaphoretic. What do you tell her to do Give the child an 8 oz cup of milk A newborn is unconscious and not breathing. You check their airway and they still are not breathing, what do you do Give 2 breaths to lift the chest up A child with acyanotic heart defect is cyanotic. High heart rate, high RR what do you do Assess pulse Ox A 9 year old is in what stage of Erikson Industry A 12 year old has a hearing deficit. How would you communicate with him Animated facial expressions A child has a ruptured appendix, what finding would be most concerning An elevated BUN A child is having a Grand Mal seizure. What do you do Observe A child has nephritic syndrome, edema, oliguria. What fruit would you allow him to eat Apple (Low K) A 22 mo old has RSV. He also has a younger and older sibling. What would be the most important thing to teach the parent before the child is discharged Frequent hand washing Pertussis (Not sure about the rest of the question) Immunize the child and other family members A child is taking an anti histamine and albuterol metered dose inhaler and is complaining of …. Ask how many times she takes the metered dose inhaler daily A child had a cardiac cath via Right Femoral Artery. How would you know there is an arterial obstruction The right foot is cool to touch and pale A child with transposition of the great vessels is given prostaglandin to keep the ductus open. How would you know the Tx is effective (Not sure the answer, but…) The Tx is used to prevent cyanosis and help oxygenate the child’s blood RF caused by a bacterial infection beta hemolytic strep that injures the heart and its valves. A child is having an open-heart surgery, what teaching needs to be done preoperatively Teach the child to cough, deep breath and splint the chest for pain