PN HESI Peds QUESTIONS AND ANSWERS

PN HESI Peds QUESTIONS AND ANSWERS A 15-year-old male with mild mental retardation who is hospitalized for minor surgery tells a female practical nurse (PN), "Wow, you have big ones." Which response is best for the PN to make? Correct Answer: That language is not permitted." The health care provider prescribes carbamazepine (Tegretol) for a child whose tonic-clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week. The mother asks why so many blood tests are necessary. What complication is assessed through frequent laboratory testing that the nurse should explain to this mother? Correct Answer: Bone marrow suppression The practical nurse (PN) is reviewing signs and symptoms of congestive heart failure with the parents of a 2-year-old child with a congenital heart defect. Which behavior is most important for the parents to report to the health care provider? Correct Answer: Exhibits a sudden and unexplained weight gain A child with poison ivy weighs 25 kg and receives a prescription for Benadryl PO 5 mg/kg. Benadryl is available as a 125 mg/5 mL solution. How many milliliters should the practical nurse administer? (Fill in the blank.) Correct Answer: 5ml A short arm cast is applied to a child with a fractured right ulna. The practical nurse (PN) is preparing the parents with home instructions and should reinforce that the parents follow which discharge instruction? Correct Answer: "Call the health care provider immediately if the nail beds appear 'blue' or 'empty.'" The health care provider prescribes amoxicillin 60 mg PO three times a day for a child who weighs 13 pounds. The pediatric dosage range is 20 to 40 mg/kg/day in three equal doses. What is the maximum dosage in 24 hours that should be given? (Fill in the blank.) Correct Answer: First, convert the pounds to kg because the conversion is for kg. 1 kg = 2.2 lb 13 lb/(2.2 lb/kg) = 5.9 kg Second, determine the maximum dose the child can have in 24 hours: 40 mg × 5.9 kg = 236 mg. The maximum dose the child can have is 236 mg. The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate (Atropine) IM STAT. What is the primary purpose for administering this drug to the child at this time? Correct Answer: Decrease the oral secretions. The practical nurse (PN) is caring for a child who had a cleft lip repair. What is the most important reason to minimize this child's crying during the postoperative recovery period? Correct Answer: Crying stresses the suture line. The parents of a 1-year-old child, who was recently diagnosed with hypospadias, state that they plan to delay corrective surgery to see if the child will outgrow the problem. What response is best for the practical nurse (PN) to provide to these parents? Correct Answer: "Discuss your decision with your healthcare provider for additional information of what you understand about your child's diagnosis." A child with cystic fibrosis is receiving ticarcillin disodium (Ticar) for Pseudomonas pneumonia. What adverse effect should the nurse assess for and report promptly to the health care provider? Correct Answer: Petechiae The practical nurse (PN) is caring for a child with an acute respiratory condition. When the PN is monitoring for impending respiratory distress, what sign is the child likely to exhibit first? Correct Answer: Restlessness The practical nurse (PN) is examining a child with an exacerbation of juvenile rheumatoid arthritis (JRA) and notes that the child's mobility is greatly reduced. What factor should the PN observe that affects the child's mobility? Correct Answer: Joint inflammation The practical nurse (PN) is caring for a toddler who is admitted for cleft palate repair. Which type of restraint should the PN prepare to apply in the postoperative period? Correct Answer: Elbow The practical nurse (PN) in the clinic receives a phone call from the mother of a 6-year-old child with a newly applied cast for a fracture of the femur. The mother reports that the child is in pain and is crying and that the child's foot appears swollen and blue. Which nursing diagnosis supports the PN's initial intervention? Correct Answer: Altered peripheral tissue perfusion The parents of a 7-month-old male infant with spastic cerebral palsy bring him to the pediatric clinic. Which statement by the parents warrants immediate intervention by the practical nurse (PN)? Correct Answer: "My son often chokes while I am feeding him." The practical nurse (PN) observes the unlicensed assistive personnel (UAP) placing a tongue blade at the bedside of a child diagnosed with a seizure disorder. Which intervention should the PN implement? Correct Answer: Tell the UAP that tongue blades should not be inserted during a seizure. A mother phones the clinic because her 6-year-old child has been taking prescribed antibiotics for 7 of the previous 10 days and continues to cough. She also reports that the cough is worsening and is nonproductive. What information should the practical nurse (PN) provide to this mother? Correct Answer: "Bring the child to the clinic today for an examination related to the cough." A child is admitted to the hospital for confirmation of a diagnosis of acute lymphoblastic leukemia. When performing a nursing assessment, which symptoms that are commonly manifested by this condition should the practical nurse (PN) observe in the child? Correct Answer: Bone pain, pallor A child with acute appendicitis who is scheduled for surgery in 3 hours is complaining of abdominal pain. Which intervention should the practical nurse implement? Correct Answer: Assist the child into a position of comfort. To minimize separation anxiety in a hospitalized 2-year-old, which nursing intervention is best for the practical nurse to implement Correct Answer: Encourage parents to room-in. The practical nurse (PN) is caring for an infant with pyloric stenosis. What nursing intervention should be included in the preoperative period? Correct Answer: Observe for projectile vomiting. The practical nurse (PN) is assessing a child with asthma for retractions during respirations. When should the PN recognize the absence or presence of intercostal retractions? Correct Answer: Inspiration A 5-year-old tells the practical nurse (PN) that she "needs a Band-Aid" when she has an injection. Which action is best for the PN to take? Correct Answer: Apply a Band-Aid over the injection site. The teacher reports that a 7-year-old child frequently daydreams in school, experiences abrupt interruptions in conversations, and stares into space. Which action should the practical nurse take? Correct Answer: Observe the child's behavior in the classroom. The practical nurse (PN) is caring for a child with Wilms' tumor. Which preoperative intervention should the PN implement? Correct Answer: Put a sign above the bed reading, "Do not palpate abdomen." The mother of a 6-month-old asks the practical nurse (PN) when her baby will get the first measles, mumps, and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease Control and Prevention, which response is accurate? Correct Answer: 12 to 15 months The practical nurse (PN) is preparing a child with an intussusception for a prescribed barium enema. The PN should explain to the parent that the purpose for conducting this procedure before surgical intervention is to achieve what objective? Correct Answer: Reduce the invaginated bowel segment. The practical nurse (PN) is caring for a child with a diagnosis of acquired aplastic anemia. What should the PN expect in the child's health history that is a common cause of this type of anemia? Correct Answer: Exposure to certain drugs A full-term infant is admitted to the newborn nursery. During the initial PO feeding, the practical nurse (PN) observes the infant for possible tracheal esophageal atresia. Which symptoms are likely to be exhibited during the feeding if this condition is present? Correct Answer: Choking, coughing, and cyanosis The practical nurse (PN) is assessing an 8-month-old who has a medical diagnosis of tetralogy of Fallot. The child demonstrates cyanosis with crying and exertion. Which other symptom is this infant most likely to exhibit? Correct Answer: Clubbed fingers While examining a 6-year-old visiting the clinic for fever and a rash, the practical nurse (PN) notices several elevated 1- to 3-mm white spots on the buccal mucosa. What other signs should the PN expect this child to exhibit? Correct Answer: Red blotchy macular rash on the face and neck A 2-year-old child who is hospitalized with an acute upper respiratory infection (URI) is crying uncontrollably because her mother went to the cafeteria for lunch. Which action should the practical nurse implement? Correct Answer: Distract the child with a favorite toy. A child with nephrotic syndrome is receiving prednisone (Deltasone). The practical nurse (PN) reviews breakfast foods at a fast food restaurant with the child's mother. Which selections indicate that the mother understands the dietary guidelines necessary for her child? Correct Answer: Toasted oat cereal and low-fat milk The practical nurse (PN) should take the vital signs of a 4-month-old child in which sequence to collect the most accurate results? Correct Answer: Respiratory rate, heart rate, then axillary temperature The practical nurse (PN) is taking the temperature of a 5-year-old child with otitis media. During the previous 24 hours, the child's temperature readings have ranged from 101.2° F oral to 102° F tympanic. Which statement accurately evaluates these findings and should be considered when planning care for the remainder of the shift? Correct Answer: A tympanic temperature and an oral temperature are equally accurate techniques in evaluating the child's fever. The practical nurse (PN) is evaluating the play behaviors of a 2-year-old child. Which behavior should the PN expect the toddler to exhibit? Correct Answer: Displays possessiveness with toys An infant is born with a ventricular septal defect (VSD), and surgery is planned to correct the defect. The practical nurse (PN) should understand that the surgical correction is designed to achieve which hemodynamic outcome? Correct Answer: Prevent the return of oxygenated blood to the lungs. An 11-year-old boy is admitted after being hit in the head with a baseball during a Little League game. Which subject is most important for the practical nurse to explore during history taking? Correct Answer: The level of consciousness exhibited after the injury A newborn who has mild transitional (positional) clubfeet is placed in bilateral casts in an overcorrected valgus (outward) position. What is the primary issue the practical nurse should review with the parents during discharge teaching? Correct Answer: Observe for skin and circulation compromise from the cast. The father of a 4-year-old often observes his daughter at day care via a video camera hookup to his computer. The father tells the practical nurse (PN) at the day care center that he frequently observes his daughter eating with her fingers rather than with utensils. How should the PN respond? Correct Answer: Offer reassurance that this behavior is normal but that he can begin teaching his child how to use utensils. A male high-school graduate with attention deficit hyperactivity disorder (ADHD) presents to the family healthcare provider for his precollege physical. He tells the practical nurse (PN), "I don't want to take my Adderall (amphetamine-dextroamphetamine) in college." How should the PN respond? Correct Answer: "What are your concerns about continuing Adderall?" A 2-year-old child had tympanostomy ventilating tubes inserted into both tympanic membranes (TMs) 1 week earlier. During a postoperative clinic visit, the practical nurse (PN) notes that the child has a purulent discharge from the right ear, and the mother explains that the toddler has had a cold for 3 days. What action should the PN implement? Correct Answer: Collect a specimen of the otorrhea for culture. What is the most important information for the practical nurse (PN) to review with a 12-year-old who is receiving long-term and rescue medications for routine management of asthma? Correct Answer: Use albuterol (Proventil) for prevention of exercise-induced bronchospasm. Minocycline (Minocin) 50 mg PO every 8 hours is prescribed for a 18-year old adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.) Correct Answer: Report vaginal itching or discharge. Protect skin from natural and artificial ultraviolet light. Avoid driving until response to medication is known. Use a nonhormonal method of contraception if sexually active. A 12-year-old with type 1 diabetes mellitus complains of abdominal pain and has experienced increased thirst during the previous 24 hours. What action should the practical nurse implement first? Correct Answer: Test urine for ketones and glucose. Which action should the practical nurse (PN) implement first when obtaining the tympanic temperature of a 2-year-old child? Correct Answer: Apply the probe cover to the electronic thermometer. Which intervention should the practical nurse implement when a child cannot swallow prescribed tablets? Correct Answer: Crush tablets to a fine powder and mix with a small amount of soft food. The nurse observes that a 3-year-old child combines words in short phrases and understands the concepts of hot and cold and big and little. Which intervention should the PN implement? Correct Answer: Document that the child's expressive speech is age-appropriate. The health care provider prescribes the anticonvulsant carbamazepine (Tegretol) for an adolescent client with a seizure disorder. The nurse should instruct the client to notify the health care provider if which condition occurs? Correct Answer: Develops a sore throat A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injection site to administer this immunization? Correct Answer: Vastus la