pediatric hesi test bank|300 + questions and answers all 100% correct

pediatric hesi test bank|300 + questions and answers all 100% correct Norms for growth and development Correct Answer: Birth weight doubles by 6 months, triples by yr Peek a boo by 6 month Sits upright without support by 8 pincher grip by 10-12 Hesi hint Correct Answer: Mobiles: infant Puppets: toddler/preschool Cars: preschool Games: school age Themselves: adolescent Toddlers Correct Answer: 2-3 word sentences at 2 Ritualistic Preschool Correct Answer: Favorite word is why Sentences of 5-8 School age Correct Answer: Each yr gains 4-6 lbs grows 2 inches Socialization with peers very important Immunization Correct Answer: Cold doesn't stop it unless 99 Use acetaminophen orally Cystic fibrosis Correct Answer: Autosomal recessive Absence of pancreatic enzymes Greasy stool Chronic pulmonary infections High sweat test Pancreatic enzymes with meals Digoxin therapy in kids Correct Answer: Hold infants 100, kids 80 Don't skip or make up dose Give 1-2 hrs before meals S/s over dose: vomiting, diarrhea, muscle weakness, drowsiness Vent septal defect Correct Answer: Abnormal opening between ventricles Acyanotic Atrial septal defect Correct Answer: Opening in atria Acyanotic Patent ductus arterious Correct Answer: Hole between aorta and pulmonary artery Acyanototic So are coarctation of aorta and aortic stenosis Cyanotic heart defects Correct Answer: Tetralogy of fallot: 4 defects Transposition of the great vessels: everything is criss crossed Truncus arterious : single great vessel instead of 2 Rheumatic fever Correct Answer: Most common cause of acquired heart disease Affects connective tissue, sore throat than fever Lots of rest, home school Resp distress infants Correct Answer: Increase rr axillAry muscles for breathing Restlessness Nasal flaring Tripod Grunting Cyanotic Resp failure infants Correct Answer: Brady Deceased rr Apneic Deceased loc Grunting Deceased breath sounds When does birth length double? Correct Answer: By 4 years When does the child sit unsupported? Correct Answer: 8 months When does a child achieve 50% of adult height? Correct Answer: 2 years When does a child throw a ball overhand? Correct Answer: 18 months When does a child speak 2-3 word sentences? Correct Answer: 2 Yeears Age groups concepts of bodily injury Correct Answer: Infants: After 6 months, their cognitive development allows them to remember pain. Toddlers: Fear intrusive procedures. Preschoolers: Fear body mutilation. School age: Fear loss of control of their body. Adolescent: Major concern is change in body image. Following immunization, what teaching should the nurse provide to the parents? Correct Answer: Irritability, fever (102 degrees F), redness and soreness at injection site for 2-3days are normal side effects of DPT and IPV administration.Call healthcare provider if seizures, high fever, or high -pitched crying occur.A warm washcloth on the thigh injection site and "bicycling" the legs w/each diaper change will decrease soreness.Acetaminophen (Tylenol) is administered orally every 4-6 hours (10-15 mg/Kg) Hgb norms Correct Answer: Newborn: 14 to 24 g/dl Infant: 10 to 15 g/dl Child: 11 to 16 g/dl Autosomal recessive Correct Answer: Both parents must be heterozygous, or carriers of the recessive trait, for the disease to be expressed in their offspring. With each pregnancy, there is a 1:4 chance of the infant having the disease. However, all children of such parents CAN get the disease - NOT 25% of them. A child with leukemia is being discharged after beginning chemotherapy. Which of the following instructions will the nurse include when teaching the parents of this child? a)provide a diet low in protein and high carbohydrates b) avoid fresh vegetables that are not cooked or peeled c) notify the doctor if the child's temperature exceeds 101 F (39C) d) increase the use of humidifiers throughout the house Correct Answer: Answer B fresh fruits and vegetables harbor microorganisms, which can cause infections in immune-compromised child. Fruits and vegetables should either be peeled or cooked. The physician should be notified of a temperature above 100F, a diet low in protein is not indicated, and humidifiers harbor fungi in the water containers. A client with hemophilia has a very swollen knee after falling from bicycleriding. Which of the following is the first nursing action? a)initiate an IV site to begin administration of cryoprecipitate b) type and cross-match for possible transfusion c) monitor the client's vital signs for the first 5 minutes d) apply ice pack and compression dressings to the knee Correct Answer: Answer D rest, ice, compression, and elevation (RICE)are the immediate treatments to reduce the swelling and bleeding into the joint. These are the priority actions for bleeding into the joint of a client with hemophilia A client and her husband are positive for the sickle cell trait. The client asks the nurse about chances of her children having sickle cell disease. Which of the following is appropriate response by the nurse? a)one of her children will have sickle cell disease b) only the male children will be affected c) each pregnancy carries a 25% chance of the child being affected d) if she had four children, one of them would have the disease Correct Answer: Answer C In autosomal recessive traits, both parents are carriers. There is a 25% chance with each pregnancy that a child will have the disease. An 8 year old child has been diagnosed to have iron deficiency anemia. Which ofthe following activities is most appropriate for the child to decrease oxygen demands on the body? a)Dancing b) playing video games c) reading a book d) riding a bicycle Correct Answer: Answer C reading a book is restful activity and can keep the child from becoming bored. Choices a, b, and d require too much energy for a child with anemia and can increase oxygen demands on the body. A 16 month old child diagnosed with Kawasaki Disease (KD) is very irritable,refuses to eat, and exhibits peeling skin on the hands and feet. Which of the following would the nurse interpret as the priority? a)applying lotions to the hands and feet b) offering foods the toddler likes c) placing the toddler in a quiet environment d) encouraging the parents to get some rest Correct Answer: Answer C One of the characteristics of children with KD is irritability. They are often inconsolable.Placing the child in a quiet environment may help quiet the child and reduce the workload of the heart. The child's irritability takes priority over peeling of the skin. A newborn's failure to pass meconium within the first 24 hours after birth may indicate which of the following? a.Hirschsprung disease b. Celiac disease c. Intussusception d. Abdominal wall defect Correct Answer: Answer A Failure to pass meconium within the first 24 hours after birth may be an indication of Hirschsprung disease, a congenital anomaly resulting in mechanical obstruction due to inadequate motility in an intestinal segment. Failure to pass meconium is not associated with celiac disease, intussusception, or abdominal wall defect. Which of the following should the nurse do first after noting that a child with Hirschsprung disease has a fever and watery explosive diarrhea? a. Notify the physician immediately b. Administer antidiarrheal medications c. Monitor child ever 30 minutes d. Nothing, this is characteristic of Hirschsprung disease Correct Answer: Answer A For the child with Hirschsprung disease, fever and explosive diarrhea indicate enterocolitis, a life-threatening situation. Therefore, the physician should be notified immediately. Generally, because of the intestinal obstruction and inadequate propulsive intestinal movement, antidiarrheals are not used to treat Hirschsprung disease. The child is acutely ill and requires intervention, with monitoring more frequently than every 30 minutes.Hirschsprung disease typically presents with chronic constipation. When assessing a child for possible intussusception, which of the following would be least likely to provide valuable information? a.Stool inspection b. Pain pattern c. Family history d. Abdominal palpation Correct Answer: Answer C Because intussusception is not believed to have a familial tendency, obtaining a family history would provide the least amount of information. Stool inspection, pain pattern, and abdominal palpation would reveal possible indicators of intussusception. Current, jelly-like stools containing blood and mucus are an indication of intussusception. Acute,episodic abdominal pain is characteristics of intussusception. A sausage-shaped mass may be palpated in the right upper quadrant. After teaching the parents of a preschooler who has undergone T and A(Tonsillectomy and Adenoidectomy) about appropriate foods to give the child afterdischarge, which of the following, if stated by the parents as appropriate foods, indicates successful teaching? a)meatloaf and uncooked carrots b) pork and noodle casserole c) cream of chicken soup and orange sherbet d) hot dog and potato chips Correct Answer: Answer C for the first few days after a T and A (Tonsillectomy and Adenoidectomy) , liquids and soft foods are best tolerated by the child while the throat is sore. Avoid hard and scratchy foods until throat is healed. A child diagnosed with tetralogy of fallot becomes upset, crying and thrashing around when a blood specimen is obtained.The child's color becomes blue and respiratory rate increases to 44 bpm.Which of the following actions would the nurse do first? a)obtain an order for sedation for the child b) assess for an irregular heart rate and rhythm c) explain to the child that it will only hurt for a short time d) place the child in knee-to-chest position Correct Answer: Answer D the child is experiencing a "tet spell" or hypoxic episode.Therefore the nurse should place the child in a knee-to-chest position. Flexing the legs reduces venous flow of blood from lower extremities and reduces the volume of blood being shunted through the interventricular septal defect and the overriding aorta in the child with tetralogy of fallot. As a result, the blood then entering the systemic circulation has higher oxygen content, and dyspnea is reduced. Flexing the legs also increases vascular resistance and pressure in the left ventricle. An infant often assumes a knee-to-chest position to relieve dyspnea. If this position is ineffective, then the child may need sedative. Once the child is in this position, the nurse may assess for an irregular heart rate and rhythm.Explaining to the child that it will only hurt for a short time does nothing to alleviate hypoxia. Which of the following would the nurse perform to help alleviate a child's joint pain associated with rheumatic fever? a)maintaining the joints in an extended position b) applying gentle traction to the child's affected joints c) supporting proper alignment with rolled pillows d) using a bed cradle to avoid the weight of bed lines on the joints Correct Answer: Answer D for a child with arthritis associated with rheumatic fever, the joints are usually so tender that even the weight of bed linens can cause pain. Use of the bed cradle is recommended to help remove the weight of the linens on painful joints. Joints need to be maintained in good alignment, not positioned inextension, to ensure that they remain functional.Applying gentle traction to the joints is not recommended because traction is usually used to relieve muscle spasms, not typically associated with rheumatic fever. Supporting the body in good alignment and changing the client's position are recommended, but these measures are not likely to relieve pain. Which of the following health teachings regarding sickle cell crisis should be included by the nurse? a) it results from altered metabolism and dehydration b) tissue hypoxia and vascular occlusion cause the primary problems c) increased bilirubin levels will cause hypertension d) there are decreased clotting factors with an increase in white blood cells Correct Answer: Answer B tissue hypoxia occurs as a result of the decreased oxygen-carrying capacity of the red blood cells. The sickled cells begin to clump together, which leads to vascular occlusion. Which of the following should the nurse expect to note as a frequent complication for a child with congenitalheart disease? a.Susceptibility to respiratory infection b. Bleeding tendencies c. Frequent vomiting and diarrhea d. Seizure disorder Correct Answer: Answer A Children with congenital heart disease are more prone to respiratory infections.Bleeding tendencies, frequent vomiting, and diarrhea and seizure disorders are not associated with congenital heart disease While assessing a newborn with cleft lip,the nurse would be alert that which of the following will most likely be compromised? a.Sucking ability b. Respiratory status c. Locomotion d. GI function Correct Answer: Answer A. Because of the defect, the child will be unable to from the mouth adequately around nipple, there by requiring special devices to allow for feeding andsucking gratification. Respiratory status may be compromised if the child is fed improperly or during postoperative period, Locomotion would be a problem for the older infant because of the use of restraints. GI functioning is not compromised in the child with a cleft lip When providing postoperative care for the child with a cleft palate, the nurse should position the child in which of the following positions? a.Supine b. Prone c. In an infant seat d. On the side Correct Answer: Answer B. Postoperatively children with cleft palate should be placed on their abdomens to facilitate drainage.If the child is placed in the supine position, he or she may aspirate. Using an infant seat does not facilitate drainage. Side-lying does not facilitate drainage as well as the prone position Which of the following nursing diagnoses would be inappropriate for the infant with gastroesophageal reflux(GER)? a.Fluid volume deficit b. Risk for aspiration c. Altered nutrition: less than body requirements d. Altered oral mucous membranes Correct Answer: Answer D GER is the backflow of gastric contents into the esophagus resulting from relaxation or incompetence of the lower esophageal (cardiac)sphincter. No alteration in the oral mucous membranes occurs with this disorder. Fluid volume deficit, risk for aspiration, and altered nutrition are appropriate nursing diagnoses Which of the following parameters would the nurse monitor to evaluate the effectiveness of thickened feedings for an infant with gastroesophageal reflux (GER)? a.Vomiting b. Stools c. Uterine d. Weight Correct Answer: Answer A Thickened feedings are used with GER to stopthe vomiting. Therefore, the nurse wouldmonitor the child's vomiting to evaluate theeffectiveness of using the thickened feedings.No relationship exists between feedings andcharacteristics of stools and uterine. Iffeedings are ineffective, this should be notedbefore there is any change in the child's weight. Following the reduction of an incarcerated inguinal hernia, a 4-month-old boy is scheduled for surgical repair of the inguinal hernia. Under which circumstance should the parents notify the health care provider prior to surgery? Correct Answer: Presence of an inguinal bulge after gentle palpation Rationale: The parents should notify the health care provider if the hernia remains irreducible after implementing simple measures, such as gentle palpation, warm bath, and comforting to reduce crying. If a loop of intestines is forced into the inguinal ring or scrotum and incarcerates, swelling can follow and possible strangulation of the bowel, intestinal obstruction, or gangrene of the bowel loop can occur, necessitating emergency surgical release. At which point during the physical examination should a child with asthma be assessed for the presence or absence of intercostal retractions? Correct Answer: Inspiration Rationale: Intercostal retractions result from respiratory effort to draw air into restricted airways. The retractions will not be noticeable when air is expelled from the lungs, such as when the client is coughing or expiring The nurse is planning postoperative care for a child who has had a cleft lip repair. What is the most important reason to minimize this child's crying during the recovery period? Correct Answer: Crying stresses the suture line. Rationale: Prevention of stress on the lip suture line is essential for optimum healing and the cosmetic appearance of a cleft lip repair. A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F. What caloric amount does this child need? Correct Answer: 600 calories/day Rationale:An infant requires 108 calories/kg/day. The first step is to change 10 lb 15 oz to 10.9 lb. Then convert pounds to kilograms by dividing pounds by 2.2, which is 10.9/2.2 = 4.954 kg, rounded to 5 kg. The second step is to multiply 108 calories/kg/day (108 × 5 = 540 calories/day). However, this infant requires 10% more calories because of the 1° F temperature elevation. Ten percent of 540 (calories/day) is 54 and 540 + 54 = 594. This infant will require approximately 600 calories/day A 3-month-old infant returns from surgery with elbow restraints and a Logan's bow over a cleft lip suture line. Which intervention should the nurse implement to maintain suture line integrity during the initial postoperative period? Correct Answer: Place the infant upright in an infant seat position. Rationale: The use of an infant seat simulates a supine position with the head elevated and also prevents aspiration. Prone positioning should be avoided to prevent disruption of the protective Logan's bow and prevent the infant from rubbing the face on the bed surface. Mittens are not necessary and decrease the ability to provide sensory comfort, such as hand holding. Nasal suctioning should be avoided to prevent trauma or dislodging clots at the surgical site. Water-soluble lubricant will dry the suture line and cause crusting, which predisposes the suture line to poor healing and scarring. The nurse assigns an unlicensed assistive personnel (UAP) to provide morning care to a newly admitted child with bacterial meningitis. What is the most important instruction for the nurse to review with the UAP? Correct Answer: Use designated isolation precautions. Prophylactic antibiotics are prescribed for a child who has mitral valve damage. The nurse should advise the parents to give the antibiotics prior to which occurrence? Correct Answer: Urinary catheterization Rationale: Prophylactic antibiotics are usually prescribed prior to any invasive procedure for children who have valvular damage. A 4-year-old child has cystic fibrosis. Which stage of Erikson's theory of psychosocial development is the nurse addressing when teaching inhalation therapy? Correct Answer: Initiative Rationale: Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson's theory of psychosocial development A nurse is preparing to end the shift and receives a lab report stating that a child with asthma has a theophylline level of 15 mcg/dL. Which action should the nurse take? Correct Answer: Communicate the result to the oncoming nurse and document. Rationale: The therapeutic level of theophylline is 10 to 20 mcg/dL, so the child's level is within the therapeutic range. This information evaluates the prescribed therapy and should be communicated in the nurse's report. A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine evaluation. Which assessment finding suggests the presence of a common complication often experienced by those with Down syndrome? Correct Answer: Presence of a systolic murmur Rationale: Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down syndrome). Defects of the atrial or ventricular septum that create systolic murmurs are the most common heart defects associated with this congenital anomaly. Which preoperative nursing intervention should be included in the plan of care for an infant with pyloric stenosis? Correct Answer: Observe for projectile vomiting. Rationale: Projectile vomiting (D), the classic sign of pyloric stenosis, contributes to metabolic alkalosis. A 6-month-old male infant is admitted to the postanesthesia care unit with elbow restraints in place. He has an endotracheal tube and is ventilator-dependent but will be extubated soon following recovery from anesthesia. Which nursing intervention should be included in this child's plan of care? Correct Answer: Remove restraints one at a time and provide range-of-motion exercises. Rationale: Removing restraints one at a time is safer than simultaneously. The infant should have the restrained extremities assessed frequently for signs of neurologic or vascular impairment, and range-of-motion exercises should be performed with these assessments. Under no circumstances should restraints be applied to the client continuously. Documentation of assessment finding