Pediatric Hesi Review questions and answers

Pediatric Hesi Review questions and answers How is Duchenne muscular dystrophy inherited? Correct Answer: X-linked disorder typically due to *frameshift* (deletions, duplications, or nonsense) mutations -- truncated dystrophin protein -- inhibited muscle regeneration X-linked recessive, affecting males mostly *D*uchenne = *d*eleted *d*ystrophin An infant has patent ductus arteriosus and is receiving indomethacin, what is the purpose of administering this drug? Correct Answer: decrease murmur What kind of toy is appropriate for a 10 yr old child with Rheumatic fever who is on strict bedrest Correct Answer: checkers What assessment is most important for the nurse to obtain when a dm1 pt said she wants to use a pump instead of insulin inj? Correct Answer: understanding quality control and troubleshooting the pump A nine-week old infant is scheduled for a cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite? A. wt gain lbs from birth B. RBC count of 2.3 million C. Urine specific gravity is 1.011 D. WBC count of 10,000 Correct Answer: RBC of 2.3 million/ normal is 4-5.5 What intervention is most important for nurse to include in the care of a child with pertussis receiving IV azithromycin Correct Answer: Monitor for signs of facial swelling and urticaria What may be a problem seen after surgery for Tetrology of Fallot? Correct Answer: Post-op fatigue, anorexia, resp distress What are the S/S of pyloric stenosis? Correct Answer: Olive mass in epigastric region visible peristaltic waves hyperemeresis What kind of diet is best for celiac disease? Correct Answer: gluten free items and ingredients What would cause an infant to have flaring nares ? Correct Answer: Sign of respiratory distress, infant are nose breathers When and why would a Lyme test be done on a child ? Correct Answer: By drawing blood, testing for Borrelia burgdorferi after getting bitten by ticks. Done after 1-2 wks exposure. What test is done to detect cystic fibrosis in children? Correct Answer: A 'sweat chloride test' is done if PKU/ Metabolic screening is positive or there is a meconium ileus in the newborn or when the infant has other such as; salty skin What is cradle cap and how do you get rid of it on an infant Correct Answer: A skin condition on the infants scalp due to excessive sebum production; yellow/ brown scales on top of the head - use mineral oil to moisten and brush with a fine comb What is acute myeloid leukemia (AML) in children and what are the s/s? Correct Answer: blood caner where blast cells do not become healthy wbc and stay in the bone marrow s/s- anemia, frequent inf, bone/joint pain, bruising/ bleeding with petechiae peaks btwn ages 2-5 What causes acute glomerlonephritis (AGN)? Correct Answer: post-streptococcal inf. tea colored urine with hematuria, protein, and HBP with fluid retention self limiting Why do sickle cell pts have enuresis (bedwetting) Correct Answer: over hydration due to crisis & diluted urine enuresis is a s/s of sickle What is Wilm's tumor? Correct Answer: nephroblastoma (kidney), mass in the ABD, DO NOT PALPATE What are the s/s of congenital hip dysplasia? Correct Answer: Asymmetrical gluteal folds, seen with breech babies, get an ultrasound & ortalani maneuver to check for loose hip in the socket -tx with pavlik harness to abduct the hips, traction, serial casting What is patent ductus arteriosus (PDA)? Correct Answer: heart defect w/ machine like murmur treat w/ idomethacin to see if it will close w/o surgery can cause lung probs What is the 'field of gaze' in a newborn and how important is this to assess? Correct Answer: if a newborn does not respond when you talk or stare back at you when you are 'enface' position then you may consider they have a hearing, sight, or autistic problem What is a VP shunt? Correct Answer: a ventriculoperitoneal shunt is placed to relieve pressure on the ventricles (4) of the head. primarily used in hydrocephaly What is juvenile idiopathic arthritis (JIA) and how is it treated? Correct Answer: dx- before age 16; if you have arthritis for 6 weeks or more, doctor rules out other causes. tx- NSAIDs, steroids, methotrexate regular eye exams to monitor for damage due to inflammation When should solid food be offered to a baby? Correct Answer: when they are able to turn their head toward the spoon 4-6mo, only give one food at a time What is 'Synagis' and why is it given? Correct Answer: RSV vaccine, series of 5 injections When a pediatric patient has an amputation what kind of teaching will the nurse do that is very important to the patient's health? Correct Answer: inspect the stump for breakdown The nurse is performing a routine assessment of a 3 yr old at a community health center. Which behavior by the child should alert the nurse to request a follow up for a possible autistic spectrum disorder? A. History of tamper tantrums B. Strokes hair of a doll C. Shows indifference to verbalize stimuli D. Performs odd repetitive behaviors Correct Answer: Performa odd repetitive behaviors A toddler is hospitalized with Kawasaki's disease. Pharmacological management includes aspirin therapy. What is the benefit of the aspirin in this disease? A. Minimize vascular inflammation B. Reduce joint swelling C. Manage irritability D. Control high fever Correct Answer: Minimize vascular inflammation A hospitalized adolescent female demands that her mother stay with her. The mother tells the nurse she cannot understand her daughter acting this way. What response is best for the nurse to provide? A. Try not to reward her manipulation B. It is likely she is regressing to an earlier age C. Possibly she is lonely for her friends D. She is probably feeling insecure Correct Answer: She is probably feeling insecure A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). What is the best explanation for this finding? A. High thyroxine levels normally occur in breastfeeding infants B. The thyroid gland does not produce normal levels of thyroxine for se