Evolve HESI Practice Questions A 2-year-old child recently diagnosed with hemophilia A is discharged home. What information should the nurse include in a teaching plan about home care? Minimize interactive play with other children to lessen chances for injury. Give low -dose children's chewable aspirin in orange flavor for joint discomfort. Use a firm and dry toothbrush to clean teeth at least twice per day. Apply pr essure and ice for bleeding while elevating and resting the extremity. - Apply pressure and ice for bleeding while elevating and resting the extremity. Hemophilia, a blood disorder, causes joint bleeding which is treated with rest, ice, compression, and e levation (RICE) (D). (A, B, and C) are inaccurate. A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome? Congenital heart disease. Fragile X chromosome. Trisomy 13. Pyloric stenosis. - Congenital heart disease. Congenital heart disease (A) is the most common associated defect in children with Down syndrome. (C) might have seemed possible since Down synd rome is a trisomal chromosomal abnormality of chromosome 21. (B) is a sex -linked abnormality also causing mental retardation. (D) is not associated with Down syndrome. A 2-year-old child with gastro -esophageal reflux has developed a fear of eating. What instruction should the nurse include in the parents' teaching plan? Invite other children home to share meals. Accept that he will eat when he is hungry. Reward the child with a nap after eating. Consistently follow a set mealtime routine. - Consistentl y follow a set mealtime routine. A 2-year-old child is comforted by consistency (D). (A) is contraindicated because two -
year-olds may participate in parallel activities with other children but are too young to feel comfort and support by the presence of o ther children when anxious or afraid. (B) may or may not be true and does not address the child's fears. The child with reflux should remain upright at least two hours after eating (C) to reduce symptoms. A 3-month -old infant develops oral thrush. Which p harmacologic agent should the nurse plan to administer for treatment of this disorder? Nystatin (Mycostatin). Nitrofurantoin (Macrodantin). Norfloxacin (Noroxin). Neomycin sulfate (Mycifradin). - Nystatin (Mycostatin). Nystatin (Mycostatin) (A) is a n antifungal drug that is effective in treating thrush, an oral fungal infection. (B, C, and D) are not indicated for the treatment of oral thrush. A 3-week -old newborn is brought to the clinic for follow -up after a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction sho uld the nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.) A. Monitor the the infant's weight and number of wet diapers per day. B. Increase the infant's intake per feeding by 1 to 2 ounces per week. C. M ix the dose of prophylactic antibiotic in a full bottle of formula. D. Allow the infant to rest and refeed on demand or every 2 hours. E. Use a softer nipple or increase the size of the nipple opening. - A. Monitor the the infant's weight and number of wet diapers per day. B. Increase the infant's intake per feeding by 1 to 2 ounces per week. D. Allow the infant to rest and refeed on demand or every 2 hours. E. Use a softer nipple or increase the size of the nipple opening. Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of formula (C) because it is difficult to ensure that the total dose is consumed. They sho uld be monitored for weight gain and at least 6 wet diapers per day (A). A one -
month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces per day by 4 -months of age (B) A 3-year-old boy is brought to the emergency room because he swallowed an entire bottle of children's vitamin pills. Which intervention should the nurse implement first? Insert N/G tube for gastric lavage. Determine the child's pulse and respirations. Assess the child's level of consciousness. Administer an IV D5/0.25 NS as prescribed. - Determine the child's pulse and respirations. The most important principle in dealing with a poisoning is to treat the child first, not the poison. Initiate immediate life support measures with assessment of v ital signs (B), in particular, respirations. Inserting an airway or initiating mechanical ventilation may be necessary. Assessment and identification of the poison should occur prior to (A). (C and D) should occur after assessing the airway. A 3-year-old client with sickle cell anemia is admitted to the Emergency Department with abdominal pain. The nurse palpates an enlarged liver, an x -ray reveals an enlarged spleen, and a CBC reveals anemia. These findings indicate which type of crisis? Aplastic. Seque stration. Hyperhemolytic. Vaso -occlusive. - Sequestration. The findings support a sequestration crisis (B), where blood pools in the spleen, and is characterized by abdominal pain and anemia. (A and C) crises produce anemia but no abdominal pain or sp lenic enlargement. (D) crisis may produce abdominal pain, but no splenic enlargement or exacerbation of anemia. A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast is applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? Call the healthcare provider immediately if his nail beds appear blue. Check his fingers hourly for the first 48 hours to see that he is able to move them without pain. Be sure his arm remains above his heart for the first 24 hours. Take his temperature q4h for the next two days and call if an elevation is noted. - Call the healthcare provider immediately if his nail beds appear blue. Cyanosis (A) indicates impaired circulation to fingers and should be reported immediately. Although the actions described in (B, C, and D) may be indicated, they are implemented rather excessively --and might tend to frighten the parents. It is not necessar y to check the child's ability to move his fingers hourly for 2 days (B). Elevating the arm above the heart will help to decrease swelling but (C) is stated in a frightening way. It is not necessary to take the child's temperature q4h unless indicated by o ther symptoms. A 4-year-old girl continues to interrupt her mother during a routine clinic visit. The mother appears irritated with the child and asks the nurse, "Is this normal behavior for a child this age?" The nurse's response should be based on which information? Children need to retain a sense of initiative without impinging on the rights and privileges of others. Negative feelings of doubt and shame are characteristic of 4 -year-old children. Role conflict is a common problem of children this age . She is just wondering where she fits into society. At this age children compete and like to produce and carry through with tasks. She is just competing with her mother. - Children need to retain a sense of initiative without impinging on the rights and privileges of others. Children aged 3 to 6 are in Erickson's "Initiative vs. Guilt" stage, which is characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At this age, children
year-olds may participate in parallel activities with other children but are too young to feel comfort and support by the presence of o ther children when anxious or afraid. (B) may or may not be true and does not address the child's fears. The child with reflux should remain upright at least two hours after eating (C) to reduce symptoms. A 3-month -old infant develops oral thrush. Which p harmacologic agent should the nurse plan to administer for treatment of this disorder? Nystatin (Mycostatin). Nitrofurantoin (Macrodantin). Norfloxacin (Noroxin). Neomycin sulfate (Mycifradin). - Nystatin (Mycostatin). Nystatin (Mycostatin) (A) is a n antifungal drug that is effective in treating thrush, an oral fungal infection. (B, C, and D) are not indicated for the treatment of oral thrush. A 3-week -old newborn is brought to the clinic for follow -up after a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction sho uld the nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.) A. Monitor the the infant's weight and number of wet diapers per day. B. Increase the infant's intake per feeding by 1 to 2 ounces per week. C. M ix the dose of prophylactic antibiotic in a full bottle of formula. D. Allow the infant to rest and refeed on demand or every 2 hours. E. Use a softer nipple or increase the size of the nipple opening. - A. Monitor the the infant's weight and number of wet diapers per day. B. Increase the infant's intake per feeding by 1 to 2 ounces per week. D. Allow the infant to rest and refeed on demand or every 2 hours. E. Use a softer nipple or increase the size of the nipple opening. Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of formula (C) because it is difficult to ensure that the total dose is consumed. They sho uld be monitored for weight gain and at least 6 wet diapers per day (A). A one -
month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces per day by 4 -months of age (B) A 3-year-old boy is brought to the emergency room because he swallowed an entire bottle of children's vitamin pills. Which intervention should the nurse implement first? Insert N/G tube for gastric lavage. Determine the child's pulse and respirations. Assess the child's level of consciousness. Administer an IV D5/0.25 NS as prescribed. - Determine the child's pulse and respirations. The most important principle in dealing with a poisoning is to treat the child first, not the poison. Initiate immediate life support measures with assessment of v ital signs (B), in particular, respirations. Inserting an airway or initiating mechanical ventilation may be necessary. Assessment and identification of the poison should occur prior to (A). (C and D) should occur after assessing the airway. A 3-year-old client with sickle cell anemia is admitted to the Emergency Department with abdominal pain. The nurse palpates an enlarged liver, an x -ray reveals an enlarged spleen, and a CBC reveals anemia. These findings indicate which type of crisis? Aplastic. Seque stration. Hyperhemolytic. Vaso -occlusive. - Sequestration. The findings support a sequestration crisis (B), where blood pools in the spleen, and is characterized by abdominal pain and anemia. (A and C) crises produce anemia but no abdominal pain or sp lenic enlargement. (D) crisis may produce abdominal pain, but no splenic enlargement or exacerbation of anemia. A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast is applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? Call the healthcare provider immediately if his nail beds appear blue. Check his fingers hourly for the first 48 hours to see that he is able to move them without pain. Be sure his arm remains above his heart for the first 24 hours. Take his temperature q4h for the next two days and call if an elevation is noted. - Call the healthcare provider immediately if his nail beds appear blue. Cyanosis (A) indicates impaired circulation to fingers and should be reported immediately. Although the actions described in (B, C, and D) may be indicated, they are implemented rather excessively --and might tend to frighten the parents. It is not necessar y to check the child's ability to move his fingers hourly for 2 days (B). Elevating the arm above the heart will help to decrease swelling but (C) is stated in a frightening way. It is not necessary to take the child's temperature q4h unless indicated by o ther symptoms. A 4-year-old girl continues to interrupt her mother during a routine clinic visit. The mother appears irritated with the child and asks the nurse, "Is this normal behavior for a child this age?" The nurse's response should be based on which information? Children need to retain a sense of initiative without impinging on the rights and privileges of others. Negative feelings of doubt and shame are characteristic of 4 -year-old children. Role conflict is a common problem of children this age . She is just wondering where she fits into society. At this age children compete and like to produce and carry through with tasks. She is just competing with her mother. - Children need to retain a sense of initiative without impinging on the rights and privileges of others. Children aged 3 to 6 are in Erickson's "Initiative vs. Guilt" stage, which is characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At this age, children
