Hesi Pediatric Practice Exam 2023 with 100% correct question and answers

the nurse observes a 4 yr old boy in a daycare. Which behavior should the nurse consider normal for this child? Demonstrates aggressiveness by boasting when telling a story A burned child is brought to the ER. In estimating the % of body burned, the nurse uses a modified "Rule of Nines." Which part of the body is calculated as a larger % of total body surface than an adult? Head and neck (a child's head and neck are proportionately larger to their body than an adult's) The nurse receives a lab report stating a child w/ asthma has a theophylline level of 15mcg/dL. What action will the nurse take? Pass the info on in the report (therapeutic level is 10-20) A 12 month old is admitted w/ a respiratory infection and possible pneumonia. He is placed in a mist tent w/ O2. Which nsg intervention has the greatest priority? Have a bulb syringe readily available to remove secretions (patent airway has the highest priority. Humidification will liquefy the nasal secretions - thereby increasing the amt of secretions and making that a priority) All of the following interventions can be used to eval the effectiveness of nsg and medical interventions used to tx diarrhea. Which intervention is the least useful in the nurse's eval of a 20 month old child? Assessing the fontanels (Weighing diapers, checking skin turgor, and observing mucous mb's for moisture evaluate fluid status in infants. But how old is this child? Posterior fontanel closes at 2 months and anterior closes by 18 months) A 5 month old is admitted to the hospital w/ vomiting and diarrhea. The dr. prescribes dextrose 5% and 0.25% NS w/ 2 mEq KCl/ 100ml to be infused at 25mL/hr. Prior to initiating the infusion, the nurse should obtain which assessment finding? Serum BUN and creatinine levels (Regardless of the age, adequate renal fxn must be present b/f adding K+ IVF) The nurse is assigning care for a 4 yr old w/ otitis media and is concerned about the child's increasing temp over the last 24 hrs. When planning care for this child, it is important for the nurse to consider that a tympanic measurement of temp will provide the most accurate reading (A tympanic mb sensor is an excellent site because both the eardrum and hypothalamus (temp regulating center) are perfused by the same circulation. the sensor is unaffected by the cerumen and the presence of suppurative or unsuppurative otitis media does not effect measurement. RULE OF THUMB: for mgmt -sterile procedures should be assigned to licensed personnel. Mgmg skills be be tested on the NCLEX. An RN is not required) The nurse is assessing an 8 month old who has a medical dx of Tetrology of Fallow. Which sx is this client likely to exhibit? Clubbed fingers OF is a cyanotic defect, it causes clubbing of fingers and toes) As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which child's fontanel finding should be reported to the HCP? A 6 month old w/ FTT that has a closed anterior fontanel (At 6 months of age, the anterior fontanel should be open, and it should not be closed until about 18 months old) A preschool child who is hospitalized for hypospadias repair is most strongly influenced by which behavior? Concern for body integrity (Their major stressor is concern for body integrity) An infant is born w/ VSD and surgery is planned to correct the defect. The nurse recognizes that surgical correction is designed to achieve which outcome? Prevent the return of oxygenated blood to the lungs (Closure of VSDs stops oxygenated blood from being shunted from the LV to the RV) A 3 month old weighing 10 #, 15 oz has an axillary temp of 98.9F. The nurse determines the daily caloric need for him as approximately 600 calories/ day (10# 15 oz = 10.9#. Convert # to kg and rounded to 5. 10.9/2.2=4.954 = 5kg. An infant requires 108 calories/kg/day. So, 108 * 5 = 540 cal/day. however, this infant requires 10% more because he has a one degree tempt elevation. so 10% of 540 is 54. So 540 + 54 = 594) The nurse is preparing a health teaching program for parents of toddlers and preschoolers and plans to include info about prevention of accidental poisonings. It is most important for her to include which instruction? Store all toxic agents and meds in locked cabinets A 6 month old infant w/ CHF is receiving digoxin elixer. Which observation by the nurse warrants immediate intervention? Apical HR of 60bpm. (A HR of 60 is much lower than normal for a 6 month old. the normal HR for a 6 month old is 80 - 150 bpm when awake and 70 when sleeping is considered WNL) At 8:00 a.m. the UAP informs the charge nurse that a female adolescent client w/ acute glomerulonephritis has a BP of 210/110. The 4 a.m. reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take 1st? Administer PRN nifedipine (Procardia) sl. SL Procardia lowers BP very quickly, and this should be done 1st) A premature newborn girl, born 24 hrs ago, is dx'd w/ a PDA and placed under an O2 hood at 35%. the parents visit the nursery and ask to hold her. Which response should the nurse provide to the parents? "The O2 hood is holding the baby's O2 level just at the point needed. You may stroke and talk to her" (The baby is at 35%, which is much more than RA at 21%, and at this time, the baby should not be moved from under the hood. The nurse should offer the parents an alt such as to stroke and reassure the infant) The nurse is dvp'g a POC for a 3 yr old who is scheduled for a cardiac cath. To assist in decreasing the anxiety for the child on the day of the procedure, which intervention is best for the nurse to implement? Give the child a ride on a gurney to visit the cardiac cath lab and meet a nurse who works there (familiarizing the child and mom w/ the dpt will help decrease anxiety of the child and mom. 3 is a difficult age to undergo a procedure that requires cooperation. Restraints and possible sedation may be required) When taking the health hx of a child, the nurse knows that which finding is an early indication of hypothyroidism in children? Cessation of growth in a child that had been normal (Since the thyroid gland is responsible for metabolism, cessation of growth which was previously WNL is the most common sign for hypothyroidism in kids. The child w/ hypothyroidism is likely to be HYPOactive) The nurse is teaching a 12 yr old male and his family about taking injections of GH for idiopathic hypopituitarism. Which adverse sx's commonly associated w/ GH therapy should the nurse plan to describe to the child and family? Polyuria and polydipsia (s/s of diabetes or hyperglycemia need to be reported. Those receiving GH should be monitored to detect elevated sugars and glucose intolerance) The nurse is caring for a 12 yr old w/ SIADH (syndrome of inappropriate antidiruetic hormone). this child should be carefully assessed for which complication? Chgs in LOC (The child must be monitored for s/s hypOnatremia, which creates secondary CNS alterations such as chgs in LOC, seizure, and coma. Fluid overload occurs w/ SIADH) A 4 yr old girl continues to interrupt her mom during a routine clinic visit. The mom appears irritated w/ the child and asks the nurse "Is this normal behavior for a child this age?" The nurse's response should be based on which info? Children need to retain a sense of initiative w/out impinging on the rights and privileges of others (children 3-6 are in Erickson's "Initiative vs Guilt" stage, which is characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At this age, children dvp a conscience and must learn to retain a sense of initiative w/out impinging on the rights of others. 1-3 yrs is shame vs doubt 3-6 yrs is initiative vs guilt 6-12 yrs is industry vs inferiority 12-18 yrs is identity vs role confusion) The mother of a 2 yr old boy consults the nurse about her son's increased temper tantrums. The mother states, "yesterday he threw a fit in the grocery store and I did not know what to do. I was so embarrassed. What can I do if this occurs again?" Which recommendation is best for the nurse to provide this mother? Walk away from him and ignore the behavior (the best approach for a toddler is to ignore the attn seeking behavior. The parent should be somewhat nearby, w/in view of the child but should avoid reinforcing the behavior in any way. Tantrums can sometimes be avoided by talking to the child before the situation occurs) A 14 yr old female tells the nurse that she is concerned about the acne she has recently dvp'd. Which recommendation should the nurse provide? Wash the hair and skin frequently w/ soap and hot water (washing the hair and skin w/ soap and water removes oil and debris from the skin and helps prevent and tx acne. Oily skin is especially bothersome during adolescence when hormones cause enlargement of sebaceous glands and increased glandular secretions which predispose the teenager to acne.) During d/c teaching of a child w/ juvenile RA, the nurse should stress to the parents the importance of obtaining which dx'c testing? Eye exams (Visual chgs leading to blindness can occur in children w/ JRA. Regular eye exams can help to prevent this complication A hospitalized 16 yr old male refuses all visits from his classmates because he is concerned about his distorted appearance. To increase the child's social interaction, what intervention is best for the nurse to initiate? Arrange for an internet connection in his room for email communication (body image and peer acceptance are key concerns for the adolescent. This allows for social interaction w/out face to face contact, thus protecting his self-image while also promoting social interaction) The nurse is assessing a 2 yr old. What behavior indicates the child's language dvpmt is w/in normal limits? Capable of making 3 word sentences (at 1-3 yrs old, they are capable of making 2-3 word senstences) when evaluating the effectiveness of interventions to improve the nutritional status of an infant w/ gastro-esophageal reflux, which intervention is most important for the nurse to implement? Record wt daily (the most definitive measure of improved nutrition in an infant is obtaining the child's daily wt)