Peds Hesi

Peds Hesi The nurse is conducting an admission assessment of an 11-months old infant with congestive heart failure who is scheduled repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower, with pathophysiologic mechanism support these findings? Ans- The lumen of the aorta reduces the volume of flow to the lower extremities A child is to receive vancomycin (Vancocin) 20 mg/kg IV one hour before a scheduled procedure. The child weight 77 pounds. How many mg of the medication should the nurse prepare to administer? (Enter numeric value only) Ans- 700mg A toddler with hemophilia is being discharged from the hospital. Which teaching should the nurse include in the discharge instructions to the mother? Ans- Apply padding on the sharp corners of the furniture The nurse is using the Stage Questionnaire (b) to assess a 24 - month-old child. What is the best intervention for the nurse to initiate after the assessment is completed? Ans- Provide the parents with a list of stimulating activities When caring for a child sickle cell disease, the nurse knows that the child will most likely exhibit which sign when experiencing a sickle cell crisis? Ans- Pain The nurse is administering an oral medication to a reluctant preschool-age boy. Which intervention should the nurse implement? Ans- Use straightforward approach with the child The nurse is planning care for a newborn infant scheduled for a cardiac catheterization. Which occurrence poses the greatest risk for this child? Ans- Acute hemorrhage from the entry site of the catheter after the procedure The school nurse is presenting a seminar to parents about child safety that focuses on prevention of spinal cord injuries. What information is most important for the nurse include in the teaching plan? AnsSeat belt and car seat laws for use in motor vehicles should be reinforced A mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2 F (38 C). Which intervention should the nurse implement? Ans- Ask the mother if the child has had a runny nose A mother is concerned that her 3-year-old son wants to play with female doll figures. The child is not interested in building blocks, trucks, or other typical "boy" toys. How should the nurse respond to the mother's concern? Ans- Exploring different roles in imaginary play is typical at this age Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children? Ans- Carefully recording the height and weight of children to detect inappropriate growth rates The parents of a 4 week-old infant phone the pediatric clinic to report that their infant eats well but vomits after each feeding. To differentiate between normal regurgitation and pyloric stenosis, which information is most important for the nurse to obtain? Ans- Degree of forcefulness of vomiting episodes A 4-month-old boy has an inguinal hernia that is visible when he cries, but it does not cause him discomfort. His parents ask if the hernia should be repaired now. The nurse's response should be based on what information? Ans- Surgical correction is indicated if the hernia is incarcerated A 2-year-old child with heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 beast| minute. What action should the nurse implement? Ans- Administer the scheduled dose The nurse is assisting the mother of child with phenylketonuria (PKU) to select foods that are in keeping with the child's dietary restrictions. Which foods are contraindicated for this child? Ans- Foods sweetened with aspartame During a routine physical exam, a male adolescent client tell the nurse, " Sometimes, my mother gets angry because I want to be with my own friends". What is the best initial response by the nurse? AnsAsk about client's response to his mother's age Which response demonstrates that the mother of a young girl with a urinary tract infection (UTI) understands home care for the child? Ans- I will bring her back to the doctor's office for another urine test The nurse is caring for a one-year-old boy who has type 1 diabetes mellitus (DM). His mother asks how will she recognize hypoglycemia in her infant who cannot tell her how he feels. Which information should the nurse provide? Ans- Hypoglycemia in infants causes changes in behavior and cold clammy skin An 8 year-old child is admitted to the Emergency Department because of lower right quadrant pain, nausea, and vomiting. Which assessment of the abdomen should the nurse conduct after all other assessments are complete? Ans- Palpation An infant is admitted for surgery who has a Wilms' tumor. What nursing intervention should the nurse implement during the preoperative period? Ans- Careful bathing and handling that avoids abdominal manipulation A female of child - bearing age receives a rubella vaccination. She has two children at home, ages 13 months and 3 years. Which instruction is most important for the nurse to provide to this client? AnsEncourage the client to immunize the children The teacher notifies the school nurse that a child's nose is bleeding for no apparent reason. What action should the nurse implement first? Ans- Pinch the nose using thumb and finger for 10 minutes 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? Ans- The TSH is high because of the low production of T4 by the thyroid When administering indomethacin (Indocin) to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome? Ans- Decreased cardiac murmur A hospitalized child stiffens and stars to seize as the nurse enters the room. What actions should the nurse take? (Select all apply) Ans- • Turn client to the side if possible • Pad side rails with available pillows and blankets • Monitor duration and progress of the seizure A middle school male student was recently diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) and is having trouble with his grades. He is referred to the school nurse by the teacher because he continues to have learning problems. Which action should the school nurse take? Ans- Refer the child to the school counselor for educational testing An adolescent boy is hospitalized with full-thickness (third degreed) burns to both hands following a house fire. Three days after his admission to the burned unit, the nurse notes that teenager's hands are becoming more edematous. Which intervention is most important for the nurse to include in this client's plan care? Ans- Assess radial pulses every 2 hours A 10-year-old boy has been seen frequently by the nurse over the past three weeks after school begins in the fall. He reports headaches, stomach, and difficulty sleeping. What intervention should the nurse implement? Ans- Ask the boy to describe a typical day at school A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents? Ans- The chorea or movements are temporary and will eventually disappear A 3-year -old girl who has been blind since birth is hospitalized because of a compound fracture of the femur and is now in traction. Which intervention is best for the nurse to implement to address this child's blindness? Ans- Request parents bring familiar objects as a stuffed animal from home The nurse has provided discharge teaching to the mother of a premature infant. Which statement by the mother would indicated that the understands the importance of making sure that her baby gets the monthly palivizumab (Synagis) injection? Ans- The medication will protect my baby from respiratory syncytial virus A 16 -year-old adolescent with acute myelocytic leukemia is receiving chemotherapy (CT) via an implanted medication port at the out-patient oncology clinic. What action should the nurse implement when the infusion is completed? Ans- Flush the mediport with saline and a heparin solution The nurse is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective? Ans- Laughs readily, turns from back to side A pre-school-age girl who has been taking oral ampicillin (Omnipen, Polycillin) for 3 days for a nonrespiratory condition repeatedly tells the nurse that her throat hurts. The child has no evidence of dyspnea or urticaria. Which action should the nurse implement? Ans- Explain gently that medication must be taken A 9-year-old boy is diagnosed with diabetes mellitus Type 1. Which stage of Erikson's theory of psychosocial development is the nurse addressing when teaching this client about insulin injections? Ans- Industry After receiving a single fluid bolus of 20 mg / kg of normal saline, a child's heart rate is 140 beats/ minute, blood pressure is 70/50, and capillary refill is 6 seconds. The child is anxious and crying. Which intervention should the nurse implement first? Ans- Repeat the normal saline bolus as prescribed The clinic nurse is assessing a 3-year -old child with sudden onset of irritability, thick muffled voice, and barking on inspiration. The child is febrile and leaning forward to breathe with tongue protruding, is drooling, and has suprasternal retractions. Which interventio