HESI EXIT FAMILY NURSE PRACTITIONER FINAL
EXAMS(GRADED A,RATIONALEAND VERIFIED).
1. The following sequence is recommended for well-child examinations up tothe
age of 5 years:
• 2 weeks, 2 months, 4 months, 6 months, 1 year, 15 months, 18 months, and
every year from ages 2-5.
• 2 months, 4 months, 6 months, 9 months, and annually from years 1- 5.
• 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18
months, and annually years 2-5.
• The same intervals recommended for immunizations.
3. 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18
months, and annually years 2-5.
Rationale: These are the recommended health evaluation intervals for children to
obtain regular assessment information regarding growth anddevelopment and to
administer recommended immunizations.
2. An appropriate treatment for overweight children under 8 years of age would be
to:
• Administer an appetite suppressant.
• Eliminate all carbohydrates in the diet.
• Plan a program of activity, balanced diet, and exercise.
• Use vitamin therapy and herbal teas.
3. Plan a program of activity, balanced diet, and exercise.
Rationale: An approach with a well-balanced diet, activity, and exercise is
necessary for weight reduction. This allows for a slow approach to weight loss that
incorporates healthy behavior habits.
,3. The family nurse practitioner examines a 2-week-old newborn during a first
clinic visit. The family nurse practitioner notes dysmorphic facial features. The
family nurse practitioner's evaluation includes:
• Ordering a chromosome analysis.
• Completing a postnatal history.
• Writing a detailed physical exam and perinatal history.
• Avoiding discussion with parents until diagnostic studies are completed
• Writing a detailed physical exam and perinatal history.
Rationale: The first and most important part of all data gathering starts with a
detailed history and physical exam. A detailed, objective description of the
dysmorphic features is essential for comparison to textbook descriptions and other
data. Although chromosome analysis will probably be ordered, it is not done
initially. Parents should be included in the discussion of the findings and kept
informed of the progress throughout the evaluation process.
• An 18-month-old's feet turn inward. The mother is concerned, although the
child is unaware of the problem. The differential diagnosis includes all except:
• Femoral anteversion.
• Metatarsus adductus.
• Legg-Calvé-Perthes disease.
• Adducted great toe.
3. Legg-Calvé-Perthes disease.
Rationale: In-toeing is a common problem in children and can result
from femoral anteversion, adduction of the great toe, medial tibial torsion, and
metatarsus adductus. Legg-Calvé-Perthes disease is commonly seen in older
children (ages 4 to 8 years) who have loss of hip medial rotation.
5. The characteristics of an innocent heart murmur in children include:
• Asymptomatic, loud diastolic rumble, grades I to V.
, • Mid-systolic, no thrill, and asymptomatic.
• Asymptomatic with an S4 heard at lower left sternal border.
• May disappear on sitting and following any type of physical activity.
2. Mid-systolic, no thrill, and asymptomatic.
Rationale: Characteristics of innocent murmurs include mid-systolic;
asymptomatic; less than a grade III; loudest in pulmonic area (2–3 left intercostal
space at the left sternal border); no radiation to other areas; may disappear on
sitting; and may intensify with fever, activity, anemia, and stress. Any S4 sound is
considered pathologic in children as well as in adults.
6. The family nurse practitioner is examining a 6-month-old infant. What would be
the anticipated findings on examining the infant's fontanels?
• Both anterior and posterior should be open.
• The anterior should be open, the posterior closed.
• Both anterior and posterior should be closed.
• The anterior should be closed, the posterior open.2. The anterior should be
open, the posterior closed.
Rationale: The posterior fontanel is usually closed by 2 months of age; theanterior
fontanel closes at about 24 months of age.
7. Genu varum up to 20 degrees is normal until age:
• 18 years.
• 5 years.
• 18 months.
• 6 months. 3. 18 months.
Rationale: Genu varum (bowleg) of up to 20 degrees is a normal finding in children
until the age of 18 months.
8. When approaching a toddler to complete a cardiac assessment, the family nurse
practitioner would:
EXAMS(GRADED A,RATIONALEAND VERIFIED).
1. The following sequence is recommended for well-child examinations up tothe
age of 5 years:
• 2 weeks, 2 months, 4 months, 6 months, 1 year, 15 months, 18 months, and
every year from ages 2-5.
• 2 months, 4 months, 6 months, 9 months, and annually from years 1- 5.
• 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18
months, and annually years 2-5.
• The same intervals recommended for immunizations.
3. 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18
months, and annually years 2-5.
Rationale: These are the recommended health evaluation intervals for children to
obtain regular assessment information regarding growth anddevelopment and to
administer recommended immunizations.
2. An appropriate treatment for overweight children under 8 years of age would be
to:
• Administer an appetite suppressant.
• Eliminate all carbohydrates in the diet.
• Plan a program of activity, balanced diet, and exercise.
• Use vitamin therapy and herbal teas.
3. Plan a program of activity, balanced diet, and exercise.
Rationale: An approach with a well-balanced diet, activity, and exercise is
necessary for weight reduction. This allows for a slow approach to weight loss that
incorporates healthy behavior habits.
,3. The family nurse practitioner examines a 2-week-old newborn during a first
clinic visit. The family nurse practitioner notes dysmorphic facial features. The
family nurse practitioner's evaluation includes:
• Ordering a chromosome analysis.
• Completing a postnatal history.
• Writing a detailed physical exam and perinatal history.
• Avoiding discussion with parents until diagnostic studies are completed
• Writing a detailed physical exam and perinatal history.
Rationale: The first and most important part of all data gathering starts with a
detailed history and physical exam. A detailed, objective description of the
dysmorphic features is essential for comparison to textbook descriptions and other
data. Although chromosome analysis will probably be ordered, it is not done
initially. Parents should be included in the discussion of the findings and kept
informed of the progress throughout the evaluation process.
• An 18-month-old's feet turn inward. The mother is concerned, although the
child is unaware of the problem. The differential diagnosis includes all except:
• Femoral anteversion.
• Metatarsus adductus.
• Legg-Calvé-Perthes disease.
• Adducted great toe.
3. Legg-Calvé-Perthes disease.
Rationale: In-toeing is a common problem in children and can result
from femoral anteversion, adduction of the great toe, medial tibial torsion, and
metatarsus adductus. Legg-Calvé-Perthes disease is commonly seen in older
children (ages 4 to 8 years) who have loss of hip medial rotation.
5. The characteristics of an innocent heart murmur in children include:
• Asymptomatic, loud diastolic rumble, grades I to V.
, • Mid-systolic, no thrill, and asymptomatic.
• Asymptomatic with an S4 heard at lower left sternal border.
• May disappear on sitting and following any type of physical activity.
2. Mid-systolic, no thrill, and asymptomatic.
Rationale: Characteristics of innocent murmurs include mid-systolic;
asymptomatic; less than a grade III; loudest in pulmonic area (2–3 left intercostal
space at the left sternal border); no radiation to other areas; may disappear on
sitting; and may intensify with fever, activity, anemia, and stress. Any S4 sound is
considered pathologic in children as well as in adults.
6. The family nurse practitioner is examining a 6-month-old infant. What would be
the anticipated findings on examining the infant's fontanels?
• Both anterior and posterior should be open.
• The anterior should be open, the posterior closed.
• Both anterior and posterior should be closed.
• The anterior should be closed, the posterior open.2. The anterior should be
open, the posterior closed.
Rationale: The posterior fontanel is usually closed by 2 months of age; theanterior
fontanel closes at about 24 months of age.
7. Genu varum up to 20 degrees is normal until age:
• 18 years.
• 5 years.
• 18 months.
• 6 months. 3. 18 months.
Rationale: Genu varum (bowleg) of up to 20 degrees is a normal finding in children
until the age of 18 months.
8. When approaching a toddler to complete a cardiac assessment, the family nurse
practitioner would:
