HESI 2024 7th Edition PEDS Exam Part 1

When caring for a child with congenital heart disease and polycythaemia, which nursing action has the highest priority? - Maintaining adequate hydration The nurse is preparing a teaching plan for the mother of a child who has been diagnosed with celiac disease. Choosing which lunch will be within the therapeutic management of a child with celiac disease? - Baked chicken, coleslaw, soda, and frozen fruit dessert A 7-month-old male infant diagnosed with spastic cerebral palsy is seen by the nurse in the clinic. Which statement by the parent warrants immediate intervention by the nurse? - "My son often chokes while I am feeding him." The nurse is caring for a child with intussusception who is scheduled for a barium enema prior to a surgical procedure. Which action should the nurse take first? - Place the child on a clear liquid diet. The nurse should teach the parents of a child with a cyanotic heart defect to perform which action when a hypercyanotic spell occurs? - Allow the child to assume a knee-chest position, with the head and chest slightly elevated. The nurse is teaching the parents of a 2-year-old child with a congenital heart defect about signs and symptoms of congestive heart failure. Which information about the child is most important for the parents to report to the healthcare provider? - Exhibits a sudden and unexplained weight gain. Prophylactic antibiotics are prescribed for a child who has mitral valve damage. The nurse should advise the parents to give the antibiotics prior to which occurrence? - Urinary catheterization A 7-month-old infant with a rotavirus causing severe diarrhea is admitted for treatment. Which action should the nurse take first? - Insert an intravenous (IV) line and begin IV fluids. The nurse admits a child to the intensive care unit with a possible diagnosis of Wilms tumor. What is the most important safety precaution for child? - Place a do not palpate abdomen sign on head of bed. The nurse is taking the family history of a 2-year-old child with atopic dermatitis (eczema). Which statement by the mother is most important in formulating a plan of care for this child? - "My husband and our daughter are both lactose-intolerant." A mother calls the clinic because her 6-year-old son, who has been taking prescribed antibiotics for 7 of the previous 10 days, continues to have a cough that she reports is worsening. Further questioning by the nurse reveals that the cough is nonproductive. What is the nurse's best instruction to the mother? - Bring the child to the clinic today for an examination related to the cough. The nurse is assessing a male adolescent client's knowledge of contraception. The teen states, "I have all the info I need." What is the best response by the nurse? - "Tell me what you know about birth control." The nurse is examining a male child experiencing an exacerbation of juvenile rheumatoid arthritis (JRA) and notes that mobility is greatly reduced. What is the most likely cause of the child's impaired mobility? - Joint inflammation A father of a 5-year-old calls the nurse to report that his child, who has had an upper respiratory infection, is complaining of a headache, with a rectal temperature of 103°F/39.4°C. Which action has the highest priority? - Tell the parent to take the child to the emergency department. A child comes to the school nurse complaining of itching. Further assessment reveals that the child has impetigo. What action should the nurse take? - Send the child home with the parents to see the healthcare provider before returning to school. An infant is receiving digoxin for congestive heart failure. The apical heart rate is assessed at 80 beats/min. What action should the nurse take first? - Obtain a therapeutic drug level. The nurse is conducting an initial admission assessment of a 12-month-old child in celiac crisis. Which action is most important for the nurse to take first? - Assess the child's mucous membranes and skin turgor. When inserting a nasogastric tube into the stomach of a 3-month-old infant, which action is most important for the nurse to take first? - Monitor the infant's heart rate. The nurse assigns an unlicensed assistive personnel (UAP) to provide morning care to a newly admitted child with bacterial meningitis. What is the most important instruction for the nurse to review with the UAP? - Use designated isolation precautions. The nurse is helping a family prepare to send their 7-year-old child to school for the first time. The child is wheel-chair bound, and has a permanent tracheostomy. What information must the nurse include in the teaching plan for the child? - Place suctioning supplies on the back of the wheelchair when transporting. A woman is being discharged following the birth of her second child. Her first child died at 6 weeks of age because of sudden infant death syndrome (SIDS). The mother tells the nurse that she is fearful that this infant will also develop SIDS. What is the nurse's best response? - "The fear of losing another child to SIDS is very realistic. Have you thought about what support you may need?" A 3-week-old infant is referred to an orthopedic clinic because the pediatrician heard a click when flexing the child's right hip during a routine physical examination. Which risk factor is most closely related to developmental hip dysplasia? - Breech presentation The nurse is teaching an adolescent girl with scoliosis about a Milwaukee brace that her healthcare provider has prescribed. Which instruction should the nurse provide to this client? - Remove the brace 1 hour each day for bathing only. Which preoperative nursing action should be included in the plan of care for an infant with pyloric stenosis? - Observe for projectile vomiting. The nurse expects a 2-year-old child to exhibit which behavior? - Display possessiveness with toys. The nurse is preparing a health teaching program for parents of toddlers and preschoolers, and plans to include information about the prevention of accidental poisonings. It is most important for the nurse to include which instruction? - Store all toxic agents and medicines in locked cabinets. The nurse observes a 4-year-old boy in a day care setting. Which behavior should the nurse expect this child to exhibit? - Boasts aggressively when telling a story. A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 99.6°F. How many calories per day will the nurse include in the infant's plan of care? - 600 calories/day The nurse is planning postoperative care for a child who has had a cleft lip repair. What is the most important reason to minimize this child's crying during the recovery period? - Crying stresses the suture line. A 6-month-old infant is admitted to the post-anesthesia care unit with elbow restraints in place. An endotracheal tube is in place connected to a ventilator, but the child will be extubated soon following recovery from anesthesia. Which action should the nurse include in the child's postoperative care? - Remove restraints one at a time and provide range-of-motion exercises. A nurse is preparing to end the shift and receives a laboratory report stating that a child with asthma has a theophylline level of 15 mcg/dL. Which action should the nurse take? - Communicate the result to the oncoming nurse and document. Following the administration of immunizations to a 6-month-old infant, the nurse provides the family with home care instructions. Which statement by the mother indicates that further teaching is needed? - "I will give my baby a baby aspirin every 4 hours as needed for fever." During routine screening at a school clinic, an otoscope examination of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. Based on these findings, what action should the nurse take? - Ask if the child has had a cold, runny nose, or any ear pain lately. A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine evaluation. Which assessment finding suggests the presence of a common complication often experienced by those with Down syndrome? - Presence of a systolic murmur At which point during the physical examination should a child with asthma be assessed for the presence or absence of intercostal retractions? - Inspiration A newborn whose mother is HIV-positive is scheduled for the first follow-up assessment with the nurse. If the child is HIV-positive, which initial symptom will the child most likely exhibit? - Persistent cold An 18-month-old child returns to the unit following a cardiac catheterization with a cannulated femoral artery site. Which action will the nurse include when teaching the parents about immediate post-procedure care? - Show the parents how to hold the child with the extremity extended. The nurse notes that a 16-year-old is refusing classmates visits. Further assessment reveals a concern over edematous facial features. Which concern will the nurse plan to address first? - Ineffective coping A child breaks out with varicella infection while hospitalized for a minor surgical procedure. Which action should the nurse take first? - Place the child in strict isolation to prevent an outbreak on the unit. A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of psychosocial development is the nurse addressing when teaching inhalation therapy? - Initiative In making the initial assessment of a 2-hour-old infant, which finding should lead the nurse to suspect a congenital heart defect? - Diminished femoral pulses A 3-month-old infant returns from surgery with elbow restraints and a Logan bow over a cleft lip suture line. Which action should the nurse take to maintain suture line integrity during the initial postoperative period? - Place the infant upright in an infant seat position.