Pediatric HESI Practice Questions with |\ |\ |\ |\ |\
answers
The nurse is preparing a child with an intussusception for a prescribed
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
barium enema. What is the main purpose of conducting this procedure prior
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to surgical intervention?
|\ |\ |\
|\
A.Evacuate the bowel of impacted feces. |\ |\ |\ |\ |\
|\
B.Reduce the invaginated bowel segment. |\ |\ |\ |\
|\
C.Locate the presence of diverticula. |\ |\ |\ |\
|\
D.Identify the area of esophageal atresia. - CORRECT ANSWERS ✔✔ANS: B
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Intussusception, an invagination or telescoping of one portion of the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
intestine into another, causes intestinal obstruction in children (usually
|\ |\ |\ |\ |\ |\ |\ |\ |\
occurs between 3 months and 5 years of age). Nonsurgical treatment is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
attempted with hydrostatic pressure created by barium instillation, which
|\ |\ |\ |\ |\ |\ |\ |\ |\
often reduces the area of bowel intussusception (B), thereby negating the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
need for surgical intervention. A barium enema is likely to cause (A). A
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
barium enema could be used to detect (C), but this is not the reason for its
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
use with intussusception. (D) is not a use for a barium enema.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
The nurse is teaching an adolescent girl with scoliosis about a Milwaukee
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
brace that her health care provider has prescribed. Which instruction should
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the nurse provide to this client?
|\ |\ |\ |\ |\
,A.Remove the brace 1 hour each day for bathing only.
|\ |\ |\ |\ |\ |\ |\ |\ |\
B.Remove the brace only for back range-of-motion exercises.
|\ |\ |\ |\ |\ |\ |\
|\
C.Wear the brace against the bare skin to ensure a good fit.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
|\
D.Wearing the brace will cure the spinal curvature. - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔ANS: A |\
The Milwaukee brace is designed to slow the progression in spinal curvature
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
while the adolescent is growing. The brace should be worn 23 hours a day
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and removed a total of 1 hour a day for hygiene (A). There are no specific
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
exercises for increasing the range of motion in the back that should be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
performed (B). A T shirt should be worn next to the body and the brace put
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
on over the T shirt to protect the skin (C). The brace will not cure the spinal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
curvature (D) but should slow the progression of the scoliosis.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
The nurse should teach the parents of a child with a cyanotic heart defect to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
perform which action when a hypercyanotic spell occurs?
|\ |\ |\ |\ |\ |\ |\
A.Place the child's head flat, with the knees on pillows above the level of the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
heart.
|\
|\
B.Have the child lie on the right side, with the head elevated on one pillow.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
|\
C.Allow the child to assume a knee-chest position, with the head and chest
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
slightly elevated. |\
,|\
D.Encourage the child to sit up at a 45-degree angle, drink cold water, and|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
take deep breaths. - CORRECT ANSWERS ✔✔ANS: C
|\ |\ |\ |\ |\ |\ |\
Assuming a knee-chest position with the head and chest slightly elevated (C)
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
will help restore hemodynamic equilibrium. (A and B) are incorrect
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
positions and may hinder the child's condition. (D) may cause chest pain or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
a vasovagal response, with resulting hypotension.
|\ |\ |\ |\ |\
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?
A.No action is required, because this is an expected finding for a school-aged
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
child.
|\
|\
B.Ask if the child has had a cold, runny nose, or any ear pain lately.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
|\
C.Send a note home advising parents to have the child evaluated by a health
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
care provider.
|\
|\
D.Call the parents and have them take the child home from school for the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
rest of the day. - CORRECT ANSWERS ✔✔ANS: B
|\ |\ |\ |\ |\ |\ |\ |\
More information is needed to interpret these findings (B). The tympanic
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
membrane is normally pearly gray, not bulging, and moves when a client
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
blows against resistance or when a small puff of air is blown into the ear
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, canal. Because these findings are not completely normal, further assessment
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of history and related signs and symptoms are needed to interpret the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
findings accurately. Based on the data obtained from the otoscope
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
examination, (A, C, and D) are not indicated. |\ |\ |\ |\ |\ |\ |\
A newborn female 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 is she most likely to exhibit?
|\ |\ |\ |\ |\ |\ |\
A.Shortness of breath |\ |\
|\
B.Joint pain |\
|\
C.Persistent cold |\
|\
D.Organomegaly - CORRECT ANSWERS ✔✔ANS: C |\ |\ |\ |\ |\
Respiratory tract infections commonly occur in the pediatric population, but
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the child with AIDS has a decreased ability to defend the body against these
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
common infections. Thus, the most typical presenting symptom of a child
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
who contracted AIDS through vertical transmission (i.e., from the mother
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
during delivery) is a persistent cold or respiratory infection (C). (A, B, and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
D) are symptoms of AIDS complications that may occur later as the disease
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
progresses.
A child breaks out with varicella infection (chickenpox) while hospitalized
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
for a minor surgical procedure. Which intervention should the nurse
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
implement first? |\
answers
The nurse is preparing a child with an intussusception for a prescribed
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
barium enema. What is the main purpose of conducting this procedure prior
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to surgical intervention?
|\ |\ |\
|\
A.Evacuate the bowel of impacted feces. |\ |\ |\ |\ |\
|\
B.Reduce the invaginated bowel segment. |\ |\ |\ |\
|\
C.Locate the presence of diverticula. |\ |\ |\ |\
|\
D.Identify the area of esophageal atresia. - CORRECT ANSWERS ✔✔ANS: B
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Intussusception, an invagination or telescoping of one portion of the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
intestine into another, causes intestinal obstruction in children (usually
|\ |\ |\ |\ |\ |\ |\ |\ |\
occurs between 3 months and 5 years of age). Nonsurgical treatment is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
attempted with hydrostatic pressure created by barium instillation, which
|\ |\ |\ |\ |\ |\ |\ |\ |\
often reduces the area of bowel intussusception (B), thereby negating the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
need for surgical intervention. A barium enema is likely to cause (A). A
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
barium enema could be used to detect (C), but this is not the reason for its
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
use with intussusception. (D) is not a use for a barium enema.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
The nurse is teaching an adolescent girl with scoliosis about a Milwaukee
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
brace that her health care provider has prescribed. Which instruction should
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the nurse provide to this client?
|\ |\ |\ |\ |\
,A.Remove the brace 1 hour each day for bathing only.
|\ |\ |\ |\ |\ |\ |\ |\ |\
B.Remove the brace only for back range-of-motion exercises.
|\ |\ |\ |\ |\ |\ |\
|\
C.Wear the brace against the bare skin to ensure a good fit.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
|\
D.Wearing the brace will cure the spinal curvature. - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔ANS: A |\
The Milwaukee brace is designed to slow the progression in spinal curvature
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
while the adolescent is growing. The brace should be worn 23 hours a day
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and removed a total of 1 hour a day for hygiene (A). There are no specific
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
exercises for increasing the range of motion in the back that should be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
performed (B). A T shirt should be worn next to the body and the brace put
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
on over the T shirt to protect the skin (C). The brace will not cure the spinal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
curvature (D) but should slow the progression of the scoliosis.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
The nurse should teach the parents of a child with a cyanotic heart defect to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
perform which action when a hypercyanotic spell occurs?
|\ |\ |\ |\ |\ |\ |\
A.Place the child's head flat, with the knees on pillows above the level of the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
heart.
|\
|\
B.Have the child lie on the right side, with the head elevated on one pillow.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
|\
C.Allow the child to assume a knee-chest position, with the head and chest
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
slightly elevated. |\
,|\
D.Encourage the child to sit up at a 45-degree angle, drink cold water, and|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
take deep breaths. - CORRECT ANSWERS ✔✔ANS: C
|\ |\ |\ |\ |\ |\ |\
Assuming a knee-chest position with the head and chest slightly elevated (C)
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
will help restore hemodynamic equilibrium. (A and B) are incorrect
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
positions and may hinder the child's condition. (D) may cause chest pain or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
a vasovagal response, with resulting hypotension.
|\ |\ |\ |\ |\
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?
A.No action is required, because this is an expected finding for a school-aged
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
child.
|\
|\
B.Ask if the child has had a cold, runny nose, or any ear pain lately.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
|\
C.Send a note home advising parents to have the child evaluated by a health
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
care provider.
|\
|\
D.Call the parents and have them take the child home from school for the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
rest of the day. - CORRECT ANSWERS ✔✔ANS: B
|\ |\ |\ |\ |\ |\ |\ |\
More information is needed to interpret these findings (B). The tympanic
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
membrane is normally pearly gray, not bulging, and moves when a client
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
blows against resistance or when a small puff of air is blown into the ear
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, canal. Because these findings are not completely normal, further assessment
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of history and related signs and symptoms are needed to interpret the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
findings accurately. Based on the data obtained from the otoscope
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
examination, (A, C, and D) are not indicated. |\ |\ |\ |\ |\ |\ |\
A newborn female 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 is she most likely to exhibit?
|\ |\ |\ |\ |\ |\ |\
A.Shortness of breath |\ |\
|\
B.Joint pain |\
|\
C.Persistent cold |\
|\
D.Organomegaly - CORRECT ANSWERS ✔✔ANS: C |\ |\ |\ |\ |\
Respiratory tract infections commonly occur in the pediatric population, but
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the child with AIDS has a decreased ability to defend the body against these
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
common infections. Thus, the most typical presenting symptom of a child
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
who contracted AIDS through vertical transmission (i.e., from the mother
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
during delivery) is a persistent cold or respiratory infection (C). (A, B, and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
D) are symptoms of AIDS complications that may occur later as the disease
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
progresses.
A child breaks out with varicella infection (chickenpox) while hospitalized
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
for a minor surgical procedure. Which intervention should the nurse
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
implement first? |\
