HESI RN PEDIATRIC EXAM
STUDY GUIDE 2020/2021 (GRADED A+)
Which client requires immediate
intervention by the RN?
A.
A child with cystic
fibrosis who is constipated.
B.
A toddler with chicken pox who is scratching,
C.
A child with acute renal failure and hyperkalemia.
D.
An adolescent with a
migraine and photophobia.
A 7 year old male is referred to the school clinic
because he fainted on the playground. His height
is 3 feet, 7 inches (107.5 cm), he weighs 55 pounds (25 kilograms), and his
body mass index (BMI) is 20.9. Which
assessment finding is most important
for the RN to address?
A.
He consumed2 bottles
of water in 30 minutes
prior to fainting.
B.
Since age 3 he has experienced exercise
induced asthma.
C. Reports drinking 3-4 high calorie,
carbonated beverages daily.
D.
The child’s father
has a history of fainting
when exercising.
The RN of a 6 year old girl is concerned about her child’s
obesity. The child’s
weight plots at the 75th percentile, and height
at the 25th percentile. The child’s body mass index (BMI) is at the 85th percentile for age and gender. Which
interventions should the RN implement? (Select
All That Apply)
A.
Explain that the child
is likely to grow into her weight.
B.
Determine the child’s usual physical activity
pattern.
C.
Obtain the child’s 3- day diet history based on the mothers input.
D.
Inquire as to whether
or not the school has a physical education program.
E.
Tell the mother that girls
hit their growth
spurt before boys so eating
more is expected.
(B, C, and D) are correct. The child’s growth parameters,
particularly her BMI, indicate that she is
overweight. (B and D) assess for the child’s level of activity, which should be
evaluated and increased if possible.
(C) Provides information about the quantity and quality of the child’s dietary
intake, which is information that is needed
to create an individualized diet teaching plan.
(A) Does
not consider the serious health and psychological consequences associated with childhood obesity. Girls do not hit their
growth spurt before boys in preadolescence, but this child is only 6 years of age and the child’s obesity
should not be negated because
of this growth
and development expectation. (e)
A toddler with hemophilia is being discharged from
the hospital. Which teaching should the RN
include in the discharge instructions to the mother?
A.
Apply padding on the sharp corners
of the furniture.
B.
Prevent the client
from running inside
the house.
C.
Give an 81 mg tablet
of aspirin for pain
relief.
D.
Use a soft bristle toothbrush from frequent
cleaning.
The RN is examining
an infant for possible cryptorchidism. Which examine technique should be used?
A.
Place the infant in a side lying position to facilitate the exam.
B.
Hold the penis
and extract the foreskin gently.
C.
Cleanse the penis with an antiseptic-soaked pad.
D.
Place the infant in a warm room and use a calm approach.
An infant
who has been diagnosed with a
tracheoesophageal fistula (TEF).
What nursing intervention is indicated for this infant prior
to surgical repair?
A.
Provide frequent sips of liquid.
B.
Give isotonic enemas
as prescribed.
C.
Maintain nothing
by mouth status.
D.
Prepare the infant for a barium
enema.
An adolescent with non- Hodgkin’s lymphoma (NHL) is complaining of a sore mouth two days after
beginning chemotherapy. What activity should
the RN implement?
A.
Encourage large meals
during steroid and chemotherapy.
B.
Provide lemon glycerin
swabs and dilute
peroxide oral rinses.
C.
Recommend fluids using citrus juices
and drinking with a straw.
D.
Frequent use of saline
oral rinses and a
soft sponge toothbrush.
A child with acute laryngotracheobronchitis (croup)
received epinephrine 2 hours ago in the emergency room, and now is being prepared for discharge to go home. The RN should instruct
the parents to take which action if the child’s uncontrolled coughing reoccurs?
A.
Call for emergency transportation to the hospital.
B.
Increase the fluid intake to liquefy
the secretions.
C.
Administer a dose of the prescribed cough medicine.
D.
Sit with the child in
the bathroom with hot
steam.
Moist, warm air (D) promotes bronchodilation, which helps
relieve spasms that cause the coughing. If the symptoms continue or worsen, the child may need to be transported
to the
hospital (A). Fluids will thin the secretions (B)
and cough medicine (C) may decrease cough, but
neither of these interventions decrease
swelling or dilate the airway to improve
breathing.
The RN is performing a routine examination of a 6-month old infant
at the community health clinic. Records indicate that the child
weighed 3 kg at birth. The clinic uses lbs to describe weight. When assessing this child, approximately what weight, in
lbs, should the RN consider to be within normal range for this child?
A.
15 to 18 lbs.
B.
12 to 15 lbs.
C.
9 to 11.5 lbs.
D.
6 to 7.5 lbs.
Birth weight should
at least be double
at this time.
When developing a teaching plan for an adolescent male who was recently diagnosed with Type 1 Diabetes Mellitus, the RN should
instruct the client to eat a source of sugar if which symptom occurs?
A.
Excessive thirst.
B.
Racing pulse.
C.
Profuse perspiration.
D.
Seeing spots.
Tachycardia is one of the symptoms of hypoglycemia.
A breast feeding
mother returns to work when her infant is 5 months old. She is
having difficulty pumping enough
milk to mete her infant’s dietary requirements. Which suggestion should the RN provide to this mother?
A.
Mix infants formula
with breast milk.
B.
Supplement with an iron-rich formula.
C.
Introduce baby food for one meal daily.
D.
Offer a follow-up
transitional formula.
The RN 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?
A.
Keeps fists clenched,
opens hands when grasping an object.
B.
Has strong Moro and tonic
neck reflexes.
C.
Can lift head, but not chest when lying on
abdomen.
D.
Laughs readily, turns from back to side.
The RN is assessing
an infant with aortic stenosis
and identifies bilateral
fine crackles in both lung fields. Which additional finding should the RN expect to obtain?
A.
Vigorous feeding and sanitation.
B.
Hemiplegia.
C.
Fever.
D.
Hypotension and tachycardia.
A child with possible Duchenne muscular dystrophy
(MD) undergoes an electro-myelogram (EMG). Following the procedure, the child’s parents
tell the RN that the child is complaining of sore muscles. How should the RN respond?
A. Explain
that muscle aches and pain are commonly experienced by children with this form of muscular
dystrophy.
B. Advise the parents that children with chronic diseases may seek attention by reporting
pain or other unpleasant symptoms.
C. Encourage the parents to monitors the child’s body temperature for the next 24 hours and report a rise above 101
degree F.
D. Offer reassurance that muscle soreness
following this procedure
is temporary and does
not indicate a problem.
During an EMG, small needles are placed in the muscles to
record contractions. This can cause temporary
muscle aches following the procedure (D). Muscle weakness and hypertrophy, followed
by atrophy are associated with MD rather
than pain (A). Muscle soreness
is an expected finding
following an EMG and does not indicate attention-seeking behavior (C). It is
not necessary to monitor body temperature (C) following EMG.
Version | 2021 |
Category | HESI |
Pages | 41 |
Language | english |
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