Which client requires immediate intervention by the RN?
• A child with cystic fibrosis who is constipated.
• A toddler with chicken pox who is scratching,
• A child with acute renal failure and hyperkalemia.
• An adolescent with a migraine and photophobia.
A 7 year old male is referred...
HESI RN PEDIATRIC EXAM STUDY GUIDE
Which client requires immediate intervention by the RN?
• A child with cystic fibrosis who is constipated.
• A toddler with chicken pox who is scratching,
• A child with acute renal failure and hyperkalemia.
• 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?
• He consumed2 bottles of water in 30 minutes prior to fainting.
• Since age 3 he has experienced exercise induced asthma.
• Reports drinking 3-4 high calorie, carbonated beverages daily.
• 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
th th
75 percentile, and height at the 25 percentile. The child’s body mass index (BMI) is at the
th
85 percentile for age and gender. Which interventions should the RN implement? (Select All
That Apply)
• Explain that the child is likely to grow into her weight.
• Determine the child’s usual physical activity pattern.
• Obtain the child’s 3- day diet history based on the mothers input.
• Inquire as to whether or not the school has a physical education
program.
• 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?
• Apply padding on the sharp corners of the furniture.
• Prevent the client from running inside the house.
• Give an 81 mg tablet of aspirin for pain relief.
• Use a soft bristle toothbrush from frequent cleaning.
,The RN is examining an infant for possible cryptorchidism. Which examine technique should be
used?
• Place the infant in a side lying position to facilitate the exam.
• Hold the penis and extract the foreskin gently.
• Cleanse the penis with an antiseptic-soaked pad.
• 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?
• Provide frequent sips of liquid.
• Give isotonic enemas as prescribed.
• Maintain nothing by mouth status.
• 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?
• Encourage large meals during steroid and chemotherapy.
• Provide lemon glycerin swabs and dilute peroxide oral rinses.
• Recommend fluids using citrus juices and drinking with a straw.
• 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?
• Call for emergency transportation to the hospital.
• Increase the fluid intake to liquefy the secretions.
• Administer a dose of the prescribed cough medicine.
• 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?
• 15 to 18 lbs.
• 12 to 15 lbs.
• 9 to 11.5 lbs.
• 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?
• Excessive thirst.
• Racing pulse.
• Profuse perspiration.
• 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?
• Mix infants formula with breast milk.
• Supplement with an iron-rich formula.
• Introduce baby food for one meal daily.
• 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?
• Keeps fists clenched, opens hands when grasping an object.
• Has strong Moro and tonic neck reflexes.
• Can lift head, but not chest when lying on abdomen.
• 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?
• Vigorous feeding and sanitation.
• Hemiplegia.
• Fever.
• 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?
• Explain that muscle aches and pain are commonly experienced by children
with this form of muscular dystrophy.
• Advise the parents that children with chronic diseases may seek attention
by reporting pain or other unpleasant symptoms.
• Encourage the parents to monitors the child’s body temperature for the
next 24 hours and report a rise above 101 degree F.
• 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.
The heart rate of a 3 year old with a congenital heart defect has steadily decreased over the last
few hours, and is now at 76 beats/minutes; the previous reading 4 hours ago was 110 beats/
minutes. Which additional clinical finding should be reported immediately to the healthcare
provider?
• Respiratory rate of 25 bpm.
• Urine output of 20 mL/hr.
• Oxygen saturation of 94%.
• Blood pressure of 70/40
The HCP prescribes epinephrine 0.01 mg/kg IM for a child with asthma who weighs 55 lbs. The
available medication is labeled, 1 mg/ml. based on the child’s weight, how many mL should the
RN administer?
After receiving a single fluid bolus of 20 mL/kg of NS, a child’s heart rate is 140 bpm, blood
pressure 70/50, and capillary refill is 6 seconds. The child is anxious and crying. Which
intervention should the RN implement first?
• Repeat the NS bolus as prescribed.
• Allow the child to assist with caregiving.
• Recommend age appropriate activities.
• Encourage the caregiver to remain at bedside.
The RN should instruct the parents of an 8 year old child who has sickle cell anemia to be alert
for which complaint from the child?
• “I’m shorter than everyone else.”
• “I’m really hot and thirsty.”
• “I don’t want to eat any vegetables.”
• “I have to urinate every few hours.”
Parents needs to be alert to situations where dehydration may be a possibility. Symptoms such as
decreased urinary output and increased thirst indicate dehydration, which precipitate a sickle cell
crisis (B). (A) Is sometimes expected with children with sickle cell anemia, especially if the child
experiences many crisis. Many children do not like vegetables (C). Needing to urinate every few
hours is not a warning sign for a possible sickle cell crisis (D); in fact, it may indicate adequate
hydration.
The RN is assessing an 8 month old who has a cough, axillary temperature of 100, and
rhinorrhea. What information is most important for the RN to obtain from this child’s mother?
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ETHANDOC. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $18.49. You're not tied to anything after your purchase.
