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PEDIATRICS HESI PRACTICE EXAM (EVOLVE)
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PEDIATRICS HESI PRACTICE EXAM (EVOLVE)
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PEDIATRICS HESI PRACTICE EXAM (EVOLVE) Which should the nurse assess last when examining a 5-year-old child?a. Heart.
b. Lungs.
c. Throat.
d. Abdomen. - answer - c. Throat.
Examination of the mouth, throat, and perineum is considered to be more invasive than other parts of a physical examination. Invasive procedures should be left for the end of the examination for a preschooler.
The community health nurse teaches the parents of school-age children about the need for fluoride as part of a dental health program. Which statement by the parents indicates
that they understand the teaching?
a. "Excessive amounts of fluoride will make teeth turn brittle and yellow."
b. "Having our children brush with fluoride toothpaste is not effective."
c. "Use of fluoride in water is mostly effective during initial tooth formation."
d. "Dental caries can be prevented through fluoridation of public water." - answer - d. "Dental caries can be prevented through fluoridation of public water."
Dental caries can be prevented through fluoridation of public water.
The nurse is assessing an infant with diarrhea and lethargy. Which finding should the nurse identify that is consistent with early dehydration?
a. Tachycardia.
b. Bradycardia.
c. Dry mucous membranes.
d. Increased skin turgor. - answer - a. Tachycardia.
In early dehydration (during the first 2 days), fluid loss occurs first from the extracellular and intravascular fluid spaces. Blood pressure falls and heart rate increases in response to a diminished blood volume.
When conducting a hygiene class for adolescent girls, it is important for the nurse to include which instruction about preventing toxic shock syndrome?
a. Wash your hands before inserting a tampon.
b. Use super absorbent tampons.
c. Wear cotton underwear.
d. Douche following menstruation. - answer - a. Wash your hands before inserting a tampon. The single most effective means of preventing infection is handwashing.
The nurse is caring for an irritable, lethargic 18-month-old child who swallowed several over-the-counter (OTC) antihistamine tablets an hour ago. Which intervention should the nurse implement?
a. Initiate gastric lavage.
b. Administer naloxone.
c. Give a dose of ipecac syrup.
d. Encourage oral intake of water or milk. - answer - a. Initiate gastric lavage.
Gastric lavage should be implemented within 2 hours of ingestion to ensure gastric removal of a noncorrosive substance, such as an OTC antihistamine.
Which sign of malignant hyperthermia should the nurse assess for during the perioperative period in a child receiving general anesthesia?
a. Apnea.
b. Tachypnea.
c. Bradycardia.
d. Decreased blood pressure. - answer - b. Tachypnea.
Malignant hyperthermia, a potentially fatal autosomal genetic myopathy, can cause a change in vital signs that demands immediate attention in the perioperative period when
these individuals are exposed to anesthetic agents. Early symptoms of the disorder include tachycardia and tachyarrhythmia, tachypnea, hypercarbia, and metabolic and respiratory acidosis. An elevated temperature is a late sign of the disorder.
A child with a penetrating eye injury comes to the school clinic. Which action should the nurse implement?
a. Remove the object impaled in the eye and then apply a regular eye patch.
b. Place an ice bag over the eye until the healthcare provider is seen
c. .Irrigate the affected eye copiously with a cool sterile saline solution.
d. Apply a Fox shield to the affected eye and any type of patch to the other eye. - answer - d. Apply a Fox shield to the affected eye and any type of patch to the other eye.
The treatment for a penetrating eye injury is not to remove or manipulate the impaled object, but to apply a Fox shield over the eye, if available (not a regular eye patch). Place an eye patch over the unaffected eye to prevent bilateral eye movement. The child should be transported to the emergency department immediately. If a Fox shield is
not available, tape a paper cup over the eye and object. The nurse is triaging a child with a fever brought to the emergency department by the parents. Which finding requires the nurse's immediate intervention?
a. Prolonged exhalations.
b. Thick yellow rhinorrhea.
c. Frequent nonproductive cough.
d. Oxygen saturation of 95% by pulse oximeter. - answer - a. Prolonged exhalations.
Prolonged exhalation indicates breathing difficulty and requires immediate intervention. According to the American Heart Association's Pediatric Advance Life Support (PALS) algorithm, a prolonged expiration in a pediatric client is indicative of lower airway obstruction.
A newborn who is breastfeeding is diagnosed with galactosemia. Which action should the nurse implement?
a. Stop the infant breastfeeding.
b. Add amino acids to breast milk.
c. Give galactokinase with breast milk.
d. Substitute a lactose-containing formula. - answer - a. Stop the infant breastfeeding.
Galactosemia is a rare genetic disorder that involves an inborn error of carbohydrate metabolism in which a hepatic enzyme, galactokinase, involved in the conversion of galactose to glucose is absent. Treatment consists of eliminating all lactose-containing foods, including breast milk, so the infant should stop breastfeeding. Soy protein formula is the feeding of choice during infancy.
A 12-year-old male client tells the nurse that he is happy to be taking growth hormones because now he can grow to be as tall as his friends. What response is best for the nurse to provide?
a. "You must remember that this treatment regimen is not always effective."
b. "Although being tall is important to you, remember there are far more important characteristics than height."
c. You will grow with this medicine, and are likely to be taller than anyone in your family."
d. "Being taller is important to you and taking your injections will help achieve that goal."
- answer - d. "Being taller is important to you and taking your injections will help achieve
that goal."
A 4-year-old child who is ventilator-dependent is receiving tube feedings in the home setting. The family wants to begin oral feeding of the child and asks the home health nurse to orally feed the 4-year-old baby food. What steps should be taken? (Rank in priority order.)
1. Acknowledge the request.
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