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SAUNDERS HESI PEDS EXAM 2024/2025 QUESTIONS WITH COMPLETED & VERIFIED SOLUTIONS.
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SAUNDERS HESI PEDS EXAM 2024/2025 QUESTIONS WITH COMPLETED & VERIFIED SOLUTIONS.
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SAUNDERS HESI PEDSINTEGUMENTARY DISORDERS - ANS
The nurse is monitoring a child with burns during treatment for burn shock. Which assessment
provides the most accurate guide to determine the adequacy of fluid resuscitation?
1. Skin turgor
2. Level of edema at burn site
3. Adequacy of capillary filling
4. Amount of fluid tolerated in 24 hours - ANS 3
Parameters such as vital signs (especially heart rate), urinary output volume, adequacy of
capillary filling, and state of sensorium determine adequacy of fluid resuscitation. Although
options 1, 2, and 4 may provide some information related to fluid volume, in a burn injury, and
from the options provided, adequacy of capillary filling is most accurate.
The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been
scratching the skin continuously and has developed a rash. The nurse assesses the child and
suspects the presence of scabies. The nurse bases this suspicion on which finding noted on
assessment of the child's skin?
1. Fine grayish red lines
2. Purple-colored lesions
3. Thick, honey-colored crusts
4. Clusters of fluid-filled vesicles - ANS 1
Scabies is a parasitic skin disorder caused by an infestation of Sarcoptes scabiei (itch mite).
Scabies appears as burrows or fine, grayish red, threadlike lines. They may be difficult to see if
they are obscured by excoriation and inflammation. Purple-colored lesions may indicate various
disorders, including systemic conditions. Thick, honey-colored crusts are characteristic of
impetigo or secondary infection in eczema. Clusters of fluid-filled vesicles are seen in
herpesvirus infection.
Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which
instruction to the parents regarding the use of this treatment?
1. Apply the lotion to areas of the rash only.
2. Apply the lotion and leave it on for 6 hours.
3. Avoid putting clothes on the child over the lotion.
4. Apply the lotion to cool, dry skin at least 30 minutes after bathing - ANS 4
,Permethrin is massaged thoroughly and gently into all skin surfaces (not just the areas that
have the rash) from the head to the soles of the feet. Care should be taken to avoid contact with
the eyes. The lotion should not be applied until at least 30 minutes after bathing and should be
applied only to cool, dry skin. The lotion should be kept on for 8 to 14 hours, and then the child
should be given a bath. The child should be clothed during the 8 to 14 hours of treatment
contact time.
The school nurse has provided an instructional session about impetigo to parents of the children
attending the school. Which statement, if made by a parent, indicates a need for further
instruction?
1. "It is extremely contagious."
2. "It is most common in humid weather."
3. "Lesions most often are located on the arms and chest."
4. "It might show up in an area of broken skin, such as an insect bite." - ANS 3
Impetigo is a contagious bacterial infection of the skin caused by β-hemolytic streptococci or
staphylococci, or both. Impetigo is most common during hot, humid summer months. Impetigo
may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo is
extremely contagious. Lesions usually are located around the mouth and nose, but may be
present on the hands and extremities.
The clinic nurse is reviewing the health care provider's prescription for a child who has been
diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the
prescription if which is noted in the child's record?
1. The child is 18 months old.
2. The child is being bottle-fed.
3. A sibling is using lindane for the treatment of scabies.
4. The child has a history of frequent respiratory infections - ANS 1
Lindane is a pediculicide product that may be prescribed to treat scabies. It is contraindicated
for children younger than 2 years because they have more permeable skin, and high systemic
absorption may occur, placing the children at risk for central nervous system toxicity and
seizures. Lindane also is used with caution in children between the ages of 2 and 10 years.
Siblings and other household members should be treated simultaneously. Options 2 and 4 are
unrelated to the use of lindane. Lindane is not recommended for use by a breast-feeding
woman because the medication is secreted into breast milk
A topical corticosteroid is prescribed by the health care provider for a child with atopic dermatitis
(eczema). Which instruction should the nurse give the parent about applying the cream?
1. Apply the cream over the entire body.
2. Apply a thick layer of cream to affected areas only.
,3. Avoid cleansing the area before application of the cream.
4. Apply a thin layer of cream and rub it into the area thoroughly. - ANS 4
Atopic dermatitis is a superficial inflammatory process involving primarily the epidermis. A
topical corticosteroid may be prescribed and should be applied sparingly (thin layer) and rubbed
into the area thoroughly. The affected area should be cleaned gently before application. A
topical corticosteroid should not be applied over extensive areas. Systemic absorption is more
likely to occur with extensive application.
The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment
finding indicates that a child has a "positive" head check?
1. Maculopapular lesions behind the ears
2. Lesions in the scalp that extend to the hairline or neck
3. White flaky particles throughout the entire scalp region
4. White sacs attached to the hair shafts in the occipital area - ANS 4
Pediculosis capitis is an infestation of the hair and scalp with lice. The nits are visible and
attached firmly to the hair shaft near the scalp. The occiput is an area in which nits can be seen.
Maculopapular lesions behind the ears or lesions that extend to the hairline or neck are
indicative of an infectious process, not pediculosis. White flaky particles are indicative of
dandruff.
The nurse caring for a child who sustained a burn injury plans care based on which pediatric
considerations associated with this injury? (SELECT ALL THAT APPLY.)
1. Scarring is less severe in a child than in an adult.
2. A delay in growth may occur after a burn injury.
3. An immature immune system presents an increased risk of infection for infants and young
children.
4. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body
surface area.
5. The lower proportion of body fluid to body mass in a child increases the risk of cardiovascular
problems.
6. Infants and young children are at increased risk for protein and calorie deficiency because
they have smaller muscle mass and less body fat than adults. - ANS 2, 3, 6
Pediatric considerations in the care of a burn victim include the following: Scarring is more
severe in a child than in an adult. A delay in growth may occur after a burn injury. An immature
immune system presents an increased risk of infection for infants and young children. The
higher proportion of body fluid to body mass in a child increases the risk of cardiovascular
problems. Burns involving more than 10% of total body surface area require some form of fluid
resuscitation. Infants and young children are at increased risk for protein and calorie
deficiencies because they have smaller muscle mass and less body fat than adults
, HEMATOLOGICAL DISORDERS - ANS HEMATOLOGICAL DISORDERS
The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands
that which result will most likely be abnormal in this child?
1. Platelet count
2. Hematocrit level
3. Hemoglobin level
4. Partial thromboplastin time - ANS 4
Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific
coagulation proteins. Results of tests that measure platelet function are normal; results of tests
that measure clotting factor function may be abnormal. Abnormal laboratory results in
hemophilia indicate a prolonged partial thromboplastin time. The platelet count, hemoglobin
level, and hematocrit level are normal in hemophilia.
The nurse is providing home care instructions to the parents of a 10-year-old child with
hemophilia. Which sport activity should the nurse suggest for this child?
1. Soccer
2. Basketball
3. Swimming
4. Field hockey - ANS 3
Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific
coagulation proteins. Children with hemophilia need to avoid contact sports and to take
precautions such as wearing elbow and knee pads and helmets with other sports. The safe
activity for them is swimming.
The nursing student is presenting a clinical conference and discusses the cause of
β-thalassemia. The nursing student informs the group that a child at greatest risk of developing
this disorder is which of these?
1. A child of Mexican descent
2. A child of Mediterranean descent
3. A child whose intake of iron is extremely poor
4. A breast-fed child of a mother with chronic anemia - ANS 2
β-Thalassemia is an autosomal recessive disorder characterized by the reduced production of 1
of the globin chains in the synthesis of hemoglobin (both parents must be carriers to produce a
child with β-thalassemia major). This disorder is found primarily in individuals of Mediterranean
descent. Options 1, 3, and 4 are incorrect.
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