Pediatrics HESI Practice Questions

A 9-month-old child is seen in the well clinic. Which of the following behaviors would the nurse expect to see? SATA

(A) Plays peek-a-boo

(B) Walks independently

(C) Feeds self with a spoon

(D) Stacks 2 blocks together

(E) Transfers objects from hand to hand

A, E

-walks independently at 15 months

-feeds self with spoon at 18 months

-stacks 2 blocks together at 18 months

The mother of a six-year-old child arrives at the clinic because the child has been experiencing red and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the lab. Chlamydia conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation?

(A) Possible trauma to the eye

(B) Possible sexual abuse

(C) Presence of an allergy

(D) Presence of a respiratory infection

(B) Possible sexual abuse

-Chlamydia is sexual transmitted disease. The diagnosis of chlamydia in a child not sexually active should signal the health care provider to assess the signs of possible sexual abuse

The school nurse determines a group of young women are in early adolescents based on the following observation. All of the women:

(A) Have decided on their career path

(B) Are dressed in the same-style clothes and have the same hair style

(C) Broke curfew by staying out late at a party they went to

(D) Brag about drinking beer when their parents were at work

(B) Peer identity is important at this age

The nurse is watching two siblings, ages 7 and 9 years of age, verbally arguing over a toy. The nurse has counseled the parents before about how to handle the situation. The nurse should judge that the teaching has been effective when the parent takes which action?

(A) Tell the siblings to stop arguing and shake hands

(B) Ignores the arguing and continues what she is doing

(C) Tells the children they will be punished when they go home

(D) Says they will not go out to lunch now since they have argued

(B) The best approach by the mother is not to interfere. The children need to learn how to solve disagreements on their own. If the parents always intervenes, when the children do not learn how to do this

The nurse is caring for a newborn with a suspected diagnosis of imperforated anus. Which clinical manifestation is associated with this defect?

(A) Bile-stained fecal emesis

(B) The passage of current jelly stools

(C) Failure to pass meconium stool in the first 24 hours after birth

(D) Sausage-shaped mass in the upper right quadrant

(C) This is a defect where incomplete development or absence of the anus

Which drug may be given to newborns to close the patent ductus arteriosus (PDA)?

Indomethacin (prostaglandin inhibitor)

Which drug may be given to newborns to keep the ductus arteriosus (PDA) open until surgery can be performed?

Prostaglandin E

After receiving change of shift report, which patient should you assess first?

(A) An 18-month-old with coarcation of the aorta who has decreased pedal pulses

(B) A 3-year-old with rheumatic fever who reports severe knee pain

(C) A 5-year-old with endocarditis who has crackles throughout both lungs

(D) An 8-year-old with Kawasaki's disease who has a fever of 102.2

(C) Crackles through the lungs indicate the child has left ventricular failure as a complication of endocarditis. Hypoxemia is likely, so the child needs a rapid respiratory assessment, possible administration of oxygen. The other children should be assessed as quickly as possible, but are not experiencing life-threatening complications

An infant is born with ventricular septal defect (VSD) and surgery is planned to correct the defect. The nurse recognizes that surgical correction is designed to achieve which outcome?

(A) Stop the flow of deoxygenated blood into systemic circulation

(B) Increase the flow of deoxygenated blood to the lungs

(C) Prevent the return of oxygenated blood to the lungs

(D) Reduce peripheral tissue hypoxia and nail bed clubbing

(C)

The nurse would suggest genetic counseling for each of the following except:

(A) Sickle cell anemia

(B) B-thalassemia

(C) Hemophilia A

(D) Henoch-Schonlein purpura

(D) This is an inflammation of the small blood vessels of the skin, joints, bowels, and kidneys and is common in children. However, it is not genetic

What priority assessment should the nurse perform before administering the IV solution 5% dextrose and 0.9% NS with 20 mEq KLC / liter in a child with hypotonic dehydration?

(A) Weight

(B) Temperature

(C) Blood pressure

(D) Urine output

(D) Potassium should never be administered in the presence of oliguria or anuria or if the urine output is less than 1-2 mL/kg per hour

An 11-month-old is admitted to the hospital with severe diarrhea. The nurse explains to the infant's mother that diarrhea is best defined on the basis of which?

(A) Odor of the stool

(B) Amount of the stool

(C) Frequency of the stool

(D) Consistency of stool

(D) Loose or watery stool indicates diarrhea

A child with nephrotic syndrome is receiving corticosteroids. Which of the following statements by the parent would cause the nurse to reinforce the instructions? SATA

(A) "My child's blood pressure is good because of the steroids"

(B) "Steroids reduce inflammation"

(C) "Steroids are making my child's urine have solid particles"

(D) "Steroids prevent my child from getting an infection"

(E) "Steroids make the kidneys work better"

A, C, D

The desired effect of corticosteroids in treating a child with nephrotic syndrome is to reduce inflammation and cause fluid to be removed from the body. It may increase blood pressure or make the child more prone to infections, but it is not a desired outcome. An increase of protein in the urine would suggest that the child is worse and not improving from treatment

The parents ask the nurse why the physician ordered Mannitol for a closed head injury. The nurse should reply, "Mannitol will

(A) "Help hold fluid in the vascular bed, to prevent shock"

(B) "Help decrease fluid, to decrease swelling in the brain"

(C) "Increase calorie intake, to aid wound healing"

(D) "Fight off bacteria, to prevent infections"

(B)

A child who is bleeding heavily is in hypovolemic shock. The nurse determines the child is currently compensating for the loss of blood when the nurse notes which of the following?

(A) Hypotension

(B) Cyanosis

(C) Tachycardia

(D) Bradypnea

(C)

Hypotension, cyanosis, and bradypnea would be late signs and show decompensation.

A child with type 1 diabetes is brought to the ER by his mother who states the child has been complaining of abdominal pain and is lethargic. Diabetic ketoacidosis is diagnosed. Which type of IV solution should the nurse anticipate will be ordered?

(A) Potassium infusion

(B) NPH insulin infusion

(C) 5% dextrose infusion

(D) NS infusion

(D)

DKA is a complication of diabetes mellitus when severe insulin deficiency occurs. Hyperglycemia occurs and the body breaks down fat for energy causing ketones to form. NS is the initial IV fluids along with regular insulin, not NPH

A 2-year-old child has just been diagnosed with type 1 diabetes. The nurse is providing education to parents regarding signs and symptoms of hypoglycemia. Which should the nurse include?

(A) The child's breathe will smell like fruit

(B) The child will complain of excessive thirst

(C) The child will appear sleepy and fatigued

(D) The child will have more frequent temper tantrums and appear angry

(D)

The other three options resemble hyperglycemia

When taking the health history of the child, the nurse knows that which finding is an early indication of hypothyroidism in children?

(A) Hyperactive behavioral traits

(B) Delay in the eruption of permanent teeth

(C) Slow sexual development, but within normal range

(D) Cessation of growth in a child that had been normal

(D)

Since the thyroid gland is responsible for metabolism, cessation of growth which was previously within normal range, is the most common sign for hypothyroidism in children. The child with hypothyroidism is likely to be hypoactive.

The nurse is admitting a 10-year-old with an intellectual disability for surgery. Before providing the child with pre-op teaching, the nurse must determine which of the following?

(A) Child's pre-operative medications

(B) Length of time the child will be in the recovery room

(C) Child's diagnosed developmental level

(D) Type of IV fluid the surgeon will use

(C)

Teaching needs to be done to the child's developmental age, not chronological age

A child has Duchenne Muscular Dystrophy. The nurse knows the following relatives should be tested (SATA):

(A) Mother

(B) Sister

(C) Brother

(D) Aunts and all female cousins

(E) Uncles and all male cousins

A, B

Duchenne Muscular Dystrophy is an X-linked trait. Women carry the disease and males are affected. Genetic counseling is important

Parents confide to their nurse that their child, 35-months-old, does not talk and spends hours sitting on the floor watching the ceiling fan go around. They are concerned the child has autism. Which question should the nurse ask the parents?

(A) "Does the child have brothers and sisters?"

(B) "Does your child seek you out for comfort and love?"

(C) "Do you have trouble getting babysitters for your child?"

(D) "Does your child require speech therapy?"

(B)

Children with autism lack social skills, such as seeking reciprocity and comfort from parents. Unable to make eye contact, inability to develop peer relationships. Autism is a complex developmental disorder

The nurse is concerned that a child recently diagnosed with ADHD has been misdiagnosed because of which following factor?

(A) He is 10-years-old

(B) He is at the top of the math and reading group

(C) He is disruptive in church and school

(D) He is able to communicate effectively

(B)

The symptoms of ADHD adversely affect learning. The diagnosis can be made in any child under age 12

The nurse is assigned to care for an 11-year-old child who has a profound hearing deficit who is in skeletal traction. Which of the following actions should the nurse perform?

(A) Clap hands behind the child's line of vision to see if the child responds

(B) Look directly into the child's face when speaking to the child

(C) Educate the child regarding the success of cochlear implant surgery

(D) Assessing the tympanic membrane in each ear for redness and bulging

(B)

No need to assess the child's hearing because the child already has been diagnosed with hearing difficulties. Nothing in question that implies the child has an ear infection

You are the charge nurse on a pediatric unit and the physician wants to admit a child with measles. Which factor is of most concern to you in determining whether to admit this child to the unit?

(A) The unit is staffed with fewer RNs than usual

(B) No negative airflow rooms are available

(C) The infection control liason nurse is not available today

(D) There are several children receiving chemotherapy

(B) Patients with measles require the implementation of airborne precautions, which include placement in a negative-airflow room. If no rooms are available, the child cannot be admitted to the floor

The mother asks a nurse why it is necessary to have her baby immunized if she disinfects her house daily. The nurse's best response is:

(A) It is a state law that your child receives immunizations

(B) You don't have to immunize your child if you are sure you disinfect everything in your house

(C) Why don't you discuss your concerns with the baby's doctor

(D) Even if you clean every day your baby is susceptible to infections because a baby's immune system is immature

(D)

A mother asks the nurse why she should immunize her child for human papillomavirus (HPV) when my child is only 11-years-old? Isn't this a sexually transmitted disease? Which of the following responses by the nurse is appropriate?

(A) "I agree with you. I will ask the doctor is the HPV vaccine can wait until she is sexually active"

(B) "It is recommended that children begin the series when they are pre-teen so they have time to develop full immunity"

(C) "Although HPV is defined as an STD, it can also be transmitted if upper respiratory warts coughs or sneezes"

(D) "I understand. It is important to realize that a majority of the people in this country are affected by the virus by the time they are in high school"

(B)

HPV is only transmitted by direct contact.

A 1-year-old is being seen in the pediatrician's office. He is UTD on his immunizations. The mother asks, "will my child need any shots today?" Which of the following responses by the nurse is appropriate?

(A) "The rotovirus will be given today to prevent serious diarrhea"

(B) "Children's first influenza will be administered today and given every year at the same time"

(C) "The last hepatitis B vaccine is due to administered today"

(D) "The measles, mumps, rubella (MMR), varicella, and hepatitis A vaccines are given when a child reaches 1 year of age"

(D)

A 10-month-old infant has been exposed to chicken pox. The nurse would expect the pediatrician to order which intervention to protect the baby from contracting the disease?

(A) IV antibiotics

(B) Varicella zoster immune globulin

(C) Varicella immunization

(D) Nothing because the baby is protected by the mother's antibodies

(D)

The vaccine isn't given until 1-year-of age

What is an appropriate intervention to provide comfort for the child with itching associated with chickenpox?

(A) Encourage frequent warm baths

(B) Administer aspirin for fever

(C) Administer Benadryl for itching

(D) Apply thick coat of Caladryl lotion over open lesions

(C)

Cool baths should be used instead of warm baths. Aspirin should never be used. Never apply a thick layer of Caladryl

A physician needs to obtain written informed consent for a surgical procedure on an adolescent. Which situation allows the physician to obtain written informed consent from the adolescent and not his parents?

(A) The adolescent's 18th birthday is next week

(B) The adolescent is estranged from his parents and lives independently

(C) The adolescent gives his verbal consent to the procedure

(D) The physician doesn't need to obtain consent because the procedure is a minor one

(B)