HESI PEDIATRICS LATEST EXAM 2024/2025
WITH QUESTIONS AND REAL ANSWERS
GRADED A+//REAL ANSWERS
Ampicillin, 75 mg/kg, is prescribed for a 22-lb child. It is available in a solution that contains 250 mg/5 mL. How many milliliters should the nurse administer in one dose? -ANSWER- 15 mL
A 3-week-old infant is referred to an orthopedic clinic because the pediatrician heard a click when flexing the child's right hip during a routine physical examination. Which risk factor is most closely related to developmental hip dysplasia? -ANSWER- Breech presentation
Developmental dysplasia of the hip (DDH) occurs more often in infants who present in the breech position, not the vertex (head-first) position. Twice as many females as males present in the breech position; thus, 80% of children with DDH are females, not males. Of breech presentations, 60% occur with first-born children, not subsequent siblings, possibly because of the unstretched uterus and compaction of the surrounding abdominal contents, which tend to increase compression on the uterus in the nulliparous woman.
Which nursing interventions are therapeutic when caring for a hospitalized toddler? (Select all that apply.)
- Require parents to leave the room when performing invasive procedures.
- Allow the toddler to choose a colored Band-Aid after an injection.
- Give brief but simple explanations to the child before procedures.
- Insert a urinary catheter if bedwetting occurs during hospitalization. 1 / 4
- Do not allow any toys to be brought in from the child's home. -ANSWER- B &
C
Giving the toddler a choice may increase autonomy in the hospitalized setting.Brief but simple explanations are beneficial with the toddler. Separation from the parent can cause emotional distress. Regression is expected, and bedwetting is not an indication for a urinary catheter. The nurse should encourage age-appropriate toys to be brought in from home.
Following the administration of immunizations to a 6-month-old infant, the nurse provides the family with home care instructions. Which statement by the mother indicates that further teaching is needed? -ANSWER- "I will give my baby a baby aspirin every 4 hours as needed for fever."
Although fever may occur, non-aspirin-containing medications should be used because of the risk of Reye syndrome. Option B indicates a severe reaction, whereas option C is a common side effect. Option D decreases soreness in the thigh injection site.
A child presents to the emergency department with vomiting and diarrhea for 36 hours. Which finding is most concerning to the nurse? -ANSWER- Urine specific gravity of 1.035
The normal specific gravity is 1.002 to 1.025. The high specific gravity is a sign that the child has a fluid volume deficit. No tears when crying is an indication of dehydration, but it is not as definitive as the specific gravity reading. Pink lips and gums are an expected finding. The temperature is a low-grade fever and not as concerning as the specific gravity.
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A mother is carrying in her 3-year-old to the emergency department (ED) screaming, "I think my baby swallowed a bottle of Tylenol." What is the nurse's next action? -ANSWER- Take the child's vital signs.
Assessment first. Know the child's baseline, unless the child is lifeless, then start CPR. Since there is no data indicating lifelessness and no option of CPR, then taking the vital sign assessment is correct. The health care provider will need to know the child's condition to know how to proceed. An IV may be an unnecessary intervention, and only initiated when the child's condition is known. Identifying the poison is important, but does not address the immediate needs of the child.
The nurse is providing care to a newborn with hypospadias. Which parent statement indicates the nurse's teaching has been successful? -ANSWER- A circumcision will not be performed before discharge.
A hypospadias is a genital anomaly of the urinary meatus placement below the glans. The foreskin removed with circumcision can be used in the surgical reconstruction. Breast feeding is permissible with this condition. Genetic counseling is not necessary as the exact cause of hypospadias is not known. A heart rate of 150 is normal for an infant.
The nurse assesses a newborn during an initial feeding of formula and notes choking, coughing, and bluish lips. What is the nurse's next action? -ANSWER- Stop the feeding.
The infant is displaying signs esophageal atresia, the blue lips are the concerning sign in this scenario. The infant could aspirate the formula. The nurse must stop the feeding and further assess the infant. Firmly tap the back is appropriate for choking. Further assessment is not indicated as enough data are collected with the presenting signs. Further assessment may result in a delay of care. Raising the bassinette is an appropriate position, but not as important preventing aspiration.
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A 3-month-old infant returns from surgery with elbow restraints and a Logan bow over a cleft lip suture line. Which action should the nurse take to maintain suture line integrity during the initial postoperative period? -ANSWER- Place the infant upright in an infant seat position.
The use of an infant seat simulates a supine position with the head elevated and also prevents aspiration. Prone positioning should be avoided to prevent disruption of the protective Logan bow and prevent the infant from rubbing the face on the bed surface. Mittens are not necessary and decrease the ability to provide sensory comfort, such as hand holding. Nasal suctioning should be avoided to prevent trauma or dislodging clots at the surgical site. Water-soluble lubricant will dry the suture line and cause crusting, which predisposes the suture line to poor healing and scarring.
Which nursing action will the nurse take first for the child known to have diabetes admitted to the emergency room? -ANSWER- Take a blood glucose reading.
Assessment of the blood glucose will determine the next course of action.Assessment first. Dipstick for ketones is an unreliable measure. Starting an IV and administering orange juice will depend on the blood glucose reading.
A newborn whose mother is HIV-positive is scheduled for the first follow-up assessment with the nurse. If the child is HIV-positive, which initial symptom will the child most likely exhibit? -ANSWER- Persistent cold
Respiratory tract infections commonly occur in the pediatric population, but the child with AIDS has a decreased ability to defend the body against these common infections. Thus, the most typical presenting symptom of a child who contracted AIDS through vertical transmission (i.e., from the mother during delivery) is a persistent cold or respiratory infection. Options A, B, and D are symptoms of AIDS complications that may occur later as the disease progresses.
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