HESI RN Nursing Care of Children Exam

HESI RN Nursing Care of Children Exam

VERSION 10

• The nurse is planning care for a 5 - month-old with gastroesophageal reflux disease whose

weight has decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instruction should the nurse provide this mother?• Dilute the child’s formula with equal parts of water • Offer 10% dextrose in water between most feeding • Give small amounts of baby food with each feeding • Thicken formula with cereal for each feeding

4- years-old boy was recently diagnosed with Duchenne muscular dystrophy (DMD).Which characteristic of the disease is most important for the nurse to focus on during the initial teaching?• Muscular strength can be regained with physical exercise and therapy • Growth and development have been abnormal since birth • Respiratory dysfunction and aspiration are prime concerns at this stage of the disease • Lower legs become progressively weaker, causing a wedding, unsteady gait

• In caring for an client with acute epiglottitis, which nursing action takes priority?

• Obtain a stat CBC • Prepare for endotracheal intubation • Auscultate breath sounds • Apply ice packs to the neck

• Which client requires immediate intervention by the nurse?

• A toddler with chickenpox who is scratching • An adolescent with a migraine and photophobia • A child with cystic fibrosis who is constipated • A Child with acute renal failure and hyperkalemia

• The nurse is conducting an admission assessment of an 11-months old infant with

congestive heart failure who is scheduled repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower, with pathophysiologic mechanism support these findings?• The aortic semi lunar valve obstructs blood flow into the systemic circulation • An opening in the atrial septum causes a murmur due to a turbulent left to right shunt • The lumen of the aorta reduces the volume of flow to the lower extremities • The pulmonic valve prevents adequate blood volume into the pulmonary circulation toddler with hemophilia is being discharged from the hospital. Which teaching should the nurse include in the discharge instructions to the mother?• Apply padding on the sharp corners of the furniture • Prevent the child from running inside the house • Give an 81 mg tablet of aspirin for pain relief 1 / 4

• Use a soft toothbrush for frequent cleaning

• The nurse is using the Stage Questionnaire (b) to assess a 24 - month-old child. What is the

best intervention for the nurse to initiate after the assessment is completed?• Assess for changes in the vital signs • Review the child’s birth history • Provide the parents with a list of stimulating activities • Meet with a social worker to review the results

• When caring for a child sickle cell disease, the nurse knows that the child will most likely

exhibit which sign when experiencing a sickle cell crisis?• Decreased hemoglobin • Pain • Infection • Dehydration

• The nurse is administering an oral medication to a reluctant preschool-age boy. Which

intervention should the nurse implement?• Advise the parents that they will need to give the medication • Use straightforward approach with the child • Mix the medication in with the child’s favorite breakfast cereal • Offer to bring the medicine back later in the day

• The nurse is planning care for a newborn infant scheduled for a cardiac catheterization.

Which occurrence poses the greatest risk for this child?• Loss of pulse proximal to the entry side of the catheter • Allergic response to the plastics in the catheter used for catheterization • Acute hemorrhage from the entry site of the catheter after the procedure • Fever associated with nausea and vomiting after the procedure

• The school nurse is presenting a seminar to parents about child safety that focuses on

prevention of spinal cord injuries. What information is most important for the nurse include in the teaching plan?• Trampoline activities of school-aged children should be supervised by adults • Protective gear to prevent neck flexion should be worn during contact sports • Seat belt and car seat laws for use in motor vehicles should be reinforced • Monkey bars should be removed from school playgrounds to reduce falls mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child’s oral temperature is 101.2 F (38 C). Which intervention should the nurse implement?• Provide parent education to prevent recurrence • Clearance purulent exudate from the affected ear canal • Apply a topical antibiotic to the preauricular area 2 / 4

• Ask the mother if the child has had a runny nose

mother is concerned that her 3-year-old son wants to play with female doll figures. The child is not interested in building blocks, trucks, or other typical “boy” toys. How should the nurse respond to the mother’s concern?• Letting male toddlers play with female-typed toys can have negative effects • Replacing female doll figures with male doll figures reinforces masculinity • Exploring different roles in imaginary play is typical at this age • Experimenting with different toys is an acceptable behavior

• Which nursing intervention is most important to assist in detecting hypopituitarism and

hyperpituitarism in children?• Noting a marked weight gain without a gain in height on a growth chart • Performing head circumference measurements on infants under one year of age • Assessing for behavioral problems at home and school by interviewing the parents • Carefully recording the height and weight of children to detect inappropriate growth rates

• The parents of a 4 week-old infant phone the pediatric clinic to report that their infant eats

well but vomits after each feeding. To differentiate between normal regurgitation and pyloric stenosis, which information is most important for the nurse to obtain?• Level of infant’s distress after vomiting • Degree of forcefulness of vomiting episodes • Odor and texture associated with emesis • Position of the infant when vomiting occurs 4- month-old boy has an inguinal hernia that is visible when he cries, but it does not cause him discomfort. His parents ask if the hernia should be repaired now. The nurse’s response should be based on what information?• An inguinal hernia is treated as a surgical emergency • Surgical repair is planned after successful toilet training • An inguinal hernia is surgically repaired if persistent diarrhea occurs • Surgical correction is indicated if the hernia is incarcerated

female of child - bearing age receives a rubella vaccination. She has two children at home, ages 13 months and 3 years. Which instruction is most important for the nurse to provide to this client?• Tell the mother to isolate the children for 3 days • Inquire if anyone in the family is allergic to eggs • Encourage the client to immunize the children • Assess family history for incidence of rubella

• The teacher notifies the school nurse that a child’s nose is bleeding for no apparent reason.

What action should the nurse implement first?• Tip the child’s head back to avoid swallowing blood 3 / 4

• Pinch the nose using thumb and finger for 10 minutes • Insert a sterile cotton ball in the nares that is bleeding • Apply an ice compress to the child’s nose right away 2- year-old child with heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 beast| minute. What action should the nurse implement?• Determined the pulse déficit • Calculate the safe dose range • Administer the scheduled dose • Review the serum digoxin level

• The nurse is assisting the mother of child with phenylketonuria (PKU) to select foods that

are in keeping with the child’s dietary restrictions. Which foods are contraindicated for this child?• High fat foods • Foods sweetened with aspartame • Wheat products • High calorie foods

• During a routine physical exam, a male adolescent client tell the nurse, “ Sometimes, my

mother gets angry because I want to be with my own friends”. What is the best initial response by the nurse?• Offer to discuss his concerns together with his mother • Ask about client’s response to his mother’s age • Determine if his friends are engaged unsafe behaviors • Offer reassurance that his mother’s concern is normal

• Which response demonstrates that the mother of a young girl with a urinary tract infection

(UTI) understands home care for the child?• I will give the antibiotics until she does not complain of burning anymore • I will bring her back to the doctor’s office for another urine test • I will make sure she wipes from back to front after she uses the bathroom • I will refill the prescription for antibiotics if her symptoms are skill present after taking these

• The nurse is caring for a one-year-old boy who has type 1 diabetes mellitus (DM). His

mother asks how will she recognize hypoglycemia in her infant who cannot tell her how he feels. Which information should the nurse provide?• The baby’s breath smell swells sweet when the sugar and blood ketone levels are high • Hypoglycemia in infants causes changes in behavior and cold clammy skin • Weight loss and a good appetite often occur when a baby’s glucose levels change • Excess urination and dry skin are common indicators of hypoglycemia

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