HESI RN Pediatric Exam

HESI RN Pediatric Exam

VERSION 8

• A mother brings her 8 mo. old baby boy to clinic because he has been vomiting and had

diarrhea for last 3 days. Which assessment is most important for nurse to make?

• Assess infant abdomen for tenderness
• Determine if the infant was exposed to a virus
• Measure the infant’s pulse
• Evaluate the infant’s cry

It is essential to establish if the infant is dehydrated because the extent of dehydration, if severe it can lead to metabolic acidosis, seizures, and death. One of the first signs of dehydration is tachycardia, so measurement of the child’s heart rate (A) is essential. The underlying cause of dehydration may be associated with abdominal tenderness (B) or viral exposure (D), but determining the etiology is not the most urgent assessment to obtain. A child who is severely dehydrated may have a weaker cry than normal, but this symptom is difficult to measure (C) and is usually a later symptom.

• While obtaining the vital signs of a 10 year old who had a tonsillectomy this morning, the

nurse observes the child swallowing every 2-3 minutes. Which assessment should the nurse implement?

• Inspect the posterior oropharynx
• Assess for teeth clenching or grinding
• Touch the tonsillar pillars to stimulate the gag reflex
• Ask the child to speak to evaluate change in voice tone

• The parents of a 3-year old boy who has Duchenne muscular dystrophy ask, “How can

our son have this disease? We are wondering if we should have any more children.” What information should the nurse provide to parents?

• This is an inherited X-linked recessive disorder, which primarily affects male

children in the family

• The striated muscle groups of males can be impacted by a lack of the protein

dystrophin in their mothers

• The male infant had a viral infection that went unnoticed and untreated so muscle

damage was incurred

• Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus

weakening the muscles DMD is inherited from an X-linked recessive gene, and affects males most exclusively (A), and about one-third of all cases occur from new mutations. DMD is characterized by progressive weakness and muscle wasting of skeletal muscle, not striated muscle, and dystrophin is a protein found in skeletal muscle (B) that is absent in children with DMD. DMD does not occur as a result of (C or D).

• A 2-week-old female infant is hospitalized for the surgical repair of an umbilical hernia.

After returning to the postoperative neonatal unit, her RR and HR have increased during the last hour. Which intervention should the nurse implement?

• Notify the HCP of these findings
• Administer a PRN analgesic prescription
• Record the findings in the child’s record
• Wrap the infant tightly and rock in rocking chair 1 / 2

• A 2-year-old girl is brought to the clinic by her 17 year old mother. When the nurse

observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother?

• A 2-year old should be speaking in 2 word phrases
• Dental caries are associated with drinking soda
• Drinking soda is related to childhood obesity
• Toddlers should be sleeping 10 hours a night
• Toddlers should be drinking from a cup by age 2
• A mother brings her 3 month old infant to the clinic because the baby does not sleep

through the night. Which finding is most significant in planning care for this family?

• The mother is a single parent and lives with her parents
• The mother states the baby is irritable during feedings
• The infant’s formula has been changed twice
• The diaper area shows severe skin breakdown

• The nurse determines that an infant admitted for surgical repair of an inguinal hernia

voids a urinary stream from the ventral surface of the penis. What action should the nurse take?

• Document the finding
• Palpate scrotum for testicular descent
• Assess for bladder distension
• Auscultate bowel sounds

• A 16 year old with acute myelocytic leukemia is receiving chemotherapy (CT) via an

implanted medication port at the out-patient oncology clinic. What action should the nurse implement when the infusion is complete?

• Administer Zofran
• Obtain blood samples for RBCs, WBCs, and platelets
• Flush mediport w/ saline and heparin solution
• Initiate an infusion of normal saline

• A mother brings her 3-week old infant to the clinic because the baby vomits after eating

and always seems hungry. Further assessment indicates that the infant’s vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life threatening complication?

• Irregular palpable pulse
• Hyperactive bowel sounds
• Underweight for age
• Crying without tears

An irregular pulse (B) can be the result of dehydration, which can cause life threatening cardiac arrhythmias in a neonate. Crying without tears (A) is a sign of dehydration. The projectile vomiting prevents the neonate’s normal weight gain (C). Hyperactive bowel sounds (D) may indicate an obstruction.

• The nurse is performing a routine assessment of a 3-year old at a community health

center. Which behavior by the child should alert the nurse to request a follow-up for a possible autistic spectrum disorder?

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