Pediatrics HESI 2023 Complete Exam 350

pg. 1 Pediatrics HESI 2023 Complete Exam/ 350 Actual Exam Questions with Correct Detailed Answers (Verified Answers) Graded A+

The nurse is assessing an 8-month-old child who has a medical diagnosis of Tetralogy of Fallot. Which symptom is this client most likely to exhibit?

• Bradycardia.
• Machinery murmur.
• Weak pedal pulses.
• Clubbed fingers. - Correct Answer - Clubbed fingers.

Tetralogy of Fallot, a cyanotic heart defect, causes clubbing of fingers and toes (D) due to tissue hypoxia. Tachycardia, not (A), is a manifestation of congenital heart disease. (B) is a classic sign of ventricular septal defect. (C) is characteristic of coarctation of the aorta.

Surgery is being delayed for an infant with undescended testes. In collaboration with the healthcare provider and the family, which prescription should the nurse anticipate?

• A trial of adrenocorticotrophic hormone injections.
• Frequent stimulation of the cremasteric reflex.
• A trial of human chorionic gonadotrophic hormone.
• Frequent warm baths to gently dilate the scrotal area. - Correct Answer - A

trial of human chorionic gonadotrophic hormone.A trial of HCG (human chorionic gonadotrophic hormone) (C) may aid in testicular descent, but does not replace surgical repair for true undescended testes.Undescended testes (cryptorchidism) may be found in the inguinal canal due to exaggerated cremasteric reflex. (A) is not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather than descend in the scrotum (B). (D) may relax the cremasteric muscle, but may not cause the testes to descend.

A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by which behavior? 1 / 4

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• Ability to communicate verbally.
• Response to separation from family.
• Concern for body integrity.
• Socialization with other children. - Correct Answer - Concern for body

integrity.The preschooler's major stressor is concern for his body integrity (C). He fears that his "insides will leak out." A child undergoing surgery to his genitalia is even more concerned about body integrity. The preschooler is quite verbal, so comprehension of the words he uses or hears may be inaccurate, while his imagination and fears may fantasize the reality (A). (B) is a concern for all children, but of most concern to the toddler. (D) is not a prime concern in this situation.

A six-month-old returns from surgery with elbow restraints in place. What nursing care should be included when caring for any restrained child?

• Keep restraints on at all times.
• Remove restraints one at a time and provide range of motion exercises.
• Remove all restraints simultaneously and provide play activities.
• Renew the healthcare provider's prescription for restraints every 72 hours. -

Correct Answer - Remove restraints one at a time and provide range of motion exercises.Removing restraints one at a time (B) is safer than removing all of them at once (C).The child needs to exercise and should not be kept in restraints at all times (A). The renewal of the healthcare provider's prescription varies with hospitals (D), and it does not really answer the question.

A child with cystic fibrosis is having stools that float and are foul smelling.Which descriptive term should the nurse use to document the finding?

• Diarrhea.
• Rhinorrhea.
• Galactorrhea.
• Steatorrhea. - Correct Answer - Steatorrhea.

Steatorrhea (D) is defined as stools with an abnormally high fat content that are usually foul smelling and float on water. (A, B, and C) do not describe this finding.

A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast is applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? 2 / 4

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• Call the healthcare provider immediately if his nail beds appear blue.
• Check his fingers hourly for the first 48 hours to see that he is able to move

them without pain.

• Be sure his arm remains above his heart for the first 24 hours.
• Take his temperature q4h for the next two days and call if an elevation is

noted. - Correct Answer - Call the healthcare provider immediately if his nail beds appear blue.Cyanosis (A) indicates impaired circulation to fingers and should be reported immediately. Although the actions described in (B, C, and D) may be indicated, they are implemented rather excessively--and might tend to frighten the parents. It is not necessary to check the child's ability to move his fingers hourly for 2 days (B).Elevating the arm above the heart will help to decrease swelling but (C) is stated in a frightening way. It is not necessary to take the child's temperature q4h unless indicated by other symptoms.

The vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and Respirations 24. The child's pedal pulses are present with a volume of +1, and no edema is observed. What action should the nurse implement first?

• Insert an indwelling urinary catheter.
• Start an IV infusion of normal saline.
• Send a specimen to the lab for urinalysis.
• Document the child's vital signs and pulses. - Correct Answer - Start an IV

infusion of normal saline.The current vital sign readings and the decreased peripheral pulse volume indicate that the child is experiencing fluid volume deficit due to the polyuria, so the priority action is to restore fluid volume (B). (A) is useful in obtaining a precise urine output measure, but is a lower priority than restoring fluid volume at this time. (C) is not indicated based on the current assessment data, and (D) does not recognize the need for immediate action to combat the fluid volume deficit.

The mother of a preschool-aged child asks the nurse if it is all right to administer Pepto Bismol to her son when he "has a tummy ache." After reminding the mother to check the label of all over-the-counter drugs for the presence of aspirin, which instruction should the nurse include when replying to this mother's question?

• If the child's tongue darkens, discontinue the Pepto Bismol immediately.
• Do not give if the child has chickenpox, the flu, or any other viral illness.
• Avoid the use of Pepto Bismol until the child is at least 16 years old. 3 / 4

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• Pepto Bismol may cause a rebound hyperacidity, worsening the "tummy ache." -

Correct Answer - Do not give if the child has chickenpox, the flu, or any other viral illness.Pepto Bismol contains aspirin and there is the potential of Reye's syndrome (B). (A) is a common effect of Pepto Bismol and does not warrant discontinuation. Pepto Bismol can be used by children (C). Pepto Bismol does not cause rebound hyperacidity (D), which is a complication of antacids containing calcium.

Which restraint should be used for a toddler after a cleft palate repair?Clove hitch.Mummy.Elbow.Jacket. - Correct Answer - Elbow Elbow restraints prevent children from bending their arms and bringing their hands to the oral surgical site. (A) restrains the hands, but the child can bend and bring their head to their hands. (B) is used during procedures. (D) restrains the body torso and is not appropriate.

When planning the care for a child who has had a cleft lip repair, the nurse knows that crying should be minimized because it

• increases salivation.
• increases the respiratory rate.
• leads to vomiting.
• stresses the suture line. - Correct Answer - stresses the suture line.

Prevention of stress on the lip suture line (D) is essential for optimum healing and the cosmetic appearance of a cleft lip repair. Although crying also causes (A, B, and C), these conditions do not create a problem for the child with a cleft lip repair.

A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome?

• Congenital heart disease.
• Fragile X chromosome.
• Trisomy 13.
• Pyloric stenosis. - Correct Answer - congenital heart disease.
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