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PEDIATRICS HESI LATEST 2023 -2024 TESTBANK
COMPLETE 350 ACTUAL EXAM QUESTIONS
WITH CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) GRADED A+
A 3-year-old boy is brought to the emergency room because he swallowed an entire bottle of children's vitamin pills. Which intervention should the nurse implement first?
- Insert N/G tube for gastric lavage.
- Determine the child's pulse and respirations.
- Assess the child's level of consciousness.
- Administer an IV D5/0.25 NS as prescribed. - Correct Answer - Determine the
child's pulse and respirations.
Rationale:
The most important principle in dealing with a poisoning is to treat the child first, not the poison. Initiate immediate life support measures with assessment of vital signs (B), in particular, respirations. Inserting an airway or initiating mechanical ventilation may be necessary. Assessment and identification of the poison should occur prior to (A). (C and
- should occur after assessing the airway.
To take the vital signs of a 4-month-old child, which order provides the most accurate results?
- Respiratory rate, heart rate, then rectal temperature.
- Heart rate, rectal temperature, then respiratory rate.
- Rectal temperature, heart rate, then respiratory rate.
- Rectal temperature, respiratory rate, then heart rate. - Correct Answer -
Respiratory rate, heart rate, then rectal temperature.
Rationale:
The respiratory rate should be taken first (A) in infants, since touching them or performing unpleasant procedures usually makes them cry, elevating the heart rate and making respirations difficult to count (B). Rectal temperature is the most invasive procedure, and is most likely to precipitate crying, so should be done last (C and D). 1 / 4
pg. 2 The parents of a 3-week-old infant report that the child eats well but vomits after each feeding. What information is most important for the nurse to obtain?
- Description of vomiting episodes in past 24 hours.
- Number of wet diapers in last 24 hours.
- Feeding and sleep schedule.
- Amount of formula consumed during the past 24 hours. - Correct Answer -
Description of vomiting episodes in past 24 hours.
Rationale:
A description of the vomiting episodes (A) will assist the nurse in determining the reason for the symptoms, which may be helpful in developing a plan of care for this infant. (B and C) provide related information but are not as helpful as (A). (D) may be related to the vomiting, but the nurse should first obtain a better description of the vomiting episodes.
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribes dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be infused at 25 ml/hour. Prior to initiating the infusion, the nurse should obtain which assessment finding?
- Frequency of emesis in the last 8 hours.
- Serum BUN and creatinine levels.
- Current blood sugar level.
- Appearance of the stool. - Correct Answer - Serum BUN and creatinine levels.
Rationale:
Regardless of a client's age, adequate renal function must be present before adding potassium to IV fluids (B). (A) is important in determining the need for fluid replacement.(C) is not indicated. (D) is useful information, but will not impact administration of the prescribed IV solution.
Which finding in a 19-year-old female client should trigger further assessment by the nurse?
- Menstruation has not occurred.
- Reports no tetanus immunization since childhood.
- Denies having any wisdom teeth.
- History of painful, inward growth on bottom of foot. - Correct Answer -
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Menstruation has not occurred.
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Rationale:
Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically occurs by age 18, so (A) should prompt further investigation to determine the cause of this primary amenorrhea. Children receive tetanus as part of the DPT childhood immunization series, and a booster is not typically given until age 16 (B).Wisdom teeth are the third molar teeth of the permanent dentition and are the last to erupt, so (C) is a normal finding. (D) describes a plantar surface wart, harmless but painful because of the pressure with walking or standing.
The nurse is assessing an 8-month-old child who has a medical diagnosis of Tetrology of Fallot. Which symptom is this client most likely to exhibit?
- Bradycardia.
- Machinery murmur.
- Weak pedal pulses.
- Clubbed fingers. - Correct Answer - Clubbed fingers.
Rationale:
Tetrology 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.
Rationale:
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.
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pg. 4 A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by which behavior?
- Ability to communicate verbally.
- Response to separation from family.
- Concern for body integrity.
- Socialization with other children. - Correct Answer - Concern for body integrity.
Rationale:
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.
Rationale:
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.
All of the following interventions can be used to evaluate the effectiveness of nursing and medical interventions used to treat diarrhea. Which intervention is least useful in the nurse's evaluation of a 20-month-old child?
- Weighing diapers.
- Assessing fontanels.
- Checking skin turgor.
- Observing mucous membranes for moisture. - Correct Answer - Assessing
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fontanels.