PEDIATRICS - HESI PRACTICE EXAM UPDATED 2022/2023 WITH Q & A ALL CORRECT RATED A+

The nurse is teaching the parents of a 5 year old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the parents understand? A. perform postural drainage before starting aerosol therapy B. Give respiratory treatments when the child is coughing a lot C. Administer aerosol therapy followed by postural drainage before meals D. ensure respiratory therapy is done daily during any respiratory infection (ANS- C. Administer aerosol therapy followed by postural drainage before meals Postural drainage for a child with cystic fibrosis is most effective when performed after nebulization and before meals, or at least 1 hour after eating to prevent N/V. Postural drainage uses gravity to promote mucous removal after nebulization treatments which open the airways. Pulmonary toileting or respiratory treatments should be given 3 to 4 times daily, not episodically. The nurse is assessing the neurovascular status of a child in Russell's traction. Which finding should the nurse report to the healthcare provider? A. pale bluish coloration of the toes B. skin is warm and dry to the touch C. toes are wiggled upon command D. capillary refill less than 3 seconds (ANS- A. pale bluish coloration of the toes Russell's skin traction is used for fractures of the femur in young children and adolescents, whose growth plates remain open and is applied to the lower leg using moleskin and elastic wrap bandages, which can compress the peroneal nerve and arteries that supply the foot. Assessment of adequate circulation, movement, and sensation of the toes and skin distal to the application is made to identify compromised blood flow so cyanosis should be reported immediately. A child is rescued from a burning house and brought to the emergency room with partial-thickness burns on the face and chest. Which action should the nurse implement first? A. insert an indwelling urinary catheter B. administer IV pain medication C. collect blood specimen for laboratory studies D. assess the child's respiratory status. (ANS- D. assess the child's respiratory status Assessing the airway and the respiratory status is the highest priority since burns to the face and chest place the child at risk for smoke inhalation injury and compromised airway The mother of a 4 year old child asks the nurse what she can do to help her other children cope with their sibling's repeated hospitalizations. Which is the best response that the nurse should offer? A. inform the parent that the child is too young to visit the hospital B. suggest that the child visit a grandmother until the sibling returns home. C. ask the mother if the child asks when the sibling will be discharged D. encourage the mother to have the children visit the hospitalized sibling. (ANS- D. encourage the mother to have the children visit the hospitalized sibling. Needs of a sibling will be better met with factual information and contact with the ill child, so sibling visitation should be encouraged. Parents are experts on their children and should determine when their children are old enough to visit in the hospital. Separation from family and home may intensify fear and anxiety. Children may have difficulty expressing questions so the support of parents and other caregivers are needed to help alleviate their fears. Which finding in a 19 year old female client should trigger further assessment by the nurse? A. menstruation has not occurred B. reports no tetanus immunization since childhood C. denies having any wisdom teeth D. history of painful, inward growth on bottom of foot (ANS- A. menstruation has not occurred 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. 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. A 15 year old girl tells the school nurse that all of her friends have started their periods and she feels abnormal because she has not. Which response is best for the nurse to provide? A. refer the adolescent to the healthcare provider for a pregnancy screen B. schedule a conference with her parents to recommend hormone therapy C. explain that menarche varies and occurs between the ages of 12 and 18 years. D. suggest that she use diversions to help her not worry about delayed menarche (ANS- C. explain that menarche varies and occurs between the ages of 12 and 18 years. The nurse should provide a factual and reassuring explanation that focuses on individual variations of menarche, which can normally occur between 12 and 18 years of age. (A) does not address the adolescent's concern and is judgmental. Menarche is influenced by hereditary general health and nutritional status, so (B) is not indicated. (D) dismisses the adolescent's concerns and does not offer factual information. Which measurements should be used to accurately calculate a pediatric medication dosage? (Select all that apply) A. child's height and weight B. adult dosage of medication C. body surface area of child D. average adult's body surface area E. average pediatric dosage of medication F. nomogram determined mathematical constant. (ANS- A. child's height and weight C. body surface area of child F. nomogram determined mathematical constant.