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HESI Peds School-aged children + Adolescents exam questions and answers
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HESI Peds School-agedchildren + Adolescents
exam questions and
answers
A parent of a 7-year-old child asks a nurse how to tell the difference
between measles (rubeola) and German measles (rubella). What should
the nurse tell the parent differentiates rubeola from rubella? - answer
High fever and Koplik spots
The signs and symptoms of rubeola (measles) include a high fever,
photophobia, Koplik spots (white patches on the mucous membranes of
the oral cavity), and a rash. Rubella (German measles) usually does not
cause a high fever, runs a 3- to 6-day course, and never causes Koplik
spots. The rash of rubeola (measles) spreads over most of the body.
Nausea, vomiting, and abdominal cramps are vague clinical findings and
occur with many illnesses. Some signs and symptoms may be similar to
those of a severe cold, but rubeola is associated with high fever.
A nurse is caring for a 6-year-old child who has undergone laparoscopic
appendectomy. What interventions should the nurse document on the
child's clinical record? Select all that apply. - answer - Intake and output
- Measurement of pain
- Presence or absence of bowel sounds
Assessment and documentation of fluid balance are critical aspects of all
postoperative care. Laparoscopic surgery involves insufflating the
abdominal cavity with air, which is painful until it has been absorbed. The
degree of pain should be assessed and documented. Pain can be measured
with the use of numbers 1 through 10 for the older child and with the use
of the Wong FACES scale for the younger child. Auscultating for bowel
sounds and documenting their presence or absence help the nurse
, evaluate the child's adaptation to the intestinal trauma caused by the
surgery. A special diet is not indicated after this surgery. After a
laparoscopic appendectomy there is little drainage and no dressings.
A nurse in the pediatric clinic is evaluating a 6-year-old child with sickle
cell anemia whose spleen autoinfarcted by age 4. What is the priority
nursing care at this time? - answer - Determining parental knowledge
about infection
The spleen plays a role in immunity. Initially the spleen enlarges and
becomes congested with accumulated sickled red blood cells; in time,
fibrous material replaces the tissue in the spleen, and by age 5 the spleen
is obliterated. Without a spleen the child is prone to infection, which can
precipitate a sickle cell crisis. Assessing the child for jaundice is not a
priority, because jaundice is an expected adaptation that is not life
threatening. Abdominal assessments are important but not required
frequently in this situation. Serial hematocrit readings are necessary only
if the child is in sickle cell crisis.
A nurse is performing an assessment on a fifth-grader who has been
admitted to the pediatric unit with the diagnosis of acute lymphocytic
leukemia (ALL). What early clinical findings does the nurse expect to
identify? - answer - Fatigue and ecchymotic areas
Fatigue and ecchymoses are early clinical findings to ALL. They are caused
by decreased white blood cell, red blood cell (RBC), and platelet
production that results when the bone marrow is crowded with abnormal
lymph cells. Although epistaxis does occur, papilledema is not a common
presenting sign because the blood-brain barrier is an initial deterrent.
Pain is not an early symptom of ALL. The skin will be pale, not reddened,
because of a decreased RBC count. Enlargement of lymph nodes in the
axillae and groin is a sign of lymphoma or a late, not early, sign of
leukemia.
A nurse teaches the parents of a 5-year-old boy with type 1 diabetes
about blood glucose monitoring at home. What statement by the parents
indicates that the teaching has been effective? - answer "We'll notify the
clinic if the blood sugar is higher than 200 (11.1 mmol/L)."
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