PEDS HESI REMEDIATION

PEDS HESI REMEDIATION An alert child has been treated for a submersion injury (near drowning). Which complication should the nurse anticipate? A. hypertension B. Edema C. Oliguria D. Hypothermia Ans- D. Hypothermia Almost half of all children who experience near drowning, whether they are asymptomatic or minimally symptomatic, will experience complications during the first 24 hours after the incident. Hypothermia is common in children due to their large surface area relative to body mass, decreased subcutaneous fat, and limited thermoregulation. The nurse is reviewing the lab values for an eight-year-old client and notes that the child's absolute neutrophil count (ANC) is below 500 cells/mm3. Which nursing intervention should the nurse implement first? A. Transfer the child to a negative pressure room B. Notify the HCP of the lab result C. Initiate reverse isolation D. Call the lab and request stat unit of plt Ans- C. Initiate reverse isolation precautions for this child The normal ANC value is considered greater than 1500 cells/mm3. Mild neutropenia is between 1000- 1500 cells/mm3, moderate between 500- 1000 cells/mm3. ANC below 500 cells/mm3 are considered severe neutropenia. Clients with an ANC below 500 cells/mm3 should be placed on reverse isolation precautions as soon as detected to prevent acquiring an overwhelming infection. Reverse isolation consists of being placed in a positive pressure room and generally no consumption of fresh fruit or vegetables, unless the food is thoroughly washed and no live plants or flowers in the room. Which information about toxic shock syndrome should the nurse emphasize when counseling an adolescent female client? A. symptoms B. prevention C. medication D. treatment Ans- B. Prevention Toxic shock syndrome (TSS) occurs from a buildup of toxins produced by staphylococcus bacteria and can lead to acute multisystem organ failure. Education should focus on preventive measures, such as the dangers of prolonged tampon replacement use. A mother brings in a three-year-old child who has respiratory rate of 36 breathes per minute; heart rate of 160 beats per minute; weaken and thready pulse; and pale and sweaty skin. The nurse suspects the child is going into shock which action should the nurse perform first? A. obtain ABG's B. obtain vitals C. administer O2 D. Establish IV access Ans- C. Administer oxygen When providing care to a child in shock, the nurse's priority is to ensure adequate oxygenation. The nurse should administer oxygen or provide assistance in establishing an airway. The best way to remember the order of priority of care to be given is the "ABCs"; airway, bleeding and circulation The nurse recognizes signs that a 9-month-old toddler may be living in an abusive home. Which action is the priority for the nurse? A. encourage the child to speak freely B. report the suspected abuse to local authorities C. document head to toe assessment D. test the child for STD Ans- B. report suspected abuse The nurse's priority in suspected abuse cases is the safety and welfare of the child. According to national statistics, children under the age of one have the highest incidences of being abuse. Nurses are mandated reporters and are required to report suspected cases of abuse to local authorities in order to protect the child from further abuse The nurse is assessing a two-month-old in preparation for surgery for coarctation of the aorta repair. Which best describes the pathophysiology of coarctation of the aorta? A. acyanotic defect, increase pulmonary blood flow B. cyanotic defect, obstructed blood flow from ventricles C. acyanotic defect, obstructed blood flow from ventricles D. cyanotic defect, decreased pulmonary blood flow Ans- C. acyanotic defect, obstructed blood flow from ventricles Coarctation of the aorta causes localized narrowing near the insertion of the ductus arteriosus. This results in increased pressure proximal to the defect (head and upper extremities) and decreased pressure distal to the obstruction (body and lower extremities). A six-year-old client, who received a kidney transplant presents with signs including fever, decreased urine output, and tenderness over the transplanted organ. Laboratory results reveal an elevated serum creatinine level. This presentation is likely due to which cause? A. immunosuppression medications B. obstructive uopathy C. transplant rejection D. nephrotic syndrome Ans- C. transplant rejection Transplant rejection is caused by the recipient's immune system response to foreign tissue. Signs that may alert the nurse to rejection of a kidney transplant include fever, tenderness over the graft area, decreased urine output, and elevated serum creatinine. The nurse is reviewing an electronic medical record (EMR) of a four-year-old child who is scheduled for an outpatient cardiac catheterization. The child has midazolam prescribed pre-procedure to alleviate anxiety. Which prescription should the nurse seek further clarification from the healthcare provider? A. Parents may administer the med just prior to coming to the hospital B. the child may have clear liquids up to two hours prior to administration of medicine C.the child is to be accompanied the resuscitative equipment during transport to cardiac suite D. parents may accompany the child during transportation to cardiac procedure room. Ans- A. Parents may administer the med just prior to coming to the hospital Midazolam is commonly prescribed to decrease anxiety in children undergoing surgical procedures. When midazolam is administered to children, there should be a Pediatric Advance Life Support (PALS) certified personnel and resuscitative equipment accompanying the child to the procedure room. Children older than 3 years should be NPO of solid and non-clear liquids for a minimum of 6 hours and may have clear liquids up to two hours prior to sedation. The practical nurse (PN) needs to contact the healthcare provider and request for a new prescription to be written and the parents to be notified of the new prescription. A 12-month-old client is being discharged with a body spica cast. Which information should the nurse include in the parents' discharge teaching plan? A. foul odor from cast may indicate infection or skin breakdown B. pillows should not be placed under cast C. the child can safely transported in a stroller D. use pillows to elevate the child's head Ans- A. foul odor from cast may indicate infection or skin breakdown Care of a child in a body spica cast can be challenging for parents at home. Skin under the cast should be protected from injury and debris, so parents should be instructed that a foul odor from the cast can be indicative of skin breakdown or infection and to contact their health care provider. Which medication is administered to premature infants to reduce the severity of symptoms associated with respiratory syncytial virus (RSV) infection? A. respaire B. singulair C. menomune D. synagis Ans- D. synagis Respiratory syncytial virus (RSV) causes infection of the respiratory tract which can be fatal to premature infants and children younger than 2 -years-old with lung and/or heart conditions. Synagis (Palivizumab), a monoclonal antibody which binds to the RSV virus, preventing the virus from reproducing. The shot is administered before the RSV season and then is given monthly to high-risk infants during RSV season which can start as early in October and last until March to prevent hospitalization associated with RSV. A child has been diagnosed with chicken pox and the nurse teaches the parent not to give the child aspirin. Which condition may result when a child with chickenpox is given aspirin? A. Reye's syndrome B. Huntingtons disease c. Raynaud syndrome D. purpura disorder Ans- A. reye's syndrome Reye's syndrome is a rare, but serious condition that causes brain and liver damage that has been linked with aspirin use in children, when given to treat a viral infections, such as chicken pox. Reye's syndrome can be prevented by avoiding the use of aspirin in children. A 10-year-old client with asthma arrives at an urgent care clinic with apparent bronchial constriction. Which class of drugs should the nurse expect to be administered for this condition? A. methylxanthines B. anticholinergic C. long-acting beta2 agonists D. oral corticosteroids Ans- D. oral corticosteroids Corticosteroids are fast-acting anti-inflammatory drugs. They are used to treat reversible airflow obstruction, control symptoms, and reduce bronchial constriction with the fewest side effects. The nurse is preparing to administer furosemide (lasix) to an adolescent who has developed congestive heart failure as the result of cystic fibrosis. Which condition would indicate the medication regime is being effective? A. decrease of crackles B. decrease of BMI C. decrease of urine output D. decrease of blood glucose Ans- D. decrease of blood glucose The one of the goals of diuretics, in particular furosemide in the medical treatment of heart failure is to help decrease the fluid overload in the lungs as the result of the congestive heart failure. Decrease of crackles in the lungs is indicative that the medication is working and there is less fluid congestion in the lungs. Which action should the nurse take when caring for a child with epiglottitis? A. examine the trhoat with tongue depressor B. set up emergency airway equipment at bedside C. place the child in supine position D. perform a throat culture Ans- B. set up emergency airway equipment at bedside Epiglottitis can quickly progress to severe respiratory distress. Emergency airway equipment should be readily available in case the client's condition worsens. A school nurse is assessing rashes on a child's lower shins and forearms that appear streaked and inflamed and are blistered with clear oozing substance present. The child reports that it is painful. Based on these signs and symptoms, what most likely caused this condition? A. shellfish B. penicillin elixir C. laundry detergent D. poison ivy or oak Ans- D. poison ivy or oak Dermatitis reactions to plants that contain oil with urushiol, usually will cause localized rashes and are seen on areas of the skin that are not typically covered by clothing and appear to be streaky or spotty, inflamed, blisterd with oozing clear substance and painful. Three common plants which contain this substance are poison ivy, oak and sumac. Which is the best method a nurse can teach a mother of an infant to minimize the occurrence of a diaper rash? A. place talcum powder in the diaper B. dry the infant's buttocks with hair dryer C. change the diaper as soon as it is soiled D. to place petrolatum on the infant's buttocks Ans- C. change the diaper as soon as it is soiled Changing a soiled diaper as soon as soiling is detected is the best way to decrease the occurrence of a diaper rash. Which situations lead to exacerbation of acne in an adolescent female? (SATA) A. the consumption of chocolate products B. cosmetics containing lanolin and lauryl alcohol C. food products containing high levels of caffeine D. frequent exposure to cooking oils and grease E. the premenstrual days leading up to menstrual cycle Ans- B,D,E Many factors can have an impact on the occurrence of acne flare-ups. They can range from working in a fast food restaurant being exposed to cooking oils and grease, to wearing make-up that contains lanolin and lauryl alcohol to hormonal balances leading up to a female's menstrual cycle. A 10-year-old client with a recent history of playing in the woods, presents to the school nurse's clinic with localized skin eruptions on the hands and feet which are streaked, consisting of blisters discharging clear fluid that are painful and itchy. What should the school nurse suspect to be the causative agent? A. sun burn B. poison ivy C. insect bite D. heat rash Contact with the oil called "Urushiol" which is found in poison ivy, oak and sumac may produce an allergic reaction. Symptoms include localized, streaked, or oozing blisters. These skin lesions are usually painful and itchy. AnsA nurse is assessing a three year old diagnosed with psoriasis. Which is a common treatment for most forms of psoriasis? A. exfoliation B. cyrotherapy C. oral antibiotics D. phototherapy Ans- D. phototherapy All types of psoriasis commonly respond to topical creams and phototherapy (ultraviolet light exposure) when administered 3 to 5 times a week. A child is brought to the emergency department after ingesting a large amount of household drain cleaner. Which is the nurse's first priority when caring for this client? A. perform NG suctioning B. Assess and maintain an open airway C. give small amounts of water to ingest D. Obtain chest and abdomen radiographs Ans- B. assess and maintain an open airway Ingestion of corrosive household agents may cause airway obstruction due to rapidly developing laryngeal edema. The first priority is to assess and monitor the client's airway. A 12-year-old athlete reports severe ankle pain and an audible "popping" sound in the ankle after a fall at soccer practice. The nurse upon inspection observes moderate swelling, bruising, and joint instability. Initial radiographs of the ankle appear normal. Which type of injury should the nurse suspect? A. strain B. sprain C. fracture D. dislocation Ans- B. Sprain The ankle is a common site for sprain injuries. Ankle sprains can range from mil