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2024 PEDIATRIC HESI PART 1 EXAM WITH ANSWERS
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2024 PEDIATRIC HESI PART 1 EXAM WITH ANSWERS
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2024 PEDIATRIC HESI PART 1EXAM WITH ANSWERS
The nurse should teach the parents of a child with a cyanotic heart defect to
perform which action when a hypercyanotic spell occurs? - CORRECT
ANSWERS-Allow the child to assume a knee-chest position, with the head and
chest slightly elevated.
Rationale: Assuming a knee-chest position with the head and chest slightly
elevated will help restore hemodynamic equilibrium.
The nurse is conducting an initial admission assessment of a 12-month-old
child in celiac crisis. Which intervention is most important for the nurse to
implement? - CORRECT ANSWERS-Assess the child's mucous membranes
and skin turgor
Rationale: An infant having a celiac crisis has severe diarrhea and is at high
risk for fluid volume deficit. The nurse should first assess for indications of
fluid volume deficit
A woman whose first child died at 6 weeks of age because of sudden infant
death syndrome (SIDS) is being discharged following the birth of her second
child. The mother tells the nurse that she is fearful that this infant will also
develop SIDS. Which response is best for the nurse to provide this woman? -
CORRECT ANSWERS-"The fear of losing another child to SIDS is very realistic.
Have you thought about what support you may need?"
Rationale: The most effective way to provide emotional support is to
acknowledge what clients may be feeling, be a sounding board for them so
they can listen to themselves, and allow them to discover their own solutions
A child with a permanent tracheostomy is confined to a wheelchair and is
going to school for the first time tomorrow. During the school day, which
intervention should be implemented for this child? - CORRECT ANSWERS-
Place suctioning supplies on the back of the wheelchair when transporting.
Rationale: Suctioning supplies should always be readily available for use with
any client who has a tracheostomy.
A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic
for a routine evaluation. Which assessment finding suggests the presence of
a common complication often experienced by those with Down syndrome? -
CORRECT ANSWERS-Presence of a systolic murmur
Rationale: Congenital heart disease occurs in 40% to 50% of children with
trisomy 21 (Down syndrome). Defects of the atrial or ventricular septum that
,create systolic murmurs are the most common heart defects associated with
this congenital anomaly.
Which preoperative nursing intervention should be included in the plan of
care for an infant with pyloric stenosis? - CORRECT ANSWERS-Observe for
projectile vomiting.
Rationale: Projectile vomiting (D), the classic sign of pyloric stenosis,
contributes to metabolic alkalosis.
A 6-month-old male infant is admitted to the postanesthesia care unit with
elbow restraints in place. He has an endotracheal tube and is ventilator-
dependent but will be extubated soon following recovery from anesthesia.
Which nursing intervention should be included in this child's plan of care? -
CORRECT ANSWERS-Remove restraints one at a time and provide range-of-
motion exercises.
Rationale: Removing restraints one at a time is safer than simultaneously.
The infant should have the restrained extremities assessed frequently for
signs of neurologic or vascular impairment, and range-of-motion exercises
should be performed with these assessments. Under no circumstances
should restraints be applied to the client continuously. Documentation of
assessment findings regarding the restrained extremities must occur much
more frequently than every 72 hours; however, the reason for using
restraints must be justified and should be stated in the medical record.
The nurse notes that a 16-year-old male client is refusing visits from his
classmates. Further assessment reveals that he is concerned about his
edematous facial features. Based on these assessment findings, the nurse
should plan interventions related to which nursing diagnosis? - CORRECT
ANSWERS-Social isolation
Rationale: Peer acceptance and body image are significant issues in the
growth and development of adolescents. The answer addresses the problem
of a lack of contact with peers stemming from his desire to protect his ego.
Ampicillin, 75 mg/kg, is prescribed for a 22-lb child. It is available in a
solution that contains 250 mg/5 mL. How many milliliters should the nurse
administer in one dose? - CORRECT ANSWERS-15
Rationale: Take 22lbs / 2.2 = 10kg
10kg X 75mg/kg = 750mg
750/250 mg = 3mg X 5mL = 15
A child comes to the school nurse complaining of itching. Further assessment
reveals that the child has impetigo. What action should the nurse take? -
CORRECT ANSWERS-Send the child home with the parents to see the health
care provider before returning to school.
,Rationale: Impetigo is a staphylococcal infection and is transmitted by
person-to-person contact. The child should be sent home with a note to the
parents explaining the condition
The nurse observes a 4-year-old boy in a day care setting. Which behavior
should the nurse expect this child to exhibit? - CORRECT ANSWERS-Boasts
aggressively when telling a story
Rationale: Four-year-old children are aggressive in their behavior and enjoy
telling tales
During routine screening at a school clinic, an otoscope examination of a
child's ear reveals a tympanic membrane that is pearly gray, slightly bulging,
and not movable. Based on these findings, what action should the nurse
take? - CORRECT ANSWERS-Ask if the child has had a cold, runny nose, or
any ear pain lately.
Rationale: The tympanic membrane is normally pearly gray, not bulging, and
moves when a client blows against resistance or when a small puff of air is
blown into the ear canal. Because these findings are not completely normal,
further assessment of history and related signs and symptoms are needed to
interpret the findings accurately.
Following the administration of immunizations to a 6-month-old girl, the
nurse provides the family with home care instructions. Which statement by
the mother indicates that further teaching is needed? - CORRECT
ANSWERS-"I will give her a baby aspirin every 4 hours as needed for fever."
Rationale: Although fever may occur, non-aspirin-containing medications
should be used because of the risk of Reye's syndrome
A 7-month-old infant with a rotavirus causing severe diarrhea is admitted for
treatment. Which intervention should the nurse implement first? - CORRECT
ANSWERS-Insert an intravenous (IV) line and begin IV fluids.
Rationale: An infant with severe diarrhea is at high risk for dehydration, so
the nurse's priority is to initiate IV fluids
The nurse is preparing a child with an intussusception for a prescribed
barium enema. What is the main purpose of conducting this procedure prior
to surgical intervention? - CORRECT ANSWERS-Reduce the invaginated bowel
segment.
Rationale: Intussusception, an invagination or telescoping of one portion of
the intestine into another, causes intestinal obstruction in children (usually
occurs between 3 months and 5 years of age). Nonsurgical treatment is
attempted with hydrostatic pressure created by barium instillation, which
often reduces the area of bowel intussusception, thereby negating the need
for surgical intervention.
, In making the initial assessment of a 2-hour-old infant, which finding should
lead the nurse to suspect a congenital heart defect? - CORRECT ANSWERS-
Diminished femoral pulses
Rationale: Diminished femoral pulses (D) could indicate coarctation of the
aorta.
Which assessment finding(s) should the nurse expect when caring for a child
with cystic fibrosis? (Select all that apply.) - CORRECT ANSWERS-Steatorrhea
Foul-smelling stools
Delayed growth
Pulmonary congestion
Which nursing intervention(s) is (are) therapeutic when caring for a
hospitalized toddler? (Select all that apply.) - CORRECT ANSWERS-Allow the
toddler to choose a colored Band-Aid after an injection & Give brief but
simple explanations to the child before procedures.
Rationale: Giving the toddler a choice may increase autonomy in the
hospitalized setting. Brief but simple explanations are beneficial with the
toddler. Separation from the parent can cause emotional distress. Regression
is expected, and bedwetting is not an indication for a urinary catheter. The
nurse should encourage age-appropriate toys to be brought in from home.
A newborn female whose mother is HIV-positive is scheduled for the first
follow-up assessment with the nurse. If the child is HIV-positive, which initial
symptom is she most likely to exhibit? - CORRECT ANSWERS-Persistent cold
Rationale: Respiratory tract infections commonly occur in the pediatric
population, but the child with AIDS has a decreased ability to defend the
body against these common infections. Thus, the most typical presenting
symptom of a child who contracted AIDS through vertical transmission (i.e.,
from the mother during delivery) is a persistent cold or respiratory infection
The nurse is preparing a health teaching program for parents of toddlers and
preschoolers and plans to include information about the prevention of
accidental poisonings. It is most important for the nurse to include which
instruction? - CORRECT ANSWERS-Store all toxic agents and medicines in
locked cabinets.
Rationale: The only reliable way to prevent poisonings in young children is to
make the items inaccessible
A 7-month-old male infant diagnosed with spastic cerebral palsy is seen by
the nurse in the clinic. Which statement by the parent warrants immediate
intervention by the nurse? - CORRECT ANSWERS-"My son often chokes while
I am feeding him."
Rationale: Airway obstruction is always a priority when caring for any client
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