Exam (elaborations)
Pediatrics HESI PN Review, HESI PN Obstetrics-Maternity Practice Exam 2024
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Pediatrics HESI PN Review, HESI PN Obstetrics-Maternity Practice Exam
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Pediatrics HESI PN Review, HESI PNObstetrics/Maternity Practice Exam
The practical nurse (PN) is monitoring a child who is manifesting signs of shock after a
motor vehicle collision. Which finding is most important for the PN to report to the
charge nurse?
a) narrowing pulse pressure
b) apprehension
c) irritability
d) thirst - Answer -Answer: A
Rationale:
As shock progresses, perfusion in the microcirculation becomes marginal despite
compensatory adjustments, and the signs of decompensated shock become
pronounced, such as tachycardia and narrowing pulse pressure (A). (The difference
between systolic and diastolic blood pressure), which should be reported immediately.
(B,C, and D) are not as significant as (A).
The mother of a 9 month old male infant is concerned because he cries whenever she
leaves him with a sitter. What is the best response for the practical nurse (PN) to
provide?
a) "Have you noticed whether your baby is teething?"
b) "Crying when you leave him in a healthy sign of attachment."
c) "Consider taking the baby to the doctor because he may be ill."
d) "You could consider leaving the infant more often so he can adjust." - Answer -
Answer: B
Rationale:
Healthy attachment is manifested by stranger anxiety in late infancy (B). Pain from
teething expressed by the infant's cries does not occur only when the mother leaves the
infant with another person (A). The PN should evaluate the infant's developmental
needs (C) before suggesting the infant may be ill. An infant who manifests stranger
anxiety is best supported by the mother if the infant is left for shorter periods of time, not
(D).
,Which preoperative action is most important for the practical nurse (PN) to implement
for a newborn with meningomyelocele?
a) document vital signs
b) prevent skin breakdown
c) minimize the risk for infection
d) monitor neurologic functioning - Answer -Answer: C
Rationale:
A meningomyelocele provides a direct entry for bacteria into the central nervous
system, leading to meningitis. Measures that protect the integrity of the
meningomyelocele sac and infection control measures should be implemented to
minimize the risk of infection (C). (A,B, and D) should be implemented but do not have
the priority of (C).
The practical nurse is caring for a 6 year old girl who had surgery 12 hours ago. The
child tells the PN that she does not have pain but a few minutes later, tells her parents
that she does. What child development concept is relevant to this situation?
a) inconsistency in pain reporting suggests that pain not present
b) a child may have pain yet deny its presence to the nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their parents - Answer -Answer: B
Rationale:
A child may fear receiving an injection for pain or may believe that pain is a deserved
punishment for some misdeed, so the pain is denied (D) when the nurse asks the child,
who then readily admits having pain to a parent. This behavior should not be interpreted
as (C) but as a valid indication of pain. (A and C) are incorrect interpretations of this
behavior.
A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst. What should
the practical nurse (PN) offer?
a) popsicle
b) lemonade
c) orange juice
d) chocolate milk - Answer -Answer: A
Rationale:
Small amounts of clear liquids without red dyes should be offered to the child. Popsicles
(A) are cold and help soothe a dry throat. Citrus drinks (B and C) are acidic and irritate
the operative site in the posterior oropharynx. Milk (D) thickens oral mucus which makes
swallowing more difficult and causes coughing.
,The mother of a male newborn calls the clinic to inquire about the formation of a yellow
crust over her son's circumcision area. What information should the practical nurse (PN)
provide?
a) do not remove the yellow crust from the site
b) stop using petroleum around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper - Answer -Answer: A
Rationale:
Crust formation is part of the healing process and should be removed (A). (C) is not
indicated at this time. The diaper should be fastened loosely, not tightly (D) which can
place pressure on the incision site. (B) assists in the healing process and should not be
discontinued.
The mother of a child with croup is having barking, coughing episodes calls the clinic for
assistance. What action should the practical nurse (PN) recommend that the mother
implement first?
a) take the child outside in the cool air
b) bring the child directly to the emergency room
c) sit with the child in bathroom with a hot shower running
d) have the child drink plenty of fluids - Answer -Answer: C
Rationale:
Croup (laryngotracheobronchitis) is a viral infection that causes a "barking" cough and
varying degrees of inspiratory stridor, which often responds to a high humidity
environment. Most children can be managed at home using the stream from a hot
shower in a closed bathroom (C) which often stops laryngeal spasm. Increasing the
child's fluid intake is important (D), but not a priority at this time.Although exposure to
cold air (A) also relieves stridor, parents should be encouraged to use mist humidifier in
the child's room. (B) is not necessary unless the child is having increasingly difficulty
breathing that may lead to a compromised airway.
Which finding should the practical nurse confirm with the parents of an infant who is
admitted with possible intussusception?
a) red currant jelly stools
b) clay colored stools
c) constant abdominal pain
d) projectile vomiting after meals - Answer -Answer: A
Rationale:
Red currant jelly stools (A) is a sign of intussusception, which causes a mixture of stool,
mucous, and blood as the intestines telescopes inside itself. (D) is associated with
pyloric stenosis. (B) is consistent with biliary obstruction. Infants with intussusception
, usually have periods of severe pain followed by intervals in which they appear
comfortable, not (C).
The practical nurse (PN) is observing a group of children at a day care center to
determine whether children are achieving developmental milestones. Which activity
should the PN identify as typical for a 2 year old child's cognitive development?
a) has a vocabulary of about 1000 words
b) uses short sentences to express self
c) initiates play with other children
d) recognizes right and wrong - Answer -Answer: B
Rationale:
Although children develop at different rates, a 2 year old typically uses short sentences
to express independence and control (B) and has a vocabulary of up to 300 words, not
(A). At the age of 2 years, a toddler is developing negativism without understanding the
concepts of right and wrong (D). A 2 year old engages in solitary play and parallel play
but does not initiate or cooperative with other children (C) in play, which begins with
socialization of the preschool child.
The practical nurse (PN) is interviewing a 10 year old girl about school and her
extracurricular activities. She responds, "I like school. I play the flute in the school band,
and I take tennis lessons." Based on Erikson's psychosocial theory, the PN identifies
that this child is in what stage of development?
a) identity
b) intimacy
c) industry
d) initiative - Answer -Answer: C
Rationale:
Erikson's stage of industry (C) for a school aged child is demonstrated by successful
participation in new skills and peer activities, such as sports and band. (A, B, and D) are
achieved in other age groups.
The practical nurse (PN) identifies an increased frequency of otitis media (OM) is
children who are coming to the clinic. Based on this finding, which age group should the
PN monitor a child for signs and symptoms of OM?
a) toddler
b) preschooler
c) school ager
d) adolescent - Answer -Answer: A
Rationale:
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