PEDIATRICS HESI PRACTICE EXAM
QUESTIONS WITH COMPLETE
ANSWERS
A seven-month old infant is admitted with nonorganic failure to thrive (NFTT). To aid the
child's growth and development, which intervention is most important for the nurse to
implement?
Encourage the parents to participate in a planned program of play with the infant.
Refer the parents for psychological counseling to identify parental detachment.
Demonstrate feeding strategies and infant cues that indicate hunger and satiation.
Provide instructions about formula preparation and feeding schedules. - Answer
Demonstrate feeding strategies and infant cues that indicate hunger and satiation.
NFTT most often occurs due to inadequate parental knowledge or a disturbance in
parental-child attachment, but the first goal for infants with NFTT is to provide nutrition
to promote "catch-up" growth. The nurse should demonstrate positive feeding strategies
that reduce parent and infant frustration, such as recognizing the infant's cues indicated
by vigorous sucking and satiation.
The nurse is triaging a child with a fever brought to the emergency department by the
parents. Which finding requires the nurse's immediate intervention?
Prolonged exhalations.
Thick yellow rhinorrhea.
Frequent nonproductive cough.
Oxygen saturation is 95% by pulse oximeter. - Answer Prolonged exhalations.
Prolonged exhalation indicates breathing difficulty and requires immediate intervention.
According to the American Heart Association's Pediatric Advance Life Support (PALS)
algorithm, a prolonged expiration in a pediatric client is indicative of lower airway
obstruction.
,The nurse is assessing the coping behaviors of the parents whose child has been
recently diagnosed with a chronic illness. What reaction by the parents is a positive step
in the ability to cope with this new situation?
Endowing the illness with meaning.
Refusing to believe the child is ill.
Entertaining an unrealistic future plan for the child.
Placing complete faith in religion to the point of relinquishing own responsibility. -
Answer Endowing the illness with meaning.
Coping mechanisms are behaviors directed at reducing the tension elicited by a crisis.
Approach behaviors are coping mechanisms resulting in movement toward adjustment
and resolution of the crisis. The parents' ability to assign the illness meaning within an
existing medical, scientific, or spiritual philosophy of life is a long-term coping strategy
significantly related to successful family functioning.
A 15-year-old girl tells the school nurse that she wants to have a baby. How should the
nurse respond?
"Will you be able to support the baby?"
"Do you have plans to continue school?"
"Have you talked with your parents about this?"
"Can you tell me how your life will be if you have an infant?" - Answer "Can you tell me
how your life will be if you have an infant?"
Developing a dialogue with the teen is important. By using an open-ended question the
nurse will encourage communication and explanation. This question directs the teen to
consider real life experiences and allows the nurse to assess the teen's perception and
reality orientation.
The nurse is caring for a premature infant who needs an IV access restarted. What
action should the nurse take when using adhesive tape?
Use solvents such as water, mineral oil, or petrolatum to remove adhesives instead of
pulling on skin.
Avoid using tape and adhesives until skin is more mature.
Use scissors carefully to remove tape instead of pulling tape off.
,Use alcohol to remove the adhesives. - Answer Remove adhesives with water, mineral
oil, or petrolatum.
The use of adhesives should be minimized as much as possible in the treatment of
preterm neonates. They should be removed using water, mineral oil, or petrolatum. The
skin of the premature infant is fragile, delicate, and thinner compared to a full-term
infant, and is easily traumatized. Alcohol should not be used to remove adhesives.
The nurse calculates a 4 ml dose of prescribed digoxin a 9-month-old infant. What
action should the nurse implement?
Mix dose with juice to disguise its taste.
Suspect dosage error and do not give dose.
Check heart rate and administer dose by placing it to the back and side of mouth.
Check heart rate and administer dose by letting the infant suck it through a nipple. -
Answer Suspect dosage error and do not give dose.
Digoxin's narrow margin of safety for an infant should not exceed 1 mL (50 mcg) in one
dose. The nurse's calculation indicates a dosage error and should not be given. Digoxin
is given without mixing with any other fluids or foods because the infant may refuse to
consume the total amount, which results in an inaccurate drug dose. Generally,
pediatric digoxin elixir is available as 0.05 mg/mL. Great care must be taken in dosage
calculation and should be double-checked with another nurse prior to administration.
The parents of a toddler brought to the clinic for a well-child visit tell the nurse that their
child becomes upset if even the smallest things change in the environment. What
information should the nurse provide the parents?
A child is insecure because trust is not fostered and developed during infancy.
A toddler should be exposed to different routines to promote adapting to new
experiences.
Children of this age are comfortable with ritualism and display global thinking.
Objects should be frequently moved in the environment to teach the child to acclimate
to change. - Answer Children of this age are comfortable with ritualism and display
global thinking.
A 2-year-old is ritualistic and wants consistency and routine. Changes in the toddler's
environment or schedule is upsetting. Another mark of the toddlers' sensitivity to change
is global thinking. When there is a change in one small part of the environment, such as
, a minor shift in room arrangement, or changes in the whole environment, the 2-year-
old's composure disintegrates.
How should the nurse measure the length of a 14-month-old child ?
Children younger than 24 to 36 months of age should be measured for length in the
supine position from crown to heel, known as recumbent length.
A 5-year-old child who is one day postoperative has bilateral eye patches in place and
should be out of bed. What nursing intervention should be implemented first before
leaving the bedside?
Speak to the child when entering the room.
Allow the child to assist in feeding himself.
Orient the child to the immediate surroundings.
Allow the parents to stay in the room with the child. - Answer Orient the child to the
immediate surroundings.
When sighted children temporarily lose their vision, many aspects of the environment
becomes bewildering and frightening. To minimize the effects of temporary loss of
vision, the child should be oriented immediately to the surroundings and should be told
about the nurse's actions and any experiences that are felt or heard during procedures.
The child and family should be reassured throughout every phase of treatment and
encouraged to be independent (with assistance) in self-care activities such as eating
and bathing.
The nurse observes the interactions of a 2-year-old child who says, "No," even when
"Yes" is what the child really wants to say. The parent says to the nurse, "We, as
parents, are such positive people, why is our child so negative?" How should the nurse
respond?
A 2-year-old often acts in the opposite way to get attention.
This age child is testing the limits of the parent's patience.
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