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OB/PEDS HESI PRACTICE QUESTIONS WITH CORRECT ANSWERS
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OB/PEDS HESI PRACTICE QUESTIONS WITH CORRECT ANSWERS
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OB/PEDS HESI PRACTICE QUESTIONSWITH CORRECT ANSWERS
The6RN6is6monitoring6an6infant6with6CHD6closely6for6SSx6of6HF.6The6RN6should6assess6t
he6infant6for6which6early6sign6of6HF?
1.Pallor6
2.Cough6
3.Tachycardia6
4.Slow6and6shallow6breathing6-6ans--3.6tachycardia
RATIONALE:
HF6is6the6inability6of6the6heart6to6pump6a6sufficient6amt6of6blood6to6meet6the6O26and6met
abolic6needs6of6the6body.6The6early6SSx6of6HF6include6tachycardia,6tachypnea,6profuse6
scalp6sweating,6fatigue6&6irritability,6sudden6weight6gain,6and6resp6distress.6A6cough6ma
y6occur6in6HF6as6a6result6of6mucosal6swelling6&6irritation,6but6is6not6an6early6sign.6Pallor6
may6be6noted6in6an6infant6w/6HF,6but6is6not6an6early6sign.
The6nurse6reviews6the6laboratory6results6for6a6child6with6a6suspected6diagnosis6of6rheum
atic6fever,6knowing6that6which6laboratory6study6would6assist6in6confirming6the6diagnosis?
1.Immunoglobulin6
2.Red6blood6cell6count6
3.White6blood6cell6count6
4.Anti-streptolysin6O6titer6-6ans--4.6anti-streptolysin6O6titer
RATIONALE:
Rheumatic6fever6is6an6inflammatory6autoimmune6disease6that6affects6the6CT6of6the6heart
,6joints,6skin6(SQ6tissues),6BV,6and6CNS.6A6Dx6of6rheumatic6fever6is6confirmed6by6the6pre
sence6of626major6manifestations6or616major6and626minor6manifestations6from6the6Jones6c
riteria.6In6addition,6evidence6of6a6recent6strep6infection6is6confirmed6by6a6+6anti-
streptolysin6O6titer,6streptozyme6assay,6or6anti-DNase6B6assay.
On6assessment6of6a6child6admitted6with6a6diagnosis6of6acute-
stage6Kawasaki6disease,6the6nurse6expects6to6note6which6clinical6manifestation6of6the6ac
ute6stage6of6the6disease?
1.Cracked6lips6
,2.Normal6appearance6
3.Conjunctival6hyperemia6
4.Desquamation6of6the6skin6-6ans--3.6conjunctival6hyperemia
RATIONALE:
Kawasaki6disease,6aka6mucocutaneous6lymph6node6syndrome,6is6an6acute6systemic6infl
ammatory6illness.6In6the6acute6stage,6the6child6has6a6fever,6conjunctival6hyperemia,6red6t
hroat,6swollen6hands,6rash,6and6enlargement6of6the6cervical6lymph6nodes.6In6the6subacu
te6stage,6cracking6lips6and6fissures,6desquamation6of6the6skin6on6the6tips6of6the6fingers6a
nd6toes,6joint6pain,6cardiac6manifestations,6and6thromobocytosis6occur.6In6the6convalesc
ent6stage,6the6child6appears6normal,6but6SSx6of6inflammation6may6be6present
The6mother6of6a6child6being6discharged6after6heart6surgery6asks6the6nurse6when6the6chil
d6will6be6able6to6return6to6school.6Which6is6the6most6appropriate6response6to6the6mother?
1."The6child6may6return6to6school6in616week."6
2."The6child6will6not6be6able6to6return6to6school6during6this6academic6year."6
3."The6child6may6return6to6school6in616week6but6needs6to6go6half-
days6for6the6first626weeks."6
4."The6child6may6return6to6school6in636weeks6but6needs6to6go6half-
days6for6the6first6few6days."6-6ans--
4.6"The6child6may6return6to6school6in636weeks6but6needs6to6go6half-
days6for6the61st6few6days"
RATIONALE:
After6heart6surgery,6the6child6may6be6able6to6return6to6school6in636weeks6but6needs6to6go
6half-
days6for6the61st6few6days.6The6mother6also6should6be6told6that6the6child6cannot6participat
e6in6PE6for626months.
Prostaglandin6E16is6prescribed6for6a6child6with6transposition6of6the6great6arteries.6The6m
other6of6the6child6is6a6registered6nurse6and6asks6the6nurse6why6the6child6needs6the6medi
cation.6What6is6the6most6appropriate6response6to6the6mother6about6the6action6of6the6med
ication?
1.Prevents6blue6(tet)6spells6
2.Maintains6adequate6cardiac6output6
3.Maintains6an6adequate6hormonal6level6
4.Maintains6the6position6of6the6great6arteries6-6ans--2.6maintains6adequate6CO
RATIONALE:
A6child6with6transposition6of6the6great6arteries6may6receive6prostaglandin6E16temporarily6
to6increased6blood6mixing6if6systemic6and6pulmonary6mixing6is6inadequate6to6maintain6a
dequate6CO.
, The6nurse6is6assessing6a6newborn6with6heart6failure6before6administering6the6prescribed
6digoxin.6In6reviewing6the6laboratory6data,6the6nurse6notes6that6the6newborn6has6a6digoxi
n6blood6level6of61.66ng/mL6(2.056mmol/L)6and6an6apical6heart6rate6of6906beats/
min.6The6mother6also6tells6the6nurse6that6the6newborn6just6vomited6her6formula.6Which6in
tervention6should6the6nurse6take?
1.Retake6the6apical6pulse.6
2.Administer6the6medication.6
3.Withhold6the6medication6for616hour.6
4.Withhold6the6medication6and6notify6the6health6care6provider.6-6ans--
4.6withhold6the6med6and6notify6HCP
RATIONALE:
The6apical6pulse6rate6for6a6newborn6is6120-1606bpm.6The6therapeutic6dig6level6is60.5-
0.8.6Bc6the6apical6rate6is6low6and6the6dig6blood6level6is6elevated,6indicating6toxicity,6the6R
N6would6withhold6the6med6and6notify6the6HCP
The6nurse6is6preparing6to6administer6digoxin6to6an6infant6with6heart6failure.6Before6admin
istering6the6medication,6the6nurse6double-
checks6the6dose,6counts6the6apical6heart6rate6for616full6minute,6and6obtains6a6rate6of6806b
eats/minute.6Based6on6this6finding,6which6is6the6appropriate6nursing6action?
1.Withhold6the6medication.6
2.Administer6the6medication.6
3.Check6the6blood6pressure6and6then6administer6the6medication.6
4.Check6the6respiratory6rate6and6then6administer6the6medication.6-6ans--
1.6withhold6the6med
RATIONALE:
Dig6is6a6cardiac6glycoside6that6is6used6to6treat6HF.6A6primary6concern6is6dig6toxicity,6and6
the6RN6needs6to6monitor6closely6for6SSx6of6toxicity6and6monitor6dig6blood6levels.6The6me
d6is6effective6within6a6narrow6therapeutic6dig6range6(0.5-
0.8).6Safety6in6administration6is6achieved6by6double6checking6the6dose6and6counting6the6
apical6HR6for616full6minute.6The6apical6HR6for6an6infant6is690-
1306bpm.6If6the6HR6is6less6than6906bpm6in6an6infant,6the6RN6would6withhold6the6dose6an
d6contact6the6HCP.
The6nurse6is6creating6a6plan6of6care6for6a6child6admitted6with6a6diagnosis6of6Kawasaki6di
sease.6In6developing6the6initial6plan6of6care,6the6nurse6should6include6monitoring6the6chil
d6for6signs6of6which6condition?
1.
Bleeding
2.
Heart6failure
3.
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