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SAUNDERS HESI PEDS EXAM WITH QUESTIONS AND VERIFIED DETAILED ANSWERS
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SAUNDERS HESI PEDS EXAM WITH QUESTIONS ANDVERIFIED DETAILED ANSWERS 2025-2026
INTEGUMENTARY DISORDERS
The nurse is caring for a child who has burns and is receiving treatment for burn shock.
Which assessment will provide the best guide in determining the adequacy of fluid
resuscitation?
1. Skin turgor
2. Level of edema at burn site
3. Adequacy of capillary filling
4. Amount of fluid tolerated in 24 hours - Answer 3
Parameters such as vital signs, especially heart rate, urinary output volume, adequacy
of capillary filling, and state of sensorium determine adequacy of fluid resuscitation.
Though options 1, 2, and 4 may provide some information related to fluid volume, in a
burn injury and from the provided options, adequacy of capillary filling is most accurate.
An 3-year-old client comes to a clinic and informs a nurse that his child has been
scratching the skin with continuous development of a rash. Based on assessment, the
nurse suspects scabies. The nurse is basing this suspicion on what finding noted on
assessment of the child's skin?
1. Fine grayish red lines
2. Purple-colored lesions
3. Thick, honey-colored crusts
4. Groups of fluid-filled vesicles - Anwer 1
Scabies Scabies is a parasitic skin disorder caused by an infection of Sarcoptes scabiei
,(itch mite). Scabies Burrows or fine grayish red threadlike lines may be seen, although
they may be obscured by excoriation and inflammation. Red-purple lesions
Purple-coloured lesions may indicate a variety of disorders including systemic
conditions. Honey-coloured crusts Thick, honey-coloured crusts are typical of impetigo
or secondary infection in eczema. Herpes virus infection Clusters of fluid-filled vesicles
are characteristic of herpesvirus infection.
Scabies infestation has been diagnosed in a child, and permethrin has been prescribed.
Which of the following instructions would the nurse give to the parents regarding this
medication?
1. Apply lotion only to the areas of the rash
2. Apply lotion and leave on for 6 hours
3. Do not put clothes on the child over the lotion.
4. Apply lotion to cool, dry skin at least 30 minutes after bathing - Answer 4
Permethrin is massaged well and gently into all skin surfaces (not just the areas that
have the rash) from the head to the soles of the feet. Care should be taken to avoid
contact with the eyes. Do not apply the lotion until at least 30 minutes after bathing.
Apply the lotion only to cool, dry skin. Leave the lotion on for 8 to 14 hours with
subsequent bathing. During the 8 to 14 hours of treatment contact time the child should
be clothed.
The school nurse has provided an educational session on impetigo for parents whose
children are in the school. Based on the following parent responses about impetigo,
which statement identifies that this parent requires further teaching?
1. "It is very contagious."
2. "It occurs most frequently in humid weather."
3. "Lesions most frequently occur on the arms and chest.
4. "It can appear in an area of broken skin, such as an insect bite."-Answer 3
Impetigo is a contagious bacterial infection of the skin caused by β-hemolytic
,streptococci or staphylococci, or both. Impetigo is most common during hot, humid
summer months. Impetigo may begin in an area of broken skin, such as an insect bite or
atopic dermatitis. Impetigo is extremely contagious. Lesions usually are located around
the mouth and nose, but may be present on the hands and extremities.
The clinic nurse is reviewing the health care provider's prescription for a child who has
been diagnosed with scabies. Lindane has been prescribed for the child. The nurse
would question the prescription if which is noted in the child's record?
1. The child is 18 months old.
2. The child is being bottle-fed.
3. A sibling is using lindane for the treatment of scabies.
4. The child has a history of frequent respiratory infections - Answer 1
Lindane is a pediculicide product that may be prescribed to treat scabies. It is
contraindicated for children younger than 2 years because they have more permeable
skin and high systemic absorption may occur, placing the children at risk for central
nervous system toxicity and seizures. Lindane also is used judiciously in children
between 2 and 10 years of age. Siblings and other household members should be
treated at the same time. Options 2 and 4 have no relationship to the use of lindane.
Lindane is contraindicated for use by a breast-feeding woman because the medication
is excreted into breast milk.
The healthcare provider prescribes a topical corticosteroid for a child diagnosed with
atopic dermatitis (eczema). Which of the following is a correct statement that the nurse
should include when instructing the parent about the application of the cream?
1. Apply the cream to the child's entire body.
2. Apply a thick layer of cream to affected areas only.
3. Do not clean the area before the application of cream.
Apply as a thin layer, rubbing well into the affected area.
Atopic dermatitis is a superficial inflammatory process involving primarily the
, epidermis. A topical corticosteroid is often prescribed and should be applied sparingly
(thin layer) and rubbed into the area thoroughly. The affected area should be cleaned
gently before application. A topical corticosteroid should not be applied over extensive
areas. Extensive application could lead to systemic absorption.
The school nurse is performing examinations for pediculosis capitis. Which of the
following physical examination findings would confirm that a child has a "positive" head
check?
1. Maculopapular lesions behind the ears
2. Lesions in the scalp that extend to the hairline or neck
3. White flaky particles throughout the entire scalp region
4. White sacs attached to the hair shafts in the occipital area - Answer 4
Pediculosis capitis is an infection of the hair and scalp with lice. The nits are visible and
are attached tightly to the hair shaft near the scalp. The occiput is a place where one
can find the nits. Maculopapular lesions behind the ears or those lesions that extend on
to the hairline or neck point to an infectious etiology, not pediculosis. White flaky
particles suggest dandruff.
The nurse caring for a child who experienced a burn injury bases care on which of the
following pediatric considerations related to this injury? (SELECT ALL THAT APPLY.)
1. Scarring is less severe in a child compared to an adult.
2. A growth delay may occur after a burn injury.
3. An immature immune system makes infants and young children at increased risk for
infection.
4. Fluid resuscitation is not necessary unless the burns exceed 25% of total body
surface area.
5. The smaller the percentage of body fluid to body mass, the more susceptible to
cardiovascular complications the child is.
6. Because infants and young children have less muscle and body fat as compared to
adults, they are more at risk for deficits in protein and calorie intake. -Answers 2, 3, 6
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