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SAUNDERS HESI PEDS |Questions with 100% Correct Answers
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SAUNDERS HESI PEDS |Questions with 100%Correct Answers
Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific
coagulation proteins. The primary treatment is replacement of the missing clotting factor;
additional medications, such as agents to relieve pain, may be prescribed depending on the
source of bleeding from the disorder. A child with hemophilia A is at risk for joint bleeding after
a fall. Factor VIII would be prescribed intravenously to replace the missing clotting factor and
minimize the bleeding. Factor X and iron are not used to treat children with hemophilia A.
The nurse is instructing the parents of a child with iron deficiency anemia regarding the
administration of a liquid oral iron supplement. Which instruction should the nurse tell the
parents?
1. Administer the iron at mealtimes.
2. Administer the iron through a straw.
3. Mix the iron with cereal to administer.
4. Add the iron to formula for easy administration. - ✔️✔️2
In iron deficiency anemia, iron stores are depleted, resulting in a decreased supply of iron for
the manufacture of hemoglobin in red blood cells. An oral iron supplement should be
administered through a straw or medicine dropper placed at the back of the mouth because
the iron stains the teeth. The parents should be instructed to brush or wipe the child's teeth or
have the child brush the teeth after administration. Iron is administered between meals
because absorption is decreased if there is food in the stomach. Iron requires an acid
environment to facilitate its absorption in the duodenum. Iron is not added to formula or mixed
with cereal or other food items.
Laboratory studies are performed for a child suspected to have iron deficiency anemia. The
nurse reviews the laboratory results, knowing that which result indicates this type of anemia?
1. Elevated hemoglobin level
,2. Decreased reticulocyte count
3. Elevated red blood cell count
4. Red blood cells that are microcytic and hypochromic - ✔️✔️4
In iron deficiency anemia, iron stores are depleted, resulting in a decreased supply of iron for
the manufacture of hemoglobin in red blood cells. The results of a complete blood cell count in
children with iron deficiency anemia show decreased hemoglobin levels and microcytic and
hypochromic red blood cells. The red blood cell count is decreased. The reticulocyte count is
usually normal or slightly elevated.
The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia
who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which
prescriptions documented in the child's record should the nurse question? (SELECT ALL THAT
APPLY.)
1. Restrict fluid intake.
2. Position for comfort.
3. Avoid strain on painful joints.
4. Apply nasal oxygen at 2 L/minute.
5. Provide a high-calorie, high-protein diet.
6. Give meperidine, 25 mg intravenously, every 4 hours for pain. - ✔️✔️1, 6
Sickle cell anemia is one of a group of diseases termed hemoglobinopathies, in which
hemoglobin A is partly or completely replaced by abnormal sickle hemoglobin S. It is caused by
the inheritance of a gene for a structurally abnormal portion of the hemoglobin chain.
Hemoglobin S is sensitive to changes in the oxygen content of the red blood cell; insufficient
oxygen causes the cells to assume a sickle shape, and the cells become rigid and clumped
together, obstructing capillary blood flow. Oral and intravenous fluids are an important part of
treatment. Meperidine is not recommended for a child with sickle cell disease because of the
risk for normeperidine-induced seizures. Normeperidine, a metabolite of meperidine, is a
central nervous system stimulant that produces anxiety, tremors, myoclonus, and generalized
seizures when it accumulates with repetitive dosing. The nurse would question the prescription
for restricted fluids and meperidine for pain control. Positioning for comfort, avoiding strain on
,painful joints, oxygen, and a high-calorie and high-protein diet are also important parts of the
treatment plan.
The nurse is conducting staff in-service training on von Willebrand's disease. Which should the
nurse include as characteristics of von Willebrand's disease? (SELECT ALL THAT APPLY.)
1. Easy bruising occurs.
2. Gum bleeding occurs.
3. It is a hereditary bleeding disorder.
4. Treatment and care are similar to that for hemophilia.
5. It is characterized by extremely high creatinine levels.
6. The disorder causes platelets to adhere to damaged endothelium. - ✔️✔️1, 2, 3, 4, 6
von Willebrand's disease is a hereditary bleeding disorder characterized by a deficiency of or a
defect in a protein termed von Willebrand factor. The disorder causes platelets to adhere to
damaged endothelium. It is characterized by an increased tendency to bleed from mucous
membranes. Assessment findings include epistaxis, gum bleeding, easy bruising, and excessive
menstrual bleeding. An elevated creatinine level is not associated with this disorder.
ONCOLOGICAL DISORDERS - ✔️✔️ONCOLOGICAL DISORDERS
The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The
nurse checks the head dressing for the presence of blood and notes a colorless drainage on the
back of the dressing. Which intervention should the nurse perform immediately?
1. Reinforce the dressing.
2. Notify the health care provider (HCP).
3. Document the findings and continue to monitor.
4. Circle the area of drainage and continue to monitor - ✔️✔️2
, Colorless drainage on the dressing in a child after craniotomy indicates the presence of
cerebrospinal fluid and should be reported to the HCP immediately. Options 1, 3, and 4 are not
the immediate nursing intervention because they do not address the need for immediate
intervention to prevent complications.
A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse
notes that the child is restless, the pulse rate is elevated, and the blood pressure has decreased
significantly from the baseline value. The nurse suspects that the child is in shock. Which is the
most appropriate nursing action?
1. Place the child in a supine position.
2. Notify the health care provider (HCP).
3. Place the child in Trendelenburg position.
4. Increase the flow rate of the intravenous fluids. - ✔️✔️2
: In the event of shock, the HCP is notified immediately before the nurse changes the child's
position or increases intravenous fluids. After craniotomy, a child is never placed in the supine
or Trendelenburg position because it increases intracranial pressure (ICP) and the risk of
bleeding. The head of the bed should be elevated. Increasing intravenous fluids can cause an
increase in ICP.
The mother of a 4-year-old child tells the pediatric nurse that the child's abdomen seems to be
swollen. During further assessment, the mother tells the nurse that the child is eating well and
that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilms'
tumor, should avoid which during the physical assessment?
1. Palpating the abdomen for a mass
2. Assessing the urine for the presence of hematuria
3. Monitoring the temperature for the presence of fever
4. Monitoring the blood pressure for the presence of hypertension - ✔️✔️1
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