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Voorbeeld 2 van de 6 pagina's
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Voorbeeld van de inhoud
Hesi-PEDS-a sore throat last week - ANSThe nurse is assessing a 9-year-old boy who has been admitted
to the hospital with possible acute post-streptococcal glomerulonephritis (APSGN). In obtaining
his history, what information is most significant?
-palpate the anterior fontanel for tension and bulging - ANSThe nurse is measuring the frontal
occipital circumference (FOC) of a 3-months old infant, and notes that the FOC has increased 5
inches since birth and the child's head appears large in relation to body size. Which action is
most important for the nurse to take next?
9% - ANSa female infant recently admitted with vomiting and diarrhea now weighs 10kg. Her
weight at a previous well-baby visit was 11kg. What is the percentage of body weight loss for
this infant?
-tell him to eat a sandwich and fruit before beginning the game - ANSA male high school
student with Type 1 diabetes tests his blood glucose level before playing a game of soccer, and
he obtains a reading of 180. Based on this reading, which action should the nurse take?
-sore throat - ANSA 7-year-old child is admitted to the hospital with a diagnosis of acute
rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of
which illness is most significant?
-ask if the right tests has been seen in the scrotum before. - ANSA mother brings her 2 month
old son to the clinic for a well baby exam. During the assessment the nurse finds that the right
testicle is not descended into the scrotum but the left is palpable. Which action should the nurse
take?
-demonstrate startle reflex - ANSThe nurse is assessing a 6-month old infant. Which response
requires further evaluation by the nurse?
-"talks" to an imaginary friend - ANSA 4 year old girl returns to the pediatricians office for a post
op visit following hospitalization for minor surgery. When observing the child in the waiting area,
which behavior should the nurse consider normal for this age child?
-obtain bedside trays for intubation or tracheostomy by the healthcare provider. - ANSA
preschool aged child is experiencing respiratory distress is brought ti the er by the parents. The
child is anxious, has a temp of 102.8 and is drooling from the mouth while leaning forward while
sitting. Which action should the nurse prepare for the child next?
-echocardiogram - ANSThe nurse is caring for a preschool aged child with a congenital heart
defect who is admitted with intermittent low grade fever, fatigue, and weight loss. Further
, physical assessment findings include a new murmur, splinter hemorrhages under the nails, and
painless red lesions on the palms of the hands. Which diagnostic procedure should the nurse
prepare the parents to expect the healthcare provider to prescribe?
-recommend increasing daily fruits and vegetables and daily exercise - ANSA six year old male
with the BMI in the 90th percentile for gender and age arrives at the clinic after a referral from
the school nurse. His lab findings include hemoglobin A1c of 5.5%, blood pressure in the 50th
percentile for age, height in the 75th percentile, and LDL cholesterol of 90 mg/dL, which lifestyle
modification should the nurse discuss with the parents?
-Decreased cardiac murmur - ANSWhen administering indomethacin (Indocin) to a premature
infant who has patent ductus arteriosus, the nurse should anticipate which outcome?
-Using a large piece puzzle - ANSA two-year-old boy who had hypospadias repair yesterday
goes to the hospital play room with his mother. Which activities should the nurse recommend?
-Play pillows inside the side rails
-Ask the mother to release the child
-Monitor the child's airway and tongue - ANSEmail child is being prepared for a CT scan when
he begins to have a tonic clonic seizure. His mother is hysterical. I'm trying to hold a child down.
What actions should the nurse take?
-Play the child in a quiet environment - ANSA child diagnosed with Kawasaki disease is brought
to the clinic. The mother reports her child is irritable, refuses to eat, it has skin peeling on both
hands and feet. Which intervention should the nurse instruct the mother to implement first?
-Wheat bread - ANSThe nurse is caring for a school-age child who has lab results that reveal
the presence of anti-Gliadin and anti-endomysial immunoglobulin G and immunoglobulin A
antibodies. The nurse should identify with the parent and child which food to avoid after
discharge home?
-administer the injection into the middle of the lateral aspect of the thigh - ANSThe nurse is
giving an im injection of antibiotic to a 16 month old toddler with pneumonia. Toddler does not
have any known allergies and has been walking without assistance for one month. Which
technique should the nurse select for administration?
-Inspect the child oropharynx - ANSWell, administering the final dose of oral amoxicillin to a
preschool age. Boy, he tells the nurse said his throat hurts. Which intervention is most important
for the nurse to implement?
-Reassure the mother that beginning to replace prepared foods, wood table food can provide
the needed nutrients - ANSThe mother of a 14 month old child tells the nurse that she feeds her
child nothing but prepared food and feels they provide the best nutrition for her child, but is
concerned about the cost. How should the nurse respond?
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