HESI Review: Pediatrics Questions And Correct Detailed Answers (Verified Answers) Already Graded A+

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HESI Review: Pediatrics Questions And Correct

Detailed Answers (Verified Answers) Already Graded A+

• The nurse is assessing the neurovascular status of a child in Russell's traction.

Which finding should the nurse report to the healthcare provider?

• Pale bluish coloration of the toes. B. Skin is warm and dry to the touch. C. Toes are

wiggled upon command. D. Capillary refill less than 3 seconds.Correct Answer: A. Pale bluish coloration of the toes Rationale: Russell's skin traction is used for fractures of the femur in young children and adolescents. It is applied to the lower leg using moleskin and elastic wrap bandages, which can compress the peroneal nerve and arteries that supply the foot. Assessment of adequate circulation, movement, and sensation of the toes and skin distal to the application is made to identify compromised blood flow, so cyanosis (A) should be reported immediately. (B, C and D) are normal findings.

• A hospitalized 16-year-old male refuses all visits from his classmates because he is

concerned about his distorted appearance. To increase the client's social interaction, what intervention is best for the nurse to initiate?

• Encourage the client to use a hand-held video game that is popular with all his friends. B.

Assign a 25-year-old female nursing student to offer support to the client. C. Arrange for an Internet connection in the client's room for email communication. D. Encourage the client's mother to arrange a surprise get together in the cafeteria.Correct Answer: C. Arrange for an Internet connection in the client's room for email communication. Rationale: Body image and peer acceptance are key concerns for the adolescent. (C) allows for social interaction without face to face contact, thus protecting his self-image while also promoting social interaction. (A) does not promote social interaction. (B) does not encourage interaction with his own peer group, which is of greater importance. (D) does not respect the client's concern about his body image.

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• During administration of a blood transfusion, a child complains of chills, headache,

and nausea. Which action should the nurse implement?

• Start another IV of dextrose solution and stay with the child. B. Continue the transfusion

and monitor the child's vital signs. C. Stop the infusion immediately and notify the healthcare provider. D. Slow the transfusion and assess for cessation of symptoms.Correct Answer: C. Stop the infusion immediately and notify the healthcare provider.Rationale: The child is exhibiting signs of a reaction to the blood transfusion. The blood transfusion should be stopped immediately and the healthcare provider notified. After the transfusion is discontinued, IV access should be maintained. (A) is incorrect because fluids should not introduce any more cellular products. (B & D) place the child at risk for further blood reactions.

• A 16-year-old is brought to the Emergency Center with a crushed leg after falling off

a horse. The adolescent's last tetanus toxoid booster was received eight years ago.What action should the nurse take?

• Dispense a tetanus antitoxin. B. Prepare human tetanus immune globulin. C. Administer

tetanus toxoid booster. D. Delay the tetanus toxoid booster until due.Correct Answer: C. Administer the tetanus toxoid booster. Rationale: After the completion of the initial tetanus immunization schedule, the recommended booster for an adolescent or adult is every ten years or less if a traumatic injury occurs that is contaminated by dirt, feces, soil, or saliva, such as puncture or crushing injuries. The adolescent's injury is considered a contaminated wound requiring prophylactic therapy, so the tetanus toxoid booster should be administered.

• The nurse is preparing a health teaching program for parents of toddlers and

preschoolers and plans to include information about prevention of accidental poisonings. It is most important for the nurse to include which instruction?

• Tell children they should not taste anything but food. B. Store all toxic agents and

medicines in locked cabinets. C. Provide special play areas in the house and restrict play in other areas. D. Punish children if they open cabinets that contain household chemicals.Correct Answer: B. Store all toxic agents and medicines in locked cabinets. Rationale: The only reliable way to prevent poisonings in young children is to make them inaccessible (B).

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Teaching children not to taste is important (A), but ineffective for young children. (C and D) will not control a child's curiosity.

• Which growth and development characteristic should the nurse consider when

monitoring the effects of a topical medication for an infant?

• A lower sensitivity reactions to skin irritants. B. A thin stratum corneum that increases

topical absorption. C. A smaller percentage of muscle mass. D. A greater body surface area that requires larger dosages.Correct Answer: B. A thin stratum corneum that increases topical absorption. Rationale: Infants have a thin outer skin layer (stratum corneum), so the nurse should monitor the infant for a prompt onset and response to the application of topical medication. (A, C, and

• are unrelated to topical medication administration.

• Which restraint should be used for a toddler after a cleft palate repair?
• Clove hitch. B. Mummy. C. Elbow. D. Jacket.

Correct Answer: C. Elbow. Rationale: Elbow restraints prevent children from bending their arms and bringing their hands to the oral surgical site. (A) restrains the hands but the child can bend and bring their head to their hands. (B) is used during procedures. (D) restrains the body torso and is not appropriate.

• The nurse receives a lab report stating a child with asthma has a theophylline level

of 15 mcg/dl. What action will the nurse take?

• Pass the information on in the report. B. Notify the healthcare provider because the

value is high. C. Repeat the lab study because the value is too high. D. Hold the next dose of theophylline.Correct Answer: A. Pass the information on in the report. Rationale: The therapeutic level of theophylline is 10 to 20 mcg/dl, so the child's level is within the therapeutic range. This information evaluates the prescribed therapy and should be communicated in the nurse's report.

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• The nurse assigning care for a 5-year-old child with otitis media is concerned about

the child's increasing temperature over the past 24 hours. Which statement is accurate and should be considered when planning care for the remainder of the shift?

• An RN should be assigned to take temperatures frequently. B. Tympanic and oral

temperatures are equally accurate. C. The PN should take rectal temperatures on this child. D. The pediatrician should decide how to assess the temperature.Correct Answer: B. Tympanic and oral temperatures are equally accurate. Rationale: A tympanic membrane sensor approximates core temperatures because the hypothalamus and eardrum are perfused by the same circulation. Tympanic readings obtained using proper technique correlated moderately to strongly with oral temperatures in recent research studies.

• When planning the care for a child who has had a cleft lip repair, the nurse knows

that crying should be minimized because it:

• Increases salivation. B. Increases the respiratory rate. C. Leads to vomiting. D. Stresses

the suture line.Correct Answer: D. Stresses the suture line. Rationale: Prevention of stress on the lip suture line is essential for optimum healing and the cosmetic appearance of a cleft lip repair. Although crying also causes (A, B, and C), these conditions do not create a problem for the child with a cleft lip repair.

• Which class of antiinfective drugs is contraindicated for use in children under 8

years of age?

• Aminoglycosides. B. Tetracyclines. C. Penicillins. D. Quinolones.

Correct Answer: B. Tetracyclines Rationale: Tetracyclines cause enamel hypoplasia and tooth discoloration in children under 8 years of age.

• The nurse is assessing an 8-month-old child who has a medical diagnosis of

Tetrology of Fallot. Which symptom is this client most likely to exhibit?

• Bradycardia. B. Machinery murmur. C. Weak pedal pulses. D. Clubbed fingers.