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Pediatric HESI Questions And Correct Detailed Answers (Verified Answers) Already Graded A+
- A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F.
What caloric amount does this child need?
Correct Answer: 600 calories/day
Rationale: An infant requires 108 calories/kg/day. The first step is to change 10 lb 15 oz to 10.9 lb. Then convert pounds to kilograms by dividing pounds by 2.2, which is 10.9/2.2 = 4.954 kg, rounded to 5 kg. The second step is to multiply 108 calories/kg/day (108 × 5 = 540 calories/day). However, this infant requires 10% more calories because of the 1° F temperature elevation. Ten percent of 540 (calories/day) is 54 and 540 + 54 = 594. This infant will require approximately 600 calories/day.
- A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a
routine evaluation. Which assessment finding suggests the presence of a common complication often experienced by those with Down syndrome?
Correct Answer: Presence of a systolic murmur
Rationale: Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down syndrome). Defects of the atrial or ventricular septum that create systolic murmurs are the most common heart defects associated with this congenital anomaly.
- Following the reduction of an incarcerated inguinal hernia, a 4-month-old boy is
scheduled for surgical repair of the inguinal hernia. Under which circumstance should the parents notify the health care provider prior to surgery?
Correct Answer: Presence of an inguinal bulge after gentle palpation
Rationale: The parents should notify the health care provider if the hernia remains irreducible after implementing simple measures, such as gentle palpation, warm bath, and comforting to reduce crying. If a loop of intestines is forced into the inguinal ring or scrotum and incarcerates, swelling can follow and possible strangulation of the bowel, intestinal obstruction, or gangrene of the bowel loop can occur, necessitating emergency surgical release.
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- A 3-month-old infant returns from surgery with elbow restraints and a Logan's bow
over a cleft lip suture line. Which intervention should the nurse implement to maintain suture line integrity during the initial postoperative period?
Correct Answer: Place the infant upright in an infant seat position.
Rationale: The use of an infant seat simulates a supine position with the head elevated and also prevents aspiration. Prone positioning should be avoided to prevent disruption of the protective Logan's bow and prevent the infant from rubbing the face on the bed surface.Mittens are not necessary and decrease the ability to provide sensory comfort, such as hand holding. Nasal suctioning should be avoided to prevent trauma or dislodging clots at the surgical site. Water-soluble lubricant will dry the suture line and cause crusting, which predisposes the suture line to poor healing and scarring.
- A nurse is preparing to end the shift and receives a lab report stating that a child
with asthma has a theophylline level of 15 mcg/dL. Which action should the nurse take?
Correct Answer: Communicate the result to the oncoming nurse and document.
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.
- At which point during the physical examination should a child with asthma be
assessed for the presence or absence of intercostal retractions?
Correct Answer: Inspiration
Rationale: Intercostal retractions result from respiratory effort to draw air into restricted airways. The retractions will not be noticeable when air is expelled from the lungs, such as when the client is coughing or expiring.
- A 4-year-old child has cystic fibrosis. Which stage of Erikson's theory of
psychosocial development is the nurse addressing when teaching inhalation therapy?
Correct Answer: Initiative
Rationale: Children 4 to 5 years of age are in the "Initiative vs. Guilt" stage of Erikson's theory of psychosocial development.
- The nurse is planning postoperative care for a child who has had a cleft lip repair.
What is the most important reason to minimize this child's crying during the recovery period?
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Correct Answer: Crying 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.
- Prophylactic antibiotics are prescribed for a child who has mitral valve damage. The
nurse should advise the parents to give the antibiotics prior to which occurrence?
Correct Answer: Urinary catheterization
Rationale: Prophylactic antibiotics are usually prescribed prior to any invasive procedure for children who have valvular damage.
- The nurse assigns an unlicensed assistive personnel (UAP) to provide morning care
to a newly admitted child with bacterial meningitis. What is the most important instruction for the nurse to review with the UAP?
Correct Answer: Use designated isolation precautions.
- Which preoperative nursing intervention should be included in the plan of care for
an infant with pyloric stenosis?
Correct Answer: Observe for projectile vomiting.
Rationale: Projectile vomiting, the classic sign of pyloric stenosis, contributes to metabolic alkalosis.
- A 6-month-old male infant is admitted to the postanesthesia care unit with elbow
- The nurse notes that a 16-year-old male client is refusing visits from his
restraints in place. He has an endotracheal tube and is ventilator-dependent but will be extubated soon following recovery from anesthesia. Which nursing intervention should be included in this child's plan of care?Correct Answer: Remove restraints one at a time and provide range-of-motion exercises.Rationale: Removing restraints one at a time is safer than simultaneously. The infant should have the restrained extremities assessed frequently for signs of neurologic or vascular impairment, and range-of-motion exercises should be performed with these assessments. Under no circumstances should restraints be applied to the client continuously. Documentation of assessment findings regarding the restrained extremities must occur much more frequently than every 72 hours; however, the reason for using restraints must be justified and should be stated in the medical record.
classmates. Further assessment reveals that he is concerned about his edematous
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facial features. Based on these assessment findings, the nurse should plan interventions related to which nursing diagnosis?
Correct Answer: Social isolation
Rationale: Peer acceptance and body image are significant issues in the growth and development of adolescents. The answer addresses the problem of a lack of contact with peers stemming from his desire to protect his ego.
- Ampicillin, 75 mg/kg, is prescribed for a 22-lb child. It is available in a solution that
contains 250 mg/5 mL. How many milliliters should the nurse administer in one dose?
Correct Answer: 15
Rationale: Take 22lbs / 2.2 = 10kg. Then 10kg X 75mg/kg = 750mg. Finally 750/250 mg = 3. 3 X 5mL = 15 mL.
- A child comes to the school nurse complaining of itching. Further assessment
- The nurse observes a 4-year-old boy in a day care setting. Which behavior should
reveals that the child has impetigo. What action should the nurse take?Correct Answer: Send the child home with the parents to see the health care provider before returning to school.Rationale: Impetigo is a staphylococcal infection and is transmitted by person-to-person contact. The child should be sent home with a note to the parents explaining the condition.
the nurse expect this child to exhibit?
Correct Answer: Boasts aggressively when telling a story
Rationale: Four-year-old children are aggressive in their behavior and enjoy telling tales.
- During routine screening at a school clinic, an otoscope examination of a child's
ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. Based on these findings, what action should the nurse take?Correct Answer: Ask if the child has had a cold, runny nose, or any ear pain lately.Rationale: The tympanic membrane is normally pearly gray, not bulging, and moves when a client blows against resistance or when a small puff of air is blown into the ear canal.Because these findings are not completely normal, further assessment of history and related signs and symptoms are needed to interpret the findings accurately.
