Pediatrics HESI PN exam Review Correct and Verified Answers Graded A

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Pediatrics HESI PN exam Review Correct and Verified Answers Graded A

• The practical nurse (PN) is interviewing a 10 year old girl about school and her

extracurricular activities. She responds, "I like school. I play the flute in the school band, and I take tennis lessons." Based on Erikson's psychosocial theory, the PN identifies that this child is in what stage of development?

• identity
• intimacy
• industry
• initiative

Correct Answer: C

Rationale: Erikson's stage of industry (C) for a school aged child is demonstrated by successful participation in new skills and peer activities, such as sports and band. (A, B, and D) are achieved in other age groups.

• The practical nurse (PN) is observing a group of children at a day care center to

determine whether children are achieving developmental milestones. Which activity should the PN identify as typical for a 2 year old child's cognitive development?

• has a vocabulary of about 1000 words
• uses short sentences to express self
• initiates play with other children
• recognizes right and wrong

Correct Answer: B

Rationale: Although children develop at different rates, a 2 year old typically uses short sentences to express independence and control (B) and has a vocabulary of up to 300

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words, not (A). At the age of 2 years, a toddler is developing negativism without understanding the concepts of right and wrong (D). A 2 year old engages in solitary play and parallel play but does not initiate or cooperative with other children (C) in play, which begins with socialization of the preschool child.

• Which finding should the practical nurse confirm with the parents of an infant who is

admitted with possible intussusception?

• red currant jelly stools
• clay colored stools
• constant abdominal pain
• projectile vomiting after meals

Correct Answer: A

Rationale: Red currant jelly stools (A) is a sign of intussusception, which causes a mixture of stool, mucous, and blood as the intestines telescopes inside itself. (D) is associated with pyloric stenosis. (B) is consistent with biliary obstruction. Infants with intussusception usually have periods of severe pain followed by intervals in which they appear comfortable, not (C).

• The mother of a child with croup is having barking, coughing episodes calls the clinic for

assistance. What action should the practical nurse (PN) recommend that the mother implement first?

• take the child outside in the cool air
• bring the child directly to the emergency room
• sit with the child in bathroom with a hot shower running
• have the child drink plenty of fluids

Correct Answer: C

Rationale: Croup (laryngotracheobronchitis) is a viral infection that causes a "barking" cough and varying degrees of inspiratory stridor, which often responds to a high humidity environment. Most children can be managed at home using the stream from a hot shower in a closed bathroom (C) which often stops laryngeal spasm. Increasing the child's fluid intake is important (D), but not a priority at this time. Although exposure to cold air (A) also relieves stridor, parents should be encouraged to use mist humidifier in the child's room.

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(B) is not necessary unless the child is having increasingly difficulty breathing that may lead to a compromised airway.

• The mother of a male newborn calls the clinic to inquire about the formation of a yellow

crust over her son's circumcision area. What information should the practical nurse (PN) provide?

• do not remove the yellow crust from the site
• stop using petroleum around the head of the penis
• bring him into the clinic
• tightly fasten the diaper

Correct Answer: A

Rationale: Crust formation is part of the healing process and should be removed (A). (C) is not indicated at this time. The diaper should be fastened loosely, not tightly (D) which can place pressure on the incision site. (B) assists in the healing process and should not be discontinued.

• A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst. What should

the practical nurse (PN) offer?

• popsicle
• lemonade
• orange juice
• chocolate milk

Correct Answer: A

Rationale: Small amounts of clear liquids without red dyes should be offered to the child.Popsicles (A) are cold and help soothe a dry throat. Citrus drinks (B and C) are acidic and irritate the operative site in the posterior oropharynx. Milk (D) thickens oral mucus which makes swallowing more difficult and causes coughing.

• The practical nurse is caring for a 6 year old girl who had surgery 12 hours ago. The child

tells the PN that she does not have pain but a few minutes later, tells her parents that she does. What child development concept is relevant to this situation?

• inconsistency in pain reporting suggests that pain not present
• a child may have pain yet deny its presence to the nurse

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• truthful reporting of pain should occur by this age
• children use pain experiences to manipulate their parents

Correct Answer: B

Rationale: A child may fear receiving an injection for pain or may believe that pain is a deserved punishment for some misdeed, so the pain is denied (D) when the nurse asks the child, who then readily admits having pain to a parent. This behavior should not be interpreted as (C) but as a valid indication of pain. (A and C) are incorrect interpretations of this behavior.

• Which preoperative action is most important for the practical nurse (PN) to implement

for a newborn with meningomyelocele?

• document vital signs
• prevent skin breakdown
• minimize the risk for infection
• monitor neurologic functioning

Correct Answer: C

Rationale: A meningomyelocele provides a direct entry for bacteria into the central nervous system, leading to meningitis. Measures that protect the integrity of the meningomyelocele sac and infection control measures should be implemented to minimize the risk of infection (C). (A, B, and D) should be implemented but do not have the priority of (C).

• The mother of a 9 month old male infant is concerned because he cries whenever she

leaves him with a sitter. What is the best response for the practical nurse (PN) to provide?

• "Have you noticed whether your baby is teething?"
• "Crying when you leave him in a healthy sign of attachment."
• "Consider taking the baby to the doctor because he may be ill."
• "You could consider leaving the infant more often so he can adjust."

Correct Answer: B

Rationale: Healthy attachment is manifested by stranger anxiety in late infancy (B). Pain from teething expressed by the infant's cries does not occur only when the mother leaves the infant with another person (A). The PN should evaluate the infant's developmental