Pediatric Practice Exam HESI

Pediatric Practice Exam HESI Related

Review Pediatric Practice Exam HESI related questions and content

A newborn with an anorectal anomaly had an anoplasty performed. At the 2-week follow-up visit, a series of anal dilations is begun. What should the nurse recommend to the parents to help prevent the infant from becoming constipated?

  • A. Use a soy formula if necessary.
  • B. Breastfeed if possible.
  • C. Avoid administering a suppository nightly.
  • D. Do not offer glucose water between feedings.
Correct Answer: B

Rationale: Breastfeeding is recommended to help prevent constipation in infants due to the easily digestible nature of breast milk, which often leads to softer stools. Breastfeeding is preferred over formula feeding as it provides optimal nutrition for the infant's digestive system. Choice A, using a soy formula if necessary, may be considered only if there are specific dietary concerns or allergies; however, breast milk is still the preferred option. Choice C, avoiding administering a suppository nightly, is correct as it is not a routine method for preventing constipation in infants and may not be appropriate without medical advice. Choice D, not offering glucose water between feedings, is recommended as it may not address the root cause of constipation and may introduce unnecessary sugar to the infant's diet.

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A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate?

  • A. Cannot stand on one foot
  • B. Builds a tower of 7 blocks
  • C. Uses echolalia when speaking
  • D. Colors outside the lines of a picture
Correct Answer: C

Rationale: The correct answer is C. Using echolalia, which is the repetition of words or phrases, is not typical for a 2-year-old child and may indicate the need for further evaluation. Choices A, B, and D are all within the expected developmental skills for a 2-year-old. While most 2-year-olds may not be able to stand on one foot, it is not a cause for concern at this age. Building a tower of 7 blocks and coloring outside the lines of a picture are both appropriate for a 2-year-old's developmental skills.

When caring for a neonate with a suspected tracheoesophageal fistula, what nursing care should be included?

  • A. Elevating the head and not giving anything by mouth
  • B. Elevating the head at all times
  • C. Administering glucose water only during feedings
  • D. Avoiding suctioning unless the infant is cyanotic
Correct Answer: A

Rationale: When caring for a neonate with a suspected tracheoesophageal fistula, it is essential to elevate the head and avoid giving anything by mouth. Elevating the head helps prevent aspiration, and withholding oral intake reduces the risk of complications like aspiration pneumonia. Elevating the head at all times (choice B) is overly restrictive and unnecessary. Administering glucose water only during feedings (choice C) is not recommended as it can still lead to aspiration. Avoiding suctioning unless the infant is cyanotic (choice D) is incorrect because maintaining airway patency may require suctioning, irrespective of cyanosis, in a neonate with a suspected tracheoesophageal fistula.

A health care provider orders a tap water enema for a 6-month-old infant with suspected Hirschsprung disease. What rationale causes the nurse to question the order?

  • A. The result could lead to loss of necessary nutrients.
  • B. It could cause a fluid and electrolyte imbalance.
  • C. It could increase the fear of intrusive procedures.
  • D. The result could cause shock from a sudden drop in temperature.
Correct Answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas do not directly lead to loss of necessary nutrients. Choice C is incorrect as it focuses on emotional impact rather than physiological risks. Choice D is incorrect as shock from a sudden drop in temperature is not a common consequence of a tap water enema in this scenario.

When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, what does this decision indicate?

  • A. The newborn has no rights.
  • B. It is the same as euthanasia.
  • C. It is illegal professional practice.
  • D. The newborn is being allowed to die.
Correct Answer: D

Rationale: When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, it means that aggressive interventions will not be pursued, allowing the newborn to die naturally. This decision is legal and ethical, respecting the principle of non-maleficence by avoiding unnecessary suffering. Choice A is incorrect because all individuals, including newborns, have rights, but the decision to withhold extraordinary care is based on ethical considerations. Choice B is incorrect as withholding care is not the same as euthanasia, which involves actively ending life. Choice C is incorrect as long as the decision is made within legal and ethical boundaries, it is not considered illegal professional practice.

After clearing the airway of a newborn who is not in distress, what is the most important action for you to take?

  • A. Apply free-flow oxygen
  • B. Clamp and cut the cord
  • C. Keep the newborn warm
  • D. Obtain an APGAR score
Correct Answer: C

Rationale: Keeping the newborn warm is crucial as newborns are at high risk of hypothermia due to their large body surface area and limited subcutaneous fat. Hypothermia can lead to complications such as respiratory distress, hypoglycemia, and metabolic acidosis. Providing warmth helps maintain the newborn's body temperature and supports physiological processes, promoting overall well-being. Applying free-flow oxygen is not necessary if the newborn is not in distress. Clamping and cutting the cord can be done after addressing the immediate need for warmth. Obtaining an APGAR score is important for assessing the newborn's overall condition but ensuring warmth takes precedence to prevent complications related to hypothermia.

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