Pediatric Practice Exam HESI

Pediatric Practice Exam HESI Related

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During a routine monthly examination, a 5-month-old infant is brought to the pediatric clinic. What assessment finding should alert the nurse to notify the health care provider?

  • A. Temperature of 99.5°F
  • B. Blood pressure of 75/48 mm Hg
  • C. Heart rate of 100 beats per minute
  • D. Respiratory rate of 50 breaths per minute
Correct Answer: D

Rationale: A respiratory rate of 50 breaths per minute in a 5-month-old infant is considered high and may indicate respiratory distress. Infants normally have a higher respiratory rate than older children and adults, but a rate of 50 breaths per minute is above the expected range. This finding warrants immediate attention as it may be indicative of an underlying respiratory issue or distress.

Choice A (Temperature of 99.5°F) is within the normal range for body temperature and does not necessarily indicate a critical issue. Choice B (Blood pressure of 75/48 mm Hg) is not typically assessed in isolation for a 5-month-old infant during a routine examination, and the values provided are not indicative of a critical condition. Choice C (Heart rate of 100 beats per minute) is within the normal range for heart rate in infants and may not be a cause for immediate concern during a routine examination.

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What behavior is essential for preventing in a child postoperatively after undergoing heart surgery to repair defects associated with tetralogy of Fallot?

  • A. Crying
  • B. Coughing
  • C. Straining at stool
  • D. Unnecessary movement
Correct Answer: C

Rationale: Preventing straining at stool is crucial postoperatively after heart surgery for tetralogy of Fallot to avoid increasing intrathoracic pressure and placing stress on the surgical site. This can help prevent complications and promote faster healing. While crying, coughing, and unnecessary movement are common postoperative behaviors, they are not specifically linked to worsening outcomes in this context. Straining at stool is particularly emphasized due to its potential to impact the surgical site and overall recovery process.

After eating, a child with a diagnosis of gastroesophageal reflux disease (GERD) should be placed in what position as recommended by the nurse?

  • A. Supine
  • B. Prone
  • C. Semi-Fowler's
  • D. Trendelenburg
Correct Answer: C

Rationale: Placing the child in a semi-Fowler's position after eating is beneficial for reducing symptoms of gastroesophageal reflux. This position helps prevent gastric contents from flowing back into the esophagus. The supine position (choice A) may worsen reflux symptoms by allowing gravity to assist in reflux, leading to discomfort and regurgitation. Prone position (choice B) is not recommended after eating as it may cause discomfort and increase the risk of aspiration due to pressure on the stomach. Trendelenburg position (choice D), with the head lower than the rest of the body, is not indicated for managing GERD after eating and may not provide the desired benefits in this context.

The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

  • A. absence of a urethral opening
  • B. penis appears shorter than usual for age
  • C. the urethral opening is along the dorsal surface of the penis
  • D. the urethral opening is along the ventral surface of the penis
Correct Answer: D

Rationale: Hypospadias is a congenital condition where the urethral opening is located along the ventral surface of the penis, not the dorsal surface (Choice C) or absent (Choice A). This leads to the characteristic appearance of a ventrally displaced urethral meatus. The penis may appear normal in size but with the urethral opening positioned abnormally (Choice D), rather than being shorter than usual (Choice B). Therefore, the correct expectation for a newborn with hypospadias is that the urethral opening is along the ventral surface of the penis, making Choice D the correct answer.

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.

What is the priority nursing responsibility when a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure?

  • A. Apply restraints.
  • B. Administer oxygen.
  • C. Protect the child from self-injury.
  • D. Insert a plastic airway in the child's mouth.
Correct Answer: C

Rationale: During a tonic-clonic seizure, the priority nursing responsibility is to protect the child from self-injury. Applying restraints is not recommended during a seizure as it can lead to further harm. Administering oxygen may be necessary after the seizure to support oxygenation, but it is not the priority during the seizure itself. Inserting a plastic airway is also not indicated as the jaw is clamped, and the child should not have anything placed in the mouth during a seizure. Therefore, the correct action is to ensure the child's safety by protecting them from self-injury, preventing harm from uncontrolled movements and potential falls.

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