Pediatric HESI Test Bank

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While Andres is being assessed at the clinic, Nurse Shiela observed that the child appears to be small, with an immature face and chubby body build. Her parents stated that their child's rate of growth of all body parts is somewhat slow, but her proportions and intelligence remain normal. As a knowledgeable nurse, you know that the child has a deficiency of which of the following?

  • A. Antidiuretic hormone (ADH)
  • B. Parathyroid hormone (PTH)
  • C. Growth hormone (GH)
  • D. Melanocyte-stimulating hormone (MSH)
Correct Answer: C

Rationale: The child described in the scenario displays characteristics consistent with growth hormone deficiency. Growth hormone is essential for the growth and development of bones, muscles, and other tissues in the body. A deficiency in growth hormone can result in growth retardation, where the child appears small with slow growth rates of body parts. Despite the physical stunting, intelligence remains normal as growth hormone does not affect intellectual development. Treatment for growth hormone deficiency usually involves hormone replacement therapy to help the child achieve normal growth and development.

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A newborn's mother is alarmed to find small amounts of blood on her infant girl's diaper. When the nurse checks the infant's urine it is straw colored and has no offensive odor. Which explanation to the newborn's mother is most appropriate?

  • A. "It appears your baby has a kidney infection"
  • B. "Breast-fed babies often experience this type of bleeding problem due to lack of vitamin C in the breast milk"
  • C. "The baby probably passed a small kidney stone"
  • D. "Some infants experience menstruation like bleeding when hormones from the mother are not available"
Correct Answer: D

Rationale: The most appropriate explanation to the newborn's mother is option D, "Some infants experience menstruation-like bleeding when hormones from the mother are not available." This condition is known as neonatal menstrual-like bleeding or pseudo-menstruation. During pregnancy, babies are exposed to the mother's hormones in the womb. After birth, when the hormonal influence from the mother decreases, some female infants may experience vaginal bleeding, which can be seen in their diapers. This type of bleeding is usually benign and resolves on its own without any intervention. It is not a cause for concern and does not indicate any serious health issue. The straw-colored urine with no offensive odor is a normal finding and further supports the explanation of neonatal menstrual-like bleeding in this case.

Which of the following IV solutions is hypertonic?

  • A. Normal saline
  • B. 0.45% NaCl
  • C. 5% dextrose in 0.9% NaCl
  • D. 0.225% NaCl
Correct Answer: C

Rationale: A hypertonic solution has a higher concentration of solutes compared to the intracellular fluid. In this case, 5% dextrose in 0.9% NaCl is hypertonic because it has a higher osmolarity due to the combined effect of dextrose and sodium chloride. The dextrose contributes to the hypertonicity, making the overall solution more concentrated than the intracellular fluid.

Which clinical manifestation would be seen in a child with chronic renal failure?

  • A. Hypotension
  • B. Massive hematuria
  • C. Hypokalemia
  • D. Unpleasant "uremic" breath odor
Correct Answer: D

Rationale: Chronic renal failure is characterized by the buildup of waste products and toxins in the blood due to kidney dysfunction. One common clinical manifestation in children with chronic renal failure is the development of an unpleasant "uremic" breath odor. This odor is often described as a fishy or ammonia-like smell and is a result of the accumulation of urea in the blood, which is normally filtered out by the kidneys. Other common clinical manifestations of chronic renal failure in children may include hypertension, fluid retention, electrolyte abnormalities (such as hyperkalemia rather than hypokalemia), anemia, growth failure, and bone abnormalities.

A 2-month-old is diagnosed with hip dysplasia. The parent asks you how long will the child be in the hip Spica Cast. How should you respond?

  • A. Not longer than 4 months.
  • B. The child will be placed in a Pavlik Harness for 3 to 5 months.
  • C. Following the osteotomy, the child remains in a cast for 5 months.
  • D. Between 2 and 4 months.
Correct Answer: B

Rationale: Hip dysplasia in infants is often managed initially with a Pavlik Harness, which helps maintain the hips in the correct position for optimum development. The Pavlik Harness is typically worn for a period of 3 to 5 months, depending on the severity of the hip dysplasia and the response to treatment. If the dysplasia is more severe or does not respond well to the Pavlik Harness, further interventions such as hip spica casting or surgery may be required, but the initial treatment is usually with the Pavlik Harness.

A patient reports on admission being "very sick" after taking erythromycin in the past. The patient is to receive erythromycin now. Which of the following actions should the nurse take regarding giving the antibiotic?

  • A. Give the antibiotic
  • B. Do not give the antibiotic
  • C. Give half of the dose
  • D. Discontinue the antibiotic
Correct Answer: B

Rationale: In this scenario, the patient reports being "very sick" after taking erythromycin in the past, indicating a history of adverse reaction to the medication. Given this information, it would be most prudent to withhold the erythromycin to prevent a potential adverse reaction or worsening of the patient's condition. It is important for the nurse to always consider the patient's previous experiences and adverse reactions when administering medications to ensure patient safety.

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