Question 2 of 60
HESI Pediatric and Women’s Health. The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations. Which priority issue should the nurse address to ensure the newborn’s survival?
- A Hypoglycemia.
- B Fluid balance.
- C Heat loss.
- D Bleeding tendencies.
Question 18
A parent rushes their 3-year-old child to the emergency department with an asthma exacerbation. Which additional finding should alert the nurse that the child is in acute respiratory distress?
- A resting respiratory rate of 35 breaths/minute.
- Bilateral bronchial breath sounds.
- Diaphragmatic respirations.
- Flaring of the nares.
Question 19
Albumin 25% IV is prescribed for a child with nephrotic syndrome. Which assessment finding indicates to the nurse that the medication is having the desired effect?
- Improved caloric intake.
- Reduction of edema.
- Weight gain.
- Reduction of fever.
Question 20
The parent of an 11-year-old client who has juvenile idiopathic arthritis tells the nurse, “I really don’t want my child to become dependent on pain medication, so I only allow taking the medication when the pain is really bad.” Which information is most important for the nurse to provide this parent?
- Encourage quiet activities such as watching television as a pain distracter.
- The use of hot baths can be used as an alternative for pain medication.
- The child should be encouraged to rest when experiencing pain.
- Giving pain medication around the clock helps control the pain.
Question 21
The nurse is conducting an admission assessment of an 11-month-old infant with heart failure who is scheduled for repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. Which pathophysiologic mechanism supports these findings?
- An opening in the atrial septum causes a murmur due to a turbulent left to right shunt.
- The aortic semilunar valve obstructs blood flow into the systemic circulation.
- The lumen of the aorta reduces the volume of blood flow to the lower extremities.
- The pulmonic valve prevents adequate blood volume into the pulmonary circulation.
Question 22
An infant born 2 days ago has not passed a meconium stool and begins to vomit bilious secretions. Which action should the nurse take first?
- Monitor strict urinary output.
- Gather supplies for an IV infusion.
- Measure abdominal circumference.
- Prepare for anorectal manometry.
Question 23 (Case Study 1 of 6)
Select the findings that will help the nurse determine what is causing the client’s symptoms.
- Current vital signs
- Shopping yesterday for 5 hours
- Foul-smelling lochia rubra
Question 24 (Case Study 2 of 6)
For each assessment finding, click to indicate whether findings from this client’s assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions.
- Feeling chilled, achy, and fatigued: Both mastitis and endometritis
- Foul-smelling lochia rubra at 2 weeks postpartum: Endometritis
- Baby fed pumped breast milk: Mastitis
- Pain rating of 4 on a 0 to 10 scale: Both mastitis and endometritis
- Pulse of 105 beats/minute: Both mastitis and endometritis
- Temperature of 101.2° F (38.4° C): Both mastitis and endometritis
Question 25 (Case Study 3 of 6)
Based on the assessment findings, the priority diagnosis suspected is _____. This diagnosis places the client at risk of _____.
- Priority diagnosis: endometritis
- Risk of: sepsis
Question 26 (Case Study 4 of 6)
The nurse knows that the mastitis in this scenario is most likely caused by _____, as evidenced by _____.
- Cause: a plugged duct
- Evidence: the firm red area at the 9 o’clock position
Question 27 (Case Study 5 of 6)
Which information should the nurse include in the discharge teaching? Select all that apply.
- Apply warm compresses to affected area before feeding.
- Vary breastfeeding positions at each feeding.
- Wash hands before handling the breast.
- Pump breasts if feeding will be missed, due to absence from the infant.
- Finish antibiotics even if symptoms improve.
Question 28 (Case Study 6 of 6)
The nurse evaluates the client 1 week later. Which finding indicates the discharge teaching was effective? Select all that apply.
- The red area on her right breast has resolved.
- The infant is breastfeeding every 2 to 3 hours for 20 minutes in a variety of positions.
- The temperature taken at home is 99.0° F (37.2° C).
Question 29
A nurse is performing a physical assessment on a 3-day-old infant. Which of the following findings should the nurse report to the provider as a manifestation of sepsis? Select all that apply.
- Temperature of 98.2° F (36.8° C). HESI Pediatric and Women’s Health
- Irritability.
- Poor feeding.
- Blood glucose 50 mg/dL.
- Acrocyanosis.
- Respiratory distress.
Question 29
A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of $102.8^\circ \text{F}$ ($39.3^\circ \text{C}$), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse implement next?
- A) Obtain bedside trays for intubation or tracheotomy by the healthcare provider.
- B) Provide a nebulizer treatment with bronchodilators.
- C) Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck.
- D) Begin prescribed intravenous antibiotic administration.
Question 30
The nurse is caring for a child with a unilateral long-leg cast applied for the correction of club foot. Which action is most important for the nurse to perform?
- A) Palpate femoral pulses.
- B) Monitor capillary refill of the toes.
- C) Examine for spontaneous movement.
- D) Compare temperature of both legs.
Question 31
Which is the most important assessment for the nurse to conduct following the administration of epidural anesthesia to a client who is at 40-weeks gestation?
- A) Variability of fetal heart rate.
- B) Level of pain sensation.
- C) Station of presenting part.
- D) Maternal blood pressure.
Question 32
During the admission procedure of a school age child, the child states, “I’m going to have an operation.” Which response is best for the nurse to provide to this child?
- A) “We’re going to do everything we can to take very good care of you.”
- B) “Tell me what an operation is.”
- C) “I’m glad your mother told you why you were coming to the hospital.”
- D) “Are you scared?”
Question 33
Review H and P, laboratory results, flow sheet, and orders. The nurse notifies the healthcare provider of the lab values, blood pressure and pulse, and current intake and output. Which prescriptions does the nurse expect the healthcare provider to write based on the information? Select all that apply.
- A) Administer a diuretic
- B) Increase the intravenous fluid rate
- C) Flush the central line with 3% sodium chloride
- D) Turn off the suction on the nasogastric tube
- E) Bolus calcium
- F) Add potassium to the intravenous fluids
- G) Decrease the percentage of sodium in the intravenous fluids HESI Pediatric and Women’s Health
Question 34
A client who is 38 weeks pregnant is concerned her baby might get a communicable disease before any immunizations are given. Which physiological mechanism should the nurse use when responding to the mother’s concerns?
- A) Passive immunity in the first months of life provides protection in newborns.
- B) Active immunity in newborns is developed fully in the first month of life.
- C) Infants can receive antiinfectants that have not developed resistance to microbes.
- D) Neutrophils may be immature in protecting neonates from the risk for infection.
Question 35
The nurse is caring for a primigravida client who delivered vaginally 48-hours ago. The client’s laboratory results are: hemoglobin $12.5 \text{ g/dL}$ ($125 \text{ g/L}$), hematocrit 34% (0.34 volume fraction), hepatitis B surface antigen negative, rubella non-immune, group B Streptococcus positive. Which prescription should the nurse prepare to administer?
- A) Rubella vaccination.
- B) Blood transfusion.
- C) Hepatitis B immunoglobulin.
- D) Penicillin G potassium.
Question 36
A child who weighs 16 pounds receives a prescription for amoxicillin $25 \text{ mg/kg/day}$ by mouth in divided doses every 12 hours. The bottle is labeled, “Amoxicillin for Oral Suspension, USP $200 \text{ mg}$ per $5 \text{ mL}$.” How many mL should the nurse administer with each dose? (Enter numerical value only. If rounding is required, round to the nearest whole number.)
- Answer: 2
Question 37
A one-month-old infant admitted to the hospital with dehydration and failure to thrive receives a prescription for enteral feedings. To maintain normal growth and development of the infant, which action should the nurse include in the plan of care?
- A) Speak to the healthcare provider about instituting physical therapy.
- B) Offer a pacifier for non nutritive sucking.
- C) Ensure placement of the nasogastric tube with an abdominal x-ray.
- D) Use sterile technique during feedings.
Question 38
A preschool-aged child is admitted to the pediatric unit for a bone marrow aspiration. When the nurse enters the room to begin the assessment, the child becomes anxious and starts to cry. Which action should the nurse take?
- A) Allow the child to cry while performing the assessment.
- B) Talk to the mother and gradually focus on the child’s toy.
- C) Request that another nurse assist with the assessment.
- D) Explain the procedure and the reasons for the bone marrow aspiration.
Question 39
While performing a vaginal examination on a client in labor, the nurse observes the umbilical cord on the perineum. Which action should the nurse implement first?
- A) Place the client in Trendelenburg.
- B) Administer oxygen at $8 \text{ to } 10 \text{ L/minute}$ via mask.
- C) Increase the rate of the intravenous fluid.
- D) Notify the surgical team of an emergency.
Question 40
The mother of a 4-month-old infant tells the nurse that she is going to begin feeding her child rice cereal in a bottle because the infant is waking up at night. Which developmental milestone should the nurse use to determine the infant’s readiness for solid foods?
- A) Wakes up during the night for a feeding.
- B) Absence of the rooting reflex.
- C) Opens mouth when food comes her way.
- D) Ability to drink from a cup.
Question 41
A 14-year-old male is brought to the school clinic by his coach after football practice. The adolescent reports sudden, intense pain in the scrotum, and the nurse notes erythema and swelling of the area. Which action should the nurse take?
- A) Provide the client with a urinal to collect a specimen for culture.
- B) Obtain a urethral swab for a gonorrhea and chlamydia screen.
- C) Report the findings immediately to the healthcare provider.
- D) Apply warm compresses to the area to increase circulation.
Question 42
A school-aged child with hemophilia A is brought to the emergency department after falling on the playground and hitting the right knee. The nurse notes that the knee is swollen and the child is guarding the area. Which action should the nurse implement first? HESI Pediatric and Women’s Health
- A) Prepare to administer factor VIII concentrate intravenously.
- B) Monitor vital signs for symptoms of hypovolemic shock.
- C) Anticipate the administration of a unit of packed red blood cells.
- D) Apply ice pack and compression dressing to knee.
Question 43
Review the patient’s data. Which of the findings require immediate action by the nurse? Select all that apply.
- A) Serum sodium
- B) Serum albumin
- C) Urine protein
- D) Edema
- E) Heart rate
- F) Weight
- G) Platelets
Question 44
A nurse is caring for an infant who is postoperative for a ventriculoperitoneal (VP) shunt. The nurse notes a small amount of serosanguineous drainage on the surgical dressing. Which action should the nurse take?
- A) Change the surgical dressing.
- B) Monitor the infant’s vital signs.
- C) Report the drainage to the healthcare provider.
- D) Reinforce the dressing with additional gauze. HESI Pediatric and Women’s Health
Question 45
The nurse is providing care for a child following a cystogram. Which action is most important for the nurse to include in the child’s plan of care?
- A) Monitor for allergic reaction to the contrast dye.
- B) Encourage the child to increase fluid intake.
- C) Ensure that the client remains in bed for at least 6 to 12 hours.
- D) Apply cold compresses to the insertion site.
