Question 12 of 60 (Case Study 1 of 6)
HESI Pediatric and Women’s Health. Summary A 10-year-old child is admitted to the pediatric unit with a history of dark-colored urine and facial edema following a recent sore throat. Clinical findings include hypertension and hematuria, suggesting a diagnosis of Acute Poststreptococcal Glomerulonephritis (APSGN).
The nurse reviews the child’s record. Which finding should the nurse identify as being the most likely cause of the child’s current condition?
- A History of a skin infection 2 days ago.
- B Recent recovery from a viral upper respiratory infection.
- C A positive culture for Group A beta-hemolytic streptococcus 3 weeks ago.
- D Diagnosis of Type 1 Diabetes Mellitus.
Question 13 of 60 (Case Study 2 of 6)
Which assessment findings should the nurse expect to observe in the child? Select all that apply.
- A Periorbital edema.
- B Tea-colored urine.
- C Hypotension.
- D Proteinuria.
- E Polyuria.
- F Hypertension. HESI Pediatric and Women’s Health
Question 14 of 60 (Case Study 3 of 6)
The nurse reviews the child’s laboratory results. Which result is most consistent with the suspected diagnosis?
- A Elevated Antistreptolysin O (ASO) titer.
- B Decreased Serum Creatinine.
- C Elevated Serum Albumin.
- D Decreased Blood Urea Nitrogen (BUN).
Question 15 of 60 (Case Study 4 of 6)
Which nursing intervention is the priority for the child’s care at this time?
- A Daily weights and blood pressure monitoring.
- B Encouraging increased fluid intake.
- C Assisting with range of motion exercises.
- D Administering high-dose corticosteroids.
Question 16 of 60 (Case Study 5 of 6)
The child’s parent asks why the child is on a restricted sodium diet. Which response by the nurse is correct?
- A Sodium increases the risk of developing a secondary infection.
- B Decreasing sodium helps reduce fluid retention and lower blood pressure.
- C A low-sodium diet prevents the loss of protein in the urine.
- D High sodium levels cause the urine to turn a dark color.
Question 17 of 60 (Case Study 6 of 6)
Which finding indicates that the child’s condition is improving?
- A Increased proteinuria.
- B Sustained weight gain.
- C Increased urinary output.
- D Elevated blood pressure. HESI Pediatric and Women’s Health
Question 18
An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin 500 mg PO daily and metronidazole 500 mg IV piggy back (IVBP) twice daily (BID). She asks the nurse, “Why do I have to be in the hospital? Why can’t I get my treatment at home?” Which purpose should the nurse provide that supports an effective outcome?
- A Detection of early symptoms of Jarisch-Herxheimer reaction.
- B Collection of serial anaerobic cultures of vaginal discharge.
- C Administration of a supervised parenteral antibiotic protocol.
- D Implementation of contact precautions to prevent spread of infection.
Question 19
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° F (39.3° C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse implement next?
- A Provide a nebulizer treatment with bronchodilators.
- B Obtain bedside trays for intubation or tracheotomy by the healthcare provider.
- C Begin prescribed intravenous antibiotic administration.
- D Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck.
Question 20
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 Station of presenting part.
- C Maternal blood pressure.
- D Level of pain sensation.
Question 21
Upon completion of a 14-day antibiotic treatment for bacterial meningitis in an infant, the nurse prepares the family for discharge. Which information should the nurse include?
- A Administer antipyretic medication on a continuous basis.
- B Have the antibiotic trough level drawn within 3 days.
- C Monitor the infant for response to auditory stimuli.
- D Continue strict monitoring of daily wet diapers for 1 week.
Question 22
Review H and P, laboratory results, flow sheet, and orders. The nurse notifies the health care 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 Flush the central line with 3% sodium chloride
- B Turn off the suction on the nasogastric tube
- C Administer a diuretic
- D Increase the intravenous fluid rate
- E Decrease the percentage of sodium in the intravenous fluids
- F Bolus calcium
- G Add potassium to the intravenous fluids HESI Pediatric and Women’s Health
Question 23
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?
- A The pulmonic valve prevents adequate blood volume into the pulmonary circulation.
- B The aortic semilunar valve obstructs blood flow into the systemic circulation.
- C The lumen of the aorta reduces the volume of blood flow to the lower extremities.
- D An opening in the atrial septum causes a murmur due to a turbulent left to right shunt.
Question 24
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 Use sterile technique during feedings.
- B Ensure placement of the nasogastric tube with an abdominal x-ray.
- C Offer a pacifier for non nutritive sucking.
- D Speak to the healthcare provider about instituting physical therapy. HESI Pediatric and Women’s Health
Question 25
The nurse is caring for a client who is HIV-positive and has just delivered a newborn. Which of the following interventions should the nurse perform?
- A. Delay the initial bath for 1 to 2 days.
- B. Give zidovudine 6 to 12 hours after birth.
- C. Encourage breastfeeding every 2 to 3 hours.
- D. Administer antibiotics for 7 to 10 days.
Question 26
A nurse is assessing a client at 34 weeks gestation during a bimonthly appointment. Which of the following findings should the nurse report to the healthcare provider?
- A. 1+ edema in the lower extremities.
- B. 2 lb weight gain over the past 2 weeks.
- C. Fetal heart rate of 110 beats/minute.
- D. Fundal height of 30 cm.
Question 27
A child with hemophilia is brought to the clinic because of a swollen and painful knee. Which of the following actions should the nurse take first?
- A. Apply ice pack and compression dressing to knee.
- B. Obtain a set of vital signs.
- C. Start an intravenous line with normal saline.
- D. Obtain blood for a type and crossmatch.
Question 28
An adolescent with sickle cell anemia is attending a school picnic on a hot, sunny day. Which of the following choices should the nurse encourage the adolescent to make from the buffet?
- A. Diet cola.
- B. Ice tea.
- C. Lemonade.
- D. Milkshake.
Question 29
A nurse is caring for a 1-year-old child following a surgical repair of a clubfoot and the application of a long-leg cast. Which of the following is the most important nursing action?
- A. Petal the edges of the cast with adhesive tape.
- B. Apply a waterproof covering to the cast.
- C. Elevate the leg with the cast using two pillows.
- D. Monitor capillary refill of the toes.
Question 30
The mother of a child with juvenile idiopathic arthritis (JIA) tells the nurse that her child has more pain in the morning. The nurse should include which of the following in the teaching?
- A. Giving pain medication once a day will control the pain.
- B. The pain is caused by the child being active during the day.
- C. Waiting to give the pain medication until the pain is really bad.
- D. Giving pain medication around the clock helps control the pain.
Question 31
The mother of a 5-month-old infant asks the nurse when she can start giving the infant solid foods. Which of the following is an indicator of the infant’s readiness for solid foods?
- A. Loss of the sucking reflex.
- B. Sleeps 6 hours through the night.
- C. Opens mouth when food comes her way.
- D. Is able to sit up without any support.
Question 32
A neonate was born via a normal spontaneous vaginal delivery 15 minutes ago. Potential Condition:
- Thermoregulation dysregulation
Actions to Take:
- Remove wet diaper or clothing
- Wrap the neonate in a warm blanket
Parameters to Monitor:
- Temperature
- Respiratory rate
Question 33
A client at 24 weeks gestation has the following lab values: Hemoglobin 10.7 g/dL, Hematocrit 32%. Which of the following should the nurse include when teaching the client about these results?
- A. Plasma volume increases, making the blood count appear low.
- B. The results are normal and do not require any teaching.
- C. The client needs to increase her intake of protein and fat.
- D. The client is experiencing a serious form of anemia.
Question 34
The nurse is preparing to administer erythromycin ophthalmic ointment to a newborn. The father asks, “Why does my baby need that?” Which of the following is the best response by the nurse?
- A. “The ointment will prevent eye infections.”
- B. “The law says that all newborns must receive it.”
- C. “The doctor ordered it to help your baby see better.”
- D. “The ointment is used to clean the baby’s eyes.”
Question 35
A 2-day-old newborn has not passed a meconium stool and is now having bilious vomiting. Which of the following is the priority nursing action?
- A. Obtain a stool culture for ova and parasites.
- B. Measure abdominal circumference.
- C. Administer an antiemetic as ordered.
- D. Assess the infant’s blood glucose level. HESI Pediatric and Women’s Health
Question 36
A nurse is teaching a group of parents about the immune system of a newborn. Which of the following should the nurse include?
- A. Passive immunity in the first months of life provides protection in newborns.
- B. Newborns have a fully developed immune system at birth.
- C. Breastfeeding does not provide any immunity to the newborn.
- D. Newborns do not need any vaccinations until they are 1 year old.
Question 37
A client who has just delivered a healthy newborn is receiving an intravenous infusion of oxytocin. The nurse should explain to the client that the purpose of the medication is which of the following?
- A. Promotion of milk production for breastfeeding.
- B. Stimulation of uterine contractions.
- C. Reduction of pain following the delivery.
- D. Prevention of infection in the postpartum period.
Question 38
A mother brings her 6-week-old infant to the clinic and reports that the infant is always hungry and has a “lump” in his stomach. The nurse notes a palpable olive-shaped mass in the right upper quadrant. Which of the following should the nurse expect to find?
- A. Projectile vomiting.
- B. Currant jelly-like stools.
- C. Diarrhea and fever.
- D. Excessive drooling.
Question 39
A nurse is caring for a newborn immediately following birth. Which of the following is the priority for the newborn’s survival after adequate respirations have been established?
- A. Infection control.
- B. Nutritional intake.
- C. Heat loss.
- D. Parent-infant bonding.
Question 40
A nurse is assessing a newborn 1 hour after birth. Which of the following findings should the nurse expect?
- A. Heart rate 110 beats/minute.
- B. Respiratory rate 30 breaths/minute.
- C. Axillary temperature 96.8°F.
- D. Blood pressure 100/60 mmHg.
Question 40
The nurse is providing preconception counseling. Which supplement should the nurse recommend to help prevent the occurrence of anencephaly?
- A Iron.
- B Folic acid.
- C Vitamin D.
- D Calcium.
Question 41
The nurse is caring for a primigravida client who delivered vaginally 48-hours ago. The client’s laboratory results are: hemoglobin 12.5 g/dL (125 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 Hepatitis B immunoglobulin.
- C Penicillin G potassium.
- D Blood transfusion.
Question 42
Case Study: A 9-month-old male born at 32 weeks gestation, recently hospitalized for RSV, presents for a well-baby check. He is fussy but eats well. He was brought in wrapped in a blanket with several layers of clothing. Noted pinhead-size papules in the folds of the neck and axilla.
Potential Condition:
- Miliaria
Actions to Take:
- Clean the area with warm water
- Remove some of the baby’s clothing
Parameters to Monitor:
- Temperature
- Parent’s understanding of education
Question 43
A child who weighs 25 kg receives a prescription for isoniazid 10 mg/kg/day by mouth once a day. The bottle is labeled “Isoniazid Oral Solution, USP 50 mg per 5 mL.” How many mL should the nurse administer? HESI Pediatric and Women’s Health
- Answer: 25
Question 44
A child is being prepared for a computed tomography (CT) scan when the child begins to have a tonic clonic seizure. The mother is hysterical and is trying to hold the child down. Which action(s) should the nurse take? Select all that apply.
- A Ask the mother to release the child.
- B Monitor the child’s airway and tongue.
- C Administer an anticonvulsant medication.
- D Close the blinds to darken the room.
- E Place pillows inside the side rails.
Question 45
An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?
- A “We should be sure to start our daughter on birth control pills.”
- B “Sexual maturity differences between my daughter and her peers will disappear within a few years.”
- C “Our daughter will be on this hormone treatment the rest of her life.”
- D “We should encourage her to dress in clothing that suits her sexual maturity level.”
Question 46
A child who weighs 16 pounds receives a prescription for amoxicillin 25 mg/kg/day by mouth in divided doses every 12 hours. The bottle is labeled, “Amoxicillin for Oral Suspension, USP 200 mg per 5 mL.” How many mL should the nurse administer with each dose?
- Answer: 2
Question 47
A client who is in labor states, “I think my water just broke!” The nurse notes that the umbilical cord is on the perineum. Which action should the nurse perform first?
- A Place the client in Trendelenburg.
- B Notify the operating room team.
- C Administer oxygen via face mask.
- D Administer a fluid bolus of 500 mL.
Question 48
The nurse who is working on a pediatric unit receives shift report for 4 neonates with congenital heart defects. The neonate with which report requires the most immediate intervention?
- A Coarctation of aorta has an elevated blood pressure in upper extremity.
- B Patent ductus arteriosus is fatigued after feedings.
- C Ventricular septal defect (VSD) has audible murmurs.
- D Tetralogy of Fallot (TOF) with hypercyanotic (TET) spells is crying.
Question 49
A male adolescent arrives at the clinic and reports intense pain in the testicular area that occurred during football practice at high school. The nurse observes the scrotum and identifies significant erythema and swelling. Which action should the nurse take?
- A Collect a sterile urine sample for culture and sensitivity.
- B Provide the adolescent with a urinal for urinary hesitancy.
- C Report the findings immediately to the healthcare provider.
- D Obtain a swab of secretions from the penis and urethra.
Question 50
A client at 6-weeks gestation presents to the office with report of vaginal bleeding for the last 12 hours without cramping. Which action should the nurse take?
- A Inquire about last occurrence of intercourse.
- B Verify date of last menstrual cycle.
- C Repeat a urine pregnancy test.
- D Check serum human chorionic gonadotropin.
Question 51
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 Flaring of the nares.
- B Bilateral bronchial breath sounds.
- C Diaphragmatic respirations.
- D A resting respiratory rate of 35 breaths/minute HESI Pediatric and Women’s Health
