HESI Pediatric and Women's Health
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Free HESI Pediatric and Women's Health Questions
Patient Data
History and Physical
The client is a 4-year-old male with a history of
prematurity, short gut syndrome, and liver and
bowel transplant. He has been hospitalized for
the past 8 months, 6 of those were spent in the
pediatric intensive care unit. He is currently in
the pediatric unit for observation as his
posttransplant medications are stabilized for
discharga.
Nurses' Notes
The child's mother has been staying at the hospital since the child's last admission. She reported that her mother has an
illness and will have to be away a few days. When she left, the child screamed and clung to her, causing his blood pressure
to increase to 120/81 mm Hg and pulse 140 beats/minute. Notified the healthcare provider.(HCP) of the vital sign change.
He cried for approximately 1 hour after his mother left, but he is sleeping now.
Day 2
The child's mom returned for a brief visit and received an update from the HCP. A child life specialist came to the bedside
when the mother left for distraction technique. The child screamed loudly and attempted to hit the child life specialist. He is
resting now with music playing.
Day 3
No visit from the mother.
Day 4
The child is refusing to participate in physical therapy. He will not speak to staff, which is unusual. He says he is sad and, misses Mommy”
Review H and P, and nurse's note.
Which action(s) is/are appropriate for the nurse caring for this child? Select
all that apply.
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Develop a trusting relationship with the child.
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Facilitate phone conversations between the child and his mother.
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Avoid mentioning anything about the mother to the child.
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Notify the mother that social services will be notified if she does not visit regularly
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Ask the mother to bring a familiar object from home.
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Have the child sign a treatment contract stating he will participate in therapy.
Explanation
The Correct Answers are:
A. Develop a trusting relationship with the child.
B. Facilitate phone conversations between the child and his mother.
E. Ask the mother to bring a familiar object from home.
A. Develop a trusting relationship with the child
Establishing trust helps the child feel secure and supported during a prolonged hospitalization. Consistent, compassionate care builds emotional safety, especially when separation anxiety is intensified by illness and prolonged hospital stays.
B. Facilitate phone conversations between the child and his mother
Maintaining contact with the primary caregiver reduces the child’s fear of abandonment and provides emotional reassurance. Hearing the mother’s voice supports attachment and helps ease the distress caused by her absence.
E. Ask the mother to bring a familiar object from home
Familiar items such as a blanket, stuffed animal, or toy provide comfort and a sense of stability in an unfamiliar hospital environment, helping reduce anxiety and promote emotional adjustment.
A child who weighs 30 kg is experiencing a grand mal seizure.
The healthcare provider prescribes diazepam 0.3 mg/kg/dose intravenous (IV) STAT. The medication is available in 5 mg/mL vials.
How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth).
-
1.5 mL
-
1.8 mL
-
2.0 mL
-
2.3 mL
Explanation
The Correct Answer is:
B. 1.8 mL
Step-by-Step Calculation:
Determine the total prescribed dose:
0.3 mg × 30 kg = 9 mg
Determine volume to administer:
Available concentration = 5 mg/mL
9 mg ÷ 5 mg/mL = 1.8 mL
Explanation:
The nurse should administer 1.8 mL of diazepam IV. This ensures the prescribed dose of 0.3 mg/kg is delivered safely and accurately for seizure control. Rounding to the nearest tenth confirms the final dose as 1.8 mL.
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?
-
Administer oxygen via face mask
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Place the client in Trendelenburg
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Notify the operating room team
-
Administer a fluid bolus of 500 mL
Explanation
The Correct Answer is:
B. Place the client in Trendelenburg
The visible umbilical cord indicates a prolapsed umbilical cord, a medical emergency that compromises fetal oxygenation due to cord compression. The nurse’s immediate priority is to relieve pressure on the cord by placing the client in a Trendelenburg or knee-chest position, allowing gravity to shift the fetus off the cord. After positioning, the nurse should manually lift the presenting part if needed, administer oxygen, and prepare for an emergency cesarean delivery.
The nurse is evaluating a preschool-aged child who is presenting with symptoms of flank pain, dysuria, and a low-grade fever. What additional information should the nurse obtain from the parent to determine if the child might have a urinary tract infection?
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Frequency of urination
-
Any recent changes in diet
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Presence of any unusual odors in the urine
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Any changes in the color of the urine
Explanation
The Correct Answer is:
A. Frequency of urination
Detailed Explanation:
When assessing for a urinary tract infection (UTI) in a preschool-aged child, obtaining a history of urinary frequency is essential. Children with UTIs often experience increased frequency, urgency, and burning during urination due to bladder irritation and inflammation. Along with flank pain, dysuria, and low-grade fever, increased urinary frequency strengthens the likelihood of a UTI diagnosis.
A youngster with nephrotic syndrome is recommended a 25% intravenous albumin. Which assessment result gives the nurse the impression that the drug is working as intended?
-
Improved caloric intake
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Reduction of edema
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Reduction of fever
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Weight gain
Explanation
The Correct Answer is:
B. Reduction of edema
In nephrotic syndrome, large amounts of protein are lost through the urine, causing hypoalbuminemia and resulting in edema due to decreased plasma oncotic pressure. Administration of albumin 25% IV increases the plasma protein concentration, raising oncotic pressure and pulling fluid back into the intravascular space. This leads to a reduction in edema, improved urine output, and decreased abdominal distention. Weight loss from fluid reduction, not gain, indicates effective treatment.
When developing a teaching plan for an adolescent male who was recently diagnosed with Type 1 diabetes mellitus, the nurse should instruct the client to consume a source of sugar if which symptom occurs?
-
Seeing spots
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Profuse perspiration
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Racing pulse
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Excessive thirst
Explanation
The Correct Answer is:
B. Profuse perspiration.
Detailed Explanation:
Profuse perspiration is a classic early sign of hypoglycemia, a condition in which blood glucose levels fall below normal (usually under 70 mg/dL). Other common symptoms include shakiness, hunger, irritability, and confusion. The nurse should teach the adolescent to immediately consume a quick-acting source of sugar such as fruit juice, glucose tablets, or regular soda to prevent progression to severe hypoglycemia, which can result in seizures or loss of consciousness.
The nurse is assessing the growth and development of a 3-year-old child.
Which speech and language skills should the nurse identify as normal developmental milestones for this child?
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Recognizes most letters and numbers.
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Uses 1-word sentences.
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Speaks in simple sentences with four or more words.
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Uses gestures with 1 to 2-word sentences.
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Uses gestures with 1 to 2-word sentences.
Explanation
The Correct Answer is:
C. Speaks in simple sentences with four or more words.
Detailed Explanation:
By age 3, a child’s language skills typically include the ability to form simple sentences of four or more words. They can carry on brief conversations, use pronouns correctly, and be understood by unfamiliar listeners most of the time. This reflects developing cognitive and social abilities as the child learns to express needs and ideas verbally. These milestones also demonstrate normal progression in receptive and expressive language development for a preschool-aged child.
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?
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Palpate femoral pulses
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Compare temperature of both legs
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Examine for spontaneous movement
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Monitor capillary refill of the toes
Explanation
The Correct Answer is:
D. Monitor capillary refill of the toes
After cast application, neurovascular assessment is the nurse’s top priority to detect early signs of circulatory impairment or compartment syndrome. Monitoring capillary refill of the toes provides a quick and reliable measure of distal perfusion. Prolonged refill time (>3 seconds), coolness, or discoloration indicates compromised circulation requiring immediate intervention to prevent permanent tissue damage or loss of limb function.
A newborn with a repaired gastroschisis is transferred to the pediatric unit after several days in the pediatric intensive care unit.
The infant is receiving parenteral nutrition and continuous enteral feedings.
To maintain normal growth and development of the infant, which action should the nurse include in the plan of care?
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Speak to the healthcare provider about instituting physical therapy.
-
Offer a pacifier for non-nutritive sucking.
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Ensure placement of the enteral tube with an abdominal x-ray.
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Use sterile technique during feedings.
Explanation
The Correct Answer is:
B. Offer a pacifier for non-nutritive sucking.
Providing a pacifier for non-nutritive sucking helps preserve oral-motor function in infants who cannot take feedings by mouth after gastroschisis repair. This practice encourages the development of the suck reflex, which is necessary for later oral feeding. It also promotes neurobehavioral organization, reduces stress, and provides comfort, helping to stabilize heart rate and oxygen levels. Supporting this reflex while the infant receives enteral or parenteral nutrition fosters smoother transition to oral feeding and contributes to healthy growth and developmental progress.
During a routine clinic visit, a nurse finds that a 5-year-old girl’s systolic blood pressure is above the 90th percentile. What should be the nurse’s subsequent action?
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Refer the child to the healthcare provider and schedule a blood pressure evaluation in two weeks.
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Perform a comprehensive assessment and avoid repeated blood pressure measurements during the examination.
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Take the child’s blood pressure three times during the visit and record the highest reading.
-
Measure the blood pressure twice more during the visit and calculate the average of the three readings.
Explanation
The Correct Answer is:
D. Measure the blood pressure twice more during the visit and calculate the average of the three readings.
Detailed Explanation:
When a child’s blood pressure reading is elevated (above the 90th percentile for age, gender, and height), the nurse should repeat the measurement twice during the same visit and calculate the average of all three readings. This confirms accuracy and reduces the chance of false elevation due to anxiety, movement, or incorrect cuff size. Only if elevated readings persist across multiple visits should further evaluation for hypertension be initiated.
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