a 15 month old child is brought to the clinic for a routine checkup the nurse notes that the child is not walking independently yet what should the nu
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HESI RN

HESI Pediatrics Practice Exam

1. A 15-month-old child is brought to the clinic for a routine checkup. The nurse notes that the child is not walking independently yet. What should the nurse do next?

Correct answer: C

Rationale: The correct answer is to reassure the parents that some children walk later than others. It is essential to understand that children reach developmental milestones at different ages. Walking independently can occur later in some children, and it is normal. Referring the child for a developmental assessment (Choice A) may cause unnecessary concern at this stage. Encouraging physical therapy (Choice B) or discussing early intervention services (Choice D) may not be warranted unless there are specific concerns identified during the checkup.

2. What instructions should the nurse provide to the parents about the treatment of head lice in a 3-year-old boy who has been confirmed to have head lice?

Correct answer: A

Rationale: The correct instruction for the nurse to provide to the parents is to wash the child's bed linens and clothing in hot soapy water. This is essential to eliminate head lice as they can survive on bedding and clothing. It is also important to wash any other items that the child may have used or come into contact with, such as brushes and combs, to prevent reinfestation. Rewashing the child's hair following an isolation period is not necessary, and taking the child to a hair salon for a shampoo and shorter haircut is not a recommended treatment for head lice.

3. The caregiver is caring for a 10-year-old child with a history of frequent ear infections. The parents are concerned about their child’s hearing and speech development. What is the caregiver’s best response?

Correct answer: A

Rationale: The appropriate response for the caregiver is to address the parents' concerns by suggesting scheduling a hearing test and potentially referring the child to a speech therapist if necessary. This proactive approach can help evaluate and support the child's hearing and speech development effectively. Choice B is incorrect as assuming that most children outgrow ear infections and speech delays may overlook potential issues that need intervention. Choice C is wrong because waiting until adolescence to address concerns may lead to missed opportunities for early intervention. Choice D is incorrect as it dismisses the parents' valid concerns without offering a solution or further evaluation.

4. The nurse is conducting an admission assessment of an 11-month-old infant with CHF who is scheduled for repair of restenosis of coarction 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. What pathophysiologic mechanisms support these findings?

Correct answer: B

Rationale: The correct answer is B. Coarctation of the aorta causes narrowing of the aorta, reducing blood flow to the lower extremities. This narrowing results in higher blood pressure in the arms compared to the lower extremities, along with stronger brachial pulses and slightly palpable femoral pulses. Choices A, C, and D are incorrect because they do not align with the pathophysiological mechanism of coarctation of the aorta, which specifically leads to reduced blood flow to the lower extremities.

5. A child who is admitted to the hospital with anemia is anxious, fearful, and hyperventilating. The nurse anticipates the child developing which acid-base imbalance?

Correct answer: C

Rationale: In this scenario, the child is hyperventilating, which leads to excessive loss of carbon dioxide. This loss of carbon dioxide causes respiratory alkalosis due to a decrease in the partial pressure of carbon dioxide in the blood. Therefore, the correct answer is respiratory alkalosis. Choices A, B, and D are incorrect. Metabolic acidosis is characterized by a decrease in pH and bicarbonate levels due to conditions like kidney disease. Respiratory acidosis is caused by retention of carbon dioxide, leading to an increase in the partial pressure of carbon dioxide. Metabolic alkalosis results from a loss of acid or an increase in bicarbonate levels.

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