Week 2 HESI/ EAQs

Question 1

Which of the school nurse’s observations are consistent with the diagnosis of bronchitis?

A dry cough that becomes productive.

The absence of fever or sore throat.

Exercise intolerance.

Response to β2-agonists.

Answer 1

A dry cough that becomes productive.

Bronchitis is characterized by a dry hacking cough that becomes productive over 2 to 3 days. The cough associated with asthma is nonproductive.

Question 2

The child’s caregiver asks the school nurse to explain the pulmonary function test. Which of the following information is accurate?

Pulmonary function tests are only accurate in children ages 8 and older who can blow a big breath out.

While helpful, pulmonary functions tests are an expensive alternative to careful history and physical assessment.

Pulmonary function tests are used to detect airflow limitation even when no symptoms are clinically evident.

Pulmonary function tests are of use at the time of diagnosis so the client will need no further testing.

Answer 2

Pulmonary function tests are used to detect airflow limitation even when no symptoms are clinically evident.

Question 3

In developing plan of care goals, the school nurse recognizes what level of activity is appropriate for children with asthma?

Sports involving running are contraindicated because of the potential for airway constriction.

Children with asthma who have a history of emergency department visits should limit physical activity.

Children with asthma should participate fully in all activities if they are in the green zone.

Children should participate in recess but cannot participate in organized sports.

Answer 3

Children with asthma should participate fully in all activities if they are in the green zone.

Question 4

Holding the breath for ____ seconds after inhalation enhances medication delivery to the lungs.

Answer 4

5 to 10

Question 5

The red zone signifies less than ___% of the child’s personal best. This is a medical emergency because it signifies that airway narrowing may be occurring.
The yellow zone signifies 50-79% of the personal best and indicates that the asthma is not well controlled and an acute exacerbation could occur.
The green zone is 80-100% of the child’s personal best and indicates that the asthma is under reasonably good control.

Answer 5

50

Question 6

Which action would the nurse take to facilitate a preschool child’s cooperation with a blood pressure measurement?

Coach the parent to perform the procedure.

Tell the child that this procedure will help them get well more quickly.

Encourage the child to handle equipment before putting the cuff in place.

Explain how the blood flows through the arm and why the blood pressure is important.

Answer 6

Encourage the child to handle equipment before putting the cuff in place.

Question 7

Which action would the nurse take when a preschooler is fearful of a vaccination?

Request a staff member sit beside the child.

Tell the child they can pick the bandage color.

Give a favorite toy to the child for distraction.

Tell the child bleeding will stop in a few seconds.

Answer 7

Tell the child they can pick the bandage color.

Question 8

Through which is the nurse’s best approach for effective communication with a preschool age child?

Play

Actions

Speech

Drawing

Answer 8

Play

Question 9

The nurse is caring for an immobilized preschool child. During this period of immobilization, which is the nurse’s best action?

Encourage wearing pajamas.

Let the child have few behavioral limitations.

Keep the child away from other immobilized children if possible.

Take the child outside of the room by wagon.

Answer 9

Take the child outside of the room by wagon.

Question 10

The nurse is providing care for a preschool child with edema. Which would the nurse use to record the urine output in the child?

Collection bag

Weighing wet pads

Collection container

Suprapubic aspiration

Answer 10

Weighing wet pads

Question 11

The nurse is preparing to administer an intramuscular immunization to a 5-year-old child. Which would be the best response by the nurse when the child says, “Please don’t do that. My blood can leak out from my body and I may die.”

“I will apply a bandage; it will not allow blood to come out.”

“Blood is in blood vessels and heart, so it will not come out.”

“Blood will not come out, as clotting factors form a clot to stop it.”

“Only a minimal amount of blood comes out in intramuscular injections.”

Answer 11

“I will apply a bandage; it will not allow blood to come out.”

Question 12

Which is the primary psychosocial task of the preschool period according to Erikson?

Identity

Intimacy

Initiative

Industry

Answer 12

Initiative

Question 13

A preschool child watches a nurse pour medication from a tall, thin glass to a short, wide glass. Which statement is developmentally appropriate for this age group?

“The amount of medicine is less.”

“Pouring medicine makes the medicine hot.”

“The glass changed shape to accommodate the medicine.”

“The amount of medicine did not change, only its appearance.”

Answer 13

“The amount of medicine is less.”

Question 14

The __________ of the food consumed is more important than the quantity.

Answer 14

quality

Question 15

Which growth and developmental change in a preschooler would the nurse include during a parent educational camp?

Incapability of differentiating gender

Curiosity about sexual reproduction

Uninterested in mingling with peers

Uninterested in playing indoor games

Answer 15

Curiosity about sexual reproduction

Question 16

The nurse prepares to administer a blood transfusion to a 7-year-old child with severe anemia with mild tissue hypoxia. The prescription reads that packed red blood cells (RBCs) are to be administered at 4 mL/kg. The nurse would contact the prescriber to clarify the prescription due to the following rationale?

The child requires supplemental oxygen.

Whole blood, not packed RBCs, would be used.

The prescribed amount for packed RBCs is too high.

Children under the age of 10 cannot receive transfusion therapy.

Answer 16

The prescribed amount for packed RBCs is too high.

Packed RBCs at 2 to 3 mL/kg should be used with a child, so the dosage is too high. Supplemental oxygen is not required because the child does not have severe tissue hypoxia. There is no age limit on transfusion therapy. Whole blood is not used because it could increase the chance of circulatory overload.

Question 17

The nurse is teaching the parents how to provide care for their child with sickle cell anemia. Which intervention would the nurse include in the teaching?

“Report a temperature of over 100°F.”

“Provide daily fluid intake as specified.”

“Enforce bladder control to avoid bed-wetting.”

“Report immediately if the spleen size decreases.”

Answer 17

“Provide daily fluid intake as specified.”

Question 18

Which description best reflects the pattern of genetic transmission known as autosomal recessive inheritance?

Disorders in which a single gene controls the particular trait

Disorders in which the abnormal gene is carried on the X chromosome

Disorders in which both genes of a pair must be abnormal for the disorder to be expressed

Disorders in which the abnormal gene for the trait is expressed even when the other member of the pair is normal

Answer 18

Disorders in which both genes of a pair must be abnormal for the disorder to be expressed

Question 19

Which is a preferred treatment for a child after a splenectomy?

Intravenous heparin

Iron dextran injection

Prophylactic antibiotics

Diphenhydramine

Answer 19

Prophylactic antibiotics

Question 20

After determining a 7-month-old African-American infant girl has sickle cell anemia and is having a crisis, the health care team begins therapy. Which activities would the nurse determine as priorities for this infant?

Immobilizing the patient’s upper extremities, administering antibiotics, and transfusing blood products

Administering pain medication, initiating intravenous (IV) fluids and electrolytes, and administering oxygen

Monitoring vital signs, inserting an indwelling urinary catheter, and encouraging activity to promote circulation

Preparing the infant for a transcranial Doppler test, administering penicillin, and administering meperidine for pain

Answer 20

Administering pain medication, initiating intravenous (IV) fluids and electrolytes, and administering oxygen

Question 21

Which is the most important nursing consideration when caring for a child with sickle cell anemia?

Refer parents and child for genetic counseling.

Teach parents and child how to minimize crises.

Observe for complications of multiple blood transfusions.

Help the child and family to adjust to a short-term disease.

Answer 21

Teach parents and child how to minimize crises.

Question 22

A child with sickle cell anemia (SCA) has a defective splenic function that increases the child’s susceptibility to infections. In reviewing the chart, which prescription would the nurse anticipate by the primary health care provider?

Pneumococcal vaccines

Oral penicillin prophylaxis

Chronic transfusion therapy

Antithymocyte globulin (ATG)

Answer 22

Pneumococcal vaccines

Question 23

The blood laboratory report of a 5-year-old child reveals a reduction in hemoglobin concentration below the normal value range. Which physiologic deficit does the nurse expect in the child?

Cyanosis due to deoxygenated hemoglobin

Iron-deficiency anemia due to decreased iron

Reduction in oxygen-carrying capacity of blood

Bone marrow failure due to reduction in hemoglobin
Eugene on target

Answer 23

Reduction in oxygen-carrying capacity of blood

Question 24

The nurse is caring for an infant with iron-deficiency anemia who is overweight. The nurse is concerned due to the following reason?

The infant will become at risk for diabetes.

The infant may be getting more milk than other foods.

The parents are overfeeding the infant with solid foods.

Infants with iron-deficiency anemia should be underweight.

Answer 24

The infant may be getting more milk than other foods.

Question 25

In a pediatric patient with cancer, the body may not be able to produce an adequate inflammatory response to infection, suppressing the usual clinical signs of infection. Which clinical sign of infection will still occur?

Fever

Swelling

Redness

Erythema

Answer 25

Fever

Question 26

For which reason is pulse oximetry often used on young children to monitor arterial oxygen saturation?

It is noninvasive.

It is more accurate than capnography.

It provides intermittent measurements of O2.

It is more accurate than arterial blood gases.

Answer 26

It is noninvasive.

Question 27

Upon assessment the nurse finds that the infant has a sunken abdomen, bowel sounds heard in the chest, nasal flaring, and grunting. What clinical condition does the nurse suspect the infant has based on these findings?

Epispadias

A ruptured viscus

A diaphragmatic hernia

Hirschsprung’s disease

Answer 27

A diaphragmatic hernia