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HESI PEDs/OB EXAM STUDY GUIDE
1. 2 contraindications to live virus immunizations: * immunocompromised child
*child in a household with an immunocompromised person
2. 3 classic S/S of measles: * photophobia
*confluent rash that begins on the face and spreads downward
*Koplik spots on buccal mucosa
3. S/S of iron deficiency: * anemia
*pale conjunctiva
*pale skin color
*atrophy of papillae on tongue
*brittle, rigid, or spoon-shaped nails
*thyroid edema
4. Food sources of Vitamin A: * liver
*sweet potatoes
*carrots
*spinach
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*peaches
*apricots
5. What disease occurs with Vitamin C deficiency?: Scurvy
6. What measure reflect present nutritional status?: * weight
*skin fold thickness
*arm circumference
7. S/S of dehydration in an infant: * poor skin turgor
*absence of tears
*dry mucous membranes
*weight loss
*depressed fontanel
*decreased urinary output
8. Laboratory findings expected in a dehydrated child: * loss of bicarbonate/decreased serum pH
*hyponatremia
*hypokalemia
*elevated Hct
*elevated BUN
9. How should burns be assessed in children?: Lund-Browder chart (takes into account the changes
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*decreased interest in play
*irritability
*short attention span
14. Purpose of Bronchodilators: Help open airways by relaxing bronchial muscles
15. Assessment findings with asthma: * expiratory wheezes
*rales
*tight cough
*signs of altered blood gases
16. Nutritional support given with cystic fibrosis: * pancreatic enzyme placement
*fat-soluble vitamins
*low carb
*high protein
*high fat
17. Why is genetic counseling important with cystic fibrosis?: Disease is autosomal
recessive
18. 7 signs of respiratory distress in a pediatric client: * restlessness
*tachycardia
*tachypnea
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*diaphoresis
*nasal flaring
*retractions
*grunting
19. Care of a child in a mist test: * monitor child's temperature
*keep tent edges tucked in
*keep clothing dry
*assess respiratory status
*look at child inside tent
20. What position does a child with epiglottitis assume?: Upright sitting, with chin out and tongue
protruding ('tripod position")
21. Why are IV fluids important for a child with an increased respiratory rate?: The child is at
risk for dehydration and acid-base imbalances
22. What is the most common postoperative complication after a tonsillectomy? What
are its S/S?: Hemorrhage
*frequent swallowing
*vomiting fresh blood
*clearing throat
23. Differentiate between a R to L shunt and a L to R shunt in cardiac disease: * A R to L
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28. What position would best relieve the child experiencing a tet spell?: Knee-chest position
or squatting
29. Common S/S of digoxin toxicity: * diarrhea
*fatigue
*weakness
*N&V
*check for bradycardia before administration
30. 5 risks of cardiac catheterization: * arrhythmias
*bleeding
*perforation
*phlebitis
*obstruction of the arterial entry site
31. Cardiac complications associated with rheumatic fever: Aortic valve stenosis and mitral valve
stenosis
32. Medications used to treat rheumatic fever: * penicillin
*erythromycin
*aspirin
33. Physical features of a child with Down Syndrome: * simian creases in palms
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*hypotonia
*protruding tongue
*upward-outward slant of eyes
34. Describe scissoring: Common characteristic of spastic CP in infants, legs are extended and crossed over each other,
feet are plantar flexed
35. 2 nursing priorities for a newborn with myelomeningocele: * prevention of infection of sac
*monitoring for hydrocephalus (measure head circumference, check fontanels, assess neurological functioning)
36. S/S of IICP in older children: * irritability
*change in LOC
*motor dysfunction
*headache
*vomiting
*unequal pupil response
*seizures
37. What teaching should parents of a newly shunted child receive?: * information about
signs of infection and IICP
*shunt should not be pumped and child will need revisions with growth
*guidance concerning growth and development
38. 3 main goals in providing nursing care for a child experiencing a seizure: * maintain
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44. Nursing interventions that can increase ICP: * suctioning
*positioning
*turning
45. Mechanism of inheritance of Duchenne muscular dystrophy: X-linked recessive trait
46. What is the Gowers sign?: Indicator of muscular dystrophy (child has to "walk" their hands up their legs to
stand)
47. Compare the S/S of acute glomerulonephritis (AGN) with those of nephrosis-
: AGN - gross hematuria, recent strep infection, mild edema Nephrosis - severe edema, massive proteinuria, frothy-appearing urine, anorexia
48. What antecedent event occurs with AGN?: Strep B infection
49. Compare the dietary interventions for AGN and nephrosis: AGN: low-sodium diet with no
added salt Nephrosis: high-protein, low-salt diet
50. Physiological reason for hypoproteinuria in nephrosis: Glomeruli are permeable to serum
proteins
51. Safe monitoring of prednisone administration and withdrawal: * long-term pred- nisone
should be given every other day
*S/S of edema, mood changes, and GI distress should be reported
*should not be discontinued suddenly (taper ott)
52. Interventions taught to prevent UTIs: * avoid bubble baths
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*void frequently
*drink fluids (especially acidic fluids - apple or cranberry juice)
*clean genital area from front to back
53. Pathophysiology of vesicoureteral reflux: Malfunction of the valves at the end of the ureters, allowing
urine to reflux out of the bladder into the ureters and possibly into the kidneys
54. Priorities for a client with a Wilms tumor: * protect child from injury to encapsulated tumor
*prepare child and family for surgery
55. Why is hypospadias correction performed before the child reaches preschool age?:
Preschoolers fear castration, achieving sexual identity, and acquiring independent toileting skills
56. Feeding techniques for a child with cleft lip or palate: * lambs nipple or prosthesis
*feed upright with frequent bubbling
57. S/S of esophageal atresia with TEF: * choking
*coughing
*cyanosis
*excess salivation
58. What nursing actions are initiated for the newborn with suspected
esophageal atresia with TEF?: * maintain NPO immediately
*suction secretions
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64. What are the priorities for a child undergoing abdominal surgery?: * maintain fluid
balance (I&O, NG suction, monitor electrolytes)
*monitor VS
*care for drains
*assess bowel function if present
*prevent infection to incision
*support child and family with appropriate teaching
65. Describe the information families should be given when a child is receiving oral iron
preparations: * give on empty stomach and with vitamin C
*use straws to avoid discoloring teeth
*tarry stools are normal
*increase dietary sources of iron
66. Dietary sources of iron: * meat
*green leafy vegetables
*fish
*liver
*whole grains
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*legumes
67. What is the genetic transmission pattern of hemophilia?: It is an X-linked recessive
chromosomal disorder transmitted by the mother and expressed in male children
68. Sequence of events in a vasoocclusive crisis in sickle cell disease: * caused by the
clumping of RBCs, which blocks small blood vessels
*cells cannot get through the capillaries
*causes pain and tissue/organ ischemia
*lowered O2 tension affects HgbS, which causes sickling of the cells
69. Explain why hydration is a priority in treating sickle cell disease: Hydration promotes
hemodilution and circulation of the red cells through the blood vessels
70. What should families and clients do to avoid triggering sickling episodes?: * keep child
well hydrated
*avoid known sources of infection
*avoid high altitudes
*avoid strenuous exercise
71. Nursing interventions and medical treatments for a child with leukemia are based
on what 3 physiologic problems?: * anemia (decreased erythrocytes)
*infections (neutropenia)
*bleeding thrombocytopenia (decreased platelets)
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*milk
*dairy products
*eggs
79. What are the 3 classic signs of diabetes?: * polydipsia
*polyphagia
*polyuria
80. Differentiate the S/S of hypoglycemia and hyperglycemia: Hypoglycemia = tremors, sweating,
headache, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around mouth, nightmares Hyperglycemia = polydipsia, polyuria, polyphagia, blurred vision, weakness, weight loss, and syncope
81. Describe the nursing care of a child with ketoacidosis: * provide care for an unconscious
child
*administer regular insulin IV in normal saline
*monitor blood gas values
*maintain strict I&O
82. Describe developmental factors that would affect the school-age with dia- betes: *
need to be liked by peers
*assuming responsibility for own care
*modification of diet
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*snacks and exercise in school
83. What is the relationship between hypoglycemia and exercise?: During exercise, insulin
uptake is increased and the risk for hypoglycemia occurs
84. List normal findings in a neurovascular assessment: * warm extremity
*brisk capillary refill
*free movement
*normal sensation of the affected extremity
*equal pulses
85. What is compartment syndrome?: Damage to nerves and vasculature of an extremity due to
compression
86. What are the S/S of compartment syndrome?: Abnormal neurovascular assessment: cold extremity,
severe pain, inability to move the extremity, and poor capillary refill.
87. What are fractures of the epiphyseal plate a special concern?: May affect the growth of the
limb
88. How is skeletal traction applied?: Skeletal traction is maintained by pins or wires applied to the distal
fragment of the fracture.
89. What discharge instructions should be included concerning a child with a spica
cast?: * check child's circulation
*keep cast dry
*do not place anything under cast
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*teaching about medication management and S/E of drugs
94. Objective signs that signify ovulation: * abundant, thin, clear cervical mucous
*spinnbarkeit (egg-white stretchiness) of cervical mucus
*open cervical os
*slight drop in basal body temperature and then 0.5-1 degree F rise
*ferning under the microscope
95. Ovulation occurs how many days before the next menstrual cycle?: 14 days
96. State 3 ways to identify the chronological age of a pregnancy (gestation).: * 10
lunar months
* 9 calendar months consisting of 3 trimesters
* 40 weeks; 280 days
97. What maternal position provides optimum fetal and placental perfusion during
pregnancy?: The knee chest position, but the ideal position of comfort for the mother which supports fetal, maternal, and placental perfusion, is the side lying position (removes pressure from the abdominal vessels [vena cava, aorta])
98. Name the major discomforts of the first trimester and one suggestion for
amelioration of each: * N&V = crackers before rising
*fatigue = rest periods and naps; 7-8 hrs of sleep at night
99. If the first day of a woman's last normal menstrual period was February 3, what is
the EDB using the Nagele's rule?: November 10
100. At 20 weeks gestation, the fundal height would be ; the fetus would
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*a baby with hair, lanugo, and vernix, but without any subcutaneous fat
101. State the normal psychological responses to pregnancy in the 2nd
trimester: * ambivalence wanes and acceptance of pregnancy occurs
*pregnancy becomes "real"
*signs of maternal-fetal bonding occur
102. The hemodilution of pregnancy
peaks at weeks and results in an in a woman's Hct: * 28-32 weeks
*decrease
103. State 3 principles relative to the pattern of weight gain in pregnancy: * total weight gain
should average 25-35 lbs
*gain should be consistent throughout pregnancy
*an average of 1 lb/week should be gained in the 2nd and 3rd trimesters
104. During pregnancy a woman should add calories to her diet and
drink of milk per day: * 300 calories
* 8 ounces
105. FHR can be auscultated by Doppler at
weeks' gestation: 10 - 12 weeks
