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HESI PN Obstetrics, Maternity, Pediatrics Practice Exam With Answers (1000 Solved Questions)

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    HESI PN Obstetrics/Maternity Practice Exam, Pediatrics HESI PN Review, Hesi Peds, PN HESI Peds, Peds & Maternity HESI, HESI Maternity/Pediatric Remediation After repeating the vital signs for a newborn who is 4 hours old, the practical nurse (PN) obtains an axillary temperature of 97.2 F and places the newborn under a radiant heat warmer. Which additional finding should the PN observe in the newborn? - Tremors of the hands during crying. Which information should the practical nurse (PN) provide the parents about the purpose of instilling erythromycin (llotycin) ophthalmic ointment in the newborn's eyes. - Prophylactic treatment for gonorrheal and chlamydia infection. What is the most important action by the practical nurse (PN) in preventing neonatal infection? - Hand washing. a client who took iron supplements during pregnancy delivers and infant by cesarean section. On the second postpartum day, the client reports having a constipated stool that is greenish-black in color. Which action should the practical nurse (PN) implement? - Record color and consistency of the stool. A client is 5 weeks pregnant call the clinic to report that her home pregnancy test is positive. She asks what she should be concerned about during the weeks before her first visit. Which signs and symptoms should the practical nurse (PN) tell the client to report immediately to the healthcare provider? (select all that apply) - A. Vaginal bleeding D. Membrane rupture E. Severe headaches A 3-day-old newborn who weighed 7 pounds, 8 ounces at birth is breast feeding and now weighs 6 pound and 15 ounces. Which action should the practical nurse take? - Document the weight loss

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    Which medication is prescribed for the prevention of ophthalmia neonatorum? - Erythromycin (iilotycin) A multiparous client's membranes rupture after 8 hours of labor. which action should the practical nurse implement at this time? - Assess the fetal heart rate (FHR) and pattern. The practical nurse (PN) palpates fundal height at the umbilicus of a multiparous client who has just given birth to an 8-pound boy when dark red blood comes from the client's vagina. What action is most important for the PN to implement? - Continue to massage the fundus until firm. Which client should the practical nurse (PN) closely monitor for severe after pains? - A multigravida who is breastfeeding. The practical nurse (PN) is assessing a client 2 hours after a vaginal delivery of a 7-pound 3-ounce newborn and determines the client's bladder is distended. Which additional finding should the PN report to the charge nurse? - Excessive bleeding on the perineal pad. The practical nurse (PN) places a newborn who is 4 hours old with an axillary temperature of 97.2 F under the radiant heat warmer. Which rationale supports the PN's action? - The newborn's thin layer of subcutaneous fat provides poor insulation. Which strategy should the practical nurse (PN) implement to prevent a puerperal infection for a client during the first postpartum week? - Implement strict medical and aseptic technique. Which client is a candidate for the administration of human immune globulin (RhoGam) after delivery? - The Rh-negative mother who delivers a Rh-positive baby. Which physiological cause(s) for constipation during pregnancy should the practical nurse (PN) explain to a client in the first trimester? (Select all that apply.) - A. Displacement of the colon. E. Decrease in peristalsis.

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    A 14-week gestational client, who weighed 125 pounds before pregnancy, comes into the health clinic for a prenatal appointment. The client's weight today is 129 pounds. What action should the practical nurse (PN) implement? - Document the finding in the medical record. The practical nurse (PN) is reviewing the informational packets with a client who is at risk for preeclampsia. Which information is most important for the PN reinforce with the client? - Notify the clinic if any vision changes are experienced. A primigravida at 33-weeks gestation is admitted after being involved in a motor vehicle collision (MVC). The client has no complaints of abdominal pain and no evidence of vaginal bleeding. Which action should the practical nurse (PN) anticipate implementing for the client? - Obtain a biophysical profile. A primigravida client asks the practical nurse (PN). "How will i know that I will be going into labor soon?" Which sign should the PN provide that is a common sign? - Burst of energy. A primigravida client who is at 39-weeks gestation arrives at the clinic and tells the practical nurse (PN) she is having contractions every 5 minutes. The healthcare provider determines she is dilated 3 cm and in early labor. What action should the practical nurse (PN) implement when the client groans with each contraction? - Demonstrate simple relaxation measures. A primiparous client asks the practical nurse (PN) how much her newborn baby should sleep every day. What information should the PN provide? - A newborn sleeps most of the day and gradually will have increasing periods of wakefulness. The mother asks the practical nurse (PN) what her infant may need if the phenylketonuria(PKU) test is positive. What type of treatment should the PN tell the mother will be required? - Lifelong dietary management. The practical nurse (PN) is discussing aspects of newborn hygiene with the new parents as they prepare for discharge. Which information should the PN provide? - Create a draft-free environment when bathing the baby.

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    A mother who is preparing for discharge begins asking the practical nurse (PN) questions about bottle feeding her infant. What information should the PN reinforce? - Burp the newborn periodically during the feeding. An infant who weight 4550 grams is delivered using forceps-assisted vaginal delivery. What action is most important for the practical nurse (PN) to implement? - Monitor for signs of hypoglycemia. A young adult female comes to the health clinic to confirm a positive home pregnancy test. After determining the client's last menstrual period (LMP) as August 5, what expected date of birth (EDB) should the practical nurse (PN) calculate? - May 12 The practical nurse (PN) quickly moves the crib of a male newborn and notices that his legs flex. arms fan out, and then return toward his midline. What action should the PN implement? - Document the newborn demonstrates a Moro reflex. Which finding for a 2-week-old infant should the practical nurse (PN) report to the healthcare provider? - Yellowish tinge around the eyes. Which intervention should the practical nurse (PN) provide a neonate during hospitalization? - Offer the neonate a pacifier between feedings. A father expresses concern that his 3-day-old infant looks "yellow." Which information should the practical nurse (PN) provide? - Physiologic jaundice occurs from a normal reduction in red blood cells. The practical nurse (PN) is monitoring a child who is manifesting signs of shock after a motor vehicle collision. Which finding is most important for the PN to report to the charge nurse? a) narrowing pulse pressure b) apprehension

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    c) irritability d) thirst - Answer: A Rationale: As shock progresses, perfusion in the microcirculation becomes marginal despite compensatory adjustments, and the signs of decompensated shock become pronounced, such as tachycardia and narrowing pulse pressure (A). (The difference between systolic and diastolic blood pressure), which should be reported immediately. (B,C, and D) are not as significant as (A). The mother of a 9 month old male infant is concerned because he cries whenever she leaves him with a sitter. What is the best response for the practical nurse (PN) to provide? a) "Have you noticed whether your baby is teething?" b) "Crying when you leave him in a healthy sign of attachment." c) "Consider taking the baby to the doctor because he may be ill." d) "You could consider leaving the infant more often so he can adjust." - Answer: B Rationale: Healthy attachment is manifested by stranger anxiety in late infancy (B). Pain from teething expressed by the infant's cries does not occur only when the mother leaves the infant with another person (A). The PN should evaluate the infant's developmental needs (C) before suggesting the infant may be ill. An infant who manifests stranger anxiety is best supported by the mother if the infant is left for shorter periods of time, not (D). Which preoperative action is most important for the practical nurse (PN) to implement for a newborn with meningomyelocele? a) document vital signs b) prevent skin breakdown

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    c) minimize the risk for infection d) monitor neurologic functioning - Answer: C Rationale: A meningomyelocele provides a direct entry for bacteria into the central nervous system, leading to meningitis. Measures that protect the integrity of the meningomyelocele sac and infection control measures should be implemented to minimize the risk of infection (C). (A,B, and D) should be implemented but do not have the priority of (C). The practical nurse is caring for a 6 year old girl who had surgery 12 hours ago. The child tells the PN that she does not have pain but a few minutes later, tells her parents that she does. What child development concept is relevant to this situation? a) inconsistency in pain reporting suggests that pain not present b) a child may have pain yet deny its presence to the nurse c) truthful reporting of pain should occur by this age d) children use pain experiences to manipulate their parents - Answer: B Rationale: A child may fear receiving an injection for pain or may believe that pain is a deserved punishment for some misdeed, so the pain is denied (D) when the nurse asks the child, who then readily admits having pain to a parent. This behavior should not be interpreted as (C) but as a valid indication of pain. (A and C) are incorrect interpretations of this behavior. A 6 year old who had a tonsillectomy 12 hours ago is complaining of thirst. What should the practical nurse (PN) offer? a) popsicle b) lemonade

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    c) orange juice d) chocolate milk - Answer: A Rationale: Small amounts of clear liquids without red dyes should be offered to the child. Popsicles (A) are cold and help soothe a dry throat. Citrus drinks (B and C) are acidic and irritate the operative site in the posterior oropharynx. Milk (D) thickens oral mucus which makes swallowing more difficult and causes coughing. The mother of a male newborn calls the clinic to inquire about the formation of a yellow crust over her son's circumcision area. What information should the practical nurse (PN) provide? a) do not remove the yellow crust from the site b) stop using petroleum around the head of the penis c) bring him into the clinic d) tightly fasten the diaper - Answer: A Rationale: Crust formation is part of the healing process and should be removed (A). (C) is not indicated at this time. The diaper should be fastened loosely, not tightly (D) which can place pressure on the incision site. (B) assists in the healing process and should not be discontinued. The mother of a child with croup is having barking, coughing episodes calls the clinic for assistance. What action should the practical nurse (PN) recommend that the mother implement first? a) take the child outside in the cool air b) bring the child directly to the emergency room c) sit with the child in bathroom with a hot shower running d) have the child drink plenty of fluids - Answer: C

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    Rationale: Croup (laryngotracheobronchitis) is a viral infection that causes a "barking" cough and varying degrees of inspiratory stridor, which often responds to a high humidity environment. Most children can be managed at home using the stream from a hot shower in a closed bathroom (C) which often stops laryngeal spasm. Increasing the child's fluid intake is important (D), but not a priority at this time.Although exposure to cold air (A) also relieves stridor, parents should be encouraged to use mist humidifier in the child's room. (B) is not necessary unless the child is having increasingly difficulty breathing that may lead to a compromised airway. Which finding should the practical nurse confirm with the parents of an infant who is admitted with possible intussusception? a) red currant jelly stools b) clay colored stools c) constant abdominal pain d) projectile vomiting after meals - Answer: A Rationale: Red currant jelly stools (A) is a sign of intussusception, which causes a mixture of stool, mucous, and blood as the intestines telescopes inside itself. (D) is associated with pyloric stenosis. (B) is consistent with biliary obstruction. Infants with intussusception usually have periods of severe pain followed by intervals in which they appear comfortable, not (C). The practical nurse (PN) is observing a group of children at a day care center to determine whether children are achieving developmental milestones. Which activity should the PN identify as typical for a 2 year old child's cognitive development? a) has a vocabulary of about 1000 words b) uses short sentences to express self

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    c) initiates play with other children d) recognizes right and wrong - Answer: B Rationale: Although children develop at different rates, a 2 year old typically uses short sentences to express independence and control (B) and has a vocabulary of up to 300 words, not (A). At the age of 2 years, a toddler is developing negativism without understanding the concepts of right and wrong (D). A 2 year old engages in solitary play and parallel play but does not initiate or cooperative with other children (C) in play, which begins with socialization of the preschool child. The practical nurse (PN) is interviewing a 10 year old girl about school and her extracurricular activities. She responds, "I like school. I play the flute in the school band, and I take tennis lessons." Based on Erikson's psychosocial theory, the PN identifies that this child is in what stage of development? a) identity b) intimacy c) industry d) initiative - Answer: C Rationale: Erikson's stage of industry (C) for a school aged child is demonstrated by successful participation in new skills and peer activities, such as sports and band. (A, B, and D) are achieved in other age groups. The practical nurse (PN) identifies an increased frequency of otitis media (OM) is children who are coming to the clinic. Based on this finding, which age group should the PN monitor a child for signs and symptoms of OM? a) toddler b) preschooler

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    c) school ager d) adolescent - Answer: A Rationale: Infants and toddlers (A) are most prone to otitis media due to the anatomical structure of the eustachian tube that allows fluid and microbial entry into the middle ear. (B, C, and D) are most susceptible to acute infectious diseases acquired through environmental transmission from daycare or school settings. The practical nurse (PN) collects information about infant growth and development milestones for infants who come to the clinic for a well child visit. Which findings should the PN document as normal infant growth and development? a) maternal iron stores persist during the first 12 months of life b) anterior fontanel closes by 6 to 10 months of age c) binocularity is well established by 8 months of age d) birth weight double by age 5 months and triples by 1 year - Answer: D Rationale: Infants gain approximately 1.5 pounds/month until age 5 to 6 months, when the birth weight doubles, and by 1 year of age, the birth weight usually triples (D). The anterior fontanel closes by 12 to 18 months of age, with the average being 14 months, not (B). Binocularity begins to develop by 6 weeks of age and should be well established by age 4 months, not (C). Maternally derived iron stores ares present for the first 5 to 6 months and gradually diminish, which results in an expected lowered hemoglobin levels toward the end of the first 6 months (A). Which nonfood item is the most common cause of respiratory arrest in young children? a) latex balloons

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    b) broken rattles c) buttons d) pacifiers - Answer: A Rationale: Nonfood items cause the majority of choking deaths in young children. Latex balloons (A), whether partially inflated, uninflated, or popped, are the leading cause of pediatric choking that leads to aspiration of small objects (A,B, and D) because they experience the environment by placing objects in the mouth, but (A) is the leading cause of death causing respiratory obstruction and arrest. The practical nurse (PN) is talking with a group of elementary students about bicycle safety. Which information should the PN provide? a) wearing protective gear on a bicycle is a voluntary measure b) children should wear a bicycle helmet when riding a bicycle c) bicycle injuries involve a collision with an automobile d) riding double is allowed if the bicycle has an extra large seat - Answer: B Rationale: Bicycle accidents that result in head injuries are a common, accidental cause of morbidity and mortality, so bicycle safety and some state laws mandate that children should wear a protective helmet (B). (A, C, and D) do not provide accurate information. An adolescent female who comes to the school clinic is reluctant to confide her concerns to the practical nurse (PN). The PN tells the teen that confidentiality and privacy are maintained unless a life- threatening situation arises. Which principal supports the PN's response? a) disclosures from the adolescent should be kept confidential b) minor adolescents should not be encouraged to disclose private concerns

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    c) the adolescent should be encouraged to seek help outside of the school clinic d) honest information ensures establishing a trusting relationship - Answer: D Rationale: Critical elements in establishing trusting relationships include active listening, responding to the adolescent's emotions, and ensuring confidentiality and privacy, but situations that pose a life- threatening situation for the adolescent must be reported. Minor-aged adolescents have the right to confidential communication with providers unless the client is being abused or a life-threatening situation is evident. Honesty (D) is vital in the development of trust between an adolescent and a health professional. (A,B, and C) do not provide immediate intervention for the adolescent's concerns about self integrity and safety. The practical nurse (PN) is caring for a 6 year old girl who had surgery 12 hours ago. The child tells the PN that she does not have pain but a few minutes later, tells her parents that she does. What child development concept is relevant to this situation? a) inconsistency in pain reporting suggests that pain is not present b) truthful reporting of pain should occur by this age c) a child may have pain yet deny its presence to the nurse d) children use pain experiences to manipulate their parents - Answer: C Rationale: A child may fear receiving an injection for pain or may believe that pain is a deserved punishment for some misdeed, so the pain is denied (C) when the nurse asks the child, who then readily admits having pain to a parent. This behavior should not be interpreted as (D) but as a valid indication of pain. (A and B) are incorrect interpretations of this behavior. The practical nurse (PN) is monitoring a child who is manifesting signs of shock after a motor vehicle collision. Which finding is most important for the PN to report to the charge nurse?

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    a) narrowing pulse pressure b) irritability c) apprehension d) thirst - Answer: A Rationale: As shock progresses, perfusion in the microcirculation becomes marginal despite compensatory adjustments, and the signs of decompensated shock become pronounced, such as tachycardia and narrowing pulse pressure (A) (the difference between systolic and diastolic blood pressure), which should be reported immediately. (B,C, and D) are not as significant as (A). The practical nurse (PN) arrives at the playgrounds and sees a school-aged boy who has eaten something he is allergic to and is demonstrating a stridor. Which action should the PN implement first? a) ask if the child is alone b) call for an ambulance c) mov the child to a different environment d) determine what the child has eaten - Answer: B Rationale: Food allergy hypersensitivity can cause an anaphylactic reaction that can occur shortly after ingestion (5- 30 minutes) or exposure to an allergen, and manifest with hives, rash, flushing, asthmatic episode, or airway compromise, such as stridor. The first action is to call for an ambulance (B) immediately, since the condition may progress and become life-threatening. (A,C, and D) do not have the same priority of (B). A child who is admitted with acute abdominal pain and possible appendicitis. Which action should the practical nurse (PN) implement for the child's abdominal discomfort?

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    a) assist the child to any position of comfort. b) give a saline enema to cleanse the bowel c) lay a heating pad on the abdomen d) place the bed in trendelenburg - Answer: A Rationale: Abdominal pain is a common childhood complaint, but this child should be assisted to any position of comfort (A) that relieves the pain. (B and D) are contraindicated with possible appendicitis and increase the risk of ruptured appendix. If the appendix should rupture, (C) increases the spread of the infection. A child is admitted for observation following a closed head injury. Which assessment is most essential for the practical nues (PN) to monitor for an early sign of a worsening condition? a) level of consciousness b) posturing c) focal neurologic signs d) vital signs - Answer: A Rationale: Following a head injury, determining a change in the child's LOC (A) provides the first indication that a progression of the injury is possible. (C) is a symptom of advanced neurologic insult. Alterations in consciousness appear earlier than alterations of (B and D). A 3 year old boy with cerebral palsy (CP) has difficulty swallowing, cannot hold a utensil, and is slightly underweight for his height. Which action should the practical nurse implement when feeding this child? a) put the child in a well-supported semi-reclining position b) offer a specialized formula per tube feeding

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    c) place the child in a sitting position with the neck hyperextended d) stabilize the child's jaw with the caregiver's hand - Answer: D Rationale: A child with CP should be fed in an upright, eating position, and manual stability of the oral mechanisms during swallowing should be provided to minimize the risk of aspiration. Hold the child's jaw (D) from the side or front of the face assists with head control, correction of the neck and trunk hyperextension, and jaw stabilization. (A, B, and C) are not indicated. Which of Freud's psychosexual development stages occurs during a toddler's growth and development? a) anal b) oral c) genital d) phallic - Answer: A Rationale: According to Freud's theory, the anal stage (A_, 1-3 years of age, focuses on toilet training and learning to delay immediate gratification. Oral gratification(B) occurs from birth to one year of age. (C) The stage of genital awareness & exploration. (D) The stage of sexual identity and expression in adolescence. Using Freud's theory, the practical nurse should expect a 2 year old boy to demonstrate the behaviors of which stage? a) phallic b) anal c) latency d) oral - Answer: B

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