the nurse is assessing a 4 year old client which finding suggests to the nurse this child may have a genetic disorder
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Pediatrics HESI 2023

1. The healthcare professional is assessing a 4-year-old client. Which finding suggests to the healthcare professional this child may have a genetic disorder?

Correct answer: C

Rationale: Low-set ears with lobe creases are often associated with genetic disorders and can indicate underlying chromosomal abnormalities. This physical characteristic is known to be a common sign in various syndromes like Down syndrome. Choices A, B, and D are not directly linked to genetic disorders. Feeding problems and specific weight/height measurements are more general indicators of growth and development, while the ability to hop on one foot but not skip is a developmental milestone assessment that does not specifically point towards a genetic disorder.

2. What finding would the nurse expect to assess in a child with hypothyroidism?

Correct answer: D

Rationale: Weight gain is the expected finding in a child with hypothyroidism. Hypothyroidism leads to a slowed metabolism, which can result in weight gain. Choices A, B, and C are not typical findings in hypothyroidism. Nervousness and heat intolerance are more commonly associated with hyperthyroidism, where the body is in a state of overactivity. Smooth velvety skin is not a characteristic sign of hypothyroidism.

3. A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. What should the nurse do first?

Correct answer: C

Rationale: The correct action to take first when a child with sickle cell anemia presents with severe chest pain, fever, cough, and dyspnea is to notify the practitioner because acute chest syndrome is suspected. This condition is a medical emergency requiring prompt intervention. Administering oxygen or pain medication may be necessary interventions but should not precede notifying the practitioner. Stroke is not typically associated with these symptoms in sickle cell anemia.

4. The nurse is teaching a father how to stimulate his 7-year-old son, who has a 'slow-to-warm-up' temperament. Which guidance will be most successful?

Correct answer: A

Rationale: The correct answer is A. Reading stories to the child about famous athletes would be the most successful guidance for a child with a 'slow-to-warm-up' temperament. This approach allows for a less active and more acceptable way of engaging with the child, aligning better with the child's temperament. Choices B, C, and D involve more active and potentially overwhelming activities for a child with such a temperament, which may not be as effective in stimulating and engaging the child.

5. What is the priority nursing responsibility when a 3-year-old child in a crib is experiencing a tonic-clonic seizure with a clamped jaw?

Correct answer: C

Rationale: During a tonic-clonic seizure, the priority nursing responsibility is to protect the child from self-injury. Applying restraints (Choice A) can cause harm by restricting movement during the seizure. While administering oxygen (Choice B) may be necessary, it is not the immediate priority during an active seizure. Inserting a plastic airway (Choice D) is contraindicated as it can lead to injury and is not recommended during a seizure. Protecting the child from self-injury (Choice C) is crucial to prevent harm from uncontrolled movements and potential falls, ensuring the safety of the child.

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