what behavior does the nurse anticipate while feeding a newborn with choanal atresia
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Nursing Elites

HESI LPN

Pediatric HESI 2023

1. What behavior does the nurse anticipate while feeding a newborn with choanal atresia?

Correct answer: D

Rationale: Correct answer: When feeding a newborn with choanal atresia, the nurse should anticipate that the infant may take only part of the feeding. This behavior is due to the condition causing difficulty in breathing through the nose while feeding, prompting the infant to pause for air. Choice A, 'Chokes on the feeding,' is incorrect as it does not specifically relate to the feeding behavior expected in choanal atresia. Choice B, 'Has difficulty swallowing,' is also incorrect because the issue in choanal atresia is primarily related to breathing rather than swallowing. Choice C, 'Does not appear to be hungry,' is not the typical behavior seen in infants with choanal atresia; they may still display hunger cues but struggle with feeding due to the condition.

2. What clinical manifestation of tetralogy of Fallot should the nurse expect when caring for children with this diagnosis?

Correct answer: B

Rationale: The correct answer is B: Clubbing of fingers. Clubbing of fingers is a common manifestation in children with tetralogy of Fallot due to chronic hypoxia. This condition causes the fingertips and nails to enlarge, creating a bulbous or club-like appearance. Slow respirations (Choice A) are not a typical clinical manifestation of tetralogy of Fallot. Decreased RBC counts (Choice C) may be seen in conditions like anemia but are not specific to tetralogy of Fallot. Subcutaneous hemorrhages (Choice D) are not a characteristic clinical manifestation of tetralogy of Fallot.

3. A parent calls the clinic because their child has ingested a small amount of household bleach. What should the nurse advise?

Correct answer: C

Rationale: In the case of a child ingesting household bleach, the primary advice should be to call the poison control center (Choice C). The poison control center can provide specific guidance on how to manage the ingestion, including whether any immediate interventions are necessary. Administering activated charcoal (Choice A) or inducing vomiting immediately (Choice B) can worsen the situation as they are not recommended treatments for bleach ingestion. Taking the child to the emergency department (Choice D) may be necessary depending on the advice given by the poison control center, but the initial step should be to seek guidance from the experts at the poison control center.

4. A nurse in the emergency department observes large welts and scars on the back of a child who has been admitted for an asthma attack. What additional information must be included in the nurse’s assessment?

Correct answer: B

Rationale: The correct answer is B: Signs of child abuse. Large welts and scars on a child may be indicative of abuse, making it crucial for the nurse to assess and report any suspicions. Assessing the history of an injury (choice A) may not provide insight into the cause of the welts and scars as effectively as looking for signs of potential abuse. Food allergies (choice C) and recent recovery from chickenpox (choice D) are not directly relevant to the observation of welts and scars on the child's back.

5. What should be the priority action when caring for a child with acute laryngotracheobronchitis?

Correct answer: D

Rationale: The priority action when caring for a child with acute laryngotracheobronchitis is to continually assess the respiratory status (Option D). Acute laryngotracheobronchitis can potentially lead to respiratory distress, making continuous monitoring crucial to identify early signs of deterioration and intervene promptly. While options A, B, and C are also important aspects of care, they do not take precedence over respiratory assessment in this critical situation. Initiating measures to reduce fever (Option A), ensuring oxygen delivery (Option B), and providing emotional support (Option C) are all significant interventions, but without ongoing assessment of respiratory status, there is a risk of missing potential respiratory deterioration.

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