How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?

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HESI Pediatrics Quizlet Questions

Question 1 of 9

How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?

Correct Answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. It confirms the absence of ganglion cells in the affected bowel segment, which is characteristic of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for confirmation as it may not provide a definitive result. Multiple saline enemas (Choice C) are utilized in the treatment of meconium ileus, a complication of cystic fibrosis, and not in the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a diagnostic tool for Hirschsprung disease; it is commonly used for gastrointestinal decompression or feeding purposes but does not confirm the diagnosis.

Question 2 of 9

A 2-year-old child with a diagnosis of autism spectrum disorder is being discharged. What should the nurse include in the discharge teaching?

Correct Answer: A

Rationale: The correct answer is to maintain a structured routine. Children with autism spectrum disorder benefit greatly from structured routines as they provide a sense of stability and predictability, which can help reduce anxiety and improve behavior. Encouraging social interaction (Choice B) is important but may need to be approached in a structured manner to prevent overwhelming the child. Positive reinforcement (Choice C) is also beneficial for behavior management but may not address the overall need for routine and predictability that is crucial for children with autism. Using a communication board (Choice D) may be helpful for facilitating communication, but establishing and maintaining a structured routine is fundamental for supporting the child's development and well-being in managing their autism spectrum disorder.

Question 3 of 9

During a primary survey of a child with partial thickness burns over the upper body areas, what action should the nurse take first?

Correct Answer: B

Rationale: When managing a child with partial thickness burns over the upper body areas, the priority action during the primary survey is to assess for a patent airway. This step is crucial as burns in this region can lead to airway compromise, potentially causing rapid deterioration in the child's condition. Checking for a patent airway ensures that the child can breathe adequately, which is essential for oxygenation and ventilation. Inspecting the child's skin color (Choice A) is an important assessment but should follow ensuring a patent airway. Observing for symmetric breathing (Choice C) is relevant, but the immediate focus should be on securing the airway. Palpating the child's pulse (Choice D) is also a vital assessment, but in this scenario, the priority is to assess and maintain a clear airway to support respiratory function and oxygen delivery.

Question 4 of 9

In a case where a limb is protruding from a mother's vagina during active labor, how should this condition be managed?

Correct Answer: B

Rationale: When a limb is protruding from the vagina during active labor, the appropriate management includes positioning the mother in a head-down position with her hips elevated. This position helps relieve pressure on the umbilical cord, reducing the risk of compromising fetal blood flow and oxygenation. Administering oxygen is essential to maintain oxygenation levels for both the mother and the fetus. Providing transport to a healthcare facility equipped to manage this obstetric emergency is crucial for ensuring a safe delivery. Choice A is incorrect because a semi-Fowler's position does not effectively relieve pressure on the umbilical cord. Choice C is incorrect as applying traction to the protruding limb can lead to injury or complications for both the mother and the fetus. Choice D is incorrect because attempting to manipulate the limb without proper positioning and preparation can worsen the situation and increase risks during delivery.

Question 5 of 9

During a primary survey of a child with partial thickness burns over the upper body areas, what action should the nurse take first?

Correct Answer: B

Rationale: The correct answer is B: Assess for a patent airway. When dealing with a child who has sustained partial thickness burns, the priority is ensuring a patent airway due to the risk of respiratory compromise. Checking the child's skin color (choice A) may be important but is secondary to assessing the airway. While observing for symmetric breathing (choice C) is crucial, assessing the airway takes precedence in this situation. Palpating the child's pulse (choice D) is not the initial priority when managing burns and potential airway compromise.

Question 6 of 9

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.

Question 7 of 9

What is the priority intervention for a 10-year-old girl in a foster family?

Correct Answer: D

Rationale: In a foster family setup, the priority intervention for a 10-year-old girl is to perform a comprehensive health assessment. This is crucial as children in foster care may have moved between different homes, leading to incomplete medical records. A comprehensive health assessment helps identify any health issues, track the child's growth and development, and ensure appropriate medical care. While addressing bullying at school, managing parental expectations, and establishing the primary caretaker are important considerations, the immediate priority for the child's well-being and holistic care is to conduct a thorough health assessment.

Question 8 of 9

A home care nurse is visiting a family for the first time. The 4-week-old infant had surgery for exstrophy of the bladder and creation of an ileal conduit soon after birth. When the nurse arrives, the mother appears tired, and the baby is crying. After an introduction, which is the most appropriate statement by the nurse?

Correct Answer: A

Rationale: The most appropriate statement by the nurse in this scenario is to inquire about the family's daily routine. This question allows the nurse to gather information about the family dynamics, the care routine for the infant post-surgery, feeding schedules, and potential stressors. It opens the conversation in a non-intrusive manner and helps the nurse assess the family's situation to provide appropriate support. Choices B, C, and D do not address the situation effectively. Asking about the daily routine is crucial for the nurse to understand the family's needs and offer targeted assistance.

Question 9 of 9

What is the most common cause of shock (hypoperfusion) in infants and children?

Correct Answer: A

Rationale: Infection is the most common cause of shock in infants and children due to their increased susceptibility to sepsis. Infants and children have underdeveloped immune systems, making them more prone to infections that can lead to septic shock. While cardiac failure is a serious condition, it is not the most common cause of shock in this population. Accidental poisoning, though dangerous, is less common than infection in causing shock in infants and children. Severe allergic reactions can lead to anaphylactic shock, but they are not as prevalent as infections in causing shock in this age group.

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