RN HESI Obstetrics and Pediatrics Exam 2

Extract:

Question 1 of 5

When administering indomethacin to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome?

Correct Answer: C

Rationale: Indomethacin promotes closure of the patent ductus arteriosus, reducing the cardiac murmur associated with the abnormal blood flow.

Question 2 of 5

A 15-year-old girl asks the clinic nurse for information about oral contraceptives because she is planning to have sexual relations with her 17-year-old boyfriend but does not want her parents to know. Which action should the nurse take?

A. Counsel the girl about the risks and benefits of using oral contraceptives. B. Explain that contraceptive information cannot be provided without the parents' permission. C. Tell the girl that information about contraceptives should be obtained from the school nurse. D. Tell the girl that a variety of contraceptives are available from the clinic.

Correct Answer: A

Rationale: Counseling about the risks and benefits of oral contraceptives prioritizes the adolescent's health, providing informed decision-making support while respecting confidentiality.

Question 3 of 5

What are some possible changes that might explain the trend in glycosylated haemoglobin in this client? Select all that apply.

A. The client may be experiencing stress at home or at school. B. The client may be taking too much insulin. C. The client may be ingesting too many calories for his energy needs. D. The client may be eating fewer carbohydrates. E. The client may have increased insulin requirements due to puberty.

Correct Answer: A,C,D,E

Rationale: Stress , excessive calorie intake , reduced carbohydrate intake , and puberty-related insulin needs can all affect glycosylated hemoglobin levels by altering blood glucose control.
Too much insulin is less likely without specific evidence.

Question 4 of 5

A 12-year-old boy with hemophilia is hospitalized for hemarthrosis of his right knee. He is complaining of severe knee pain. Which intervention should the nurse implement?

A. Elevate and immobilize right knee in a flexed position. B. Apply hot packs to the right knee. C. Perform range of motion exercises to the right knee. D. Give ibuprofen for pain.

Correct Answer: A

Rationale: Elevating and immobilizing the knee in a flexed position minimizes movement, reducing pain and further bleeding in hemarthrosis.

Question 5 of 5

A 4-month-old girl is brought to the clinic by her mother because she has had a cold for 2 to 3 days and woke up this morning with a barking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress?

A. Bilateral bronchial breath sounds. B. A resting respiratory rate of 35 breaths/minute. C. Diaphragmatic respirations. D. Flaring of the nares.

Correct Answer: D

Rationale: Flaring of the nares indicates increased respiratory effort and accessory muscle use, a clear sign of acute respiratory distress in infants.