2350C RN Pediatrics HESI NGN

Free preview · Original latest version

Sample questions from 2350C RN Pediatrics HESI NGN

This material has 150 questions with answers and rationales. Here are the first 5.

1. 1.During a 9-month well-child visit, a caregiver reports that the infant sits steadily and transfers toys between hands but does not crawl. Which response by the nurse is most appropriate?

   • A.Crawling is a required milestone, so the infant needs an immediate neurologic referral.
   • B.Some infants skip crawling; assess other developmental skills and continue routine surveillance.
   • C.The caregiver should use a walker to encourage independent mobility.
   • D.The infant should be placed in a seated position more often to strengthen the legs.

   Rationale: Crawling is variable and is not a required milestone; steady sitting and transferring objects are reassuring skills at this age. An immediate referral based only on absent crawling is premature, although the nurse should assess the full developmental pattern and follow up. Extra seated time does not promote motor progression, and walkers are unsafe and do not teach walking.

2. 2.At a home visit, the parent of a 2-year-old says, "My child screams when I leave the room and insists on doing everything myself." Which interpretation should guide the nurse's response?

   • A.The child is demonstrating regression that requires restricting choices.
   • B.The behavior indicates impaired attachment and should be addressed with separation training.
   • C.The child is showing initiative and should be expected to complete tasks independently.
   • D.These behaviors are consistent with emerging autonomy and separation anxiety.

   Rationale: Toddlers commonly seek autonomy while also experiencing separation anxiety, so both behaviors can be developmentally expected. Restricting all choices may intensify power struggles, and the behavior alone does not establish impaired attachment. Initiative is more characteristic of the preschool period, and a toddler should not be expected to manage tasks independently.

3. 3.Refer to the client's chart. Which actions should the nurse take to support safe feeding and evaluate the infant's growth pattern? Select all that apply.

   • A.Plot the current weight and length on the appropriate growth chart and compare with prior measurements.
   • B.Observe a feeding to assess latch, suck-swallow-breathe coordination, and caregiver technique.
   • C.Ask about feeding frequency, duration, formula preparation, and the infant's intake and output.
   • D.Reassure the caregiver that the weight change is expected because infants normally lose weight throughout the first month.
   • E.Recommend adding cereal to the bottle to increase caloric intake without further assessment.

   Rationale: The chart shows weight falling from 3.42 kg at birth to 3.12 kg at day 10, so observed feeding, accurate growth plotting, and a detailed intake history are appropriate next steps. Cereal in a bottle is not a safe or appropriate intervention without assessment and a specific clinical plan. Newborn weight loss is expected only during the early days after birth, with birth weight generally regained by about 10 to 14 days; continued loss at day 10 warrants evaluation.

4. 4.A preschool teacher tells the clinic nurse that a 4-year-old rarely engages in pretend play, uses mostly single words, and does not respond consistently to the child's name. Which action is the best next step?

   • A.Recommend a developmental evaluation that includes hearing and communication assessment.
   • B.Advise the teacher to require the child to maintain eye contact during interactions.
   • C.Explain that parallel play and limited speech are expected until school age.
   • D.Wait until the child begins kindergarten because screening before then is unreliable.

   Answer and rationale are in the full material.

5. 5.In the emergency department, a 3-year-old who is hospitalized for an injury becomes quiet and clings to a parent when staff approach. Which nursing action is most likely to reduce distress while supporting the child's development?

   • A.Ask the parent to leave so the child can learn that staff are safe.
   • B.Promise that the procedure will not hurt to gain the child's cooperation.
   • C.Allow the child to handle safe equipment and offer a simple, limited choice.
   • D.Explain the procedure using detailed medical terms before beginning.

   Answer and rationale are in the full material.