A toddler with a chronic illness that requires frequent hospitalization is likely to experience which psychosocial developmental challenge?- Skildor

Question 1 of 5

A toddler with a chronic illness that requires frequent hospitalization is likely to experience which psychosocial developmental challenge?

A. Fixation with feelings of inadequacy B. Interference with the development of autonomy C. Distortion of differentiation of self from parent D. Delayed language, fine-motor, and self-care skills

Correct Answer: B

Rationale: Toddlers with chronic illnesses requiring frequent hospitalization may experience interference with the development of autonomy. This is because the need for constant medical care can restrict their independence and ability to explore and make choices, which are essential aspects of achieving autonomy according to Erikson's stages of psychosocial development.

Question 2 of 5

The nurse is conducting an admission assessment of an 11-month-old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings?

A. The aortic semilunar valve obstructs blood flow into the systemic circulation B. The lumen of the aorta reduces the volume of the blood flow to the lower extremities C. The pulmonic valve prevents adequate blood volume into the pulmonary circulation D. An opening in the atrial septum causes a murmur due to a turbulent left to right shunt

Correct Answer: B

Rationale: Coarctation of the aorta causes narrowing of the aorta, reducing blood flow to the lower extremities, leading to higher blood pressure in the arms.

Question 3 of 5

The parents of a 3-year-old boy who has Duchenne muscular dystrophy ask, 'How can our son have this disease? We are wondering if we should have any more children.' What information should the nurse provide to parents?

A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family B. The striated muscle groups of males can be impacted by a lack of the protein dystrophin in their mothers C. The male infant had a viral infection that went unnoticed and untreated so muscle damage was incurred D. Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles

Correct Answer: A

Rationale: The correct answer is A. Duchenne muscular dystrophy is an X-linked recessive disorder that primarily affects males. It is crucial for the nurse to explain to the parents that this condition follows an inheritance pattern where the gene mutation responsible for the disorder is located on the X chromosome. Males have only one X chromosome, so if they inherit the mutated gene, they will develop the disease. Females, on the other hand, have two X chromosomes, providing a backup copy that can compensate for the mutation. Understanding this inheritance pattern is essential for family planning decisions, as the risk of passing on the disorder to future children can be explained based on this genetic inheritance.

Question 4 of 5

The nurse finds a 6-month-old infant unresponsive and calls for help. After opening the airway and finding the XXXX, the infant is still not breathing. What action should the nurse take next?

A. Palpate the femoral pulse and check for regularity. B. Deliver cycles of 30 chest compressions and 2 breaths. C. Give two breaths that make the chest rise. D. Feel the carotid pulse and check for adequate breathing.

Correct Answer: C

Rationale: In a scenario where a 6-month-old infant is unresponsive and not breathing after the airway is open, giving two breaths that make the chest rise is the appropriate action. This helps deliver oxygen to the infant's lungs and can help initiate breathing. Chest compressions are not recommended for infants as the first step in resuscitation. Checking pulses like the femoral or carotid pulse is not the priority when an infant is not breathing, as providing oxygen through breaths is essential.

Question 5 of 5

The nurse is assessing a 6 month old infant. Which response requires further evaluation by the nurse?

A. Has doubled birth weight. B. Turn head to locate sound. C. Plays peek-a-boo. D. Demonstrates startle reflex.

Correct Answer: D

Rationale: The startle reflex should diminish by this age; persistence requires evaluation.

Pediatric HESI

Skildor

HESI RN

HESI RN

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