HESI LPN
Pediatric HESI 2023
1. A child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?
- A. Avoid spicy foods
- B. Avoid gluten
- C. Avoid high-fat foods
- D. Avoid dairy products
Correct answer: C
Rationale: The correct dietary instruction for a child with GERD is to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux. While avoiding gluten may be necessary for individuals with gluten sensitivity or celiac disease, it is not a standard recommendation for GERD. Avoiding spicy foods and dairy products may help some individuals with GERD, but the most crucial dietary advice is to avoid high-fat foods.
2. A healthcare professional is reviewing the clinical records of infants and children with cardiac disorders who developed heart failure. What did the professional determine is the last sign of heart failure?
- A. Tachypnea
- B. Tachycardia
- C. Peripheral edema
- D. Periorbital edema
Correct answer: C
Rationale: Peripheral edema is often considered the last sign of heart failure in infants and children. It indicates significant fluid retention and circulatory compromise. Tachypnea (increased respiratory rate) and tachycardia (increased heart rate) are early signs of heart failure due to inadequate cardiac output. Periorbital edema, while a sign of excess fluid, typically occurs earlier in the progression of heart failure compared to peripheral edema.
3. When caring for a child and family who just moved out of a dangerous neighborhood, which of the following approaches is appropriate to the family stress theory?
- A. Determining who the decision maker is
- B. Assessing the child's coping abilities
- C. Finding out how siblings feel
- D. Explaining procedures to siblings
Correct answer: B
Rationale: Assessing the child's coping abilities is appropriate when applying the family stress theory because it helps understand how well the child is managing the stress of the situation. This assessment can provide insights into the child's emotional well-being and resilience, enabling healthcare providers to offer appropriate support. Choices A, C, and D are less relevant in the context of family stress theory. Determining who the decision-maker is may be important but is not directly related to assessing the child's coping abilities. Finding out how siblings feel and explaining procedures to siblings may be valuable aspects of care but are not specifically aligned with the core principles of the family stress theory, which focus on understanding and addressing stress within the family unit.
4. A child has undergone surgery using steel bar placement to correct pectus excavatum. What position would the nurse instruct the parents to avoid?
- A. Semi-Fowler
- B. Supine
- C. High Fowler
- D. Side-lying
Correct answer: D
Rationale: The correct answer is D: Side-lying. After surgery using steel bar placement to correct pectus excavatum, the nurse should instruct the parents to avoid placing the child in a side-lying position. This position should be avoided to prevent displacement of the steel bar. Choices A, B, and C are incorrect. Semi-Fowler, Supine, and High Fowler positions are generally safe and commonly used in postoperative care, but in this specific case, side-lying should be avoided to ensure the effectiveness of the surgical correction.
5. The healthcare provider is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?
- A. After a decade of escalation, the percentage of children living in low-income families has been declining since 2000.
- B. White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
- C. The proportion of children between the ages of 6 and 18 who are overweight is decreasing, but there is a significant increase in African American females.
- D. The overall health care plan of working families may improve access to specialty care but limit access to preventive services.
Correct answer: B
Rationale: Choice B is the correct answer as white, non-Hispanic children are more likely to be in very good or excellent health compared to African American and Hispanic children. This is an important disparity in health outcomes that may be influenced by various social determinants. Choices A, C, and D are incorrect because they do not accurately describe how certain families are affected by common barriers to health care. Choice A discusses the declining percentage of children in low-income families, which is not directly related to barriers to health care. Choice C talks about overweight children and the increase in African American females but does not address access to health care. Choice D discusses the impact of health care plans on working families but does not specifically address barriers to health care access for families.
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