HESI LPN
Pediatric HESI Practice Questions
1. The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a purplish color with discharge and a foul odor. The nurse suspects which infection?
- A. Burn wound cellulitis.
- B. Invasive burn cellulitis.
- C. Burn impetigo.
- D. Staphylococcal scalded skin syndrome.
Correct answer: B
Rationale: The correct answer is B: Invasive burn cellulitis. Invasive burn cellulitis presents with the burn developing a dark brown, black, or purplish color with discharge and a foul odor. Burn wound cellulitis (choice A) typically involves redness, warmth, and swelling around the burn site. Burn impetigo (choice C) is a superficial infection characterized by honey-colored crusting. Staphylococcal scalded skin syndrome (choice D) is a condition caused by exotoxins from Staphylococcus aureus, leading to widespread skin peeling.
2. A nurse is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area?
- A. Growth plate.
- B. Epiphysis.
- C. Physis.
- D. Metaphysis.
Correct answer: B
Rationale: The correct answer is B: Epiphysis. Bone growth primarily occurs in the epiphysis, which is the area where growth plates are located. The epiphysis is responsible for longitudinal bone growth. Choice A, 'Growth plate,' is incorrect as it does not specify the exact area where bone growth primarily occurs. Choice C, 'Physis,' refers to the same structure as a growth plate, but the term 'epiphysis' is more specific to bone growth. Choice D, 'Metaphysis,' is incorrect as it is the area of the bone where the epiphysis meets the diaphysis, not the primary site of bone growth.
3. On the third day of hospitalization, the nurse observes that a 2-year-old toddler who had been screaming and crying inconsolably begins to regress and is now lying quietly in the crib with a blanket. What stage of separation anxiety has developed?
- A. Denial
- B. Despair
- C. Mistrust
- D. Rejection
Correct answer: B
Rationale: The correct answer is B: 'Despair'. In separation anxiety, the stage of despair is characterized by regression and withdrawal after the initial protest. The toddler's shift from intense crying to lying quietly with a blanket demonstrates this withdrawal behavior. Choice A, 'Denial', is incorrect as denial involves refusing to accept the reality of separation. Choice C, 'Mistrust', is incorrect as it relates to a lack of trust rather than the stage of separation anxiety described in the scenario. Choice D, 'Rejection', is incorrect as it does not reflect the behavior of the toddler in the scenario, which is more indicative of withdrawal and regression.
4. A parent calls the outpatient clinic requesting information about the appropriate dose of acetaminophen for a 16-month-old child who has signs of an upper respiratory tract infection and fever. The directions on the bottle of acetaminophen elixir are 120 mg every 4 hours when needed. At the toddler’s 15-month visit, the healthcare provider prescribed 150 mg. What is the nurse’s best response to the parent?
- A. “The dose is close enough, and it doesn’t really matter which one is given.”
- B. “From your description, the medication is not necessary. It should be avoided at this age.”
- C. “It is appropriate to use dosages based on age. Children typically have weights consistent for their age groups.”
- D. “The prescribed dose of the drug was based on weight, and this is a more accurate way of determining a therapeutic dose.”
Correct answer: D
Rationale: The most accurate way to determine a therapeutic dose for children is based on their weight rather than age. Weight-based dosing accounts for individual variations in drug metabolism and distribution, ensuring a more precise and safer medication administration. Choices A, B, and C are incorrect as they do not address the importance of weight-based dosing in children, potentially leading to inappropriate dosing and safety concerns.
5. A 2-year-old child who was admitted to the hospital for further surgical repair of a clubfoot is standing in the crib, crying. The child refuses to be comforted and calls for the mother. As the nurse approaches the crib to provide morning care, the child screams louder. Knowing that this behavior is typical of the stage of protest, what is the most appropriate nursing intervention?
- A. Use comforting measures while holding the child.
- B. Fill the basin with water and bathe the child.
- C. Sit by the crib and bathe the child later when the anxiety decreases.
- D. Postpone the bath for a day because a child this upset should not be traumatized further.
Correct answer: C
Rationale: During the stage of protest, children may display distress when separated from their primary caregiver. Sitting by the crib and providing comfort when the child is less anxious is an appropriate intervention. Choice A is incorrect because attempting to hold the child while they are in distress may escalate the situation. Choice B is inappropriate as it ignores the child's emotional distress and proceeds with a task that can wait. Choice D is not the best option as postponing the bath for a day is not necessary; instead, addressing the child's emotional needs promptly is crucial in this situation.
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