HESI LPN
Pediatric Practice Exam HESI
1. Why might a healthcare provider question a health care provider's order for a tap water enema for a 6-month-old infant with suspected Hirschsprung disease?
- A. The result could lead to loss of necessary nutrients.
- B. It could cause a fluid and electrolyte imbalance.
- C. It could increase the fear of intrusive procedures.
- D. The result could cause shock from a sudden drop in temperature.
Correct answer: B
Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas are unlikely to lead to loss of necessary nutrients. Choice C is incorrect as it does not directly relate to the physiological risk of tap water enemas. Choice D is incorrect as shock from a sudden drop in temperature is not a common concern with tap water enemas.
2. After a child returns from surgery for a tracheostomy, what is the priority nursing action?
- A. Suctioning the tracheostomy tube
- B. Changing the tracheostomy dressing
- C. Monitoring respiratory status
- D. Ensuring the tracheostomy ties are secure
Correct answer: A
Rationale: The priority nursing action after a tracheostomy surgery is to suction the tracheostomy tube. Suctioning helps maintain a clear airway and prevent complications such as airway obstruction or respiratory distress. While monitoring respiratory status is important, suctioning takes precedence immediately post-surgery to ensure adequate air exchange. Changing the tracheostomy dressing and ensuring tracheostomy ties are secure are also essential tasks but are secondary to the critical need for airway maintenance through suctioning.
3. A 2-year-old 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: B
Rationale: The correct dietary instruction for a 2-year-old child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye that can worsen GERD symptoms. Avoiding gluten can help reduce inflammation and discomfort in the esophagus. Choices A, C, and D are incorrect because spicy foods, high-fat foods, and dairy products can exacerbate GERD symptoms. Spicy foods can irritate the esophagus, high-fat foods delay stomach emptying leading to increased acid reflux, and dairy products can stimulate acid production, all of which can worsen GERD symptoms.
4. A child with acute lymphoblastic leukemia (ALL) is hospitalized for treatment. What is the priority nursing intervention?
- A. Administering antibiotics
- B. Preventing infection
- C. Providing nutritional support
- D. Managing pain
Correct answer: B
Rationale: The priority nursing intervention for a child hospitalized for acute lymphoblastic leukemia (ALL) is preventing infection. Children with ALL have compromised immune systems, making them highly vulnerable to infections. Preventing infections through strict aseptic techniques, isolation precautions, and proper hygiene is crucial to safeguard the child's health. Administering antibiotics (choice A) may be necessary if an infection occurs, but the primary focus should be on infection prevention. While providing nutritional support (choice C) is important, preventing infection takes precedence due to its direct impact on the child's survival. Managing pain (choice D) is essential for the child's comfort but is not the priority over preventing life-threatening infections in this scenario.
5. Where should the child admitted with injuries that may be related to abuse be placed?
- A. In a private room
- B. With an older, friendly child
- C. With a child of the same age
- D. In a room near the nurses’ desk
Correct answer: D
Rationale: The correct answer is to place the child in a room near the nurses’ desk. This placement allows for close monitoring and immediate intervention if needed, ensuring the safety and well-being of the child. Placing the child in a private room (Choice A) may limit visibility and monitoring. Putting the child with an older, friendly child (Choice B) or a child of the same age (Choice C) does not prioritize the necessary close monitoring and intervention that a child potentially experiencing abuse requires. Hence, placing the child in a room near the nurses’ desk is the most appropriate choice in this scenario.
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