HESI LPN
Pediatrics HESI 2023
1. During the second week of hospitalization for intravenous antibiotic therapy, a 2-year-old toddler whose family is unable to visit often smiles easily, goes to all the nurses happily, and does not express interest in the parent when the parent does visit. The parent tells the nurse, 'I am pleased about the adjustment but somewhat concerned about my child’s reaction to me.' How should the nurse respond?
- A. The child is repressing feelings for the parent.
- B. Routines have been established, and the child feels safe.
- C. The child has given up fighting and accepts the separation.
- D. Behavior has improved because the child feels better physically.
Correct answer: C
Rationale: The correct answer is C: 'The child has given up fighting and accepts the separation.' This response indicates that the child is emotionally withdrawing due to the separation from the parent during hospitalization. Choice A is incorrect because the child's behavior does not necessarily suggest repressed feelings for the parent. Choice B is incorrect as feeling safe due to established routines does not fully explain the child's behavior. Choice D is incorrect because while feeling better physically may contribute to improved behavior, it does not address the emotional aspect of the child's reaction to the parent.
2. After the nurse has completed an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?
- A. Before starting school
- B. Within the next few months
- C. When the first deciduous teeth are lost
- D. At the next dental check-up for a family member
Correct answer: B
Rationale: The most appropriate time for a child to first visit the dentist is within the next few months after turning two years old. This visit allows the dentist to assess the child's oral health, provide guidance on proper oral hygiene practices, and establish a positive relationship with dental care. Choice A (Before starting school) is not as specific and timely as the recommended age of 2 years. Choice C (When the first deciduous teeth are lost) is not ideal as preventive dental visits should start earlier to establish good oral health habits. Choice D (At the next dental check-up for a family member) may delay the child's first dental visit, missing the opportunity for early preventive care and guidance.
3. After a discussion with the health care provider, the parents of an infant with patent ductus arteriosus (PDA) ask the nurse to explain once again what PDA is. How should the nurse respond?
- A. The diameter of the aorta is enlarged.
- B. The wall between the right and left ventricles is open.
- C. It is a narrowing of the entrance to the pulmonary artery.
- D. It is a connection between the pulmonary artery and the aorta.
Correct answer: D
Rationale: The correct answer is D: 'It is a connection between the pulmonary artery and the aorta.' Patent ductus arteriosus (PDA) is an abnormal connection between the pulmonary artery and the aorta, which normally closes after birth. Choices A, B, and C describe different cardiac conditions and do not accurately define PDA. Choice A is incorrect because PDA does not involve the diameter of the aorta being enlarged. Choice B is incorrect because PDA does not involve the wall between the right and left ventricles being open. Choice C is incorrect because PDA is not a narrowing of the entrance to the pulmonary artery.
4. While assessing an 18-month-old child, a nurse observes that the toddler can crawl upstairs but needs assistance when climbing the stairs upright. What does this action indicate to the nurse?
- A. Presence of talipes equinovarus
- B. Reflective of neurologic damage
- C. Expected behavior in a toddler of this age
- D. Existence of developmental dysplasia of the hip
Correct answer: C
Rationale: The correct answer is C. Needing assistance to climb stairs is considered expected behavior for an 18-month-old toddler. At this age, children are still developing their gross motor skills, coordination, and balance, which can vary in proficiency. It is common for toddlers to be able to crawl upstairs before mastering the skill of climbing stairs upright. Options A, B, and D are incorrect because at 18 months, it is normal for children to require help and practice with climbing stairs and does not necessarily point to any specific medical conditions or developmental issues.
5. A 1-week-old infant has been in the pediatric unit for 18 hours following placement of a spica cast. The nurse observes a respiratory rate of fewer than 24 breaths/min. No other changes are noted. Because the infant is apparently well, the nurse does not report or document the slow respiratory rate. Several hours later, the infant experiences severe respiratory distress and emergency care is necessary. What should be considered if legal action is taken?
- A. Most infants have slow respirations when they are uncomfortable.
- B. The respirations of young infants are irregular, so a drop in rate is unimportant.
- C. Vital signs that are outside the expected parameters are significant and should be documented.
- D. The respiratory tract of young infants is underdeveloped, and their respiratory rate is not significant.
Correct answer: C
Rationale: In this scenario, the correct answer is C. Any vital signs outside the expected range in an infant should be documented and reported, as they may indicate a developing condition that requires prompt attention. Choice A is incorrect because slow respirations in infants should not be dismissed without assessment and documentation. Choice B is incorrect because a drop in respiratory rate in this case was significant and should have been documented. Choice D is incorrect because even though infants have underdeveloped respiratory tracts, any abnormal respiratory rate should be taken seriously and documented for monitoring and intervention if necessary.
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