HESI LPN
Pediatric HESI 2024
1. A 7-month-old girl is to be catheterized to obtain a sterile urine specimen. One of the infant’s parents expresses fear that this procedure may traumatize the baby psychologically. How should the nurse provide reassurance?
- A. The fear is justified and the nurse should obtain a “clean catch” specimen.
- B. Parents have a right to refuse the catheterization and the concerns are realistic.
- C. Although the concern is appropriate, the need for a sterile specimen is the priority.
- D. The procedure is uncomfortable, but there should not be a damaging long-term effect.
Correct answer: D
Rationale: While catheterization can be uncomfortable, it does not typically result in long-term psychological harm, and obtaining a sterile specimen is important for accurate diagnosis.
2. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect when palpating the infant’s abdomen?
- A. A distended colon
- B. Marked tenderness around the umbilicus
- C. An olive-sized mass in the right upper quadrant
- D. Rhythmic peristaltic waves in the lower abdomen
Correct answer: C
Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS due to the hypertrophied pylorus muscle. Choices A, B, and D are incorrect. A distended colon is not typically associated with HPS. Marked tenderness around the umbilicus is not a specific finding of HPS. Rhythmic peristaltic waves in the lower abdomen are not expected in HPS, as the condition primarily affects the pylorus region of the stomach.
3. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?
- A. absence of a urethral opening
- B. penis appears shorter than usual for age
- C. the urethral opening is along the dorsal surface of the penis
- D. the urethral opening is along the ventral surface of the penis
Correct answer: D
Rationale: Hypospadias is a congenital condition where the urethral opening is located along the ventral surface of the penis, not the dorsal surface (Choice C) or absent (Choice A). This leads to the characteristic appearance of a ventrally displaced urethral meatus. The penis may appear normal in size but with the urethral opening positioned abnormally (Choice D), rather than being shorter than usual (Choice B). Therefore, the correct expectation for a newborn with hypospadias is that the urethral opening is along the ventral surface of the penis, making Choice D the correct answer.
4. The caregiver explains to the parent of a 2-year-old child that the toddler’s negativism is expected at this age. What need is this behavior meeting?
- A. Trust
- B. Attention
- C. Discipline
- D. Independence
Correct answer: D
Rationale: Negativism in toddlers is a common behavior at this age as they begin to assert their independence and show a desire to control their environment. Choice A, 'Trust,' does not align with the behavior of negativism, as it is more about the child's growing autonomy. Choice B, 'Attention,' while important for child development, is not the primary need being met by negativism in this context. Choice C, 'Discipline,' though important in guiding behavior, is not the underlying need being expressed through negativism. Therefore, the correct answer is D, 'Independence,' as toddlers exhibit negativism as a way to assert their independence and autonomy.
5. What would a healthcare professional expect to find when assessing the skin of a child with cellulitis?
- A. Red, raised hair follicles
- B. Warmth at skin disruption site
- C. Papules progressing to vesicles
- D. Honey-colored exudate
Correct answer: B
Rationale: Cellulitis is characterized by warmth at the site of skin disruption, indicating an infection. The correct answer is choice B. Choice A, 'Red, raised hair follicles,' is more indicative of folliculitis rather than cellulitis. Choice C, 'Papules progressing to vesicles,' is more characteristic of conditions like chickenpox, not cellulitis. Choice D, 'Honey-colored exudate,' is typical of wound infections with bacteria like Staphylococcus aureus, not cellulitis.
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