HESI LPN
Pediatric HESI 2023
1. A healthcare provider is assessing a 3-month-old infant with suspected pyloric stenosis. What clinical manifestation is the healthcare provider likely to observe?
- A. Projectile vomiting
- B. Diarrhea
- C. Constipation
- D. Abdominal distension
Correct answer: A
Rationale: Projectile vomiting is a classic clinical manifestation of pyloric stenosis in infants. This occurs due to the narrowing of the pyloric sphincter, leading to the forceful expulsion of gastric contents in a projectile manner. Diarrhea (choice B) is not typically associated with pyloric stenosis. Constipation (choice C) is also not a common symptom of this condition. Abdominal distension (choice D) may occur in pyloric stenosis but is not as specific or characteristic as projectile vomiting in diagnosing this condition.
2. A 2-year-old child with a diagnosis of atopic dermatitis is being discharged. What should the nurse include in the discharge teaching?
- A. Avoid triggers that cause flare-ups
- B. Apply topical corticosteroids as prescribed
- C. Use a soft toothbrush for oral care
- D. Avoid contact with sick individuals
Correct answer: B
Rationale: The correct answer is to 'Apply topical corticosteroids as prescribed.' Atopic dermatitis is a condition characterized by inflammation and itchiness of the skin. Topical corticosteroids are commonly used to reduce inflammation and relieve symptoms in atopic dermatitis. Teaching the caregiver to apply the medication as prescribed by the healthcare provider is crucial for managing the child's condition effectively. Choices A, C, and D are not the priority discharge teaching for atopic dermatitis. While avoiding triggers that cause flare-ups and contact with sick individuals can be beneficial, the immediate focus should be on proper medication administration to address the underlying inflammation and symptoms of atopic dermatitis.
3. What is the first action to take before administering tube feeding to an infant?
- A. Irrigate the tube with water.
- B. Offer a pacifier to the infant.
- C. Slowly instill 10 mL of formula.
- D. Place the infant in the Trendelenburg position.
Correct answer: B
Rationale: The correct first action before administering tube feeding to an infant is to offer a pacifier. Providing a pacifier stimulates the sucking reflex, aiding in digestion and providing comfort to the infant. Irrigating the tube with water (Choice A) is not typically the initial step and could potentially introduce unnecessary fluid into the infant's system. Slowly instilling formula (Choice C) should only be done after ensuring the tube is appropriately placed. Placing the infant in the Trendelenburg position (Choice D) is not necessary for tube feeding and could pose risks such as aspiration.
4. A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?
- A. Child is in the concrete operational stage of cognition.
- B. Child’s dependence on peer influence is increasing.
- C. Child will welcome opportunities for participation in self-care.
- D. Child is exploring their sense of self-identity.
Correct answer: C
Rationale: The correct answer is C. At the age of 8, children are typically eager to take on responsibilities and participate in self-care activities. This is a crucial developmental characteristic to consider when educating a child about managing a chronic condition like type 1 diabetes. Choice A is incorrect as children at this age are usually in the concrete operational stage, not abstract level, of cognition. Choice B is incorrect because while peer influence is important, it does not reach its peak at this age. Choice D is incorrect as exploring self-identity is more characteristic of adolescence, not 8-year-old children.
5. A parent calls the clinic because their child has ingested a small amount of household bleach. What should the nurse advise?
- A. Administer activated charcoal
- B. Induce vomiting immediately
- C. Call the poison control center
- D. Take the child to the emergency department
Correct answer: C
Rationale: In the case of a child ingesting household bleach, the primary advice should be to call the poison control center (Choice C). The poison control center can provide specific guidance on how to manage the ingestion, including whether any immediate interventions are necessary. Administering activated charcoal (Choice A) or inducing vomiting immediately (Choice B) can worsen the situation as they are not recommended treatments for bleach ingestion. Taking the child to the emergency department (Choice D) may be necessary depending on the advice given by the poison control center, but the initial step should be to seek guidance from the experts at the poison control center.
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