HESI LPN
Pediatric HESI 2023
1. When assessing a child with suspected nephrotic syndrome, what clinical manifestation is the nurse likely to observe?
- A. Jaundice
- B. Edema
- C. Hypertension
- D. Polyuria
Correct answer: B
Rationale: Edema is a hallmark clinical manifestation of nephrotic syndrome. In nephrotic syndrome, there is increased glomerular permeability leading to the loss of proteins, particularly albumin, in the urine. This results in decreased oncotic pressure, leading to fluid shifting into the interstitial spaces and causing edema. Jaundice (Choice A) is not a typical clinical manifestation of nephrotic syndrome. Hypertension (Choice C) is more commonly associated with conditions like glomerulonephritis. Polyuria (Choice D) is not a primary symptom of nephrotic syndrome; instead, patients may have reduced urine output due to fluid retention from edema.
2. The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). What would the nurse interpret as indicative of this disorder?
- A. Shortened prothrombin time
- B. Increased fibrinogen level
- C. Positive fibrin split products
- D. Increased platelets
Correct answer: C
Rationale: Positive fibrin split products indicate disseminated intravascular coagulation (DIC), a condition characterized by the widespread formation of blood clots throughout the body. In DIC, clotting factors are consumed, leading to increased fibrin split products. A shortened prothrombin time (Choice A) is not typically seen in DIC as it indicates faster blood clotting, which is not consistent with the pathophysiology of DIC. An increased fibrinogen level (Choice B) is also not a characteristic finding in DIC, as fibrinogen levels may be decreased due to consumption in the formation of clots. Increased platelets (Choice D) are not typically observed in DIC; instead, thrombocytopenia (decreased platelet count) is more common due to their consumption in clot formation.
3. What should the nurse advise the parents of a child with asthma on preventing asthma attacks?
- A. Avoid exposure to allergens
- B. Encourage regular exercise
- C. Provide a high-protein diet
- D. Increase fluid intake
Correct answer: A
Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are commonly triggered by allergens such as pollen, dust mites, pet dander, and mold. By minimizing the child's contact with these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise can be beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general health but are not specific preventive measures for asthma attacks.
4. A nurse is discussing the care of an infant with colic with the parents. What should the nurse explain is the cause of colicky behavior?
- A. Inadequate peristalsis
- B. Paroxysmal abdominal pain
- C. An allergic response to certain proteins in milk
- D. A protective mechanism designed to eliminate foreign proteins
Correct answer: B
Rationale: The correct answer is B: Paroxysmal abdominal pain. Colic in infants is characterized by paroxysmal abdominal pain, leading to excessive crying and fussiness. It is not caused by inadequate peristalsis (Choice A), an allergic response to certain proteins in milk (Choice C), or a protective mechanism designed to eliminate foreign proteins (Choice D). Understanding that colic is primarily associated with abdominal pain helps healthcare providers provide appropriate care and support to parents dealing with colicky infants.
5. A healthcare professional is assessing a child with suspected appendicitis. What clinical manifestation is the healthcare professional likely to observe?
- A. Right lower quadrant pain
- B. Left lower quadrant pain
- C. Rebound tenderness
- D. Epigastric pain
Correct answer: A
Rationale: Right lower quadrant pain is a characteristic clinical manifestation of appendicitis. The appendix is typically located in the right lower quadrant of the abdomen, so pain in this area is a common symptom. Left lower quadrant pain (Choice B) is less likely in cases of appendicitis. Rebound tenderness (Choice C) is a sign of peritonitis, not specific to appendicitis. Epigastric pain (Choice D) is more indicative of upper gastrointestinal issues rather than appendicitis.
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