HESI LPN
Pediatric Practice Exam HESI
1. 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.
2. Following corrective surgery for hypertrophic pyloric stenosis (HPS), an infant is returned to the pediatric unit with an IV infusion in place. What is the priority nursing action?
- A. Apply adequate restraints.
- B. Administer a mild sedative.
- C. Assess the IV site for infiltration.
- D. Attach the nasogastric tube to wall suction.
Correct answer: C
Rationale: The priority nursing action after a corrective surgery for hypertrophic pyloric stenosis (HPS) is to assess the IV site for infiltration. This is crucial to ensure proper fluid administration and prevent complications such as extravasation or infiltration. Applying restraints (Choice A) is not indicated in this scenario and can compromise the infant's comfort and safety. Administering a mild sedative (Choice B) is not necessary and should only be done based on specific clinical indications. Attaching the nasogastric tube to wall suction (Choice D) may be important for certain conditions but is not the priority immediately post-surgery; assessing the IV site is more urgent to prevent potential complications related to IV therapy.
3. The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis?
- A. Risk for impaired skin integrity due to the cast and its location.
- B. Deficient knowledge related to cast care.
- C. Risk for delayed development related to immobility.
- D. Self-care deficit related to immobility.
Correct answer: A
Rationale: The correct answer is A: Risk for impaired skin integrity due to the cast and its location. When a child has a long-leg hip spica cast, the priority nursing diagnosis is to prevent impaired skin integrity. This is because the child's mobility is restricted, and pressure from the cast can lead to skin breakdown. Option B is incorrect as while education is essential, it is not the priority when skin integrity is at risk. Option C is incorrect because while immobility can impact development, immediate skin integrity concerns take precedence. Option D is incorrect as self-care deficit, while important, is secondary to preventing skin breakdown in this scenario.
4. The nurse is reviewing the laboratory test results of a child with Addison's disease. What would the nurse expect to find?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypercalcemia
Correct answer: B
Rationale: In Addison's disease, adrenal insufficiency leads to decreased aldosterone production. This results in impaired sodium retention and potassium excretion, leading to hyperkalemia. Therefore, the correct answer is hyperkalemia (choice B). Hypernatremia (choice A) is less likely because of the loss of sodium in Addison's disease. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with Addison's disease and are less likely to be present in this condition.
5. An infant is admitted to the neonatal intensive care unit (NICU) with exstrophy of the bladder. What covering should the nurse use to protect the exposed area?
- A. Loose diaper
- B. Dry gauze dressing
- C. Moist sterile dressing
- D. Petroleum jelly gauze pad
Correct answer: C
Rationale: In cases of exstrophy of the bladder, a moist sterile dressing is the most appropriate choice to protect the exposed bladder tissue. Moist sterile dressings help maintain a clean environment, prevent infection, and promote healing. A loose diaper (Choice A) may not provide adequate protection and may lead to contamination. Dry gauze dressing (Choice B) could adhere to the wound and cause trauma upon removal. Petroleum jelly gauze pad (Choice D) is not ideal as it may not provide the necessary barrier against infection and could potentially cause irritation.
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