HESI LPN
Pediatrics HESI 2023
1. A nurse is caring for an infant with intractable vomiting. For what complication is it most important for the nurse to assess?
- A. Acidosis
- B. Alkalosis
- C. Hyperkalemia
- D. Hypernatremia
Correct answer: B
Rationale: When an infant experiences intractable vomiting, it can lead to the loss of stomach acids, resulting in metabolic alkalosis. Alkalosis is characterized by elevated blood pH and can lead to serious complications. Assessing for alkalosis is essential in this scenario to monitor and manage the infant's condition. Choices A, C, and D are incorrect because in this context, the primary concern is the metabolic imbalance caused by excessive vomiting, leading to alkalosis rather than acidosis, hyperkalemia, or hypernatremia.
2. When teaching a class of new parents about positioning their infants during the first few weeks of life, which position is safest?
- A. On the back, lying flat
- B. On either side, lying flat
- C. Head slightly elevated on the left side
- D. Head slightly elevated on the right side
Correct answer: A
Rationale: The correct answer is A: 'On the back, lying flat'. Placing infants on their back to sleep is recommended to reduce the risk of sudden infant death syndrome (SIDS). This position helps ensure the baby's airway remains clear and reduces the likelihood of suffocation. Choices B, C, and D are not as safe as placing the infant on their back, as they may increase the risk of accidental suffocation or SIDS.
3. A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?
- A. We should give this drug after he eats something.
- B. We need to watch carefully for possible infections.
- C. The drug should not be stopped abruptly.
- D. He might experience weight gain with this drug.
Correct answer: A
Rationale: Giving prednisone with food helps prevent gastrointestinal upset. Therefore, the correct statement is that the drug should be given after the child eats something, not before. Watching for infections is important due to prednisone's immunosuppressive effects, making choice B correct. Choice C is accurate because prednisone should be tapered off gradually to prevent withdrawal symptoms. Weight gain is a common side effect of prednisone, so choice D is also correct. The incorrect statement is choice A, as prednisone should be administered after a meal.
4. A 2-year-old child with a diagnosis of autism spectrum disorder is being discharged. What should the nurse include in the discharge teaching?
- A. Maintain a structured routine
- B. Encourage social interaction
- C. Use positive reinforcement
- D. Use a communication board
Correct answer: A
Rationale: The correct answer is to maintain a structured routine. Children with autism spectrum disorder benefit from a structured routine as it provides them with stability and predictability, which can help reduce anxiety and improve behavior management. Encouraging social interaction (Choice B) may not be suitable for all children with autism, as some may struggle with social skills. While positive reinforcement (Choice C) is a helpful strategy, maintaining a structured routine is more essential for overall management in children with autism spectrum disorder. Using a communication board (Choice D) may be beneficial for communication, but establishing a structured routine is a foundational strategy that should be prioritized in the discharge teaching for a child with autism spectrum disorder.
5. What should the nurse suggest to a parent asking for help with a child experiencing night terrors?
- A. Encourage the child to talk about the night terrors.
- B. Establish a bedtime routine.
- C. Allow the child to sleep with the parents.
- D. Wake the child during the night.
Correct answer: B
Rationale: Establishing a bedtime routine is the most appropriate suggestion for a parent seeking help with a child experiencing night terrors. Bedtime routines can create a sense of security and predictability for the child, potentially reducing the frequency of night terrors. Encouraging the child to talk about the night terrors (Choice A) may not be effective during the episode as the child is usually not fully awake. Allowing the child to sleep with the parents (Choice C) may inadvertently reinforce the behavior and hinder the child’s ability to learn to self-soothe. Waking the child during the night (Choice D) may disrupt the sleep cycle and exacerbate the night terrors.
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