HESI LPN
Pediatrics HESI 2023
1. A healthcare provider is discussing the care of an infant with colic with the parents. What should the healthcare provider 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: Colicky behavior in infants is primarily characterized by paroxysmal abdominal pain, resulting in excessive crying and fussiness. The pain episodes are often unpredictable and can be distressing for both the infant and the parents. Inadequate peristalsis (Choice A) refers to weak or ineffective bowel movements and is not the typical cause of colic. While some infants may experience colic due to an allergic response to certain proteins in milk (Choice C), this is not the primary cause of colic behavior in all infants. Choice D, a protective mechanism designed to eliminate foreign proteins, is not a recognized cause of colic. Therefore, the correct explanation for the cause of colicky behavior in infants is paroxysmal abdominal pain.
2. A parent and 4-year-old child who recently emigrated from Colombia arrive at the pediatric clinic. The child has a temperature of 102°F, is irritable, and has a runny nose. Inspection reveals a rash and several small, red, irregularly shaped spots with blue-white centers in the mouth. What illness does the nurse suspect the child has?
- A. Measles
- B. Chickenpox
- C. Fifth disease
- D. Scarlet fever
Correct answer: A
Rationale: The nurse should suspect measles based on the symptoms described, including the presence of Koplik spots (small, red spots with blue-white centers in the mouth). Measles typically presents with fever, irritability, runny nose, and a rash that begins on the face and spreads downward. Chickenpox (choice B) presents with vesicular lesions in different stages of healing and usually starts on the trunk. Fifth disease (choice C) presents with a 'slapped cheek' rash on the face and can cause joint pain. Scarlet fever (choice D) is characterized by a sandpaper-like rash, fever, and strawberry tongue.
3. A child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the nurse’s best initial action?
- A. Attempt to open the jaw.
- B. Place the child on the floor.
- C. Call out for assistance from staff.
- D. Place a pillow under the child’s head.
Correct answer: B
Rationale: The best initial action during a tonic-clonic seizure is to place the child on the floor. This action helps prevent injury by providing a safe environment and allows for better management of the seizure episode. Attempting to open the jaw is not recommended as it may cause harm to the child or the nurse. Calling out for assistance is important but should not delay ensuring the child's safety first. Placing a pillow under the child's head is not advisable during a seizure as it can pose a risk of suffocation or choking.
4. When evaluating the laboratory report of a 1-year-old infant’s hematocrit, a healthcare professional compares it with the expected hematocrit range for this age group. What is the hematocrit of a healthy 12-month-old infant?
- A. 19% to 32%
- B. 29% to 41%
- C. 37% to 47%
- D. 42% to 69%
Correct answer: C
Rationale: The correct answer is C: 37% to 47%. The normal hematocrit range for a 12-month-old infant is between 37% to 47%, which reflects the expected blood volume and red blood cell levels for this age. Choice A (19% to 32%) and Choice B (29% to 41%) are too low and do not encompass the typical hematocrit range for a healthy 1-year-old. Choice D (42% to 69%) is too high and falls outside the usual hematocrit values for this age group.
5. A child with a diagnosis of leukemia is admitted to the hospital with a fever. What is the priority nursing intervention?
- A. Administering antibiotics
- B. Administering antipyretics
- C. Providing nutritional support
- D. Monitoring for signs of infection
Correct answer: D
Rationale: The correct answer is D: Monitoring for signs of infection. When a child with leukemia presents with a fever, the priority nursing intervention is to monitor for signs of infection due to the immunocompromised state of the child. Administering antibiotics (choice A) may be necessary based on the assessment of signs of infection, but monitoring comes first. Administering antipyretics (choice B) helps to reduce fever but does not address the underlying cause. Providing nutritional support (choice C) is essential but not the priority when the child is at risk of infection.
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