HESI LPN
Pediatrics HESI 2023
1. A healthcare professional is reviewing the laboratory report of a child with tetralogy of Fallot that indicates an elevated RBC count. What does the professional identify as the cause of the polycythemia?
- A. Low tissue oxygen needs
- B. Tissue oxygen needs
- C. Diminished iron level
- D. Hypertrophic cardiac muscle
Correct answer: B
Rationale: The correct answer is B: Tissue oxygen needs. Polycythemia occurs as the body's response to chronic hypoxia by increasing RBC production to enhance oxygen delivery. In tetralogy of Fallot, a congenital heart defect, the heart's structure causes reduced oxygen levels in the blood. This chronic hypoxia stimulates the bone marrow to produce more red blood cells, leading to an elevated RBC count. Choice A is incorrect as low blood pressure is not directly related to polycythemia in this context. Choice C, diminished iron level, is not the cause of polycythemia in tetralogy of Fallot. Choice D, hypertrophic cardiac muscle, is not the primary cause of the elevated RBC count in this case.
2. An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?
- A. Cellular metabolism is unstable in young children.
- B. The proportion of water in the body is less than in adults.
- C. Renal function is immature in children until they reach school age.
- D. The extracellular fluid requirement per unit of body weight is greater than in adults.
Correct answer: D
Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect as cellular metabolism instability does not directly relate to the infant's condition described. Choice B is inaccurate as the proportion of water in the body is not the primary issue causing the infant's symptoms. Choice C is incorrect as renal function being immature does not explain the sudden change in the infant's health status; it is more related to fluid balance and dehydration.
3. A newborn with an anorectal anomaly had an anoplasty performed. At the 2-week follow-up visit, a series of anal dilations are begun. What should the nurse recommend to the parents to help prevent the infant from becoming constipated?
- A. Use a soy formula.
- B. Breastfeed if possible.
- C. Administer a suppository nightly.
- D. Offer glucose water between feedings.
Correct answer: B
Rationale: Breastfeeding is the best recommendation to help prevent constipation in infants. Breast milk is easily digestible and contains the right balance of nutrients, which can lead to softer stools, thus reducing the likelihood of constipation. Offering a soy formula (Choice A) may not necessarily prevent constipation as effectively as breast milk due to differences in nutrient composition. Administering a suppository nightly (Choice C) is not a routine measure for preventing constipation in infants and may not be suitable for regular use in this scenario. Offering glucose water (Choice D) between feedings is not recommended as it does not provide the necessary nutrients found in breast milk, which are essential for preventing constipation and promoting overall health in newborns.
4. A group of nursing students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?
- A. Regulation of water balance
- B. Hormonal secretion
- C. Cellular metabolism
- D. Growth stimulation
Correct answer: B
Rationale: The correct answer is 'Hormonal secretion' (Choice B). The primary function of the endocrine system is to secrete hormones that regulate various bodily functions such as metabolism, growth, and reproduction. Choice A, 'Regulation of water balance,' is primarily controlled by the kidneys and the urinary system, not the endocrine system. Choice C, 'Cellular metabolism,' is more directly related to the functions of individual cells rather than the overall function of the endocrine system. Choice D, 'Growth stimulation,' is a function that can be influenced by hormones secreted by the endocrine system, but it is not the primary function of the system.
5. .A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?
- A. Monitor blood glucose levels once a day
- B. Follow a strict meal plan
- C. Administer insulin only when blood glucose is high
- D. Recognize signs of hypoglycemia
Correct answer: D
Rationale: Recognizing signs of hypoglycemia is crucial for managing type 1 diabetes mellitus and preventing complications.
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