HESI LPN
Pediatric HESI 2023
1. Why is it recommended that closure of the palate should be done before the age of 2 for an 11-month-old infant with a cleft palate?
- A. “After the age of 2, surgery becomes frightening and should be avoided if possible.”
- B. “The eruption of the 2-year molars often complicates the surgical procedure.”
- C. “As your child grows older, the palate widens, making repair more challenging.”
- D. “Surgery should be performed before your child begins to use faulty speech patterns.”
Correct answer: D
Rationale: It is recommended to perform palate closure surgery before the child starts using faulty speech patterns to prevent the development of speech issues that may be harder to correct later. Delaying surgery until after the age of 2 can lead to the child forming incorrect speech habits, which can be challenging to correct. Choices A, B, and C are incorrect because they do not address the specific concern related to speech development in children with cleft palates.
2. The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?
- A. Instructing the parents to report adverse reactions to the growth hormone treatment
- B. Teaching the parents how to administer desmopressin acetate
- C. Informing the parents that treatment stops when puberty begins
- D. Educating the parents to report signs of acute adrenal crisis
Correct answer: B
Rationale: In a child with a disorder of the posterior pituitary gland, desmopressin acetate is commonly used to manage the condition by replacing the antidiuretic hormone. Instructing the parents to administer desmopressin acetate correctly is essential for the child's treatment. The other options are incorrect because growth hormone treatment, stopping treatment at puberty, and reporting signs of acute adrenal crisis are not directly related to managing a disorder of the posterior pituitary gland.
3. What is an essential nursing action when caring for a young child with severe diarrhea?
- A. Maintain the IV.
- B. Take daily weights.
- C. Replace the lost calories.
- D. Promote perianal skin integrity.
Correct answer: D
Rationale: Promoting perianal skin integrity is crucial when caring for a young child with severe diarrhea to prevent skin breakdown from the irritation caused by frequent bowel movements. Maintaining the IV (Choice A) may be important for hydration but is not directly related to managing skin integrity. Taking daily weights (Choice B) is important for monitoring fluid balance but does not address the immediate need to prevent skin breakdown. While replacing lost calories (Choice C) is important, it is not the priority when a child is experiencing severe diarrhea and skin integrity is at risk.
4. An 8-year-old child diagnosed with meningitis is to undergo a lumbar puncture. What should the nurse explain is the purpose of this procedure?
- A. To measure the pressure of cerebrospinal fluid
- B. To obtain a sample of cerebrospinal fluid for analysis
- C. To relieve intracranial pressure
- D. To assess the presence of infection in the spinal fluid
Correct answer: B
Rationale: A lumbar puncture is performed to obtain a sample of cerebrospinal fluid for analysis. This fluid is then examined for signs of infection, bleeding, or other abnormalities. Measuring the pressure of cerebrospinal fluid is typically done during the procedure itself, but it is not the primary purpose of the lumbar puncture. While a lumbar puncture can indirectly help relieve intracranial pressure by removing excess cerebrospinal fluid, this is not its primary purpose. Assessing the presence of infection in the spinal fluid is part of the analysis that follows the collection of the sample, making it a secondary outcome of the procedure.
5. A child is admitted with extensive burns. The nurse notes burns on the child’s lips and singed nasal hairs. The nurse should suspect that the child has a(n)
- A. chemical burn
- B. inhalation injury
- C. electrical burn
- D. hot-water scald
Correct answer: B
Rationale: Burns on the lips and singed nasal hairs are indicative of an inhalation injury. This suggests that the child has likely inhaled hot gases or smoke, leading to damage in the respiratory tract. Choice A, chemical burn, is incorrect because the symptoms described are more aligned with inhalation rather than direct contact with chemicals. Choice C, electrical burn, is incorrect as there are no mentions of contact with an electrical source. Choice D, hot-water scald, is also incorrect as the presentation of burns on the lips and singed nasal hairs is not characteristic of scald injuries.
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