an infant with a congenital heart defect is being given gavage feedings the parents ask the nurse why this is necessary how should the nurse respond
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Nursing Elites

HESI LPN

Pediatric HESI 2024

1. An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?

Correct answer: C

Rationale: The correct answer is C: 'The energy that would have been expended on sucking is conserved.' Gavage feedings are necessary for infants with congenital heart defects as they help conserve the infant’s energy by eliminating the need for sucking, which can be taxing for infants with cardiac issues. Choice A is incorrect because gavage feedings are not primarily used to limit vomiting. Choice B is incorrect as the speed of administration is not the main reason for gavage feedings in this case. Choice D is incorrect because the regulation of the quantity of nutritional liquid is not the primary rationale for gavage feedings in infants with congenital heart defects.

2. A parent calls the outpatient clinic requesting information about the appropriate dose of acetaminophen for a 16-month-old child who has signs of an upper respiratory tract infection and fever. The directions on the bottle of acetaminophen elixir are 120 mg every 4 hours when needed. At the toddler’s 15-month visit, the healthcare provider prescribed 150 mg. What is the nurse’s best response to the parent?

Correct answer: D

Rationale: The most accurate way to determine a therapeutic dose for children is based on their weight rather than age. Weight-based dosing accounts for individual variations in drug metabolism and distribution, ensuring a more precise and safer medication administration. Choices A, B, and C are incorrect as they do not address the importance of weight-based dosing in children, potentially leading to inappropriate dosing and safety concerns.

3. A child is being assessed for suspected intussusception. What clinical manifestation is the nurse likely to observe?

Correct answer: C

Rationale: The correct clinical manifestation that a nurse is likely to observe in a child with suspected intussusception is abdominal distension. Intussusception is a medical emergency where a part of the intestine folds into itself, causing obstruction. Abdominal distension is a common symptom due to the obstruction and the build-up of gases and fluids. While currant jelly stools (Choice B) are a classic sign of intussusception, they are typically seen in later stages of the condition and may not be present during the initial assessment. Projectile vomiting (Choice A) is more commonly associated with conditions like pyloric stenosis. Constipation (Choice D) is not a typical manifestation of intussusception; the condition usually presents with severe colicky abdominal pain and possible passage of blood and mucus in stools.

4. When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, what does this decision indicate?

Correct answer: D

Rationale: When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, it means that aggressive interventions will not be pursued, allowing the newborn to die naturally. This decision is legal and ethical, respecting the principle of non-maleficence by avoiding unnecessary suffering. Choice A is incorrect because all individuals, including newborns, have rights, but the decision to withhold extraordinary care is based on ethical considerations. Choice B is incorrect as withholding care is not the same as euthanasia, which involves actively ending life. Choice C is incorrect as long as the decision is made within legal and ethical boundaries, it is not considered illegal professional practice.

5. Which is the most appropriate nursing diagnosis for the child with acute glomerulonephritis?

Correct answer: C

Rationale: The most appropriate nursing diagnosis for a child with acute glomerulonephritis is fluid volume excess related to decreased plasma filtration. Acute glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys, leading to decreased plasma filtration and retention of fluid. This results in fluid volume excess rather than fluid deficit (choice B) or fluid accumulation in tissues and third spaces (choice D). The diagnosis of 'risk for injury related to malignant process and treatment' (choice A) is not directly related to the pathophysiology of acute glomerulonephritis.

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